Understanding Mental Health

greentriangle.pngWeek 3

tab.png Context

As many as one in four of us will have some sort of mental health problem in our lives, but it’s something we don’t always talk about. In addition, more than two million people with a mental health condition are out of work in the UK, and mental health conditions are the primary reason for claiming health related benefits in the UK. Just four in 10 employers say they would hire someone with a mental health condition compared to six in 10 for a physical health condition. This week, you’ll find information about some of the most common mental health conditions.

With grateful thanks to the Mental Health team at City University for their help with this week's resources.

tab.png Introduction

This week runs from 6th to 12th October. You will need to:

  1. Complete this section
  2. Complete the section on The Major Theories Of Mental Health & Mental Illness (Advanced) if appropriate to your knowledge and experience
  3. Complete the section on Examples Of Common Behaviour Changes
  4. Complete the section on Medication Used For Depression (Advanced) if appropriate to your knowledge and experience
  5. Watch the Video: Journey: Episode 2: Losing The Way
  6. Complete the exercise associated with Journey: Episode 2
  7. Join Discussion: Week 3 - Understanding Behaviour Changes

tab.png Content

This week we introduce and explore the concept of mental illness, consider the range and types of mental health, identify the main categories of mental disorder, and identify key features of particular conditions.

What are mental health problems/ illnesses/ conditions/ disorders?

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Reflecting on last week's activities we would like you to spend a few minutes thinking about what characterises a mental illness:

  • Are mental illnesses best seen as an extreme form of normal experience?
  • How common are mental illnesses?
  • How do we identify, assess and help someone with a mental health problem.

We hope that by engaging in the discussions throughout this course you will develop new perspectives and understanding from a variety of cultures.

The World Health Organization (WHO) provides a  comprehensive, nuanced description of mental health: "Mental health is defined as a state of wellbeing 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" (WHO, 2011). According to a 2000 report by the U.S. Surgeon-General, mental health “refers to the successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and cope with adversity" (Satcher, 2000)

The Australian government offers this view of mental illness: "A mental illness is a health problem that significantly affects how a person feels, thinks, behaves, and interacts with other people. It is diagnosed according to standardised criteria" (Mental Health and Workforce Division of the Australian Government Department of Health and Ageing, 2007: p1). An American definition of mental illness is: "Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning ... mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life" (NAMI, 2014). 

Whether we use mental health or mental illness (or indeed mental health issues, mental disorders, or mental health problems), it is possible to identify common characteristics. We can say that mental illnesses:

  • Involve a characteristic pattern of features (signs & symptoms) that disturb a person's:
    • thoughts;
    • feelings;
    • perceptions;
    • behaviour.
  • they are associated with:
    • subjective discomfort or distress;
    • impairment of function or disability.
  • there is often a continuum between what is considered to be a normal experience, moving through disturbance, through to a diagnosed illness.

Classifying mental illness

Classification and assessment is largely based on understanding a person's presenting characteristics, ie. symptoms or features of their illness. Think about:

  • How similar or different is this classification to other areas of health and illness?
  • Can you list some types of mental health problems you might have experienced yourself (eg. stress or anxiety)
  • Which are some of the most common features people suffer with?

Currently there are two recognised systems that are used to help classify mental illness:

  1. The International Classification of Diseases: Chapter V: Mental and Behavioural Disorders Links to an external site. (WHO)
  2. Diagnostic and Statistical Manual of Mental Disorder Links to an external site.s (American Psychiatric Association)

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Word cloud and table (below), reproduced with permission from Paul Kiritsis Links to an external site.

