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INSET_Discussant_Mental Health Awareness Program.ppt
- 4. ‘Health is astate of complete physical, mental and social well-being and not merely the absence of disease’ (WHO, 2008 – Mental Health) Wellbeing: Reflects values, norms human needs etc. as perceived by people themselves (Diener and Suh, 2000; Prlleltensky et al. 2000; Myers et al. 2005).
- 5. Understandings of‘mental health’ and ‘mental illness’ Understandings of ‘mental health’ and ‘mental illness’ determined by meanings given to experiences and determined by meanings given to experiences and feelings in a context of people’s culture feelings in a context of people’s culture (Marsella and White, (Marsella and White, 1982; Kakar, 1984; Kleinman, 1988a,b; Gaines, 1992; Fernando, 2002). 1982; Kakar, 1984; Kleinman, 1988a,b; Gaines, 1992; Fernando, 2002). Mental health is not just a Mental health is not just a technical technical matter but matter but connects with ways of life, values, and worldviews that connects with ways of life, values, and worldviews that vary across cultures. vary across cultures. Understanding of ‘wellbeing’ (in development studies) Understanding of ‘wellbeing’ (in development studies) reflects range of human experience - social, mental, reflects range of human experience - social, mental, spiritual, material. spiritual, material. (Chambers 1997). (Chambers 1997).
- 6. Community perceptions ofmental Community perceptions of mental health and wellbeing health and wellbeing Material wellbeing Material wellbeing Social wellbeing Social wellbeing Security Security Physical, mental and moral/spiritual Physical, mental and moral/spiritual wellbeing wellbeing
- 7. Material wellbeing Material wellbeing having stable having stable employment/livelihoods employment/livelihoods having stable cash incomes having stable cash incomes access to adequate land access to adequate land having permanent, secure and having permanent, secure and spacious house spacious house
- 8. Social wellbeing Social wellbeing providing good education and socialization for providing good education and socialization for children children caring for children caring for children unity and harmony within family unity and harmony within family unity and harmony within community unity and harmony within community unity and harmony with neighbouring unity and harmony with neighbouring communities/host communities communities/host communities
- 9. Social wellbeing Social wellbeing access to services access to services self-respect and dignity self-respect and dignity clean and free environment clean and free environment free of alcohol and drug abuse free of alcohol and drug abuse
- 10. Security Security a secureenvironment for their living a secure environment for their living without fear and outside threats without fear and outside threats a secure physical environment and a secure physical environment and protection from natural disasters and protection from natural disasters and conflicts conflicts free movement and living without being free movement and living without being subject to suspicion subject to suspicion
- 11. Security Security a a peaceful peacefulatmosphere free of regular atmosphere free of regular checks and intimidation from security checks and intimidation from security forces. forces. secure and strong houses to prevent secure and strong houses to prevent intruders intruders houses that ensure privacy and personal houses that ensure privacy and personal safety safety community members coming together to community members coming together to intervene and resolve problems and issues intervene and resolve problems and issues
- 12. Physical, mental andmoral and Physical, mental and moral and spiritual wellbeing spiritual wellbeing living without illness and suffering living without illness and suffering having mental happiness having mental happiness having good thoughts/feelings towards others having good thoughts/feelings towards others living with courage/endeavour, self-initiative and drive living with courage/endeavour, self-initiative and drive living with wisdom (not acting on emotions/rational living with wisdom (not acting on emotions/rational behaviour) behaviour) moral behaviour of community members moral behaviour of community members careful spending careful spending living religiously living religiously
- 13. What reduces community Whatreduces community mental health and wellbeing? mental health and wellbeing? political violence and natural political violence and natural disasters disasters displacement displacement poverty poverty poor housing conditions poor housing conditions conflicts within family and conflicts within family and community community social exclusion and isolation social exclusion and isolation
