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Mental Health

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on 16 April 2014

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Transcript of Mental Health

Mental illnesses are not the same all over the world
America has been changing the treatments and expressions of mental illnesses in other cultures
A handful of disorders- depression, PTSD, anorexia nervosa- now appear to be spreading across cultures
DSM seems to becoming the worldwide standard

Mental health ideas are never culturally neutral!
A mental health illness is an illness of the mind and cannot be understood without understanding the ideas, habits and predispositions of the mind that is its host
Americanization of
Mental illnesses
Mental Health
By: Anna Khoja,
Kelli Blayney, Hannah Green, Reanna Palmer,
Stephanie Lawson

What constitutes Mental Illness?
Mental Illness
Traditional Medications
These are some examples of medications used to treat mental illnesses:

Medicine, Behavioral & Alternative
The longer treatment is delayed from the onset of the primary episode, the more severe negative symptoms may occur.
Social Taboos
In China, negative attitudes towards the mentally ill creates barriers to recovery and integration into society

The Chinese regard mental illness within the family as highly shameful and an embarrassment

Stress within the family often results from hiding the fact that they have a mentally ill member

Hong Kong: negative view, 40% population didn’t want to live near mental hospital or families
a case study
Among Nations
In the United States...
In China...
Thank You

Bateman, K., Hansen, L., Turkington, D., & Kingdon, D. (2007). Cognitive Behavioral Therapy Reduces Suicidal Ideation in Schizophrenia: Results from a Randomized Controlled Trial. Suicide And Life-Threatening Behavior, 37(3), 284-290. http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=82c8020e-1701-4071-85a2-372d73c34040%40sessionmgr4005&vid=2&hid=4107.

Bhugra, D. (2005, May 31). The global prevalence of schizophrenia. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1140960/.

Bradshaw, W., & Roseborough, D. (2004). Evaluating the Effectiveness of Cognitive-Behavioral Treatment of Residual Symptoms and Impairment in Schizophrenia. Research On Social Work Practice, 14(2), 112-120.http://rsw.sagepub.com/content/14/2/112.full.pdf+html

Castle, D. J., Copolov, D., & Wykes, T. (2003).Pharmacological and psychosocial treatments in schizophrenia. London: Martin Dunitz. Retrieved from http://web.a.ebscohost.com/ehost/ebookviewer/ebook/bmxlYmtfXzExNTAxMl9fQU41?sid=a8970452-8475-4151-b626-5faf52057ccd@sessionmgr4003&vid=1&format=EB&rid=1

Dangdomyouth, Phyllis Stern, Areewan Oumtanee, Jintana Yunibhand. (2008). Tactful monitoring: How thai caregivers manage their relatives with schizophrenia at home. Issues in Mental Health Nursing, 29(1), 37-50. doi:10.1080/01612840701748714

Furnham, A., & Murao, M. (2000). A cross-cultural comparison of british and japanese lay theories of schizophrenia. International Journal of Social Psychiatry, 46(1), 4-20. doi: 10.1177/002076400004600103

Grano, N., Lindsberg, J., Karjalainen, M., Gronroos, P., & Blomberg, A. (2010). Duration of Untreated Psychosis Is Associated with More Negative Schizophrenia Symptoms after Acute Treatment for First-Episode Psychosis. Clinical Psychologist, 14(1), 10-13. http://web.a.ebscohost.com/ehost/detail?sid=25a19032-539a-4848-80ec-273027daa95e%40sessionmgr4004&vid=1&hid=4107&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=eric&AN=EJ880220

Harvey, P. D., Green, M. F., Keefe, R. S. E., & Velligan, D. I. (2004). Cognitive functioning in schizophrenia: A consensus statement on its role in the definition and evaluation of effective treatments for the illness.Journal of Clinical Psychiatry, 65(3), 361-372. doi: 10.4088/JCP.v65n0312

Maisel, E. (2013). The new definition of a mental disorder. Psychology Today, Retrieved from http://www.psychologytoday.com/blog/rethinking-psychology/201307/the-new-definition-mental-disorder

National Alliance on Mental Health Illness. ( 2012). Mental health care gets my vote. Retrieved from http://www.nami.org/Content/NavigationMenu/Elections1/MHCGMVCandidateKit.pdf

