Mental Health and Illness

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Mental Health and Illness

• An Epidemiological Perspective

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Mental Health-Everybodys Business

• Peter Sims
• Professor of Public Health medicine
• University of Papua New Guinea
• ltpetersims_at_upng.ac.pggt

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Teaching and Learning Aims

• There is ignorance, superstition, stigma and fear
  around Mental Illness
• Aetiology, pathogenesis diagnosis and treatment
  are imperfect.
• There is a different paradigm and a less rigorous
  epidemiology

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Often sad,sometimes mad,occasionally bad

• The medical model is
• insufficient
• Diagnosis is largely
• clinical and experiential

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More of an art than a science

• Treatment is pragmatic
• Prevention is about the politics of health
• populations,people pressures, poverty

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Mental Health is a worldwide problem
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Mental illness is common 6 in 10 women and 4 in
10 men in Western Europe and North America will
have a significant mental illness during their
lifetime Mental illness can affect any one of
us Mental illness occurs in all societies and
cultures
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We are all vulnerable
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A Holistic Approach
BODY
Arrow of Time
CULTURE
MIND
SPIRIT
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Intelligence
IQ 100
IQ
I.Q. the Mental Age x 100
the Chronological age
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Personality

• Each human being is unique
• We all have different personalities
• My personality reflects genetic inheritance and
  Environment

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Behaviour
The Parent
SUPER-EGO
EGO
The Adult
The Child
ID
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The Subconscious Mind
The Conscious
The Subconscious
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A Classification

• Affective Disorders
• Anxiety,depression,mania,obsessional disorders
• Schizophrenia
• Simple,Hebephrenic,Catatonic,paranoid
• Organic states
• Delirium,dementia
• Personality Disorder
• Abnormal personality,Psychopathy

Substance abuse problems Drugs, alcohol Learning
disorders Subnormality
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The Classification of Mental
IllnessThe NeurosesDepression, Anxiety,
Mania, Obsessions and compulsions(usually the
patient retains insight and orientation they
experience deep distress and may commit
suicide)The PsychosesSchizophrenia, puerperal
psychosis(the patient is disorientated, deluded,
and lacking in insight)The DementiasProgressiv
e deterioration with loss of recent memory and
deterioration of a normal personality,They may
be primary or more commonly secondary to another
condition e.g. alcohol, stroke
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Clinical Diagnosis
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The Classification of Mental Illness
Drug Problems Addictive drugs, (Heroin, Cocaine,
Amphetamines,) alcohol and drug related
illness-psychosis, delirium and
dementia Personality Disorders A personality and
behaviour that is damaging to the individual
and/or to society and which is not tolerated by
the dominant culture Mental subnormality/learning
disorders Problems around intelligence and
ability to learn on the basis of teaching and
experience
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Aetiology
Inheritance-Genetics/Intra-uterine environment
Schizophrenia,Huntingtons
Drug Abuse Alcohol,Heroin etc
Upbringing Mothering,education,parenting
Neurological diseases MS,Brain tumour
Trauma/head injury
Biochemistry/metabolic Porphyria,Diabetes
Infections-HIV,Syphilis,CJD
Vascular-CVA
Nutrition/PCM
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Treatment and Care
Hospital Care
Community Care
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Preventive NetworksChurch,Family, Home, Friends,
Work
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The Mental Health Act
Compulsory Psychiatric Treatment Criminal
responsibility Power of attorney
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Mental Handicap/learning disability
The mind of a young child in the body of an adult
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Canst thou not minister to a mind diseased, Pluck
from the memory a rooted sorrow, Raze out the
written troubles of the brain, And with some
sweet oblivious antidote Cleanse the stuffd
bosom of that perilous stuff Which weighs upon
the heart?
Macbeth