- 14. What reduces community Whatreduces community mental health and wellbeing? mental health and wellbeing? injustice and discrimination injustice and discrimination urbanization urbanization communicable diseases communicable diseases work stress work stress alcoholism, drug abuse and sexual alcoholism, drug abuse and sexual abuse abuse
- 15. Psychosocial context of Psychosocialcontext of mental health and wellbeing mental health and wellbeing (source: Prof. A.J.Marsella) (source: Prof. A.J.Marsella) Factors affecting mental Factors affecting mental health & wellbeing health & wellbeing Implications for mental Implications for mental health & wellbeing health & wellbeing Cultural abuse, destruction and Cultural abuse, destruction and collapse collapse Confusion and conflict Confusion and conflict Oppression and domination Oppression and domination Anger, hate & domination Anger, hate & domination Humiliation Humiliation Rage and revenge Rage and revenge Powerlessness Powerlessness Helplessness and despair Helplessness and despair Poverty Poverty Hopelessness and misery Hopelessness and misery Denigration Denigration Low esteem and worthlessness Low esteem and worthlessness Racism, sexism and agesim Racism, sexism and agesim Fragmentation and restrain Fragmentation and restrain opportunity and denies choice opportunity and denies choice
- 16. Stigma Stigma People with mentalhealth problems (studies in UK) People with mental health problems (studies in UK) 84 % experience problems in getting jobs, healthcare, mortgages 84 % experience problems in getting jobs, healthcare, mortgages (Mind survey, 2004) (Mind survey, 2004) 55 % young people would not want anyone else to know about 55 % young people would not want anyone else to know about illness illness (NUS and Rethink, 2001) (NUS and Rethink, 2001) 49% have been harassed or attacked 49% have been harassed or attacked (Mind, (Mind, Not Just Sticks and Stones, Not Just Sticks and Stones, 1986) 1986) 33% report having been dismissed or forced to resign from jobs 33% report having been dismissed or forced to resign from jobs (Read and Baker, 1996) (Read and Baker, 1996) Source: Dr Suman Fernando Source: Dr Suman Fernando
- 17. Stigma – research Stigma– research Stigma absent when mental illness is attributed to Stigma absent when mental illness is attributed to ‘spirit possession’ (in Sri Lanka) ‘spirit possession’ (in Sri Lanka) (Waxler, 1974) (Waxler, 1974) ‘ ‘brain-disease’ view of mental health problems brain-disease’ view of mental health problems increases stigma (in Germany) increases stigma (in Germany) (Angermeyer and Matschinger, 2005) (Angermeyer and Matschinger, 2005) ‘ ‘bio-genetic cause’ view of mental health problems bio-genetic cause’ view of mental health problems positively related to stigma positively related to stigma Source: Dr Suman Fernando Source: Dr Suman Fernando
- 18. Social costs andstigma Social costs and stigma Social costs of illness are high in terms of family breakdown, isolation, Social costs of illness are high in terms of family breakdown, isolation, disharmony, poverty and deprivation disharmony, poverty and deprivation Social stigma prevented many patients and their families seeking treatment Social stigma prevented many patients and their families seeking treatment from ‘Angoda hospital’ from ‘Angoda hospital’ Many patients preferred to go to general hospitals (psychiatry units) or Many patients preferred to go to general hospitals (psychiatry units) or private hospitals/doctors to avoid getting them labeled private hospitals/doctors to avoid getting them labeled Forceful admissions result in anger and hostile relationships between patient Forceful admissions result in anger and hostile relationships between patient and families and families Source: Dr Rasitha Perera Source: Dr Rasitha Perera
- 19. Care givers werereluctant to take the patient Care givers were reluctant to take the patient home and desired a long stay when home and desired a long stay when patients:- patients:- were aggressive at home were aggressive at home do not take treatment as prescribed do not take treatment as prescribed mess up family/home affairs mess up family/home affairs do not have a care giver at home do not have a care giver at home Dr Rasitha Perera Dr Rasitha Perera Family response to persons with mental illness
- 20. Care givers werereluctant to take the Care givers were reluctant to take the patient home and desired a long stay when patient home and desired a long stay when patients:- patients:- are dependent on others / lack of productivity are dependent on others / lack of productivity misuse psychoactive substance misuse psychoactive substance show hostility show hostility maintain poor self care maintain poor self care Source: Dr Rasitha Perera Source: Dr Rasitha Perera Family response to persons with mental illness
