Mental Health Prof. Ashry Gad Mohamed Consultant Medical Epidemiologist College of Medicine & KKUH

Role of the community Prevention of mental illnesses. Care of mentally handicapped.

One person in every ten has some form of mental or emotional illness, from mild to severe. On average one in four of us will experience a mental health problem in the course of a year. Only 18% of people with mental illness are employed.

55% of those with mental illness couldn't bring themselves to tell colleagues about their experience of mental distress.

Classification of mental diseases. I-Psychoneurosis Maladaptive and inappropriate behavior traits to the ordinary stresses and demands of environment and living. It is traceable to modes of personality functioning which pre-existed in infancy and childhood.

Psychoneurotic reaction involves only partially disturbed social functioning and reality testing. Legally, the psychoneurotic is responsible for his actions. Psychoneurosis occurs usually in early adult life (the period of active sexual reproductively and social responsibility). The course is usually chronic.

11- Psychosis Extreme form of breakdown in mental health. Person is no longer remains related to the reality situation. Examples: schizophrenia, manic-depressive psychosis, melancholia

III- Addiction, alcoholism and other behavioral disorders. Physical and psychological dependence on drugs that can affect mental processes and behavior. Depressants: valium. Librium & barbiturates. Stimulants: amphetamines & nicotine. Hallucinogens: marijuana & lysergic acid diethylamide.

IV: Mental retardation A person with retardation in intelligence level, adaptive behavior or academic achievement. -Genetic irregularities -Birth injury -Diseases.

Community mental health services Sites: Hospitals, mental health centers, primary health care centres. Aims 1-Promotion of mental health in the community. -Increase general fitness. -Decrease environment stress. -Consolidation of family life.

-Decrease economic stress. -Resolution of conflicts within the society. 2- Prevention of mental disorders. Causes: 1-Genetic factors: familial aggregation (genetic, environmental or social). 2- Organic: trauma, infections, malnutrition and degenerative lesions. 3-Sociocultural : stress, culture, norms. Beliefs and customs.

Childhood and early influences Education Income, wealth Occupational status Social Position Biological and other unidentified factors Common mental disorders (neurotic conditions) Physical illness Stressful life events Lack of supportive social networks Work circumstances Other known factors Melzer 2004

Preventive measures: Prenatal: decrease congenital infections and trauma. Infancy: emotional security + care of abandoned children and those without families. School age: regulate work, play and leisure. Satisfy social adjustment. Adolescence: puberty emotional problems & transition.

Adults: counseling & resolution of conflicts. Elderly: family care / leadership. 3-Care of mentally ill persons Maintain them within the community. Eradication of superstitious fears & prejudice. (Painful social stigma against handicapped. Avoid permanent prejudice against fully recovered)

4-Education Dissemination of knowledge regarding manifestation of mental disorders. 5- Participation of community in: Care of risky groups. Rehabilitation of mentally handicapped. Legislation of drug abuse.