MENTAL HEALTH
Dr Anshuli Trivedi IIIrd Year resident Dept of Community Medicine NSCB Medical College Jabalpur
[email protected]
Definition`
The WHO expert committee defines mental health as µit
is a state of wellbeing in which an individual realizes his or her own abilities, can work productively & fruitfully& is able to make a contribution to his or her community.´
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Text book of PSM-Sunderlal
Mentally Healthy personIt is not merely absence of Mental illness. Mentally healthy person has three main characteristics He He He
feels comfortable about himself. is able to communicate with persons. is able to meet the demands of life .
Text book of PSM-K.Park-20th edition
Global Burden of Mental Illness
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450 million persons suffering from Mental disorders Depressive disorders 4th leading cause of Global disease burden. Depression-121million(2001) Schizophrenia-24 million Alzeihmers-37 million Epilepsy-50 million Substance abuse-Tobbaco-1.2 billion Alcohol-70 million Drug abuse-5 million Mental retardation-5.3%
Text book of PSM-Sunderlal
Burden in India
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30-45 Million persons are affected. Severe mental disorders- 37.5% (2000) Mental retardation-5.3% (2000) Epilepsy-4.4%(1998) Neuroses-16.5% (2000) Alcohol/drug addiction -6.9% (2000)
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Mental disorders in India
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Prevalence rates are high in urban areas except epilepsy & hysteria. More common in females Age-35-44 years More common in Low-socio economic classes Social stigma prevalent
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Existing mental Health Services Only 10% of mentally ill patients has access to appropriate t/t.
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50% Medical colleges have Psychiatry ward. 1bed:30,000 population.
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International Classification of Mental & behavioral disorders Organic- dementia Mental &
in Alzheimer's disease, delirium.
behavioral disorders due to alcohol & substance
abuse.
Cognitive disorder-Schizophrenia Mood
& delusional disorders
(Affective)-Mania & psychosis. related & somatoform disorders-OCD,
Neurotic stress
Generalized anxiety disorder.
International Classification of Mental & behavioral disorders Behavioral disorders-Eating disorder, sleep Personality disorders-Paranoid personality, `
disorder. sexual disorder.
Mental retardation & developmental disorders-Ex-autism. atherosclerosis,
Organic conditions-Organic basis-cerebral
neoplasm, neurological disorders, metabolic & endocrine diseases.
Heredity-Ex-
Schizophrenia.
Common Mental Disorders
Causes of Mental Ill Health
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Organic Conditions-CVA, Neoplasms,metabolic disorders Neuro-endocrinogical disorders-thyrotoxicosis Chronic conditionsTB,Leprosy,epilepsy Heredity-Schizophrenia Social Pathological conditions-worries, anxiety,emotional stress, tension, frustration, unhappy marriages, broken homes, poverty.
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Text book of PSM-K.Park-20th edition
Environmental factors-Toxic substances-poisonous gas
exposure, Hg, Pb exposure. Psychotropic drugs-Alcohol, barbiturates. Nutritional factors-Deficiency of VitB1,Pyridoxine. Mineral deficiency-Ex-Iodine. Other factors.
Text book of PSM-K.Park-20th edition
Preventive aspect Primary
prevention-To reduce the incidence of new cases of Mental disorders. To promote emotional robustness specially among vulnerable high risk groups. Ex-Universal Iodization of Common Salt. Industrial safety to prevent Pb & Hg exposure. Prevention of nutritional disorders like pellegra,beriberi
Text book of PSM-K.Park-20th edition Text book of Community Medicine with recent advances-AH Suryakantha
Early
diagnosis T t/t of genetic disorders-Phenyl ketonuria, hypo thyrodism, hydrocepahlus.
Prevention, Early
diagnosis & M/M-PIH,Syphilis,DM & TORCH illness during pregnancy.
General measure-TLC Personality development Youth
measures
welfare activities Social welfare
Text book of Community Medicine with recent advances-AH Suryakantha
Secondary-Early
diagnosis & T/T of mental illness & social & emotional disturbances through screening programmes. Provision of Family based health facilities. Specific drug therapy. ECT General Measures- Yoga, meditation, relaxation therapy, social support.
Text book of PSM-K.Park-20th edition Text book of Community Medicine with recent advances-AH Suryakantha
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Tertiary prevention-Seeks to reduce duration of mental illness, minimize disability & rehabilitate the patient thus reduces the stresses they create for family & community. Measures²Day care programme Halfway homes Self help groups Family service programme Industrial therapy centers Vocational training centers Rehabilitation in Family
Text book of PSM-K.Park-20th edition Text book of Community Medicine with recent advances-AH Suryakantha
Mental Health services Early
diagnosis & t/t. Rehabilitation Group & individual psychotherapy Mental education Use of modern psychoactive drugs After care services.
Text book of PSM-K.Park-20th edition
` NMHP=National
Mental Health
Programme-1982
Objectives1.To ensure availability and accessibility of minimum mental health care for all in the near foreseeable future, particularly to the most vulnerable sections of the population. 2. To encourage mental health knowledge and skills in general health care and social development. 3. To promote community participation in mental health service development and to develop self-help at the Community level.
Text book of PSM-Sunderlal
AIMS
Integration of Mental health with general health. Prevention & t/t of mental & neurological disorders & their associated disabilities. Use of research findings in field of mental health to improvise general health. Application of mental health principals in total national development to improve quality of life.
Text book of PSM-Sunderlal
Components of NMHP
Prevention Rehabilitation Training
Treatment
NMHP
Research
Treatment Primary
health care approach as ³sheet anchor´ . appropriate referral system at various levels. supervision of health workers at PHC¶s.
Creation of
Training &
Linking
of mental hospital, colleges, teaching institutionfor education & research.
Text book of PSM-Sunderlal
Rehabilitation Community
based rehabilitation of psychiatric patients.
Counseling
regarding principals of rehabilitation would be provided by MO at PHC & by health workers & volunteers at village levels. at district level.
Establishing rehabilitation centre
Text book of PSM-Sunderlal
Prevention Prevent
alcohol related problems also-cover addictions, juvenile delinquency ,acute adjustment problem. health training-To train medical officers, supervisor, health workers & MBBS students on the basic skills in psychiatry to provide minimum health services. applied research to improvise Mental health services.
Text book of PSM-Sunderlal
Training
Mental
Research
Operational &
ReferencesText book of PSM-K.Park-20th edition ` Text book of PSM-Sunderlal ` Text book of Psychiatry-Neeraj Ahuja Text book of Community Medicine with recent advances-AH Suryakantha
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`Thanks