Mental health & Substance abuse

2. IMPORTANCE OF MENTAL HEALTH
Nearly ½ the world's populations are
affected by mental illness (WHO)
Impact on their self-esteem,
relationships & ability to function in
everyday life.
Everyday stress & even rapid
technological advances make most
people under marked stress
Good mental health can enhance
one’s life, while poor mental health
can prevent someone from living a
normal life.

3. Mental Health
• State of well-being in which the
individual:
• Realizes his own abilities,
• Cope with normal stresses of life,
• Can work productively
• Able to make a contribution to
community.
Mental Illness
• Any disease or conditions that
affect way a person
• Thinks,
• Feels,
• Behaves
• Ability to relate to others & to
surroundings

4. CRITERIA OF INDIVIDUALS WITH GOOD MENTAL HEALTH
Emotional
balance.
Social
adjustment.
Perceiving
things the way
they are.
Achievements
consistent
with the
individual's
abilities &
opportunities.

5. RISK FACTORS OF MENTAL DISORDERS
Sex Infections Genetic predisposition Age

6. Toxic
substances
Environmental
exposure
Homeless
Family problems
& loneliness
Malnutrition

7.  ↓ Iodine during pregnancy & ↓ O2 at birth, injuries & early childhood brain
infections → MR.
 Nutritional deficiencies “PEM” → MR.
 Depression interacts with CVDs & vice versa.
 Anxiety, depression & substance abuse can also complicate existing physical
disorders.
INTERACTION BETWEEN PHYSICAL & MENTAL HEALTH PROBLEMS

8. Schizophrenia
Psychosis &
depression
Behavioral disorders as
maladjustment & absenteeism.
Psychopathic disorders:
aggressive antisocial acts
Impaired
intelligence
TYPESOFMENTALDISORDERS

9.  Mental illness & poor mental health are public problems
 Great impact on:
THE IMPACT OF MENTAL DISORDERS

10. Individuals
• Distressing symptoms.
• Unable to participate in
work & leisure.
• Poor QoL: stigma &
discrimination.
Family
• Economic burden
• Disruption of house hold
routine & restricted
social activities.
• Lost work & social
opportunities.
Community
• Cost of providing care.
• Loss of productivity.
• Legal problems including
violence.

11. 2ry
3ry
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Prevention of Mental Illness

12. PRIMARY PREVENTION
Mental health
promotion
• Mental health educational
programs.
Genetic counseling,
antenatal & natal care
• Ensure normal fetal
development.
Public health-related
factors
• Education, employment,
social well-being
• Availability of suitable
food & housing

13. PRIMARY PREVENTION
Raising public awareness
• Patients need ttt & kind care.
Awareness of psychological
development
• Development of human
being's cognitive, emotional,
intellectual & social
capabilities.
Life skills education &
training
• Interpersonal communication
skills
• Decision-making & critical
thinking skills
• Stress management.

14. • Screening: Early
detection.
• Early diagnosis.
Detection of mental
disorders/illness in PHC
• Complete psychiatric
assessment.
• Counseling,
psychotherapy &
medical ttt.
• Admission to
psychiatric
word/hospital.
Proper management and/or
referral to a psychiatrist
• Wars, disasters &
crisis.
• Social support
improves the course
of the disease & ↓ its
duration & intensity
& enhances rapid
recovery
Crisis intervention
Intervention undertaken to reduce complications & all specific ttt.
SECONDARY PREVENTION

15. Needy/disabled
group
• ↑ Self-esteem & confidence.
• ↑ Opportunities for physical & socio-economic integration.
Family &
Community
•↑ Society understanding of causes of disabilities & abilities “Public
information campaigns →↓Stigmatization”.
•Communicate to parents about disabilities of their disabled children.
•Providing facilities/ services-day care centers & counseling sites to families &
Improve physical accessibility to public places.
•Create incentives for employers to hire disabled people.
•Training HCWs about their needs & Improving approach toward them.
Interventions that ↓ disability & all forms of rehabilitation + prevention of relapses of illness.
The integration of needy groups in the society is needed.
TERTIARY PREVENTION

