1. Presentation Name CHP200: Community Health Program-l Mohamed M. B.
Alnoor
Presentation Name
Company Name
COPMI: Children Of Parents with a Mental Illness.

2. CONTENT MENTAL HEALTH MENTAL HEALTH Definitions Mental Health
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MENTAL HEALTH
MENTAL HEALTH
CONTENT
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Definitions
Mental Health
Mental Illness( MI )
Importance
Myths of MI
We are all vulnerable
Etiology of MI
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Classification and types of MI
Distribution of MI
Overview- Morbidity and Mortality
Prevention of MI
Management of MI
Integration of MI into PHC
Conclusion
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3. Definition Mental Health
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MENTAL HEALTH
Definition
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Mental Health
The World Health Organization defines mental health as "a state of well-being in which the individual:
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realizes his/her own abilities
can cope with the usual stresses
of life
can work productively and fruitfully
is able to make a contribution to his/her community.”
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4. control their behavior
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MENTAL HEALTH
Definition
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Mental Illness
It is when someone lacks the ability to: manage day to day events
and/or
control their behavior
so that basic physical and emotional needs are threatened or unmet.
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5. Definition Mental Illness
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MENTAL HEALTH
Definition
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Mental Illness
A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom.
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6. Definition Mental Illness A clinically significant behavioral syndrome
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MENTAL HEALTH
Definition
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Mental Illness
A clinically significant
behavioral syndrome
psychological syndrome
pattern
that is associated with
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present distress
disability
significant risk of suffering
death
Pain
Disability
An important loss of freedom.
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7. Definition are medical conditions that disrupt a person's:
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MENTAL HEALTH
Definition
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are medical conditions that disrupt a person's:
Mental Illnesses
thinking
feeling
mood
ability to relate to others
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daily functioning.
Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.
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8. Myths of Mental Illness
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MENTAL HEALTH
IMPORTANCE
Background
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Myths of Mental Illness
Mental illness is caused by bad parenting.
Fact: Most diagnosed individuals come from supportive homes.
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The mentally ill are violent and dangerous.
Fact: Most are victims of violence.
People with a mental disorder are not smart.
Fact: Numerous studies have shown that many have average or above average intelligence.
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9. Facts of Mental Illness
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MENTAL HEALTH
IMPORTANCE
Background
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Facts of Mental Illness
There is ignorance, stigma, superstition, and fear
around Mental Illness
Etiology, pathogenesis diagnosis and treatment
are imperfect.
There are good reasons
to integrate mental health
into primary health care
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10. Etiology of Mental Illness
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MENTAL HEALTH
Etiology of Mental Illness
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Multifactorial Etiology
Stressors
Disability
Sociodemographic
Physical
Illness
Psycho-
pathology
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Environmental
Biological
Utilization & Access to Health Care
Other
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11. Etiology of Mental Illness
MENTAL HEALTH
Etiology of Mental Illness
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Multifactorial Etiology
BIOLOGOCAL
FACTORS
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Mental & behavioral disorders
Biological Factors: Genetics appears to play a role in the development of mood disorders. The strongest evidence for the role of genetics comes from twin studies.
Certain chemical imbalances in the brain have been linked to mood disorders. Psychological Factors: Cognitive distortions may lead to the development of mood disorders. Cognitive distortions: An illogical and maladaptive response to early negative life events that leads to feelings of incompetence and unworthiness that are reactivated whenever a new situation arises that resembles the original events. Social Factors: Difficulties in interpersonal relationships may lead to mood disorders.
The link between depression and troubled relationships may explain why women are more likely to suffer from depression--women tend to be more relationship-oriented than men.
PSYCHO-
LOGICAL
FACTORS
SOCIAL
FACTORS

12. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Always Included in Definition
depression
Schizophrenia
Major Depression
Bipolar Disorder
schizophrenia
Bi polar
Personality
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Sometimes Included
An xiety
Severe Anxiety Disorders
Cognitive Disorders
Some Personality Disorders

13. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Schizophrenia
Criteria for Schizophrenia
Delusions
Hallucinations
Disorganized Speech
Disorganized Behavior
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Negative Symptoms
Flat Affect
Lack of Motivation
Social/Occupational Dysfunction

14. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Major Depression
Criteria for Major Depression
Depressed Mood
Diminished Interest
Weight Loss or Gain
Sleep Disturbance
Restlessness or
Being Slowed Down
Fatigue & Loss of
Energy
Thoughts of Death
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15. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Major Depression
Criteria for Major Depression
Feelings of Worthlessness
or Excessive Guilt
Difficulty Thinking &
Concentrating
Symptoms Occur
Almost Every Day
Significant Distress &
Impairment
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16. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Bipolar Disorder
Criteria for Bipolar Disorder
Manic Episodes
Elevated mood
Grandiosity
Decreased need
for sleep
Talkativeness
Racing thoughts
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17. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Bipolar Disorder
Criteria for Bipolar Disorder
Marked Impairment
Occupation
Social relationships
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May Alternate with
Depressive Episodes

18. DISTRIBUTION IMPORTANCE Mental Health is a worldwide problem
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MENTAL HEALTH
IMPORTANCE
DISTRIBUTION
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Mental Health is a worldwide problem
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19. DISTRIBUTION These disorders can affect persons of any
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MENTAL HEALTH
IMPORTANCE
DISTRIBUTION
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These disorders can affect persons of any
age, race, sex, religion, or income.
Mental illnesses are not the result of:
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personal weakness.
lack of character.
poor upbringing.
We are all vulnerable
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20. DISTRIBUTION IMPORTANCE We are all vulnerable MENTAL HEALTH
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MENTAL HEALTH
IMPORTANCE
DISTRIBUTION
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We are all vulnerable
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21. DISTRIBUTION Overview- Morbidity and Mortality IMPORTANCE
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MENTAL HEALTH
IMPORTANCE
DISTRIBUTION
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Overview- Morbidity and Mortality
Mental illness usually strike individuals
in the prime of their lives
during adolescence and young adulthood.
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Established Monitoring and Treatment
Guidelines to Lower Risk Are
in Serious Mental Illness
(SMI )Populations
Underutilized
Underutilized
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22. DISTRIBUTION Overview- Morbidity and Mortality IMPORTANCE
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MENTAL HEALTH
IMPORTANCE
DISTRIBUTION
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Overview- Morbidity and Mortality
The Majority of People Who Need Mental Health Treatment Don’t Receive It
50% homeless have SMI that is untreated
> 50% of SMI do not seek treatment, the barrier: Stigma and discrimination.
Only 30% adults and 50% children with a diagnosable mental disorder receive treatment in any one year
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23. DISTRIBUTION Overview- Morbidity and Mortality
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MENTAL HEALTH
IMPORTANCE
DISTRIBUTION
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Overview- Morbidity and Mortality
Increased Morbidity and Mortality Largely Due to Preventable Medical Conditions
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Metabolic Disorders, Cardiovascular Disease, Diabetes Mellitus
High Prevalence of Modifiable Risk Factors (Obesity, Smoking)
Epidemics within Epidemics (e.g., Diabetes, Obesity)
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24. DISTRIBUTION Overview- Morbidity and Mortality IMPORTANCE
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MENTAL HEALTH
IMPORTANCE
DISTRIBUTION
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Overview- Morbidity and Mortality
Increased risk of death from medical causes in schizophrenia:
( yrs) shorter lifespan.
about 60% of premature deaths in persons with schizophrenia are due to “natural causes”
- Cardiovascular disease
- Diabetes
- Respiratory diseases
- Infectious diseases
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“natural causes”
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25. DISTRIBUTION KSA Estimates Overview- Morbidity and Mortality
MENTAL HEALTH
IMPORTANCE
DISTRIBUTION
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Overview- Morbidity and Mortality
KSA Estimates
Riyadh: 30 – 40 % of PHC patients with mental disorders (mostly undiagnosed)
Al-Khobar: 22 % of health clinics patients had mental health disorders (8 % diagnosed)
Central province: 18 % of adults with minor disorders, with rates higher among:
- Young: years (23 %)
- Divorced and widowed (40 %)
Suicidal rates: 1.1 per 100,000 mostly among
men; aged: years & immigrants
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26. DISTRIBUTION KSA Mental Healthcare Facilities MENTAL HEALTH Beds
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MENTAL HEALTH
DISTRIBUTION
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Beds
Number
Facility
each 14
MoH Psychiatric Hospitals
570 1
Al-Taif Hospital
165 total
Military, National Guards
and University Hospitals
146 total
Private Hospitals
280 each 3
Hospitals for Ʀ of Drug Dependence
20-30 each 61
Departments / Clinics in General Hospitals
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KSA Mental Healthcare Facilities
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27. DISTRIBUTION USA Estimates Overview- Morbidity and Mortality
MENTAL HEALTH
IMPORTANCE
DISTRIBUTION
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Overview- Morbidity and Mortality
( >18 yrs) 
USA Estimates
26.2%: Mental illness
10.5%:Serious Psychological Distress
6 % : SMI
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This can result from life events such as:
losing a job,
coping with disability of self or a family member
divorce,
death of a loved one,
life-threatening illness,
natural disasters such as (hurricanes, wildfires.)