Phanthunane, P. (2010). Schizophrenia in thailand: Prevalence and burden of disease. Population Health Metrics, 8(1), 24. doi:10.1186/1478-7954-8-24

Sanseeha, Ladda Sanseeha, Ratanawadee Chontawan, Hunsa Sethabouppha, Chamlong Disayavanish, Sue Turale. (2009). Illness perspectives of thais diagnosed with schizophrenia. Nursing and Health Sciences, 11(3), 306-311. doi:10.1111/j.1442-2018.2009.00474.x

UNC School of Medicine. (2014). Myths about mental illness. Department of Psychiatry. Retrieved from http://www.med.unc.edu/psych/cecmh/patient-client-information/patient-client-information-and-resources/clients-and-familes-resources/myths-about-mental-illness

What are some common mental illnesses?

Schizophrenia is the number one mental health problem
Schizophrenia is viewed negatively
Mental illness is considered shameful and is hidden, which greatly affects the family and generates high levels of stigma
Chinese tend to rely on alternative medicine and have more religious/superstitious attitude to treatment
Negative attitudes create barriers for treatment
A chronic brain disorder that affects
approximately 2.5 million Americans
and more than
24 million people worldwide
Men and women are equally at risk
May be caused by an
imbalance of chemicals
in the brain that causes messages in the brain to become disorganized
believing that what other people are saying is not true

hearing, seeing, tasting, feeling, or smelling things that others do not experience

Disorganized speech and behavior
lack of behaviors or feelings that usually are present
extra feelings or behaviors that are not usually present
Losing interest in everyday activities, like bathing, grooming, or getting dressed

Feeling out of touch with other people, family, or friends

Lack of feeling or emotion

Having little emotion or inappropriate feelings in certain situations

Having less ability to experience pleasure
Meet Jani!
A child with Schizophrenia
Goals of Mental Health Legislation
Access to mental health care and other services
Quality of mental health care
Admission to mental health facilities
Consent to treatment
Freedom from cruel, inhuman, and degrading treatment
Freedom from discrimination
Enjoyment of a full range of civil, cultural, economic, political, social rights
Provisions for legal mechanisms to promote and protect human rights

Dedicated mental health legislation:

Present in
77% of high income
countries in comparison with only
39% of low income

of people worldwide live in a country where there is any kind of legislation
Around the World
1 in 4 people develop some kind of mental illness at some point in their lives
Approximately 57.7 million Americans experience a mental illness each year
Countries in Africa have little access to psychiatric care, some have as little as 1 psychiatrist for a population of 9 million people
Some countries in Asia also have limited access to care with as little as 2 psychiatrists for a population of 29 million

Global Mental Illness
Worldwide prevalence estimates range between 0.5% and 1%
Age of first episode is typically younger among men (~21) than women (~27).
by age 30: 9 out of 10 men, but only 2 out of 10 women will manifest the illness.
1 out of 3 will attempt suicide
1 out of 10 will succeed
Schizophrenia Statistics
People in developing countries are less susceptible to developing schizophrenia
There are higher rates of schizophrenia in mobile populations (homeless and migrant workers)
Myths and
False Statements

Favor sociological (stress) explanations for mental illnesses
External forces (especially family) cause illness rather than internal (cognitive, biological, genetic)
Believe that society change is the best treatment, instead of individual medication or treatment
Believe the best place for treatment is hospitals
Rely heavily on mental institutions
Once a patient is admitted to an institution: the family is no longer responsible for care, and the patient no longer belongs to society
Less respect for rights of schizophrenics
Strong emphasis on dangerousness and abnormality
Unacceptable, unpredictable disease
schizophrenics can easily lose control
Considered taboo to discuss mental illness in public
Anxious about contact w/ schizoprenics

Japanese Views
Schizophrenic type symptoms are considered as result of stress and psychological factors before a diagnosis is made.