- 21. Illness wasthe major cause for many patients to remain single, separated Illness was the major cause for many patients to remain single, separated or divorced or divorced 50% of the patients experienced disharmony with their families 50% of the patients experienced disharmony with their families 1/3 1/3rd rd of the patients were considered a burden to the family of the patients were considered a burden to the family Only 1/4 Only 1/4th th of the patients received better family care of the patients received better family care 1/3 1/3rd rd of the care givers were not satisfied with the current status of the of the care givers were not satisfied with the current status of the patient patient Source: Dr Rasitha Perera Source: Dr Rasitha Perera Family response to persons with mental illness
- 22. Promoting mental health Promotingmental health and wellbeing and wellbeing Interventions Interventions Social Social Medical (treatments) Medical (treatments) Strengthening resilience and support Strengthening resilience and support Individual Individual Family Family Community Community Promoting recovery ( Promoting recovery (‘ ‘recovery approach recovery approach’ ’) ) Developing hope Developing hope Overcoming barriers Overcoming barriers Social inclusion Social inclusion Source: Dr Suman Fernando Source: Dr Suman Fernando
- 23. Mental Health Mental Health Interventions Interventions Medicalmodel: Medical model: Problems identified by symptoms of Problems identified by symptoms of individuals individuals ‘ ‘Illness Illness’ ’ represents bio-medical pathology represents bio-medical pathology Source: Dr Suman Fernando Source: Dr Suman Fernando
- 24. Mental Health Mental Health Interventions Interventions Medicalmodel: Medical model: Help is via individual treatments Help is via individual treatments - - Biological (medication, ECT) Biological (medication, ECT) - Psychological (e.g. - Psychological (e.g. ‘ ‘talking therapies talking therapies’ ’, CBT , CBT ) ) Environmental manipulation e.g. Environmental manipulation e.g. therapeutic communities, advice, therapeutic communities, advice, education, family support education, family support Source: Dr Suman Fernando Source: Dr Suman Fernando
- 25. Mental Health Mental Health Interventions Interventions Socialmodel Social model: : Origin / cause of MH problems are Origin / cause of MH problems are social social ‘ ‘Illness’ is socially constructed Illness’ is socially constructed Help is via social interventions and Help is via social interventions and support involving family, community, support involving family, community, living conditions etc. living conditions etc. Source: Dr Suman Fernando Source: Dr Suman Fernando
- 26. Mental health promotion Mentalhealth promotion develop ‘balanced care’ = hospital care + develop ‘balanced care’ = hospital care + community care (mixture of medical and community care (mixture of medical and social models) social models) Work as multi-disciplinary teams Work as multi-disciplinary teams support traditional healing systems support traditional healing systems promote family and community support promote family and community support integrate with community development integrate with community development social inclusion and participation social inclusion and participation reduce risk factors reduce risk factors
- 27. Factors affecting mental Factorsaffecting mental health and wellbeing of health and wellbeing of children children Lack of access to education and facilities Lack of access to education and facilities Child neglect, ill-treatment and poor care Child neglect, ill-treatment and poor care Malnutrition Malnutrition Traumatic experiences – loss of family members, Traumatic experiences – loss of family members, displacement, detention, physical injuries displacement, detention, physical injuries Substance abuse Substance abuse Sexual abuse and child prostitution Sexual abuse and child prostitution Child trafficking and labour Child trafficking and labour Domestic violence Domestic violence
- 28. Factors affecting mental Factorsaffecting mental health and wellbeing of health and wellbeing of children children Family break downs e.g. divorce, Family break downs e.g. divorce, separation, desertion separation, desertion Recruitment as child soldiers / Child Labor Recruitment as child soldiers / Child Labor Parents working abroad Parents working abroad Competition and pressures for Competition and pressures for ‘achievement’ ‘achievement’ Disabilities Disabilities
- 29. Mental health problems Mentalhealth problems of children (1) of children (1) May present as: May present as: emotional problems emotional problems such as phobias, excessive such as phobias, excessive anxiety, depression, irrational fears anxiety, depression, irrational fears Unusual behaviour / conduct Unusual behaviour / conduct such as such as aggressiveness, timidity aggressiveness, timidity Inattention / overactivity Inattention / overactivity at school or home at school or home
