Mental Health

Introduction: Mental health has become a major international
public health concern and the World Health Organization has
placed high profile focus on the importance of mental health
Mental health is recognized by the World Health Organization and
April 7, 2001 was first devoted for its observance
It is estimated that 450 million people worldwide are affected
by mental, neurological or behavioral illnesses at any given
time Mental illnesses are common to all countries and cause
immense suffering People with these disorders are often
subjected to social isolation, poor quality of life and
increasing mortality These disorders are the cause of
staggering economic and social costs Mental illnesses affect
and are affected by chronic conditions such as cancer, heart and
cardiovascular diseases, diabetes and HIV/AIDS Untreated, they
bring about unhealthy behavior, non-compliance and prescribed
medical regimens, diminished immune functioning, poor prognosis
and eventual loss of valuable human potential
Definition of Mental Health: Mental health is defined as a state
of successful performance of mental function, resulting in
fruitful activities, gratifying relationships with other people,
and also includes the ability to adapt to change and to cope
with diversity Mental health is crucial to personal well-being,
family and interpersonal relationships and contribution to
community or society
Mental disorders are health conditions that are characterized by
alterations in thinking, mood, personality, or behavior, which
are associated with distress and/or impaired functioning Mental
illness is a term that is applied collectively to all
diagnosable mental disorders
Types of Mental Health Illnesses: The difference types of mental
illnesses are enumerated in the International Classification of
Mental and Behavioral Disorders published by the World Health
Organization • Organic mental disorders eg Alzheimer’s
disease and delirium • Mental and behavioral disorders due to
psychoactive substances use eg alcohol, street drugs and
medications • Schizophrenia, schizotypal and delusional
disorders eg paranoid schizophrenia and psychotic disorders •
Mood (affective) disorders eg depression and manic depression
• Neurotic, stress-related and somatoform disorders eg anxiety
disorders and obsessive-compulsive disorders • Behavioral
syndromes associated with physiological disturbances and
physical factors eg eating disorders and non-organic sleep
disorders • Disorders of adult personality and behavior eg
paranoid personality disorder and transsexualism • Mental
retardation eg learning disabilities • Disorders of
psychological development eg specific reading disorders such
as dyslexia and childhood autism • Behavioral and emotional
disorders with onset usually occurring in childhood and
adolescent eg attention deficit (hyperactivity) disorder and
conduct disorders • Unspecified mental disorders
Burden of Disability: Mental disorders generate an immense
public health burden of disability Mental disorders vary in
severity and their impact on people’s lives Mental disorders
such as schizophrenia, major depression and manic-depressive or
bipolar illness and obsessive compulsive disorder and panic
disorder can be enormously disabling This burden of disability
often is profoundly under recognized in most parts of the world
In the United States, mental illness is on par with heart
disease and cancer Mental disorders occur across the lifespan,
affecting persons of all racial and ethnic groups, both genders
and all educational and socioeconomic groups
Mental disorders are not only the cause of limitations of
various life activities but also can be a secondary problem
among people with other disabilities Depression and anxiety,
for example, are seen more frequently among people with
disabilities than those without disabilities
Socioeconomic Burden of Mental Illness: In the United States
approximately 40 million people aged 18 to 74 years of the
population, had a diagnosis of mental disorder alone of a
co-occurring mental and addictive disorder in the past year At
least one in five children and adolescents age 9 and 17 years
has a diagnosable mental disorder in a given year
It is estimated 25 percent of people over 65 years (86 million)
experience specific mental disorders, such as depression,
anxiety, substance abuse and dementia that are not part of
normal aging Alzheimer’s disease strikes 8 to 15 percent of
people over age 65 years, with the number of cases in the
population doubling every 5 years of age after age 60 years
Alzheimer’s disease is thought to be responsible for 60 to 70
percent of all cases of dementia and is one of the leading
causes of nursing home placement
The direct costs of diagnosing and treating mental disorders in
the United States totaled approximately $ 69 billion in 1996
Lost productivity and premature death accounted for an
additional $749 billion The total cost of mental health
disorders in England has been estimated at 8356;32 billion
More than a third of this cost is attributed to lost employment
and productivity related to schizophrenia, depression, stress
and anxiety
Etiology of Mental Illness: The etiology of mental illness may
be as a consequence of complex neurochemical, anatomical and
physiological changes in the brain Social factors have also
been implicated in the pathogenesis of mental illness Some of
the main causes of mental illness are given below: • Hereditary
• Environmental contaminants eg lead, copper and mercury •
Other disease such as kidney impairment may lead to Alzheimer’s
