concept of mental health

Mental Health
Chetraj pandit
BPH,MPH

Unit 3: Mental Health in Public Health
Concept of Mental Health
o Concept of normalcy, normal mind, characteristics of
abnormalities
o Prevailing misconception about occurrence and
treatment of mental illness
o Description of measurable indicators of positive well-
being, good psychological adjustment
o Personality development including behavioural,
psychodynamic, cognitive, moral and other schools
of personality development

Concept of normalcy, normal mind,
characteristics of abnormalities
• The categories "Normality" and "Mental
health" are closely related.
• What is considered "mentally healthy" is
linked with what is estimated as "normal" in
every historical and cultural context

Definitions of Health
“Health is a state of complete physical, mental
and social well being and not merely an
absence of disease or infirmity”
WHO (1948)
Spiritual Well being have also been included by
WHO.

• Robinson (1983) define mental health: “A
dynamic state in which the thought, feelings, and
behaviour that is age- appropriate and congruent
with the local and cultural norm is
demonstrated.”
• According to WHO, Mental health is defined as
a state of well-being in which every individual
realizes his or her own potential, can cope with
the normal stresses of life, can work productively
and fruitfully, and is able to make a contribution
to her or his community.
CONCEPTS OF MENTAL HEALTH
2/16/2020 5

• Maslow (1959) sets out his hierarchy of basic
human needs, the fulfillment of which is believed
to promote mental health. These include:
– Physiological needs (food, sleep, sex etc.).
– Safety and security needs.
– Love (or belongingness) need.
– Self-esteem need.
– Self-actualization need.
CONCEPTS OF MENTAL HEALTH contd…
2/16/2020 6

• In most cases, mental health is a state of
emotional, psychological, and social
wellness evidenced by satisfying
interpersonal relationships, effective
behavior and coping, positive self-concept,
and emotional stability.
CONCEPTS OF MENTAL HEALTH
2/16/2020 7

Mental Health
 About 450 million people suffer from mental and
behavioural disorders worldwide. One person in four
will develop one or more of these disorders during their
lifetime
 Mental disorders represent not only an immense
psychological, social and economic burden to society,
but also increase the risk of physical illnesses. Given the
current limitations in effectiveness of treatment
modalities for decreasing disability due to mental and
behavioural disorders, the only sustainable method for
reducing the burden caused by these disorders is
prevention.

Criteria for Mental Health
• Adequate contact with reality
• Control of thoughts and imagination
• Efficiency in work and play
• Positive self concept
• A healthy emotional life
2/16/2020 9

Characteristics of a mentally healthy
person
Not only absence of mental illness.
Feels comfortable him/her self – reasonably
secure & adequate, neither underestimates or
overestimates his own ability, self respect.
Feels right towards others – interested in others,
love, takes responsibilities.
Mentally healthy person is able to meet the
demands of life. Sets reasonable goals, shoulders
his daily responsibilities, not bowled over by his
own emotions of fear, anger, love, guilt.

mental health problems
Mental health problems can affect the way you
think, feel and behave. Some mental health
problems are described using words that are
in everyday use, for example ‘depression’ or
‘anxiety’. This can make them seem easier to
understand, but can also mean people
underestimate how serious they can be.

• A mental health problem feels just as bad, or
worse, than any other illness – only you
cannot see it. Although mental health
problems are very common – affecting around
one in four people
• there is still stigma and discrimination towards
people with mental health problems, as well
as many myths about what different
diagnoses mean.

causes mental health problems
• childhood abuse, trauma, violence or neglect
• social isolation, loneliness or discrimination
• the death of someone close to you
• stress
• homelessness or poor housing
• social disadvantage, poverty or debt
• unemployment
• caring for a family member or friend
• a long-term physical health condition

• significant trauma as an adult, such as military
combat, being involved in a serious accident
or being the victim of a violent crime
• physical causes – for example, a head injury
or a condition such as epilepsy can have an
impact on behavior and mood
• genetic factors – there are genes that cause
physical illnesses, so there may be genes that
play a role in the development of mental
health problems.

