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Mental Disorders As An Issue Of Public Health Concern

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Question:

Discuss about the Mental Disorders as an issue of Public Health Concern.
 
 

Answer:

Mental disorder is a term used in describing an array of conditions that vary in duration and severity. Mental disorders manifest in different ways the most common being anxiety, depression, and disorders related to substance abuse. Other lesser common but severe disorders are bipolar disorders, schizoaffective disorder, and schizophrenia[1].

The effects from mental disorders can be damaging on families and also the individuals. The effects can also be spread to the larger society. For persons suffering from severe conditions, their emotional, cognitive, as well as social abilities can be significantly interfered with[2] often resulting in reduced productivity, homelessness, under-employment, unemployment, and economic disadvantage[3]. Persons with severe disorders are usually in isolation due to the illness and associated symptoms which lead to discrimination or stigmatization[4].

Statistics on Mental Disorders

  • There are more than 450 million people around the world who live with a form of mental illness[5]
  • Alcohol dependence, dementia, epilepsy, depression, schizophrenia, and other substance abuse, neurological, and mental disorders comprise of 13 percent of the world's disease burden which is a figure that is much higher than cancer and cardiovascular disease[6].
  • By the year 2030, in middle income nations, the second to the top cause of disease burden will be depression and will be third on the list in low income nations [7]
  • Person suffering form mental illnesses in the US succumb and die at an average of 25 years earlier in comparison to the rest of the population[8]. In Denmark, the gap is at 18.7 years for specific disorders with the gap believed to be wider in third world nations.[9]
  • Suicide rates across the globe have increased by 60% over a period of 45 years[10]. Of the persons that commit suicide, 90% are those that have mental disorders that are diagnosable[11].
  • In some countries, suicide accounts for one of the leading causes of mortality among persons aged 15years and 44 years and the second cause of death in persons aged 10years to 24 years.[12]
  • 70% of persons with mental disorders in the UK are discriminated with the rates even higher in developing countries.[13]
  • Unemployment rates are as high as 90% for persons with psychosocial and mental illnesses[14]
  • Persons with severe mental disorders have a higher likelihood of developing other health risks. For example, over 75% of persons in the US with severe mental disorders are smokers while persons with bipolar disorder or depression are twice as likely to be obese when compared to the general population.[15]
 

Who is at Risk

Mental illness has no one singular cause. Mental illness results from a combination of factors: environmental, psychological, and genetic. With regard to genetics, there are persons that are predisposed to becoming ill such as those that have pre-existing thought, developmental, behavioural, or mood disorders.  Medical conditions can catalyze development of some mental conditions. An example is depression, which can be triggered by other illnesses such as cancer, diabetes, stroke, heart disease, hormonal disorders, Alzheimer's, and Parkinson's disease[16].

In addition, some people that are susceptible to non-food allergies are more predisposed to depression than persons who do not suffer such allergies. Further, medications can cause or exacerbate depression in people. Such medications include antibiotics, sleeping pills, some blood pressure pills, and birth control pills. Some anti-seizure drugs such as Topamax, Lamictal, and Neurontin are related to high risk of suicide occurrence[17].

The environmental risks can start prior to birth. For example, some infections during pregnancy can increase the chances of schizophrenia. A difficult childhood characterized by physical, sexual, and emotional abuse, bullying, poverty, parental loss, watching violent parents, insecure attachment, or emotional neglect are just but a few catalysts. Ethnic representation is also a determinant; minority groups in neighbourhoods where they are few in number predispose such individuals to development of mental illnesses[18].

Mental illness such as bipolar disorder has been associated with stress. For example persons that are bi-sexual, lesbian, or gay, often have increased emotional challenges which are linked to a number of social stressors that affect their coping with society's reactions to their bisexuality or homosexuality[19]. In addition, psychiatric disorders can be as a result of unemployment and increases the possibility of drug dependence by almost quadruple the number of times, and also triples the possibility of psychotic illnesses or phobia. Unemployment increases the possibility of developing obsessive compulsive disorder, generalized anxiety disorder, and depression[20].

Potential Prevention Measures

The public responses to mental health risks need to be within different social group levels. The exact response will be dependent on the target group and the specific purpose.  However, broad categorisation of actions can be done as follows: protection and promotion of mental health; and improving or restoring mental health through care and treatment for persons that suffer from mental illness[21].  Three strategic directions can be taken namely: development and protection of individual attributes; support of communities and households; support for persons that are vulnerable within the society[22]

Development and protection of individual attributes: Between mothers and their children through enabling early attachment; provision of natal and parental care and training including post-partum depression; development of nurturing, stable, and safe relationships between caregivers, parents, and children. Ensure sufficient stimulation and nutrition for adolescents and children. Develop healthy community activities and ageing policies. Discourage substance abuse, encourage healthy diets and physical activity among all age groups[23].

Support of communities and households: Ensure that adolescents and children live in safe environments; prevention is targeted towards those with parents diagnosed with mental condition; prevent violence between intimate partners. Support increase of more employment opportunities, as well as safer and supportive working environments for employees.  Ensure low income households have basic living conditions such as sanitation, water, and shelter; provide financial and social protection. Ensure neighborhoods are safe; restrict availability of tobacco, drugs, and alcohol[24].

Support for persons that are vulnerable within the society: development and implementation of policies in social inclusions. Enforce policies and laws in anti-discrimination. Education should be availed and accessed by all. Implement policies in gender equity; promote freedoms and rights of women. Foster media reporting that is responsible. Conduct campaigns to raise awareness[25]

 

Bibliography

DoHA (Department of Health and Ageing) 2013. National Mental Health Report 2013: tracking progress of mental health reform in Australia 1993–2011. Canberra: Commonwealth of Australia.

Edwards, R. (2015). Mental Health and Mental Illness. https://www.medicinenet.com/mental_health_psychology/page3.htm McLachlan R, Gilfillan G & Gordon J 2013. Deep and persistent disadvantage in Australia. Canberra: Productivity Commission.

Morgan VA, Waterreus A, Jablensky A, Mackinnon A, McGrath JJ, Carr V, et al. 2011. People living with psychotic illness: report on the second Australian national survey. Canberra: Commonwealth of Australia.

NIH (2016). Health and Education Statistics: Suicide. https://www.nimh.nih.gov/health/statistics/suicide/index.shtml#part_153199 Psychiatric News (2011). People With Serious Mental Illness Have Shorter Life Expectancy.

https://alert.psychnews.org/2011/07/people-with-serious-mental-illness-have.html

Slade T, Johnston A, Teesson M, Whiteford H, Burgess P, Pirkis J et al. 2009. The mental health of Australians 2. Report on the 2007 National Survey of Mental Health and Wellbeing. Canberra: DoHA.

The Guardian (2010). Mental illness and the developing world. https://www.theguardian.com/commentisfree/2010/may/10/mental-illness-developing-world Torgovnick, K (2008). Why do the mentally ill die younger? https://content.time.com/time/health/article/0,8599,1863220,00.html#ixzz26AvjkszJ

WHO (2011). Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. https://apps.who.int/gb/ebwha/pdf_files/EB130/B130_9-en.pdf

WHO (2012). Mental Health: Suicide Data. https://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

WHO. (2010) People with mental disabilities cannot be forgotten. https://www.who.int/mediacentre/news/releases/2010/mental_disabilities_20100916/en/

WHO (2012). Risks to mental health: an overview of vulnerabilities and risk factors. https://www.who.int/mental_health/mhgap/risks_to_mental_health_EN_27_08_12.pdf

WHO. (2016) Mental Health: Strengthening our response. https://www.who.int/mediacentre/factsheets/fs220/en/

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