PBH.715 Week 12 Lecture
- 1. | http://online.mcphs.edu Week 12 Lecture Instructor: Gina Crosley-Corcoran, MPH PBH 715 – Introduction to Social & Behavioral Sciences
- 2. | http://online.mcphs.edu SPECIAL TOPICS: MENTAL HEALTH AND ILLNESS
- 3. | http://online.mcphs.edu Introduction This week, we begin our discussions of special topics, beginning with mental health and illness. It is estimated that one-quarter of all Americans have one of four types of mental illness at any given time. Serious mental illness affects approximately 6% of the US population These statistics make it very evident that mental health is a significant public health issue. We want to explore the issue from the perspective of the various levels of factors which influence it.
- 4. | http://online.mcphs.edu Definitions Mental health According to the World Health Organization (2007, as quote in Coreil, 2010), “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” Mental illness Refers to any cognitive, emotional, or behavioral disorder defined in the DSM-IV § Includes depressive disorders, anxiety disorders, learning disorders, psychotic disorders
- 5. | http://online.mcphs.edu Mental Health & Illness Multi-factorial problem Each factor explains only a small percentage of mental illness. Not only is the presence of mental illness multifactorial, the ability and/or decision to seek treatment is as well. Factors at one level may/do influence factors present at other levels – the levels are not “isolated” in their influence.
- 6. | http://online.mcphs.edu Intrapersonal-Level Factors Factors influencing mental illness Age, gender, genetics, biology, congenital conditions, and behavior Factors influencing care seeking for mental illness as well as compliance with treatment regimens Embarrassment Feelings that seeking help is a sign of weakness Mistrust of mental health professionals Early treatment and good compliance increase likelihood of successful treatment.
- 7. | http://online.mcphs.edu Intrapersonal-Level Factors Universal prevention • Most costly and least cost-effective as it is aimed at the entire population • May help to reduce stigma and thereby decrease illness Selective prevention • Focuses on those who have a risk factor for mental illness but have not yet had a problem • Programs that provide coping skills for those who have a mentally ill family member Indicated prevention • Designed to prevent mental illness in those who have some symptoms of but have not yet developed mental illness • Targets high risk populations The Institute of Medicine has suggested three categories of primary prevention for mental illness:
- 8. | http://online.mcphs.edu Intrapersonal-Level Factors Secondary prevention Pharmacotherapy Psychotherapy Tertiary prevention Reduction of disability, impairment, or handicap > improved quality of life Exercise programs for those with a diagnosis of mental illness
- 9. | http://online.mcphs.edu Interpersonal-Level Factors Social networks and social support Large social networks and high rates of perceived social support can help prevent mental health problems Care-seeking and compliance are also affected by social networks, support, integration, as well as the relationship with the treatment provider
- 10. | http://online.mcphs.edu Interpersonal-Level Factors Secondary prevention Focuses on building relationships and ensuring a good support structure ROSE Program (post-partum depression) Tertiary prevention Group therapy Couples or family therapy Multi-systemic therapy (anti-social behavior in youth)
- 11. | http://online.mcphs.edu Organizational-Level and Institutional-Level Factors •Job-related stress and job strain •Provision (or not) of healthcare coverage, EAP, sick leave •Stress reduction or management programs Workplace •About half of youth who receive mental health care enter through school system •In part, because some disorders (ODD, ADHD) can cause great disruption in the classroom Schools •Availability and cost of psychiatric medications Pharmaceutical industry (societal-level as well) •Medical system (societal-level as well) § Lack of training for PCPs in identifying mental illness Direct marketing of drugs to consumers (i.e. commercials, ads)
- 12. | http://online.mcphs.edu Neighborhood-Level and Community-Level Factors Physical characteristics of neighborhoods may lead to poorer mental health • May be result of exposures like lead • Physical environment may lead to feelings of low self- worth, lack of hope for the future Social aspects of neighborhoods • Social isolation • Social norms around mental health care • Stigma • Linkages between faith-based organizations and mental health services • Difficulty in entering the mental health services system
- 13. | http://online.mcphs.edu Societal-Level Factors Policy National Institute of Mental Health was created in 1946 Community Mental Health Centers Act in 1963 Medicare and Medicaid in 1965 Full mental health parity (equality in coverage) has still not been achieved Medical care system Pharmaceutical industry
- 14. | http://online.mcphs.edu Week 12 Assignment Discussion Board Extra Credit Due in Week 13 Read Mud Creek Medicine for Week 14 Live Discussion