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According to World Health Organization (WHO), mental health is defined as state of health and well-being where every individual has the potential to cope with mental stress of life and work fruitfully and productively in contributing to the community or society (Rosenfield and Mouzon, 2013). It includes all the aspects of health like psychological, social and emotional well-being. Mental health affects the way people feel, think and act and how an individual handle stress ad make healthy choices. When an individual is affected by mental health problems, one’s mood, behaviour and thinking is affected depending on mental health conditions. Any kind of biological factors like genes, life experiences like abuse, trauma, or family history of mental health can contribute to mental health issues. Mental health is an essential and integral component off health and an important implication of health is that it is more than just mental disabilities or disorders (Braveman and Gottlieb, 2014).
On the other hand, according to WHO, a state of presence of infirmity or disease in terms of mental health is ill health and considers social, mental and cultural dimensions of health. There is presence of impairment or disease in functioning that contributes to ill health affecting mental, physical and social well-being of an individual (Jorm, 2012). Various determinants of health like psychological, social and biological factors affect mental health status of an individual that contribute to poor health conditions. There are different perspectives associated with mental health and illness among individuals and society and require thorough understanding of these perspectives to mental health and well-being. Therefore, the following essay involves the evaluation of various perspectives of mental health, understanding of multidisciplinary approaches to mental health needs, determinants of mental health and policy frameworks.
For example, dementia is a mental health disorder where cognition is affected: knowing, thinking, judgment and problem solving of individuals. People with dementia experience psychiatric conditions like depression. Various factors contribute to mental illness condition in dementia like genetic, biological, psychological and societal factors. The physical changes in brain, psychological factors like ineffective coping mechanism and social factors like isolation contribute to onset and progression of dementia. The condition of dementia greatly explains that the mental illness is a combination of various factors like biological, societal and psychological factors. This explains that mental illness is caused due to the factors and dimensions that have different perspectives on mental illness. Various perceptions prevail regarding mental health where it has severe consequences for the individuals, their families and society. Social, cultural and psychological perspectives govern the concept of mental health (Tew et al., 2012).
Various models are studied to understand the concept of mental health. Biomedical model defines mental health as brain disorders that require pharmacological treatment to the targeted biological abnormalities (Deacon, 2013). The primary aim of this model is to uncover the biological determinants underlying disease and its dysfunction. The model suggests that treatment is required for targeting the physical aspects of specific disease by using science discipline. The model assumes that mental illness is due to deviations from normal biological phenomenon (somatic variables) that requires therapeutic treatment (Engel, 2012). The model demands that behavioural aberrations need to be explained on the basis on neurophysiological or biochemical processes. The model actually measures the mental disease or illness from the perspective of human body and breakdown due to biological factors. Therefore, the treatment for mental health disorders is to be undertaken by mental healthcare professionals having appropriate knowledge and use of medical technology. This mode has certain advantages being dominant in western societies explaining only biological factors for the onset and progression of mental health issues. This model is helpful for healthcare professionals in explaining that there is a strong association between health and disease and disturbance in this equilibrium greatly affect mental health leading to brain disorders. A specific advantage of this model is that it guides best possible treatment and recovery in mental health for patients and furthermore, it is supported by scientific approach (Kazdin and Rabbitt, 2013). However, this model has certain disadvantages.
Firstly, this model clearly rejects the psychological, social and behavioural dimensions of mental health. However, it is not only important to treat the mental illness from the biological perspective, rather require consideration of independent entity of social behaviour. Biomedical model lacks holistic care to improved mental health conditions and ignores the concept of social construction like how one experiences illness without disease presence and disease without feeling sick. Criticism for this model explains that mental illness is greatly linked with social and environmental changes rather than medical factors. Although, medications are helpful for treatment, but it is ineffective for the patient in recovery from mental health illness as the underlying problems still exist providing partial treatment (Bracken et al., 2012). To eliminate these limitations, social model of mental health is applied that is explained in the subsequent section.
Social model explains that the causal factors of mental health are determined by societal organization rather than psychological and biological characteristics of individuals. It is well argued that individuals are not blamed for their mental illness and behaviour. They are the victims of mental illness in the society where the social structure imposes restrictions on their behaviour that affect their mental health (Anastasiou and Kauffman, 2013). From the social model perspective, it is important to understand social conditions as well as biological inheritance on mental illness. Social model explains that social forces are the potential determinants of mental illness. The societal factors and responses affect mental health and experiences of an individual are not due to their impairment rather social factors. The social model of health explains that social forces are the major determinants that drive mental health. It defines that the environment of an individual and the behaviour is intrinsically linked with the social factors. This model explains that not only physical factors affect mental illness, but society and culture where the individual resides also matters. Social and environmental factors also show patterns in mental health (Allen et al., 2014). Although, mental health treatment improves health outcomes, however, perspectives about mental health among societies changes over time and therefore, social factors have potential influence on mental illness.