Below is a classification of the various forms of ‘insanity’ that were utilised in mental asylums in the state of Victoria (Australia) in the early 1900s (taken from inner cover of a clinical case book from Mayday Hills Lunatic Asylum) and beside them some possible contemporary equivalents: 

Antiquated Taxonomy (late 1800s, early 1900s) Contemporary Taxonomy
Congenital or infantile mental deficiency (idiocy or imbecility) occurring as early in life as it can be observed. These include an intellectual form with epilepsy, an intellectual form without epilepsy, and a moral form. Autism, congenital mental retardation, attention-deficit, and hyperactivity.
Insanity with epilepsy Seizures, convulsions, and psychosis caused by long-term neurological disorders, which are in turn caused by either alcohol abuse, brain cancer, or brain trauma.
General paralysis of the insane Localised or non-localised paralysis of the body brought on by underlying degeneration of the Central Nervous System (CNS).
Insanity with grosser brain lesions Further psychotic elements introduced by such primitive, barbaric, and theoretically- flawed psychiatric practices as Electro-Convulsive Therapy and Frontal Lobe Lobotomy.
Acute delirium Dissociative hallucinosis
Confusional Insanity Fugue state, or dissociative fugue
Stupor Low IQ
Primary dementia Psychopathological or physical conditions where dementia is a chief symptom.
The ‘manias’, further subdivided into ‘recent’, ‘chronic’, and ‘recurrent’ types. Obsessive-compulsive disorder, panic disorder linked to a particular phobia, post-traumatic stress disorder, and bipolar disorder.
The ‘melancholias’, further subdivided into ‘recent’, ‘chronic’, and ‘recurrent’ types. Depressive disorders that may or may not be symptomatic of other psychopathological disturbances.
Alternating insanity Most likely a degree of dissociative multiplicity, the severest of which is Dissociative Identity Disorder (DID)
Delusional insanity, further subdivided into ‘systematized’ and ‘non-systematized’ types. All psychopathological or physical conditions that manifest psychotic features (i.e. delusions, hallucinations, outrageous behaviours), including alcoholic dependence, schizophrenia, borderline personality, dissociative identity, Parkinson’s, Alzheimer’s, and so forth.   
Volitional insanity, further subdivided into ‘impulse’, ‘obsessive’, and ‘doubtful’ types.  Could refer to psychopathological conditions like obsessive-compulsive disorder, but is most likely connected with hypertension and many personality ‘quirks’ or neurotic habits that stood way outside the accepted conventional behaviours of the time.
Moral insanity The antisocial personality disorders, including psychopathy and sadism. This could also refer to various paraphilias like exhibitionism, frotteurism, and zoophilia, to nymphomania, to excessive masturbation, and to gender identity or sexuality issues.  
Dementia, further subdivided into ‘senility’ and ‘secondary’ or ‘terminal’ types. Dementia caused by old age or by degenerative disorders of the Central Nervous System (CNS) like Parkinson’s Disease and Alzheimer’s Disease.

Main types of mental illness

The UK Royal College of Psychiatrists provides information on the following 'common Links to an external site.' mental health diagnosis categories:

Alcohol and Drug Problems Bipolar  Disorder
Alzheimer's and Dementia Obsessive Compulsive Disorder
Anorexia and Bulimia Personality Disorder
Attention Deficit Hyperactivity Disorder (ADHD) Post Traumatic Stress Disorder (PTSD)
Anxiety, Panic and Phobias Schizophrenia
Bereavement Seasonal Affective Disorder
Depression Sleep Problems
Learning Disabilities  

 

tab.png References and Further Reading

Mental Health and Workforce Division of the Australian Government Department of Health and Ageing (2007) What is Mental Illness? Links to an external site. Canberra: Mental Health and Workforce Division of the Australian Government Department of Health and Ageing

National Alliance on Mental Illness (NAMI) (2014)  What is Mental Illness: Mental Illness Facts [WWW] http://www.nami.org/template.cfm?section=about_mental_illness Links to an external site.

Satcher DS.(2000) Executive summary: a report of the Surgeon General on mental health. Public Health Report. 115 (1): 89-101

World Health Organization (2011) Mental health: a state of wellbeing. [WWW] http://www.who.int/features/factfiles/mental_health/en/index.html Links to an external site.