Mental Health & Mental Illness: An introduction Elijah M Marangu

Mental illness.. Or is it madness?

Historical context While Philippe Pinel, a French Physician was instrumental in unchaining people with mental illness, large institutions (asylums) were established to contain People with mental illness and remove them from society Yarra Bend Asylum Established in Melbourne in 1848

History: Bedlam Hospital

Today: Mathari Hospital - Nairobi

Initial approaches to treatment Containment and Isolation Psychosurgery Insulin Coma Institutional care

Mental illness: what is it? Mental health: a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community (WHO 2007) Mental illness: refers collectively to all mental disorders. Mental disorders are conditions that are characterized by alterations in thinking, mood or behaviour (or some combination thereof) associated with distress and/or impaired functioning

How common is mental illness Globally: About 20% - 25% of people are affected (WHO 2008) Mental illness is widespread -1 in 5 people The National Survey of Mental Health and Wellbeing (2007) found an estimated 7.3 million, or almost 45% of Australians aged between 16 and 85 years, had experienced a mental health problem at some time in their life.

What causes mental illness Unknown Genetics Trauma – Physical and psychological Drugs & alcohol Medical conditions Others eg environmental stressors

Mental illness: Key disorders CategoryDisorders Anxiety disordersGeneralised Anxiety Disorder Obsessive Compulsive Disorder Phobias Post –Traumatic Stress Disorder Mood DisordersDepression Bipolar Disorder Psychotic disordersSchizophrenia Organic Psychosis Acute Psychotic Episode Substance induced disordersDrug Induced Psychosis Personality disordersBorderline Personality Disorder Narcissistic Personality Disorder Obsessive Compulsive Personality Disorder

Mental health emergencies Stops drinking or eating (nihilistic delusions or depressive stupor) Manic excitement (can lead to exhaustion and dehydration) Self-neglect (depression, dementia) Sexual vulnerability & exploitation (mania, substance abuse) Intentional self-harm and suicidal gestures Chaotic, disorganised behaviour Increased physical and verbal aggression (Psychosis, drug use)

Approaches to care and treatment Medications Psychological therapies eg Counselling, CBT, DBT etc Non-medical approaches eg ECT, TMS etc Welfare eg Housing, Pension, Disability Self-help groups including online communities

Depression and Intentional self- harm/suicide Risk factorsHelping a suicidal person Does the person have a plan, do they have the means? History of previous suicidal attempts Significant warning signs: expression of wanting to die, organising their affairs, giving away stuff, behaviour change, sudden isolation Ensure a person is not left alone Listen non-judgementally Give reassurance and information Encourage person to get appropriate professional help or facilitate same In Emergency: Phone Mental Health Crisis, Phone ‘000’, Take person to hospital ED or GP Stop drugs & Alcohol Stop access to means of self- harming or suicide

Drugs and Alcohol There is a strong relationship between drug/alcohol use and mental illness eg 25% of men with a drug/alcohol problem had an underlying depressive or anxiety disorder Addiction is recognised medically as a disease Main symptoms include: increasing tolerance, problem cutting down or controlling, a lot of time spent getting the substance, using it or recovering from its effects, relegation of social, recreational or occupational activities, continued use despite deleterious effects

Other Disorders: What you can do.. If you suspect a Mental Health Emergency, call the Crisis line (Information supplied) Report all life threatening matters to the Police Make an appointment with your GP – Ensure to book a long consultation to allow time for assessment and discussion of treatment options

Important contact numbers Suicide Helpline – Crisis Assessment and Treatment Team – For Psychiatric Emergencies (check local directory) Lifeline – a 24 hour Counselling Service – Orygen Youth Health (Youth Mental Health) – Kids Helpline – Mensline Australia – Poisons Information Centre –

Important links Beyondblue: Multicultural Mental Health Australia: Australian Government: SANE Australia: Mental Illness Fellowship of Australia:

Information sources World Health Organisation Australian Institute of Health and Welfare Australia Bureau of Statistics