Social, environmental and economic
determinants of mental health
Risks factors
 Access to drugs and alcohol
 Displacement
 Lack of education, transport, housing
 Neighbourhood disorganisation
 Peer rejection
 Poor social circumstances
 Poor nutrition
 Poverty
 Racial injustice and discrimination
 Social disadvantage
 Urbanisation
 Violence and delinquency
 War
 Work stress
 Unemployment
Protective factors
• Empowerment
• Ethnic minorities integration
• Positive interpersonal
interactions
• Social participation
• Social responsibility and
tolerance
• Social services
• Social support and
community networks

Risk and protective factors for mental
disorders
Risk factors
 Academic failure and scholastic
demoralization
 Attention deficits
 Caring for chronically ill or dementia
patients
 Child abuse and neglect
 Chronic insomnia
 Chronic pain
 Early pregnancies
 Elder abuse
 Emotional immaturity and control
 Excessive substance use
 Exposure to aggression, violence and
trauma
 Family conflict or family disorganization
 Low birth weight
Protective factors
 Ability to cope with stress
 Ability to face adversity
 Adaptability
 Autonomy
 Early cognitive stimulation
 Exercise
 Feelings of security
 Feelings of mastery and control
 Good parenting
 Literacy
 Positive attachment and early
bonding
 Positive parent–child interaction

Risk and protective factors for mental
disorders
Risk Factors
 Medical illness
 Neuro chemical imbalance
 Parental mental illness
 Parental substance abuse
 Perinatal complications
 Personal loss – bereavement
 Poor work skills and habits
 Reading disabilities
 Sensory disabilities or organic
handicaps
 Social incompetence
 Stressful life events
 Substance use during pregnancy
Protective Factors
 Problem-solving skills
 Pro-social behaviour
 Self-esteem
 Skills for life
 Social and conflict
management skills
 Socio emotional growth
 Stress management
 Social support of family and
friends

Prevailing misconception about
occurrence and treatment of mental
illness

Major Misconception about mental
health illness
• This disease is not curable
• Mentally ill people are always dangerous
• Mental health illness due to ancient and angry
of god
• It is always genetic
• Happen with bad person
• Do not cooperate with mentally ill person

• stigmatizing attitudes of mentally ill person
• Discriminatory Behaviors

Other Misconception about
Occurrence of Mental Illness
21

MISCONCEPTIONS
• Myth 1: ‘A person who has had a mental
illness can never be normal.’
• Fact: People with mental illnesses can, and do,
recover to resume normal activities. For
example, Jane Pauly, who has bipolar disorder,
has received treatment and hosted her own
television show in addition to leading an
enriched and accomplished life.
22

• Myth 2: "Young people and children don't
suffer from mental health problems.“
• Fact: It is estimated that more than six million
young people in America may suffer from a
mental health disorder that severely disrupts
their ability to function at home, in school, or
in their community.
MISCONCEPTIONS contd…
23

• Myth 3: "Mentally Ill persons are dangerous
violent and unpredictable.“
• Fact: The vast majority of people with a mental
illness are not violent. In cases when violence does
occur, the incident typically results from the same
reasons as with the general public, such as feeling
threatened or excessive use of alcohol and/or
drugs. In fact, people with severe mental illnesses
are over 10 times more likely to be victims of
violent crime than the general population.
24

• Myth 4: "People who need psychiatric care
should be locked away in institutions.“
• Fact: Today, most people can lead productive
lives within their communities thanks to a
variety of support programs, and/or
medications.
25

• Myth 5: It is impossible to prevent mental
illnesses.
• Fact: Prevention of mental, emotional, and
behavioral disorders focuses on addressing
known risk factors such as exposure to trauma
that can affect the chances that children, youth,
and young adults will develop mental health
problems.
26

• Myth 6: Electroconvulsive therapy (ECT) is
painful.
• Fact: ECT is one of the most effective
treatments for people whose depression is so
severe that antidepressant medication just
don't do the job and who are debilitated by the
depression.
27