16. MENTAL HEALTH PROGRAM IN EGYPT:
In Egypt the national mental health program focuses on:
Decentralization of MH care
& community care in
different governorates.
Inclusion of mental health in
PHC.
Training of family doctors to
deal with main mental
disorders.
Awareness-raising among
public regarding recognition
of mental disorders &
methods of referral.
The new policy may ↓ no. of psychiatric inpatients.
After-care services are still limited because of the poor understanding of most
people

17. SUBSTANCE ABUSE

19. Substance abuse “drug abuse”
• Any use of non prescribed, non controlled substances or drugs without medical
reason.
Drug Dependence
• State of psychic or physical dependence (or both) on a drug occurring after periodic or
continuous administration of that drug.
Tolerance
• Need for increasing the dose of a drug to reach the original effect of it.
Psycho Active Drugs
• Exogenous substances that affect CNS for calming, energizing or pleasurable.
• Excessive use of these drugs leads to tolerance.
Addicted Person
• Person who is unable to free himself from a harmful habit or he is unable to stop that
habit.

21.  In Egypt, drug abuse is considered one of the most serious public health
problems, especially among the young people at working ages.
 In Middle Eastern Arab countries, there is scarce information on mental
health issues, including drug dependence. This is related to the context of
the conservative nature of these societies that reject disclosing about drug
intake as well as to stigmatization.
Magnitude of the problem

23. Narcotics
• Morphine, Heroin & Codeine
• Strong psychic dependence & early physical
dependence & tolerance.
• Euphoria, ↓pain perception, nausea, constipation,
RC depression & visual disturbance.
Depressant
• Alcohol & Barbiturates.
• Psychic dependence, sedation, hypnosis,
anesthesia, muscle relaxation & sleep
Stimulants
• Amphetamine & Cocaine.
• Excitatory for CNS, alertness, euphoria,
motor activity, depression of appetite & large
doses cause convulsions
Hallucinogens
• LSD & Mascaline
• Distort perception of time & distance, induce
delusions & hallucination.
• Alter mood & may cause psychotic episodes
Cannabis
• Hashish & Marijuana & Bango.
• Affect cognition, memory & mood
• Deterioration of self perception & sensation of
time
TYPES OF PSYCHO ACTIVE DRUGS

25. Risk factors of drug addiction
Drug pharmacological
effects, “highly
addictive drug”.
Availability & easy
accessibility of drugs.
Gender.
Psychic & neurological
illness.
Family history of
addiction.
Lack of family
involvement.
Anxiety, depression and
loneliness.
Peer pressure.

27. IMPACTS OF DRUG ABUSE
Health problems &
Communicable disease
“HIV, HBV”.
↑ Accidents.
Unconsciousness, coma &
sudden death.
↑ Crime & Violence &
Suicide.
Family problems.
↓School performance &
motivation.
↓ Work performance + ↑
Absenteeism
Financial problems

28. PATTERN OF SUBSTANCE ABUSE IN EGYPT
• Cannabis, Opium, Hypnoseditives, Heroin, and Cocaine.
1980s
• Cannabis, Alcoholic beverages, Synthetic psychoactive drug.
1990s
• Cannabis became prevalent in the form of Bango “leaves of Cannabis sativa”.
• This plant is increasingly widely cultivated in Egypt, especially in Sinai Peninsula.
2nd half of the 1990s
• Tramadol “Scheduled drug”, milder synthetic opioid painkiller similar to morphine.
• Easily accessible at cheap costs from the black market
• 30% of males “14-30 years” “Students, laborers & professionals” use it regularly “For
Premature ejaculation & for extended orgasm & increase sexual pleasure”
Since 2007

29. 70 % of admissions to the addiction wing of Cairo’s massive Qasr el-Aini hospital
were linked to tramadol in 2014 alone.

30. PREVENTION OF DRUG DEPENDENCE
2ry
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31. PRIMARY PREVENTION
Empower laws
& legislations.
Health
education.
Encourage
youth for
physical
exercise & safe
recreation
activities.
Suitable
management of
family & social
problems.
Parental
supervision &
control
influence of
peers.

33. SECONDARY PREVENTION
Early diagnosis &
continuous
supervision.
Hospitalization of
severe cases.
Hot line service “rapid
management &
confidential service”.
Follow up of
recovered cases.

34. TERTIARY PREVENTION
Rehabilitation of addicts, find suitable jobs & no community
stigma