Community Mental Health Lecture 10 1 1 Overview Know what is meant by Mental Health, Mental Disorder, Mental Illness, and DSM-V Understand examples of mental disorders Emphasis on stress & suicide Understand mental health challenges Understand goals of mental disorder treatment 2 2 Introduction Mental health: Individual’s social and emotional well-being Mental disorders: Health conditions characterized by alterations in thinking, mood, or behavior associated with distress and/or impaired functioning (or, disruption of social/emotional well-being) Mental illness: All diagnosable mental disorders Diagnosis through DSM-V 3 3 Introduction Mental health: Individual’s social and emotional well-being Mental disorders: Health conditions characterized by alterations in thinking, mood, or behavior associated with distress and/or impaired functioning (or, disruption of social/emotional well-being) Mental illness: All diagnosable mental disorders Diagnosis through DSM-V 4 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (“DSM-V” or “DSM-5”) Most influential book in mental health Published by American Psychiatric Association (APA) Classifies disorders based on behavioral signs and symptoms rather than definitive tests or measurements of brain or another body system 4 Introduction Causes of disability for all ages combined (U.S., Canada, & Western Europe, 2000) 5 5 Mental Disorders: Overview May arise from various causes: Poor prenatal care; postnatal environment; genetics; environmental factors; brain function impairment; substance abuse; maladaptive family functioning; stress Various types of mental disorders exist Focus on some well-known disorders in this class 6 Mental Disorders: Overview May arise from various causes: Poor prenatal care; postnatal environment; genetics; environmental factors; brain function impairment; substance abuse; maladaptive family functioning; stress Various types of mental disorders exist Focus on some well-known disorders in this class 7 Stress is a contemporary problem in mental health Stress: Individual’s psychological and physiological response to real or perceived stressors Acute vs. chronic (by amount of time) Eustress vs. distress (by nature of influence) Stressor: Any real or perceived physical, social, or psychological event or stimulus that causes our bodies to react or respond (can be internal/external) Mental Disorders: Overview May arise from various causes: Poor prenatal care; postnatal environment; genetics; environmental factors; brain function impairment; substance abuse; maladaptive family functioning; stress Various types of mental disorders exist Focus on some well-known disorders in this class 8 Individuals typically go through three stages when responding to stressors, known as general adaptation syndrome General adaptation syndrome (GAS) Alarm (initiate “fight or flight” response) Resistance (sustained high resistance to stress) Exhaustion (Bod.

1. Community Mental Health
Lecture 10
1
1
Overview
Know what is meant by Mental Health, Mental Disorder, Mental
Illness, and DSM-V
Understand examples of mental disorders
Emphasis on stress & suicide
Understand mental health challenges
Understand goals of mental disorder treatment
2
2
Introduction
Mental health: Individual’s social and emotional well-being
Mental disorders: Health conditions characterized by
alterations in thinking, mood, or behavior associated with
distress and/or impaired functioning (or, disruption of
social/emotional well-being)
Mental illness: All diagnosable mental disorders
Diagnosis through DSM-V
3

2. 3
Introduction
Mental health: Individual’s social and emotional well-being
Mental disorders: Health conditions characterized by
alterations in thinking, mood, or behavior associated with
distress and/or impaired functioning (or, disruption of
social/emotional well-being)
Mental illness: All diagnosable mental disorders
Diagnosis through DSM-V
4
Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition (“DSM-V” or “DSM-5”)
Most influential book in mental health
Published by American Psychiatric Association (APA)
Classifies disorders based on behavioral signs and symptoms
rather than definitive tests or measurements of brain or another
body system
4
Introduction
Causes of disability for all ages combined (U.S., Canada, &
Western Europe, 2000)
5
5
Mental Disorders: Overview
May arise from various causes:
Poor prenatal care; postnatal environment; genetics;

3. environmental factors; brain function impairment; substance
abuse; maladaptive family functioning; stress
Various types of mental disorders exist
Focus on some well-known disorders in this class
6
Mental Disorders: Overview
May arise from various causes:
Poor prenatal care; postnatal environment; genetics;
environmental factors; brain function impairment; substance
abuse; maladaptive family functioning; stress
Various types of mental disorders exist
Focus on some well-known disorders in this class
7
Stress is a contemporary problem in mental health
Stress: Individual’s psychological and physiological response
to real or perceived stressors
Acute vs. chronic (by amount of time)
Eustress vs. distress (by nature of influence)
Stressor: Any real or perceived physical, social, or
psychological event or stimulus that causes our bodies to react
or respond (can be internal/external)
Mental Disorders: Overview
May arise from various causes:
Poor prenatal care; postnatal environment; genetics;
environmental factors; brain function impairment; substance
abuse; maladaptive family functioning; stress