- 30. Mental health problems Mentalhealth problems of children (2) of children (2) May present as: May present as: Difficulties / delay in Difficulties / delay in acquiring certain skills such as acquiring certain skills such as speech, writing, reading speech, writing, reading Problems in attachment Problems in attachment to parents or caregivers to parents or caregivers such as not showing or responding to affection such as not showing or responding to affection (when severe may be autism) (when severe may be autism) Food fads / eating problems Food fads / eating problems such a refusing to eat, such a refusing to eat, induced vomiting (may be anorexia) induced vomiting (may be anorexia)
- 31. Mental health problems Mentalhealth problems of children (3) of children (3) sleeping problems sleeping problems such as excessive such as excessive sleepiness, sleepiness, insomnia (may be sign insomnia (may be sign of more severe illness) of more severe illness) Post traumatic problems Post traumatic problems such as re- such as re- living traumatic living traumatic incidents (may incidents (may become ‘post traumatic stress become ‘post traumatic stress disorder’ – PTSD) disorder’ – PTSD)
- 32. Dealing with Mentalhealth Dealing with Mental health problems of children problems of children Try to pick up: Try to pick up: Special needs that child may have such as Special needs that child may have such as early learning difficulties, dyslexia early learning difficulties, dyslexia (recognition of words and writing letters), (recognition of words and writing letters), hearing loss (early deafness), visual hearing loss (early deafness), visual impairment impairment Problems in the child’s interactions with Problems in the child’s interactions with other children, teachers and others in other children, teachers and others in authority authority
- 33. Dealing with Mentalhealth Dealing with Mental health problems of children problems of children Family problems at home Family problems at home Difficulties in socialization (not Difficulties in socialization (not mixing, isolating) mixing, isolating)
- 34. How can theteachers How can the teachers help? help? Paying more attention to children Paying more attention to children with special needs or ‘problems’ (20- with special needs or ‘problems’ (20- 30 percent of children) 30 percent of children) Providing a safe context for children Providing a safe context for children to talk to talk Listening and talking to children Listening and talking to children
- 35. How can theteachers help? How can the teachers help? (2) (2) Making referrals to relevant specialists Making referrals to relevant specialists (e.g. children with severe emotional (e.g. children with severe emotional disturbance, post traumatic states, disturbance, post traumatic states, eating disorders, deafness, autism, eating disorders, deafness, autism, family issues) family issues) Enabling children to develop appropriate Enabling children to develop appropriate life-skills, self-esteem and resilience life-skills, self-esteem and resilience
- 36. Prevention of mental Preventionof mental health problems (1) health problems (1) Acquiring professional skills in Acquiring professional skills in understanding child development and understanding child development and mental health mental health Creating a supportive school Creating a supportive school environment that is conducive to environment that is conducive to learning and developing life skills learning and developing life skills Providing mental health education, Providing mental health education, knowledge, attitudes and behaviours knowledge, attitudes and behaviours to all children to all children
- 37. Prevention of mental Preventionof mental health problems (2) health problems (2) Educating parents and community Educating parents and community members on risk and protective members on risk and protective factors of mental health factors of mental health Identifying factors that place Identifying factors that place children at risk and reinforcing children at risk and reinforcing protective factors protective factors
- 38. Challenges for Teachers Challengesfor Teachers How can we provide a safe and How can we provide a safe and supportive environment in which all supportive environment in which all students can maximize their learning? students can maximize their learning? How can we remain accessible and How can we remain accessible and responsive to their needs? responsive to their needs? How can we assist our students to How can we assist our students to develop their ability to cope with develop their ability to cope with challenges and stress? challenges and stress?