Once disease labeled as schizophrenia, most Germans consider biological factors to be the cause of disease, not sociological factors

German Views
Nigerians have very negative views towards mental illness

Believe mental illness is:
"Satan's work"
"Curse by enemies"
Nigerian Views
These drugs can have side effects such as cognitive dulling and involuntary movements
Benefits of Traditional Medication
effective in treating hallucinations, delusions, thought disorder, loose associations, ambivalence
Therapy component
Behavioral component
This component is focused on understating the development of symptoms using normalizing procedures that emphasize the importance of vulnerability, stress, and coping and formulation of treatment goals and process
This component focuses on identifying recurring stresses, signs of stress, and pronominal symptoms of relapse, and teaching behavioral skills to manage stress and physiological arousal
Cognitive Behavioral Treatment
progressive relaxation
thought stopping and
distraction techniques
promote positive adaptive coping statements that replace negative thoughts and beliefs, positive self-appraisal
Improvement in psychosocial functioning,

Reduction in psychiatric symptoms

In conjunction with medication, it is more effective than standard care or medication

Is more effective compared to supportive psychotherapies

Is more effective in the acute stage of illness than standard care

Reduces the negative symptoms correlated with schizophrenia and suicide
Benefits of CBT
2 out of 3 caregivers experience significant stress and burden
could affect well-being of caregivers and their ability to care long-term
affects the course of illness in patients
Caregiver benefits:
more knowledgeable about schizophrenia
reduction of caregiver burden

Family Based Interventions
Our attitudes and lack of education can create barriers for the mentally ill to receive the adequate treatment they need.

Our culture and beliefs play a major role in our health decisions

Treatment options can greatly affect the course of the illness

CBT and family interventions are effective complementary methods to medication
Take Home Points
Anna Khoja
Kelli Blayney
Hannah Green
Stephanie Lawson
Reanna Palmer
John Nash
Won the
Nobel peace prize
for economics in 1994
Started displaying mathematical insight in the 4th grade
Graduated from Princeton and got married
His wife noticed strange behavior and enlisted him to
Trenton State Hospital
He underwent
insulin-coma therapy
His delusions subsided with age
“A mental disorder is a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.”
“A mental disorder is a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above."
Mental illnesses are not the same all over the world
America has been changing the treatments and expressions of mental illnesses in other cultures
A handful of disorders- depression, PTSD, anorexia nervosa- now appear to be spreading across cultures
The DSM seems to be becoming the worldwide standard of mental illnesses

Mental health ideas are never culturally neutral!
A mental illness is an illness of the mind and cannot be understood without understanding the ideas, habits, and predispositions of the mind that is its host

Americanization of
Mental illnesses
Social Aspects
schizophrenia is perceived differently for reasons such as:
religious background
socioeconomic status
family structure

Australians believe that mental illness stems from:
social environmental factors
Australian Views
Antisocial personality disorder
Dissociative identity disorder
Bipolar disorder
Alzheimer's disease
Asperger syndrome
Panic disorder
If a person is intelligent, they will understand they are ill and shouldn't be bothered by hallucinations or delusions
Illegal drugs can help alleviate symptoms, make patients feel better
If you have schizophrenia, there is nothing to do but get sicker and sicker until you die
Mentally ill people should not have kids
Spouse has unconditional right to divorce after diagnosis
Mental hospitals and facilities should be isolated
People snap and become psychotic with no warning or trigger
People with schizophrenia can't make meaningful contributions to the world
Schizophrenia means having multiple personalities
Early intervention won't help
People with schizophrenia are unstable, dangerous or should not be left alone
Schizophrenics are suffering for their sinful or immoral behavior
Mental illness = symptom of ‘sick’ society, along with divorce, juvenile delinquents, etc.
Men are more likely to develop schizophrenia
Biological treatments, psychotherapy, and community treatment programs
Believe in rights & respect for schizophrenics
see them as less dangerous and abnormal than Japanese/Chinese
sympathy for patients

Individual care more important than societal
Don’t believe patients belong in hospitals
More optimistic view
downplay dangerousness and abnormality
Curable, but schizophrenics can easily lose control
British Views on Mental Health
United Kingdom
Family Based
Patient benefits:

Medication adherence
Improved quality of life
Better social adjustment
More effective at reducing relapse than standard treatment methods
Increased compliance with medications
Single or group family interventions
Full transcript