Biomedical model explains the biological aspects of mental health recognizing it to be a neurological or brain disorder and neglects the societal factors that influence behaviour and treatment outcomes. It emphasizes on curing of mental illness so that the person is included in the society. On the other hand, social model explains the changing of society and negative attitudes that can help to improve their lives that make it easier for them to lead a normal life enhancing social exclusion. Observation and collaboration is important as per social model that explains in removing the social barriers like stigmatization and discrimination that respond their mental health needs and provide social inclusion (Corrigan and Rao, 2012).
Social model of mental health identifies negative attitudes, barriers and social exclusion (inadvertently or purposely) that society is contributing factor for mental illness among individuals. The physical and mental variations limit an individual’s ability to function, until the society accepts these people despite of differences and limitations that help in recovery of mental health (Mirowsky, 2013).
In dementia, stigmatization and discrimination acts as main barriers that aggravate their mental illness and give rise to further psychological and behavioural problems. Individuals with mental illness like dementia experience social stigmatization that makes their conditions worse with harder recovery. In United Kingdom, around one in four experience mental health issue reporting high rates of self-harm cases and delayed recovery. There is presence of strong social stigmatization that hinders full recovery of mentally ill patients. Stigmatization and discrimination pose negative effect on lives of people suffering with mental illness with long-term disabilities (Hatzenbuehler, Phelan and Link, 2013). Social isolation, poverty, low socio-economic status and poor housing are linked to mental illness that traps mentally ill people in the vicious cycle of mental health issues as these factors exacerbate it. Social stigma is the discriminating behaviour and prejudicial attitudes towards mentally ill people as a result psychotic labels given to them because of mental illness. Moreover, mentally ill people perceive self-stigma or perceived stigmatization internalized by mentally ill people affecting their feelings as they receive discrimination. This condition ultimately result in feelings of shame and poor health outcomes in mental health (Corrigan, Druss and Perlick, 2014).
As discussed above, stigmatization prevails in mental health illness and treatment; therefore, it is important to create awareness among people and society regarding mental illness so that affected people receive appropriate treatment and better health outcomes. Although, the perceptions of people have changes in last few decades, however, stigma still prevails due to lack of education and awareness. These factors act as overwhelming factors for people struggling with mental illness who are unaccepted in the society. This states that awareness is call of the hour so that mentally ill people are accepted and have better coping abilities. It is important to educate people about myths and truths that surround mental illness. Awareness can be helpful in identifying individuals at risk for mental illness and appropriate treatment at right time with accessible mental health services (Thoits, 2013). When people are made aware of mental health conditions, they learn how to manage and live with the disease through adversities. Most importantly, mental health awareness eliminates stigmatization prevailing in the society. If the society is aware of strengths and limitations of mental health aspects, stigmatization disappears and enhances acceptance. When awareness is raised between society and people, it increases the chances of early detection and intervention that results in faster recovery and eliminates negative adjectives recognizing mental illness as only illness (Schomerus et al., 2012). As a result, better interventions can be designed to treat mental illness with multidisciplinary approach discussed in subsequent section.
The multidisciplinary team (MDT) in mental health provide healthcare services for meeting the needs of people with mental illness. When people are aware of every aspect of mental health illness, there is better intervention and MDT approaches to treatment and counselling. Inter-professional or collaborative approach to mental health illness comprising of different mental healthcare professionals respond to clients and treat every aspect of mental health illness whether physical, mental and psychological. In mental health, professionals provide treatment using many approaches for people suffering with mental health problems. These theories provide framework for the professionals in understanding clients and help them with appropriate interventions. The MDT comprises of psychiatrists, therapists and counsellors who use theories for helping guide clients after the diagnosis (Momsen et al., 2012).
Behaviourism approach explains that actions are influenced by life experiences and as a result, behaviour is learned. Therefore, the treatment approach encompasses principles of learning where behaviour change is in response to surrounding environment. Behavioural therapy explains that identification of behaviours that cause the mental health problem is helpful in replacing negative behaviours. Systematic desensitization is a treatment done to change the abnormal reactions of an individual towards particular stimuli. This is helpful in treating phobia and handle situations when they confront feared objects (Seligman and Csikszentmihalyi, 2014).
Psychodynamic theory is another approach in which theorists also believe that actions are influenced by life experiences and behaviour is greatly determined by an individual’s past experiences. No behaviour or symptom is accidental as it is influenced by past life experiences. Psychodynamic therapists imply free association that describe any feeling, thought or image of client that comes to his or her mind, irrelevant or unimportant. Therapists look for clues or hints and make interpretations that interests clients. The interpretation of dreams, resistance to therapy and transference meaning participation to therapy are three approaches to this therapy (Schore, 2012).
