Mental Health
Dr. Neelum jamal
M.B.B.S, MSPH
C.H.S
Learning objectives
By the end of the session students should be
able to:
Define mental health
able to discuss the Burden of mental health
disorders
list the risk factors for mental health
disorders
discuss the common mental health
disorders and its prevention
Mental Health
Mental health describes either a level of
cognitive or emotional well-being or an
absence of a mental disorder.
It is the ability of individual to maintain
harmonious relationship with others and to
participate in society
Mental health issues or dysfunctions affects a
person’s ability to mentally function properly.
Burden of disease
Mental and neurological conditions account for 12.3%
of disability adjusted life years (DALYs) lost globally
31% of all years lived with disability at all ages and
in both sexes, according to 2000 estimates.
1 in 5 adults suffer from a diagnosable mental
disorder in a given year
Mental illness ranks 2nd in terms of burden of
disease in the U.S.
Depression is leading cause of lost years of healthy
life for women worldwide
Gender differences exist
Gender and
Psychopathology?
Women have more
Men have more
COMMENTS
Why women..
Vulnerability
Hormonal factors
Other factors – Gender disadvantage
Excessive Alcohol use of partner
Sexual violence
Physical violence
Being widowed or separated
Role in decision making
Family support
Life events
Child birth & maternal role
Care of elderly and sick
Women’s Mental Health -
Facts
Depressive disorders account for close to
41.9% of the disability from neuropsychiatric
disorders among women compared to 29.3%
among men.
Leading mental health problems of the elderly
are depression, organic brain syndromes and
dementias. A majority are women.
WHO report
Women’s Mental Health -
Facts
People affected by violent conflicts, civil wars,
disasters and displacement – women &
children
Lifetime prevalence rate of violence against
women ranges from 16 – 50%
Rape or attempted rape in lifetime
WHO report
Risk factors
Organic conditions
cerebral arteriosclerosis,neoplasms,neurological
disorders
Endocrine diseases
Heredity
social pathological causes
poverty, broken families, stress, tension, rejection
toxic substances e.g. mercury, lead
psychotropic drugs (barbiturates, alcohol)
Nutritional deficiencies of thiamine, pyridoxine
Road traffic accidents and radiations
Crucial points in life
cycle of human
beings
Prenatal period
First five years of life
School child
Adolescence
Old age
Mental health
disorders
Major illness
Schizophrenia (split personality
Maniac Depressive psychosis
Paranoia
Minor illness
Neurosis
Personality and character disorders
Mental retardation
Behavioral disorders
Mental disorders
How to asses Mental
health?
MSE (mental state examination)
GAD (generalized anxiety disorder)
TAP (Test of alert performance)
PERSON scale (to screen for suicide)
Patient Health Questionnaire (PHQ)
Depression, Anxiety and Stress Scale (DASS)
Depressive disorder
Leading cause of disability
Twice as common in women
More persistent in women
Atypical depression is common in female
Anxiety disorders
Lifetime risk (GAD) 2 to 3 times higher
Severity of symptoms
More often comorbid depression
Complicated course
Severe Mental
Illnesses
Favorable outcome
Abandonment
Homelessness
Vulnerability to sexual abuse & Physical abuse
Exposure to HIV
Stigma
Suicide
Female attempter & Male completer
Rising in female
18 to 29 years – Peak
10 – 17 years – Female predominate
Depressive disorder, violence, hunger,
difficulties in interpersonal relations and dowry
related harassment.
Violence & Abuse
Domestic violence
1 incident of violence – loss of 7 working days
70% of married women (15 – 49 years of age)
victims
Female feticide, sexual trafficking, public
humiliation, domestic violence.
Consequences
PTSD (Post traumatic stress disorder)
Depression,
Anxiety
Insomnia
Substance use
Gynecological complaints
Mental health
services
Early diagnosis and treatment
Rehabilitation
Group and individual psychotherapy
Mental health education
Use of modern psychoactive drugs
After-care services
Prevention
goal of prevention is to decrease the onset
and residual disability of mental disorders
Primary prevention
eliminate causative agents
enhance host resistance
reducing risk factors
mental health education programme
Prevention
Secondary prevention
early diagnosis of mental illness
screening
provision of treatment facilities
family based health services
Prevention
Tertiary prevention
aim is to reduce the duration of illness
rehabilitative services
institutionalization
PREVENTION
Institutionalization
Home based treatment
Community care
Predictive, Personalized, Preventive, Participatory