4. Various types of mental disorders exist
Focus on some well-known disorders in this class
8
Individuals typically go through three stages when responding
to stressors, known as general adaptation syndrome
General adaptation syndrome (GAS)
Alarm (initiate “fight or flight” response)
Resistance (sustained high resistance to stress)
Exhaustion (Body more susceptible to disease and sickness)
Mental Disorders
Anxiety disorder
Major depression
Bipolar disorder
Phobias (http://phobialist.com/)
Includes social phobia
Post-traumatic stress disorder (PTSD)
Collection of symptoms that occur as a delayed response to a
serious trauma.
Obsessive-compulsive disorder (OCD)
Characterized by recurrent, unwanted thoughts and repetitive
behaviors.
9
Mental Disorders
Attention-deficit/hyperactivity disorder (ADD/ADHD)
Neurobehavioral disorder associated with hyperactivity or
distraction.

5. Schizophrenia
Biological disease characterized by alterations of the senses
Other compulsion? (Hoarding)
Sleep disorders? (FFI)
10
10
Mental Disorders
Attention-deficit/hyperactivity disorder (ADD/ADHD)
Neurobehavioral disorder associated with hyperactivity or
distraction.
Schizophrenia
Biological disease characterized by alterations of the senses
Other compulsion? (Hoarding)
Sleep disorders? (FFI)
11
11
Mental Disorders
Suicide
Led to an unexpected rise in death rates among middle-aged
white Americans between 1999 and 2014
Currently the second leading cause of death on college
campuses.

6. Suicide affects persons attempting/committing suicide PLUS
friends and families of those persons.
Difficult to spot or address warning signs; need to talk about it
for prevention
12
Mental Health Challenges
Experiences of people with serious mental illness have
improved significantly in past 50 years
Challenges remain:
Mental health stigma
How to provide services to the homeless
Resolving problems of those with mental illness who are
incarcerated
13
13
Mental Health Stigma
Are these accurate description of a typical mental patient?
14
Mental Health Challenges
14

7. Mental Health Stigma
Are these accurate description of a typical mental patient?
15
Mental Health Challenges
15
Mental Health Challenges
Homelessness
2.1 million adults experience homelessness over the course of a
year
80% temporarily homeless, 10% episodically homeless, 10%
chronically homeless
About half of all homeless adults have substance use disorders,
major depression, and other co-occurring mental illness
Successful interventions include provision of housing and
services they need
16
16
Mental Health Challenges
Mental Health Care in Jails and Prisons
Rates of serious mental illness in U.S. correctional facilities are
three to four times the rates in the general population

8. Correctional facilities designed to confine and punish, not to
treat disease
Lack of space, adequate number of qualified treatment
personnel, and timely access to services
Once released back into community, more likely to commit
crime if untreated
17
17
Prevention of Mental Disorders
Primary, secondary, and tertiary prevention applicable to mental
disorders
Primary: reduces incidence of mental illness and related
problems
Secondary: reduces prevalence by shortening duration of
episodes
Tertiary: treatment and rehabilitation
18
18
Treatment of Mental Disorders
Goals of mental disorder treatment is to promote
lifestyle/behaviors that make a person’s life better
Reduce symptoms
Improve functioning (personal & social)
Develop and strengthen coping skills
Use of…(1) Psychopharmacology; (2) Psychotherapy; (3)
Technology; (4) Self-Help Groups; (5) Psychiatric
Rehabilitation Services

9. 19
19
Additional Resources
Student Counseling Service @ Division of Student Affairs,
Miami University
Professional, confidential, & inexpensive
Free initial consultation + up to 3 free counseling
Reduced/waived fee available upon request
Visit their website, or call: 513-529-4634
20
20
Additional Resources
TED talk: What’s so Funny about Mental Illness?
21
21
Take-Away Points
22
Know the definitions & highlighted concepts.
Special focus on stress as a mental health problem, including
the distinction between eustress (+) or distress (-); acute or
chronic stress.

10. Special focus on the General adaptation syndrome.
Understand how myths/stigma surrounding mental disorders are
inaccurate.
Know purpose and types of mental disorder treatments.
22
Announcement
23
Reminder: Assignment #4 due this Saturday
23
Addiction & Drug Abuse
Lecture 11
1
1
Overview
Part 1 of 2
Be able to differentiate Addiction vs. Habit when given an
example.
Know what is meant by Behavioral Addiction, Substance
Addiction, Psychological Dependence, and Physiological
Dependence.
Part 2 of 2
Know what is meant by Drug Abuse, Drug Misuse, Prescription