Cognitive theory or model defines that cognitive processes are the basis of thoughts, behaviours and emotions. The prime role of this theory approach is to explain and resolve the root cause of underpinning abnormal behaviour in mental health illness. By using this approach, clinicians understand the attitude and assumptions of clients that influences their thoughts, feelings and perceptions that help in drawing conclusions and its impact on their mental health. This interpretation is important as cognitive problems like disturbing attitude or assumptions; illogical thinking like overgeneralizations can result in abnormal functioning. This theory is very helpful as it help therapists to help clients overcome disturbing thoughts by changing their ways of thinking. When the thought process is changed, they feel, act and behave in better way, as clients are able to recognize their biased interpretations, illogical thoughts and negative thoughts. These disturbing thoughts make them depressed resulting in dysfunctional thoughts and mental health issues. Therefore, this approach helps and encourages clients to apply new thinking types in them keeping away thoughts that negate abnormal behaviour (Bratman, Hamilton and Daily, 2012).
For the treatment of dementia, client-centred approach or humanistic theory is applied that recognizes the highest potential of the clients. It provides a supportive climate for the clients focusing on common and broader aspects of human existence. Client-centred approach in dementia treatment provides full acceptance (unconditional positive regards), skill listening and paraphrasing (accurate empathy) and sincere commitment (genuineness). Gestalt therapy is another approach that focuses on experiences of clients in the present. This therapy instructs mental health clients to accept their own feelings that made them uncomfortable previously. Another therapy called existential therapy help to encourage clients to take responsibility of their lives and existing problems. This imparts freedom to clients as they understand their present condition and choose to live with a different meaning. Therefore, this theory provides a better understanding and approach to mental health treatment and counselling for the clients (Corrigan and Rao, 2012).
Determinants of mental health play an important role in improving the conditions of clients associated with mental illness. Social inclusion is important for mental health that means people are respected, valued and impart feeling of belongingness and acceptance. Three elements govern social inclusion: social connectedness in making informal relationships with family members and friends. These societal ties provide a feeling of belongingness and enhanced sense of acceptance. When network of people provide support, it is easy for people to cope with challenges and stresses in life as they help to deal with problems. Social support from people eliminates social exclusion that is experienced by mentally ill people. Social capital is another element that provide resources to the people fostering mutual trust, sense of neighbourhood and sense of cooperation among people. It also takes into account the economic resources like employment and jobs that is an important part of social capital. The civic participation and engagement is the third element that provides social inclusion in addressing community issues and advocacy for change. It helps to build ties through recreation opportunities like cultural programs, sports, youth and faith-based groups. These three elements are important in social inclusion as it helps to make clients feel respected, valued and impart social inclusion regardless of their mental illness (Tew et al., 2012).
Freedom from violence and discrimination is another determinant of mental health. When mentally ill people experience positive behaviour from society, they are able to better control their lives and feel secured. This help to make clients feel physically safe and have equitable access of healthcare services that support their physical and mental well-being. When they feel safe, they are able to lead a normal life and experience less bullying, violence, neglect and abuse from others. Stigma is the main reason for discrimination that mental health people face that put them at risk and they are unable to control their lives and feel socially excluded. They find it harder to fit into the society and lack of mental healthcare access leading to delay in treatment and burden of disease. Access to economic resources like education, housing, clothing, income and employment is important that imparts protection and promotion of positive mental health and well-being. When they are able to get equitable access to these resources, they feel socially connected, better control and impart sense of personal competence and enhance their socio-economic status. Inability to get access to economic resources can result in hardship, poverty and as a result, they are unable to afford, good food, decent housing, transportation, clothing that are basic requirements for healthy well-being. Inequality in healthcare and economic services can create stress, depression and affect mental health and well-being. Full economic inclusion and participation can help to enrich clients’ lives, feeling socially accepted, and connected (Ennis and Wykes, 2013).
Psychological approaches to mental health understanding and care explains that dysfunction or disruption in psychological process is the common pathway to mental disorder development. Along with cognitive, biological and social factors, experiences of an individual are also important that lead to mental health disorders conjoining psychological processes. In this approach, individual factors are also studied that produces abnormal feelings, thoughts and behaviours (Meyer, Castro-Schilo and Aguilar-Gaxiola, 2014).
Policy considerations in mental health
Policy and legislation frameworks also important for the implementation and regulation of mental health treatment and services by healthcare providers as it impart good mental health care. United Kingdom Mental Health Policy states the issue of mental health, its needs and equity in mental healthcare services that drive client safety, social inclusion and faster recovery. This policy in UK provide better mental health services to clients, better treatment options and physical conditions based on National Health Service (NHS) budget. This policy also states that there should be best quality of mental health care and equal allocation of resources to clients (McGorry, Bates and Birchwood, 2013).
From the above discussion, it is evident that concept of mental health lies in the ability to cope with mental stress of life and work efficiently. This is different from ill health where there is presence of disease or dysfunction that account for mental illness. Biomedical and social model of health explains mental health from the societal and physical aspects of mental health. Stigma is the main reason for discrimination that mental health people face that put them at risk and they are unable to control their lives and feel socially excluded. For this, MDT undertakes various approaches in treating mental health issues and in providing fast recovery. The MDT comprises of psychiatrists, therapists and counsellors who use theories for helping guide clients after the diagnosis. Therefore, policy considerations are important equity in mental healthcare services that drive client safety, social inclusion and faster recovery in mental health illness like dementia.
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