Purpose of Purpose of community community

mental healthmental health

Although the purpose of community Although the purpose of community mental health is a complex matter, the mental health is a complex matter, the writer's view (which is certainly not the writer's view (which is certainly not the only valid one) is that it is there to only valid one) is that it is there to provide a pathway towards overcoming provide a pathway towards overcoming the widespread fear, inertia(the widespread fear, inertia(قصورقصور) and ) and stigma that surround the phenomenon of stigma that surround the phenomenon of mental illness and to provide a beacon of mental illness and to provide a beacon of hope for sufferers and their supporting hope for sufferers and their supporting caregivers.caregivers.

Given the proper use of medication, suitable Given the proper use of medication, suitable forms of rehabilitation and good use of new forms of rehabilitation and good use of new forms of care now coming to the forefront, one forms of care now coming to the forefront, one can with reasonable confidence make the can with reasonable confidence make the following positive statements:following positive statements:

• Individuals who recover from a serious Individuals who recover from a serious episode of a mental illness can lead a quite episode of a mental illness can lead a quite independent life. independent life.

• Those persons who have residual problems Those persons who have residual problems arising from their psychiatric illnesses can arising from their psychiatric illnesses can with appropriate assistance have the leading with appropriate assistance have the leading of independent lives as a longer term goal.of independent lives as a longer term goal.

It has to be noted as a word of caution It has to be noted as a word of caution that leading an independent life is not that leading an independent life is not necessarily the same thing as a cure. necessarily the same thing as a cure. Possible many sufferers may therefore Possible many sufferers may therefore interpret the above comments as interpret the above comments as unrealistic or misleading, but evidence unrealistic or misleading, but evidence from recent researches suggests that from recent researches suggests that even in severe disorders considerable even in severe disorders considerable improvements in social functioning occur improvements in social functioning occur over a period of time in the majority of over a period of time in the majority of instances. instances.

The purpose of mental health care is The purpose of mental health care is to maximize the potential for natural to maximize the potential for natural improvement by implementing and improvement by implementing and carrying out effective intervention carrying out effective intervention programs. To be able to do so programs. To be able to do so however requires a fresh attitude however requires a fresh attitude from the general public, more from the general public, more government funding of services, and government funding of services, and donations. donations.

This introductory part tries to answer the This introductory part tries to answer the following questions:following questions:

What do we mean by mental illness? What do we mean by mental illness? What does the concept of mental health What does the concept of mental health

mean, if anything?mean, if anything? If mental health is a tangible concept can If mental health is a tangible concept can

improvements in mental health as such improvements in mental health as such assist in ameliorating the effects of a mental assist in ameliorating the effects of a mental illness?illness?

What exactly does community mental health What exactly does community mental health mean and what does this approach involve?mean and what does this approach involve?

WHAT IS MENTAL WHAT IS MENTAL ILLNESS?ILLNESS?

According to APA: "An illness with According to APA: "An illness with psychiatric or behavioral psychiatric or behavioral manifestations and / or impairment manifestations and / or impairment in functioning due to a social in functioning due to a social psychological , genetic , physical , psychological , genetic , physical , chemical or biologic disturbance." chemical or biologic disturbance."

Prevalence of mental Prevalence of mental illnessillness

At the present time the overall At the present time the overall prevalence of mental illness in prevalence of mental illness in Australia, based upon a number of Australia, based upon a number of community surveys, is indicated to community surveys, is indicated to be 18.4 per cent of the total be 18.4 per cent of the total population.population.

The age groups most affected are in The age groups most affected are in the 25-44 years age range. the 25-44 years age range.

Such arrange of disorder amongst Such arrange of disorder amongst this key age group indicates the this key age group indicates the considerable costs to the nation considerable costs to the nation because f crime, domestic because f crime, domestic disharmony , marital separation, use disharmony , marital separation, use of non-therapeutic drugs and so on. of non-therapeutic drugs and so on.

What is also important for the What is also important for the community mental health worker community mental health worker and many others working in and many others working in community settings is the high community settings is the high percent age of persons presenting percent age of persons presenting for medical treatment who are also for medical treatment who are also likely to have a psychiatric illness. likely to have a psychiatric illness.

A study by Huxley and Fitzpatrick A study by Huxley and Fitzpatrick (1984:67-73) showed that some 68 (1984:67-73) showed that some 68 per cent of social workers' clients per cent of social workers' clients had some kind of psychiatric had some kind of psychiatric morbidity. Whilst this represents a morbidity. Whilst this represents a bleak picture in that social agencies bleak picture in that social agencies are poorly equipped to deal with are poorly equipped to deal with psychiatric problems.psychiatric problems.

It would appear therefore that It would appear therefore that although the potential problem is although the potential problem is very considerable in size, such very considerable in size, such matters can be dealt with effectively matters can be dealt with effectively in reality . community mental health in reality . community mental health services are therefore a worthwhile services are therefore a worthwhile investment in increasing community investment in increasing community wellbeing and in reducing the burden wellbeing and in reducing the burden of economic costs on the workplaceof economic costs on the workplace

The meaning of mental The meaning of mental health as a concept health as a concept

Attempting to define the concept of Attempting to define the concept of mental health is unfortunately a very mental health is unfortunately a very complex matter, and there have complex matter, and there have been various attempts n recent years been various attempts n recent years to define it in either brief or to define it in either brief or elaborate ways.elaborate ways.