• Myth 7: People with a mental illness lack
intelligence.
• Fact: "This is completely false," says Kutcher.
"Intelligence has nothing to do with mental illnesses or
brain disorders."
• On one hand, many people with mental disorders are
brilliant, creative, productive people. Certain mental
illnesses may make it difficult for people to remember
facts or get along with other people, making it seem
like they are cognitively challenged.
28

• Myth 8: People with a mental illness shouldn't
work because they'll just drag down the rest of
the staff.
• Fact: People with mental illness can and do
function well in the workplace.
• They are unlikely to miss any more workdays
because of their condition than people with a
chronic physical condition such as diabetes or
heart disease.
29

• Myth 9: Mental illness is a single, rare
disorder.
• Fact: Anxiety disorders, mood disorders,
personality disorders, addiction disorders,
impulse control disorders, sexual and gender
disorders etc. are some types of mental illness,
each with its own features and underlying
causes.
30

• Myth 10: Psychiatric disorders are not true
illnesses like heart disease or cancer; people
who have a mental illness are just "crazy.“
• Fact: Unlike a broken leg or heart attack, which
are easily detected by simple tests, mental illness
has traditionally been an invisible disease. This
inability to see what's wrong may add to the
public perception, and even fear, of mental illness.
But, like heart disease, mental illnesses are bona-
fide (real) medical conditions.
31

• Myth 11: Therapy and self-help are a waste
of time.
• Fact: Treatment for mental health problems
varies depending on the individual and could
include medication, therapy, or both. Many
individuals work with a support system during
the healing and recovery process.
32

• Myth 12: People with mental illness, cannot
tolerate the stress of holding down a job.
• Fact: People with mental health problems are
just as productive as other employees.
Employers who hire people with mental health
problems report good attendance and
punctuality as well as motivation, good work,
and job tenure on par with or greater than other
employees.
33

• Myth 13: Myth: I can't do anything for a
person with a mental health problem.
• Fact: Friends and loved ones can make a big
difference. Only 38% of adults with diagnosable
mental health problems and less than 20% of
children and adolescents receive needed
treatment. Friends and family can be important
influences to help someone get the treatment and
services they need.
34

• Myth 14: Addiction is a lifestyle choice and
shows a lack of willpower.
• The problem is not that simple; addictions
involve complex factors including genetics
(alcoholism, for example, often runs in
families), the environment, and sometimes
other underlying psychiatric conditions such as
depression.
35

Introduction to Personality
• The word personality has been derived from
the Latin word “Persona” that is used for the
cover, utilized by the actors to change their
appearance, but in the Roman time it was
taken as the particular character itself.
• It is the way of responding to the
environment.
2/16/2020 37

• Personality is the sum of all traits that
differentiate one individual from another.
• The individual’s unique and distinctive way
of perceiving, behaving, and interacting
with the environment and other people.
• Emergence of personality occurs around 2
years of age.
Introduction to Personality
Contd…
2/16/2020 38

Definition
• According to Munn, personality may be
defined as the most characteristic
integration of an individual’s structures,
modes of behaviour, interests, attitudes
and capacities, abilities and attitudes’.
• Personality may be defined in the totality
of a person’s unique bio-psychosocial
and spiritual traits then consistent
influence behaviour.
2/16/2020 39

Contd…
• Many factors influence personality;
some stem from biologic and genetic
makeup, while some are acquired as a
person develops and interacts with the
environments and other person.
2/16/2020 40

Personality Development
• Behavioural Perspectives- Ivan
Pavlov
• Psychodynamic Perspectives-
Sigmund Freud
• Cognitive Perspective
• Moral
2/16/2020 41

Behavioural
Perspectives
2/16/2020 42

Classical Conditioning Theory of
Ivan Pavlov
• Ivan Petrovich Pavlov
• Born Sept 14, 1849
• Died Feb 27, 1936
• born in Ryazan, Russia
• physiologist, psychologist, and physician
• awarded the Nobel Prize in Physiology or
Medicine in 1904 for research on the
digestive system
2/16/2020 43

