Mental health

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"Mental states" redirects here. For the concept in the philosophy of mind, see Intentionality.

By analogy with the health of the body, one can speak metaphorically of a state of health of the mind, or mental health. Merriam-Webster defines mental health as "A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life."

According to the World Health Organization (WHO), there is no one "official" definition of mental health. Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined. In general, most experts agree that "mental health" and "mental illness" are not opposites. In other words, the absence of a recognized mental disorder is not necessarily an indicator of mental health.

One way to think about mental health is by looking at how effectively and successfully a person functions. Feeling capable and competent; being able to handle normal levels of stress, maintaining satisfying relationships, and leading an independent life; and being able to "bounce back," or recover from difficult situations, are all signs of mental health.

Contents 1 Overview 2 Mental hygiene concept 2.1 Cultural and religious considerations 3 Psychopathology 4 National Mental Health Anti-Stigma Campaign 5 Critical views 6 Opposition to biological psychiatry 7 Mental health promotion 8 References 9 See also 10 External links

[edit] Overview

Most experts consider mental health as a continuum. Thus, an individual's mental health may have many different possible values. Mental wellness is generally viewed as a positive attribute, such that a person can reach enhanced levels of mental health, even if they do not have any diagnosable mental health condition. This definition of mental health highlights emotional well being, the capacity to live a full and creative life and the flexibility to deal with life's inevitable challenges. Many therapeutic systems and self-help books offer methods and philosophies espousing strategies and techniques vaunted as effective for further improving the mental wellness of otherwise healthy people. Positive psychology is increasingly prominent in mental health.

According to the World Health Organization:

"Mental health has been defined variously by scholars from different cultures. Concepts of mental health include subjective well-being, perceived self-efficacy, autonomy, competence, inter-generational dependence, and self-actualization of one's intellectual and emotional potential, among others. From a cross-cultural perspective, it is nearly impossible to define mental health comprehensively. It is, however sometimes used as a broader definition, and professionals generally agree that mental health is broader than a lack of mental disorders." ^[1]

[edit] Mental hygiene concept

Mental health was first described as "mental hygiene" by Clifford Whittingham Beers in 1908, who founded the National Committee for Mental Hygiene in 1909 and actively campaigned for the rights of the mentally ill. Dr. William Glasser, a psychiatrist, described 'Mental Hygiene' in his book Mental Health or Mental Illness (1961), following the dictionary definition of hygiene as the establishment and maintenance of health, i.e. mental health.

Mental health, as defined here, is distinct from having a mental health condition. Enhancement of mental health is not the primary goal of some mental health professionals more concerned with treating illnesses and restoring function. Psychiatry relies primarily upon the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or ICD-10, as well as continually updated best-evidence guidelines such as the Texas Medication Algorhithm Project (TMAP) to diagnose and treat mental illnesses and disorders. Mainstream mental health consumer community services are an adjunct to psychiatry, not an alternative.

[edit] Cultural and religious considerations

Mental health is socially constructed and socially defined; that is different professions, communities, societies and cultures have very different ways of conceptualizing its nature and causes, determining what is mentally healthy, and deciding what interventions are appropriate. ^[2] Therefore different professionals will have different cultural and religous backgrounds and experience which may impact the methodology applied during treatment.

A holistic model of mental health generally includes concepts based upon anthropological, educational, psychological, religious and sociological perspectives as well as theoretical perspectives from personality, social, clinical, health and developmental psychology. ^[3][4]

Many mental health professionals are beginning to or already understand the importance of competency in religious diversity and spirituality. The American Psychological Association explicitly states that religion must be respected. Education in spiritual and religious matters is also required by the American Psychiatric Association. ^[5]

One example of a wellness model was developed by Myers, Sweeny and Witmer. It includes five life tasks — essence or spirituality, work and leisure, friendship, love and self-direction—and twelve sub tasks—sense of worth, sense of control, realistic beliefs, emotional awareness and coping, problem solving and creativity, sense of humor, nutrition, exercise, self care, stress management, gender identity, and cultural identity—are identified as characteristics of healthy functioning and a major component of wellness. The components provide a means of responding to the circumstances of life in a manner that promotes healthy functioning. ^[6]

[edit] Psychopathology

The scientific consensus on mental health conditions view disorders as neurobiological, but more than neurochemistry. Other brain functions identified as contributing to mental health conditions include circadian rhythms, neuroplasticity, ion channel signal transduction, cognitive processing, brain networks ^[7] and more. Brain imaging studies demonstrate physical changes in neuroanatomy accompanying disorders such as schizophrenia ^[8], autism and bipolar disorder ^[9]. As well, environmental, developmental and interpersonal factors have been studied, and research is ongoing. Best-evidence medicine as defined by the independent National Institute for Health and Clinical Excellence (NICE) treatment guidelines ^[10] indicate that bipolar disorder, for example, requires a combination of medication, psychotherapy, self-help and social supports. Mental health agencies are increasingly involved and promote self-reliance and peer support.

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[edit] National Mental Health Anti-Stigma Campaign

The Substance Abuse and Mental Health Services Administration (SAMHSA) launched the National Mental Health Anti-Stigma "What a difference a friend makes" campaign to encourage, educate, and inspire people between 18 and 25 to support their friends who are experiencing mental health problems. The prevalence of serious mental health conditions in this age group is almost double that of the general population, yet young people have the lowest rate of help-seeking behaviors. This group has a high potential to minimize future disability if social acceptance is broadened and they receive the right support and services early on.