11. Drug, and OTC Drug.
Know details (facts and misconceptions) about Marijuana
Know what is meant by “relapse,” and why it is important in
addiction treatment/recovery.
2
2
Introduction
Addiction is a persistent & compulsive dependence on a
behavior or substance, despite ongoing negative consequences.
Psychological dependence is the dependency of the mind on a
substance or behavior; Can lead to psychological withdrawal
symptoms, such as anxiety, irritability, or cravings.
Physiological dependence results in tolerance & withdrawal
Addiction is recognized as a form of mental disorder by the
APA
3
3
Introduction
Two types of addictions:
Behavior / Process Addictions (e.g., gambling, shopping, eating,
and sex)
Substance Addictions (e.g., alcoholism, drug abuse, and
smoking)
Don’t confuse two types of addictions with two forms of
dependence (psychological & physiological)
4

12. 4
What Happens to Addicts?
Dependence may be psychological and/or physiological
Often see…
Compulsion
Loss of control + tolerance
Negative consequences
Denial
Withdrawl
5
5
Why Care about Addiction? (micro)
Is addiction just a “bad” habit? (NO, not really)
Addiction involves elements of habit, a repeated behavior in
which the repetition may be unconscious.
But, not all habits are addiction
Habits can be broken.
Addiction involves repetition of a behavior that occurs with
compulsion, and considerable discomfort occurs if the behavior
is not performed (withdrawl)
6
6

13. Why Care about Addiction? (micro)
Effect on (of effect of) Family/Friends
Codependents
Enablers
Knowingly or unknowingly protect addicts from the
consequences of their behavior
7
7
Why Care about Addiction? (macro)
In the U.S… (according to the Surgeon General’s Report)
48 million people use illegal drugs or abuse prescription drugs
28 million people drive under the influence of drugs or alcohol
21 million people suffer from addiction
8 million people need treatment for drug addiction
Less than 10% of addicts receive proper treatment
8
8
Behavioral Addiction: Types
Gambling Addiction
Characteristic behaviors include preoccupation with gambling,
unsuccessful efforts to quit, and lying to conceal the extent of
one’s involvement.
Affects more than two million Americans.
Only behavioral addiction recognized by DSM-V.
Can happen to college students too
9

14. 9
Behavioral Addiction: Types
Technology / Internet Addictions
Exercise Addiction
Work Addiction
Shopping Addiction
Sexual Addiction
10
10
Substance Addiction: Background
Various routes of drug administration
11
11
Substance Addiction: Background
Drug misuse vs. abuse
Drug misuse: using a drug for a purpose for which it was not
intended
Drug abuse: excessive use of any drug.
12

15. 12
Substance Addiction: Background
Prescription vs. OTC drugs
Prescription drugs: Only available via a licensed healthcare
practitioner; Not readily available
Over-the-Counter (“OTC”) Drugs: Can be purchased without a
prescription; Many times, safer and as effective as prescribed
drugs
13
13
Substance Addiction: Background
Legal vs. illegal/controlled substance? (DEA)
Federal law vs. state/local law?
Legal infraction vs. misdemeanor vs. felony?
Total prohibition vs. allowing use vs. possession vs. sale vs.
transportation vs. cultivation of substance?
De-regulation vs. de-criminalization? (admin efficiency?)
Legalization vs. de-criminalization? (impunity?)
14
14
Substance Abuse/Addiction: Types
Legal Drugs
Can be legally bought and sold in the marketplace

16. Includes drugs that can be closely regulated, likely regulated,
and not regulated at all
Controlled Substances and Illicit Drugs
Those regulated by the Controlled Substances Act of 1970
Cannot be cultivated, manufactured, bought, sold, or used
within the confines of the law
Schedule I – high potential for abuse; no accepted medical uses
Schedules II-V – have medical uses; scheduled based on
potential for risk of dependence or abuse
Drug Enforcement Agency (DEA) responsible for enforcing
Controlled Substances Act
15
Substance Abuse/Addiction: Types
Legal Drugs
Can be legally bought and sold in the marketplace
Includes drugs that can be closely regulated, likely regulated,
and not regulated at all
Controlled Substances and Illicit Drugs
Those regulated by the Controlled Substances Act of 1970
Cannot be cultivated, manufactured, bought, sold, or used
within the confines of the law
Schedule I – high potential for abuse; no accepted medical uses
Schedules II-V – have medical uses; scheduled based on
potential for risk of dependence or abuse
Drug Enforcement Agency (DEA) responsible for enforcing
Controlled Substances Act
Alcohol, nicotine, nonprescription (OTC) drugs, prescription
drugs
Marijuana, narcotics, cocaine and crack cocaine, hallucinogens,
stimulants, depressants, club drugs and designer drugs, anabolic