disease • Poor nutrition • Poor sanitation • Homelessness •
Microbiologically unsafe food • HIV infection • Poor physical
health • Psychological stress • Posttraumatic stress • Brain
injury • Metabolic disorders eg hypothyroidism
Modern Treatments for Mental Illness: Treatments for mental
illness take many different forms, including medication,
psychotherapy, complementary therapies and self help strategies
It is worth bearing in mind that what works for one person may
not work for another Some treatments work best in combination
and even the same person may prefer different treatments at
different points in his or her life • Physical therapies
include maintaining the general physical health of the patient,
providing psychiatric medication, such as anti-depressants, or
administering electroconvulsive therapy • Psychological
treatments or talking treatments may take many different forms,
including counseling and psychotherapy Psychological therapies
usually depend on the person with a mental health problem
talking to somebody else, often a trained professional •
Alternative and complementary therapies offer alternatives,
which replace orthodox Western medicine The term complementary
therapy is generally used to indicate therapies which differ
from orthodox Western medicine and which may be used to
complement, support or sometimes to replace it Examples include
aromatherapy, meditation and yoga • Self help strategies serve
to alleviate mental health problems, ranging from individual
strategies for adapting to day-to-day difficulties and symptoms
through to self-help group and support strategies Examples of
self help strategies include: self-management of manic
depression, hearing voices strategies, self-harm strategies and
self-help groups for depression • Social support is not a
treatment as such but it can have a beneficial effect at least
equivalent to that of other forms of interventions Social
support involves providing practical help around the social
dimensions of a patient’s mental health problems For example by
ensuring that the patient is properly housed and receives an
adequate weekly income
Recommendations on Ways to Reduce, Eliminate or Prevent Metal
Illness: • Develop effective mental health policies and
legislation • Improve mental health by ensuring timely access
to appropriate, quality mental health services • Develop
service delivery mechanisms for early recognition of symptoms
and interventions • Develop fundamental structural changes that
require creative and flexible responses from service providers,
administrators, researchers and policymakers alike • Develop
more social and behavioral research programs to explore the
concept of resilience to identify strengths that may promote
health and healing • Implement strategies for translating new
knowledge into critical applications • Use community support
programs and facilities for severe and persistent disorders •
Develop educational and outreach programs to reduce negative
consequences of mental illness • Develop rehabilitation
programs • Develop new drug treatments based on the best
available science • Develop alternative methods of treatment •
Develop family support groups • Develop global action programs
that focus on forging strategic partnerships to enhance
countries capacity to combat and reduce the burden of mental
disorders and promote mental health • Adopt health lifestyles
such as: (i) Develop emotionally, creatively, intellectually and
spiritually (ii) Initiate, develop and sustain mutually
satisfying personal relationships (iii) Face problems, resolve
them and learn from them (iv) Be confident and assertive (v)
Be aware of others and empathize with them (vi) Use and enjoy
solitude (vii) Play and have fun (viii) Laugh, both at
themselves and at the world
Future Research and Mental Illness: Research on the brain and
behavior in mental illness and mental health is moving at a
rapid pace An increasing strong consumer’s movement in the
mental health field is adding urgency to the tasks of
translating new knowledge into clinical practices and refining
service delivery systems to use new and emerging information
optimally for patient/consumer needs The elimination of stigma
associated with mental disorders will in turn encourage more
individuals to seek needed mental health care
Progress in fundamental science with an emphasis on translating
new knowledge such as the use of neurogenesis and stem cell
research into clinical applications can strengthen opportunities
for future clinical and service system innovations
Research-based treatments afford an unprecedented opportunity to
achieve a major reduction in the burden of mental illness With
enhancements of clinical service and service systems, recovery
is an achievable objective of mental health clinical
intervention
References: 61607; Lebowitz, BD, Pearson, JL, Cohen,
GG (1980) Clinical Geriatric Psychopharmacology Baltimore,
MD: Williams Wilkins 61607; Murray, CJL, Lopez, AD
(1996) The Global Burden of Diseases Cambridge MA: Harvard
University Press 61607; Pattron, DD (2004) Recent Research
in Public Health New York: Scientific Publishers 61607;
Ritchie, K, Kildea, D (1995) Is senile dementia age-related
or ageing related evidence from meta analysis of dementia
prevalence in the oldest old Lancet 34, 931-934 61607;
Robins, LN, Locke, BZ, Regier, DA (1991) An overview of
Psychiatric Disorders in America New York: Free Press 61607;
Brain Work: The Neuroscience Newsletter (2004) New York: The
Dana Foundation 61607; http://wwwmentalhealthorguk
61607; http://wwwwhoint

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