Mental Health and Wellbeing Dr Karen Adam Consultant in Public Health Medicine Dr Mhairi Hepburn Clinical Fellow in Medical Education and Specialist Registrar in Old Age Psychiatry

YouTube- Schizophrenic Man Terrifies Kids At Party

What is mental illness?

Mood disorders Schizophrenia Anxiety disorders Dementia Personality disorders Learning disability Autism ADHD Eating disorders Addictions Response to trauma Sexual disorders

25%

What is depression?

Depression- key messages It is an illness, not a variant of normal It is not the same as feeling “down” or “fed up” It is common % will get it at some point It’s even more common in medical students Treatments for depression are very effective

If your friend had depression, what might they notice and what might you notice?

Depression Low mood Lack of enjoyment Low energy Disturbed sleep Poor concentration Low self esteem Guilty thoughts Change in appetite Change in psychomotor activity Suicidal thoughts or behaviour

“We take people in who have doused themselves with petrol, who have tried jumping off flats, who have taken vast amounts of paracetamol, who do not want to live any more, and we bring those people in, and I would say that nine and a half out of ten punters leave here happy and well. If that isn’t a result I don’t know what is. Pessimism has always dominated our thinking about mental illness, it’s just like the ghost of stigma reinventing itself as despair in this particular case. The idea that there’s nothing you can do, that’s complete nonsense.” Mark Salter, consultant psychiatrist

Depression is important wherever you end up working

20% of patients develop depression after a heart attack

25-30% of patients have depression following a stroke

Over half of cases of depression in the general hospital go undetected

90% of people with mental health problems are cared for entirely in primary care

10% of women develop depression after having a baby and suicide is one of the leading causes of maternal death

10% of five to fifteen year olds have a mental health problem. Childhood abuse and neglect are major risk factors for adult mental illness.

Self harm is one of the five most common reasons for A+E attendance

15% of patients develop depression after successful surgery for lung cancer

20% of patients with no previous depression suffered from depression in the six months after surgery for hip fracture

Mentally Flourishing We wish to see a Scotland where we all understand that there is no health without good mental health, where we know how to support and improve our own and others’ mental health and wellbeing and act on that knowledge and where our flourishing mental health and mental wellbeing contributes to a healthier, wealthier and fairer, smarter, greener and safer Scotland. TAMFS Scottish Government 2008

Wellbeing 3 dimensions: emotional, social and psychological This includes our ability to cope with life’s problems and make the most of life’s opportunities; to cope in the face of adversity and to flourish in all our environments: to feel good and function well, both individually and collectively. Mental wellbeing ranges from good or high mental health, or flourishing, at one end of a continuum to poor mental health, or languishing, at the other end of the continuum. TAMFS Scottish Government 2008

The WHO Triangle

DisorderLanguishingModerateFlourishing Population Approach Population mental health: emotional, psychological, social (Keyes, 2002; Rose 2003; Huppart 2005)

DisorderLanguishingModerateFlourishing Population Approach Population mental health: emotional, psychological, social (Keyes, 2002; Rose 2003; Huppart 2005)

DisorderLanguishingModerateFlourishing Population Approach Population mental health: emotional, psychological, social (Keyes, 2002; Rose 2003; Huppart 2005)

The Continua of Disorder and Health

Invest to Save: Best Buys in Economic Research 2007 Supporting parents and early years: parenting skills training/pre-school education Supporting children and young people: health promoting schools and continuing education Improving working lives: employment/ workplace Positive steps for mental health: lifestyle (diet, exercise, sensible drinking and social support) Supporting communities: environmental improvements

Evidence of What Works New Economic Foundation (2009)  Social economics of languishing  Levers for change - connect - be active - take notice - keep learning - give Mental Capital and Wellbeing – Government Office for Science report (2008). 400 world experts say priority for children, young people, mental health, work, older years.

Evidence of What Works Positive steps  supportive contact  activity  nature  creativity  good diet  alcohol sense  lifelong learning

Effects – Teenage Births

Effects - Obesity

Effects – Drug abuse

Effects: Imprisonment

Effects: Violence

Effects: Mental Health

Effects: Child Wellbeing

Effects: Social Mobility

Patient Doctor

30%

What can I do now? Follow Dundee Psychiatry on Join the RCPsych as a Student Associate (for free!) Reduce stigma by starting a conversation about mental health Look after yourself and your colleagues

Looking after self and colleagues Student support services Your GP/ University Health Service Mental Health Training Doctors Support Network