Theory of Ivan Pavlov
• Ivan Pavlov spent most of his
time studying physiology. As part
of his work, he began to study
what triggers dogs to salivate.
2/16/2020 44

Pavlov’s conditioning theory
2/16/2020 45

Psychodynamic Theory of
Sigmund Freud
2/16/2020 46

Psychodynamic Theory of
Sigmund Freud
• Psychoanalytic theory was
developed by Sigmund Freud
(1856-1939).
• Psychoanalytic theory
revolutionized the understanding
of mental life and human behavior.
2/16/2020 47

• He developed several methods
for exploring the unconscious,
including free association and
analysis of dreams.
• Freud assumed that people are
born with basic instincts or needs
including sex and aggression.
Psychodynamic Theory of Sigmund Freud
Contd…
2/16/2020 48

Psychodynamic theory of Sigmund
Freud has been divided into 3 Parts
1. Structure of Personality
2. Topography of Mind
3. Stages of Personality
Development
2/16/2020 49

Structure of Personality
• According Freud, personality is made up of
three structures-
– Id,
– Ego and
– Super Ego
2/16/2020 50

The id:
– First to develop
– Completely unconscious
– Contains all drives: instincts,
desires, and impulses.
– Seeks immediate satisfaction and
operates on the pleasure principle
– No awareness of reality
Structure of Personality contd…
2/16/2020 51

The ego: Second structure to develop
– Operates on reality principle: making
compromises between the unreasoning
demands of the id and the practical
constraints of the real world.
– Mediates conflict among Id and
superego
– Monitors quality of interpersonal
relations
– Provides synthesis and coordination
– Defends against anxiety
Structure of Personality
contd…
2/16/2020 52

The superego:
• This final structure develops during
childhood as children interject or
internalize parental and societal values;
this is our conscience.
• Most functions are unconscious
• The superego contains all the "should"
and "should not" that we are taught
growing up and operates on the morality
principle.
• This means that only the things that are
right are allowed and violating the rules
results in guilt.
2/16/2020 53

• These three structures are in
constant conflict:-
– the id making demands,
– the superego denying the id
satisfaction, and
– the ego trying to work out how to
satisfy the id and the superego.
2/16/2020 54

Topography of Mind
• According
to Sigmund Freud,
there are three
levels of
consciousness:
– Conscious (small)
– Preconscious
(small-medium):
– Unconscious
2/16/2020 56

Conscious (small):
• This is the part of the mind that
holds what we're aware of.
• We can verbalize about our
conscious experience and we can
think about it in a logical fashion.
Topography of Mind Contd…
2/16/2020 57

Preconscious (small-medium):
• This is ordinary memory.
• So although things stored here
aren't in the conscious, they can
be readily brought into
conscious.
2/16/2020 58

Unconscious (enormous):
• This part of the mind was not directly
accessible to awareness.
• Freud saw it as a dump box for urges,
feelings and ideas that are tied to
anxiety, conflict and pain.
• These feelings and thoughts have not
disappeared and they are there,
exerting influence on our actions and
our conscious awareness.
2/16/2020 59

Unconscious
Contd…
• This is where
most of the
work of the Id,
Ego, and
Superego take
place.
2/16/2020 60

• Material passes easily back and
forth between the conscious and
the preconscious.
• Material from these two areas can
slip into the unconscious.
• Truly unconscious material can't be
made available voluntarily.
Unconscious Contd…
2/16/2020 61

Cognitive development
• Cognitive psychology is the study of mental
processes such as "attention, language use, memory,
perception, problem solving, creativity, and thinking.
• Cognitive development is a field of study in
neuroscience and psychology focusing on a child's
development in terms of information processing,
conceptual resources, perceptual skill, language
learning, and other aspects of brain development
and cognitive psychology compared to an adult's
point of view.

• Moral development
– Moral development focuses on the emergence,
change, and understanding of morality from
infancy through adulthood.
– In the field of moral development, morality is
defined as principles for how individuals ought to
treat one another, with respect to justice.

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