As a brief indication of its meaning Colin As a brief indication of its meaning Colin Wilson, a seminal writer in psychology, Wilson, a seminal writer in psychology, perceives mental health as having an perceives mental health as having an optimism for the way in which the future will optimism for the way in which the future will work out. Morgan and Johnston (1976) regard work out. Morgan and Johnston (1976) regard mental health as the ability to adjust to new mental health as the ability to adjust to new situations and to handle personal problems situations and to handle personal problems without marked distress and have enough without marked distress and have enough energy remaining to be a constructive energy remaining to be a constructive member of society. one could perhaps see member of society. one could perhaps see this as a superman type of definition!this as a superman type of definition!

More recently the definition for mental health More recently the definition for mental health can be described as interactive in that mental can be described as interactive in that mental health is seen as the outcome of interchange health is seen as the outcome of interchange between the individual, the group and the between the individual, the group and the community. The report also makes the valuable community. The report also makes the valuable suggestion that mental health has its won suggestion that mental health has its won continuum and is not simply the opposite pole of continuum and is not simply the opposite pole of mental disorder. Thus mental health can be seen mental disorder. Thus mental health can be seen to run from poor to good, and individuals might to run from poor to good, and individuals might also contain some element of psychiatric also contain some element of psychiatric morbidity, however minor , such as a trivial morbidity, however minor , such as a trivial phobia. phobia.

Bryant and Veroff have attempted Bryant and Veroff have attempted what might be termed a negative what might be termed a negative view of mental health, as they list view of mental health, as they list factors that describe feelings that factors that describe feelings that would be unwanted:would be unwanted:

unhappinessunhappiness inability to meet one's own standards.inability to meet one's own standards. Strain.Strain. Vulnerability.Vulnerability. Uncertainty about the present and futureUncertainty about the present and future Isolation from society or local communityIsolation from society or local community Feeling that life –problems are uncontrollable Feeling that life –problems are uncontrollable Low self-esteem.Low self-esteem. Feeling of being overwhelmed by adverse life Feeling of being overwhelmed by adverse life

events events Feeling of facing an imminent nervous Feeling of facing an imminent nervous

breakdown.breakdown.

The role of community The role of community mental health servicesmental health services

Irving Goffman, who assessed the Irving Goffman, who assessed the horrifying effects of the institution upon its horrifying effects of the institution upon its inmates, and with the anti-psychiatry inmates, and with the anti-psychiatry movement starting from inside the movement starting from inside the profession itself with the work of Laing profession itself with the work of Laing and Szasz, who questioned the whole and Szasz, who questioned the whole emphasis upon biological factors in the emphasis upon biological factors in the causation of psychiatric illness and who causation of psychiatric illness and who wanted the most radical changes in the wanted the most radical changes in the treatment and care of this group of people.treatment and care of this group of people.

A summary of the major roles for community mental A summary of the major roles for community mental health as perceived by these writers:health as perceived by these writers:

* the way the individual functions in the community * the way the individual functions in the community may affect the course of his/her mental illness. may affect the course of his/her mental illness.

* community mental health services may prevent the * community mental health services may prevent the onset of disorder at a stage when the individual's onset of disorder at a stage when the individual's problems are more manageable.problems are more manageable.

* Community mental health may develop * Community mental health may develop a sense of a sense of communitycommunity where people "experience affiliation, where people "experience affiliation, belonging, compassion and caring' .belonging, compassion and caring' .

*Community mental health may carry out programs *Community mental health may carry out programs of rehabilitation for the seriously mentally ill.of rehabilitation for the seriously mentally ill.

Community mental health Community mental health services may also provide: services may also provide:

promotion of mental health throughout the promotion of mental health throughout the community (this is a major emphasis of the community (this is a major emphasis of the world health organization).world health organization).

A demographic study of the area A demographic study of the area geographically served, identifying factors geographically served, identifying factors such as age distribution, ethnic and racial such as age distribution, ethnic and racial groupings and rates of hospitalization. groupings and rates of hospitalization.

Collaboration with community representatives Collaboration with community representatives to identify problems and improve perceptions to identify problems and improve perceptions about mental illness and additionally to about mental illness and additionally to attempt resolutions of identified problems .attempt resolutions of identified problems .

A utilization of a particular community's A utilization of a particular community's strengths and support systems. strengths and support systems.

The use of cost-effective methods in improving The use of cost-effective methods in improving mental health, for example working with groups of mental health, for example working with groups of sufferers, families and appropriate target groups.sufferers, families and appropriate target groups.

Consultation to other caregivers of the mentally ill, Consultation to other caregivers of the mentally ill, Community education programs about the mentally Community education programs about the mentally

ill ill Assistance to sufferers in applying for services and Assistance to sufferers in applying for services and

entitlements and preserving their human rights.entitlements and preserving their human rights. Case-management services in order to facilitate Case-management services in order to facilitate

access to a full range of required services. access to a full range of required services. Physical support services to allow for independent Physical support services to allow for independent

living of sufferers for as long as they are needed living of sufferers for as long as they are needed Medical and mental health are as required. Medical and mental health are as required.