The opportunity for recovery is more likely in a society of acceptance, and this initiative is meant to inspire young people to serve as the mental health vanguard, motivating a societal change toward acceptance and decreasing the negative attitudes that surround mental illness. Mental health recovery is a journey of healing and transformation, enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.

Discrimination and stigma have made it harder and harder for people with mental illnesses to keep a job, find a home, get health insurance, and find treatment.

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[edit] Critical views

Many critics of pharmaceutical interventions question the prevailing chemical imbalance paradigm characteristic of mainstream medicine, while pointing out that the DSM-IV involves oversimplified diagnostic labels and treatments for mental disorders. MindFreedom International, for example, condemns the lack of humane, non-pharmaceutical alternatives available, promoting instead the defense of human rights and non-coercive mental health treatment options for mental health consumers.

Critics also contend that relatively mainstream mental health advocacy groups, such as the National Mental Health Association, Depression and Bipolar Support Alliance, Canadian Mental Health Association, Rethink, and others, downplay their links or financial assistance from pharmaceutical companies.

[edit] Opposition to biological psychiatry

Opposing viewpoints to biological psychiatry theories include those of anti-psychiatry advocates, some of whom are psychiatrists, who contend psychiatric patients do not necessarily have a mental health condition, but in fact are individuals who do not ascribe to the conventional belief system, or consensus reality, shared by most other people in their culture or race.

According to Dr. Glasser, a critic of psychiatry, the Public Health model is an established model delivering physical health to millions of people. He advocates to have this model expanded into a Public Mental Health Delivery model to put into practice by mental health professionals and institutions, by hiring mental health professionals (as defined by Glasser, not the established industry of mental health professionals such as psychiatric nurses and counsellors) to deliver services without diagnoses or first-line medication to people who need professional help.

This model does not provide adequate treatment for consumers with severe, persistent, genetic mental health conditions who are unable to take care of themselves, even to direct a self-empowering treatment plan. Lack of insight is a key feature of psychosis and mania in which the person does not believe (s)he is ill and refuses or does not comply with treatment.

[edit] Mental health promotion

Mental health promotion works from the principle that everyone has mental health needs, not just people who have been diagnosed with a mental health condition. Mental health promotion is essentially concerned with making changes to society that will promote people's mental well-being.

Positive psychology is also concerned with mental health and enhancement rather than treating illness.

Mental health promotion is a term that covers a variety of strategies. These strategies can be seen to occur at three levels:

• Individual - encouragement of individual resources by promotion of interventions for self-esteem, coping, assertiveness in areas such as parenting, the workplace or personal relationships.
• Communities - increasing social inclusion and cohesion, developing support structures that promote mental health in workplaces, schools and neighbourhoods.
• Government reduce socioeconomic barriers to mental health at governmental level by promoting equal access for all and support for vulnerable citizens.

[edit] References

1. ^ The world health report 2001 - Mental Health: New Understanding, New Hope, World Health Organization, 2001
2. ^ Weare, Katherine (2000). Promoting mental, emotional and social health: A whole school approach. London: RoutledgeFalmer, 12. ISBN 978-0415168755. 
3. ^ Witmer, J.M.; Sweeny, T.J. (1992). "A holistic model for wellness and prevention over the lifespan". Journal of Counseling and Development 71: 140-148. 
4. ^ Hattie, J.A.; Myers, J.E.; Sweeney, T.J. (2004). "A factor structure of wellness: Theory, assessment, analysis and practice". Journal of Counseling and Development 82: 354-364. 
5. ^ Richards, P.S.; Bergin, A. E. (2000). Handbook of Psychotherapy and Religious Diversity. Washington D.C.: American Psychological Association, 4. ISBN 978-1557986245. 
6. ^ Myers, J.E.; Sweeny, T.J.; Witmer, J.M. (2000). "The wheel of wellness counseling for wellness: A holistic model for treatment planning. Journal of Counseling and Development". Journal of Counseling and Development 78: 251-266. 
7. ^ Brain network dysfunction in bipolar disorder CNS Spectr. 2006 Apr;11(4):312-20; quiz 323-4.
8. ^ Regional deficits in brain volume in schizophrenia: a meta-analysis of voxel-based morphometry studies, Honea et al., Am J Psychiatry. 2005 Dec;162(12):2233-45
9. ^ Advances in magnetic resonance imaging methods for the evaluation of bipolar disorder CNS Spectr. 2006 Apr;11(4):269-80.
10. ^ NICE clinical guidelines: The Management of bipolar disorder in adults, children and adolescents, in primary and secondary care, 2006

[edit] See also

Mainstream mental health articles:

• Mental Health Professional
• Psychiatry
• Psychology
• 12 steps
• Mental health law
• Parental Consent Act of 2005 (HR 181)
• Sanity
• Social Work

Articles related to those opposed to biological psychiatry:

• Anti-psychiatry
• CAMHS
• International Center for the Study of Psychiatry and Psychology
• Thomas Szasz

[edit] External links

• 1 in 4 Forum - Mental health forum which covers a wide range of mental health issues.
• MentalHealth.org - National Mental Health Information Center, US Department of Substance Abuse and Mental Health Services Administration
• MentalHealth.com - 'Internet Mental Health'
• About:Mental Health
• National Mental Health Consumers' Self-Help Clearinghouse (U.S.)
• The mental health and addictions service - from The Huntercombe Group (UK)
• HealingMinds.org - A non profit for mental health assistance and education.
• www.whatadifference.org National Mental Health Anti-Stigma Campaign
• www.mentalhelpinfo.org Mental Health website with many links
• BasicNeeds - International Mental Health Charity, which highlights mental health issues in developing countries