17. drugs, inhalants
16
Substance Abuse: Legal Drugs
Alcohol & Nicotine Products
Some of most commonly used & abused substance
Presented in Lecture 12
17
Substance Abuse: Legal Drugs
Prescription Drugs
Regulated by the Food and Drug Administration (FDA)
Subject to misuse and abuse
Opioid pain relievers
Risk of dependence and unintentional overdose
Development of drug-resistant strains of pathogens
18
Substance Abuse: Legal Drugs
Over-the-Counter Drugs (OTCs)
Most only provide symptomatic relief, not a cure
Regulated by the Food and Drug Administration (FDA)
Subject to misuse and abuse

18. 19
Substance Abuse: Illegal Drugs
Marijuana
Products derived from hemp plant (active ingredient = THC)
Most abused illicit drug in the U.S.
Legal status varies by State; Not legal at federal level
Polydrug use common
Not a safer alternative to cigarette/tobacco
Acute effects – reduced concentration, slowed reaction time,
impaired short-term memory, impaired judgment
Chronic effects – damage to the respiratory system (if smoked),
amotivational syndrome
20
Substance Abuse: Illegal Drugs
Opioids (syn. = opiates; narcotics)
Opium and its derivatives, morphine and heroin, come from an
oriental poppy plant
Numb the senses and reduce pain
High potential for abuse; recently declared a “national public
health emergency” (not all are necessarily illegal)
Opium poppies do not grow in U.S.; drug trafficking problems
Heroin addiction leads to significant community health
problems
21
Substance Abuse: Illegal Drugs
Depressants
Slow down the central nervous system

19. May lower anxiety and inhibitions
Tolerance develops; Strong physical dependence
Alcohol, barbiturates, benzodiazepines
(again, not all depressants are illegal)
22
Substance Abuse: Illegal Drugs
Stimulants
Increase the activity of the central nervous system
Includes caffeine (legal)
Amphetamines
Schedule II prescription drugs; widely abused
Methamphetamines often made in secret labs
Total of all secret lab incidents involving methamphetamine
23
Substance Abuse: Illegal Drugs
Inhalants
Collection of psychoactive breathable chemicals
Paint solvents, motor fuels, glues, aerosol sprays, cleaners (e.g.,
“liquid gold”)
Easy availability + Low cost
Often drug choice of younger population
Acute and chronic effects
24

20. Prevention/Control of Drug Abuse
Primary prevention aimed at those who have never used drugs
(DARE)
Secondary prevention aimed at those who have used, but are not
chronic abusers (students)
Tertiary prevention aimed at drug abuse treatment and aftercare,
including relapse prevention (AA?)
25
Prevention/Control of Drug Abuse
Goals of prevention is to…
Reduce demand for drugs
Education
Treatment
Reduce supply and availability of drugs
Public policy
Law enforcement
NOT EASY!
26
Treatment/Recovery
Treatment/recovery is a lifelong process
Recognition of problem first step to before treatment
Persistence is key
Expect relapse
Relapse: an isolated occurrence of or full return to addictive
behavior is a defining characteristic of addiction.
27

21. 27
Take-Home Points
Addiction is a serious problem with physiological and
psychological consequences
Individuals affected by addiction go through several stages,
with external and internal characteristics
Abuse and addiction come in various forms, including use of
illicit drugs, prescription medication, uncontrolled behavior,
etc.
Substance abuse has acute and chronic effect on person’s
physical and mental health
Common drug abuse involves stimulants, marijuana,
depressants, hallucinogens, inhalants, etc.
28
Assignment #5 Due: Saturday 11/10/2018 by 11:59pm
Instruction:
· Please CHOOSE ONE of the two prompt options provided
below, and write a 2-3 page (double spaced) narrative response.
Be sure to address every point within the prompt of your choice.
· Submit completed assignment via Canvas Assignments, as
DOC, DOCX, PDF, or RTF file attachments.
Prompts:
Option #1:Recommended after lecture 10-12
Have you ever done something (or, thought about doing
something) that may be considered unhealthy when you were

22. under a lot of stress? For example, used alcohol or tobacco
products to de-stress?
1. IF YOU HAVE…
i. Why do you think that’s unhealthy?
ii. Why do you think you did what you did?
iii. What would be a healthier alternative?
1. IF YOU HAVE NOT…
i. What do you think stopped you from doing those things?
ii. Why would other people do unhealthy things when under a
lot of stress?
Option #2:Recommended after Lecture 12
There’s an on-going debate about whether or not vaping (i.e.,
use of electronic cigarettes) is “better” than traditional cigarette
smoking.
a) Conduct your own research, and try to answer the question:
“do you think vaping is better / worse than / or equally as bad
as cigarette smoking?”
b) HINT: there’s no “correct” answer. Try to find different
arguments, and weigh their evidence. Decide which you agree
with, and explain why
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