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Community Mental Health

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Community Mental Health DR. AWATIF ALAM Nurah Alamro, MD. MPH. Lecturer Community Medicine – PowerPoint PPT presentation

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Title: Community Mental Health


1
Community Mental Health
  • DR. AWATIF ALAM
  • Nurah Alamro, MD. MPH.
  • Lecturer Community Medicine

2
Introduction
  • Community health service was concerned mainly
    with the control of communicable diseases.
  • In the course of development, it has become
    increasingly concerned with every health aspect
    of life of individuals in the community.
  • Psychiatry, has developed as a personal service
    to the
  • mentally ill individual,
  • Only recently psychiatrists have attempted to
    contribute to preventive aspects of mental
    illness.
  • However, preventive psychiatry remains in its
    infancy and needs much community efforts to be
    well developed.

3
CAUSES OF MENTAL ILLNESS
  • The concept of multiple factors in the causation
    of psychogenic disorders has become generally
    accepted.
  • The factors are considered to involve the
    individual, the family and the community.

4
  • Genetic factors play a causative role in
    schizophrenia and in some manic depressive
    illnesses.
  • Stress Social and environmental
  • Social deprivation and other phenomena which
    characterize modern life.
  • Physical causes, as disease or trauma

The roles of syphilis and advanced pellagra are
well known to cause mental disturbances.
5
EXTENT OF MENTAL ILLNESS
  • It is estimated that one person in every ten, has
    some form of mental or emotional illness, from
    mild to severe, that could benefit from
    professional help or treatment.
  • Estimates vary, however, depending on the
    criteria used for diagnosis and the kinds of
    mental conditions included.
  • If only clearly disabling conditions are counted,
    the estimate of mental illness in the general
    population will be much lower than 10. If milder
    emotional upsets, psychosomatic complaints and
    any of the various problems of living are
    included, a much larger proportion of the
    population will be found to have some form of
    emotional disorder.

6
OBJECTIVES
  • Promote mental health in the community.
  • Maintain if possible the mentally ill
    within the community itself.
  • Avoid un-necessary admission and restraint in
    special hospitals.
  • Provide social therapy.

Community mental service is provided in
hospitals, mental health centers, by general
practitioners and health authorities (local and
central) all working in harmony.
7
BROAD CLASSIFICATION OF MENTAL ILLNESS
  • The psychoneurosis
  • The psychosis
  • Addictions, alcoholism, etc.
  • Mental retardation

8
Psychoneurosis
  • Comprise a group of personality disorders, in
    which
  • behavior traits,
  • thought processes,
  • emotional responses and
  • somatic functions
  • occur in a repetitive pattern maladaptive
    and inappropriate to the ordinary stresses and
    demands of environment and living.

9
Psychoneurosis
  • Symptomatology has its origin outside conscious
    awareness and is traceable to modes of
    personality functioning which pre-existed in
    infancy and childhood.
  • In general, the psychoneurotic reaction
    represents
  • Symbolic adaptation to anxiety involving only
    partially disturbed social functioning
    and reality testing.
  • The psychoneurotic in contrast to the
    psychotic, maintains the capacity to perceive and
    adapt to environmental realities.

10
  • Legally, the psychoneurotic is responsible for
    his actions.
  • The psychotic who violates legal and social
    codes is
    placed under supervision or hospitalized.
  • The onset of psychoneurosis occurs usually in
    early adult life.
  • The course tends to be chronic.
  • Appearance of these disorders, for the first
    time, after 45 years of age is unusual.

11
  • Usually symptoms express themselves in the period
    of active sexual reproductivity and social
    responsibility.
  • Psychoneurotic disturbances manifest
    themselves in the predisposed individual as a
    consequence of exposure to anxiety arousing
    situations.
  • The genetic and constitutional factors determine
    both the capacity of the personality to withstand
    stress and the determination of the organ systems
    which respond to stress.

12
  • The initial stage of personality development
    takes place during the early years of life,
    during which time the infant is wholly dependent
    upon his mother or a mother substitute.
  • If the child is pushed and urged beyond his
    maturational limits, the beginning of self-doubt
    and shame are implanted .
  • The child enters into the society of equals
    through various interactions ( sibs) , and their
    play is the introduction to the life of society
    in general.
  • The child starts to learn to adjust to the needs
    and desires of others.
  • He always strives for success.

13
Psychosis
  • Represents extreme form of breakdown in mental
    health,
  • The individual no longer remains related to the
    reality situation ,
  • The patient is subjected to irrational and
    disordered emotional and intellectual process.
  • Psychosis will lead to aberrant behavior
    recognizable by gross un-reality,
  • e.g. schizophrenia, manic depressive
    psychosis, melancholia.

14
Addictions, alcoholism, and other behavior
disorders
  • The drugs that can affect mental processes and
    behavior are classified into three general
    groups
  • Depressants e.g. Valium, Librium, barbiturates.
  • ( alcohol is the most commonly used and abused ).
  • Stimulants include amphetamines, nicotine in
    tobacco .
  • Hallucinogens include marijuana and lysergic
    acid
  • diethylamide.
  • Individuals must be fully informed of the
    possible hazard to health involved in alcohol and
    drug abuse.

15
The governmental role in control of alcohol and
drug abuse
  • Adopting certain legal regulations for
    controlling the important and export of narcotic
    drugs,
  • Regulating the production and distribution of
    drugs ,
  • Establishing penalties for illegal possession or
    sale of dangerous drugs.
  • The provision of programs including
  • - treatment,
  • - rehabilitation,
  • - research and education
  • (designed to prevent and combat the adverse
    personal and social consequences of drug abuse).

16
Mental Retardation
  • A person may be retarded in
  • intelligence level,
  • in adaptive behavior,
  • in academic achievement ,
  • in a combination of these elements.

Mental retardation can be caused by any condition
that interferes with development - before
birth,(gene incompatab., x-ray, infections) -
during birth ( birth injury ) - in early
childhood (meningitis, polio, lead poisoning)
17
The field of action for prevention encompasses
  • Protection of the very young, through promotion
    of family life.
  • Prevention of social stress and insecurity.
  • Protection of the aged who may suffer from
    cerebral degeneration, depression and/or
    psychopathic states.
  • Prevention of brain damage e.g. control of
    syphilis and alcoholism.
  • Public education in mental health.

18
The field of action for prevention encompasses
  • Pre-marital consultations and medical
    examinations.
  • Provision of suitable institutions for the care
    of the mentally ill.
  • Legislation as regards drug abuse, compulsory
    admission to residential hospitals and
    guardianship.
  • Rehabilitation.

19
Quiz
  • Individual factors in mental illness causation
    include except
  • Genetics
  • Trauma
  • Environmental stress
  • Infectious disease

20
  • Mental illness estimates vary depending on
  • Criteria used for diagnosis
  • Hospitalization
  • Recreation drugs use
  • Family history

21
  • Classification of mental illness include
  • Psychoneurosis
  • Psychosis
  • Addiction
  • Mental retardation
  • All of the above

22
  • Prevention of mental illness approach is
  • Health based
  • Social Based
  • Multisectoral based
  • Drug based

23
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