- 39. Providing supportive Providing supportive contextfor children context for children Liaising with families, parents and care- Liaising with families, parents and care- givers e.g. home visits givers e.g. home visits Fostering partnerships between school Fostering partnerships between school and community agencies, service and community agencies, service providers etc. providers etc. Strengthening community support Strengthening community support networks networks
- 40. Factors that enhance Factorsthat enhance resilience among children resilience among children Positive role models Positive role models Positive self-esteem Positive self-esteem Supportive relationships with Supportive relationships with teachers and friends teachers and friends A sense of hope and purpose A sense of hope and purpose Belief in one’s self Belief in one’s self Strong social skills Strong social skills Good peer relationships Good peer relationships
- 41. What are Life-Skills? Whatare Life-Skills? Skills that enable people to: Skills that enable people to: Live in harmony with parents, teachers and others in authority Live in harmony with parents, teachers and others in authority Live in harmony with peers from various communities and social Live in harmony with peers from various communities and social classes classes Make socially & culturally appropriate relationships Make socially & culturally appropriate relationships Make decisions that are in keeping with social and cultural norms Make decisions that are in keeping with social and cultural norms (ethical values, expectations of kith and kin, worldviews, etc.) (ethical values, expectations of kith and kin, worldviews, etc.) Maintain a sense of self-worth as well as respect for others Maintain a sense of self-worth as well as respect for others Deal with adversity in socially acceptable and culturally appropriate Deal with adversity in socially acceptable and culturally appropriate ways ways
- 42. Western and Non-Western Westernand Non-Western Understandings of Life Skills Understandings of Life Skills Western Western Non-western Non-western Decision-making and problem solving Decision-making and problem solving analyzing information and analyzing information and experiences objectively and experiences objectively and making decisions based on facts making decisions based on facts adherence to cultural norms and adherence to cultural norms and seeking guidance from elders seeking guidance from elders and spiritual influences and spiritual influences Communication Communication ability to express views and ability to express views and opinions directly opinions directly indirect expression of views, indirect expression of views, respecting views of other people, respecting views of other people, and dependence on family and dependence on family Independence Independence Depend on oneself primarily and Depend on oneself primarily and maximize self-confidence maximize self-confidence respecting opinions of others respecting opinions of others and more accepting of and more accepting of dependence on others dependence on others
- 43. Western and Non-Western Westernand Non-Western Understandings of Life Skills Understandings of Life Skills Western Western Non-western Non-western Coping with emotions Coping with emotions Recognizing emotions, Recognizing emotions, controlling emotions and controlling emotions and expressing emotions in expressing emotions in acceptable ways acceptable ways wide cultural variation in wide cultural variation in expression of emotions and expression of emotions and need to control emotions need to control emotions Coping with stress Coping with stress Understanding causes of Understanding causes of stress and controlling stress stress and controlling stress cultures vary a great deal in cultures vary a great deal in ways of dealing with stress ways of dealing with stress – – some prefer acceptance of some prefer acceptance of control control
- 44. Workshop and Teachers Workshopand Teachers Output Output
- 45. LESSON PLAN LESSON PLAN Includethe following in your content Include the following in your content areas: areas: 1. 1.Psychosocial Activities for our students Psychosocial Activities for our students 2. 2.Health related concerns to address the Health related concerns to address the needs of our students. needs of our students.