28. Preventive Networks Mosque, Family, Work, Home, Friends. MENTAL HEALTH
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Preventive Networks
Mosque,
Family,
Work,
Home,
Friends.
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29. Prevention of Mental Illness
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MENTAL HEALTH
Prevention of Mental Illness
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Protection of the very young (promotion of family life)
Prevention of social stress and insecurity
Protection of the aged who may suffer from
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Cerebral degeneration
Depression
Psychopathic states
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30. Prevention of Mental Illness
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MENTAL HEALTH
Prevention of Mental Illness
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Prevention of brain damage
Public education in mental health
Premarital consultations and medical examination
Provision of suitable institutions
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31. Prevention of Mental Illness
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MENTAL HEALTH
Prevention of Mental Illness
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Legislation as regards
drug abuse,
compulsory admission to hospitals
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guardianship
Rehabilitation
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32. management Early identification and treatment is of vital importance:
MENTAL HEALTH
management
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Early identification and treatment
is of vital importance:
By ensuring access to:
effective treatment
recovery supports
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- recovery is accelerated
- further harm related to the course of illness is minimized.
Even with serious mental illnesses today, treatment is highly effective: %
- significant reduction of symptoms
- improved quality of life.

33. What is PHC ? Integration of Mental Health into PHC
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MENTAL HEALTH
Integration of
Mental Health into PHC
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What is PHC ?
Primary health care is about:
Providing 'essential health care'
Universal accessibility to individuals and families in the community
Being based on the needs of the population.
Being Decentralized
Active participation of the community
(WHO, 1978: Declaration of Alma-Ata) 
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34. MH into PHC: Why ? (I) Integration of Mental Health into PHC
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MENTAL HEALTH
Integration of
Mental Health into PHC
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MH into PHC: Why ? (I)
Mental and physical health problems are interwoven (ensure that people are treated in a holistic manner)
The morbidity burden is great (economic and social hardships that affect the whole society)
Treatment gap is enormous (between the prevalence of mental disorders, on one hand, and the number of people receiving treatment and care)
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35. MH into PHC: Why ? (II) Integration of Mental Health into PHC
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MENTAL HEALTH
Integration of
Mental Health into PHC
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MH into PHC: Why ? (II)
Is affordable and cost effective
Generates good health outcomes,
(particularly when linked to a network of
services at secondary level and in the
community)
Promotes respect of human rights 
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36. MH into PHC: Why ? (III) Integration of Mental Health into PHC
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MENTAL HEALTH
Integration of
Mental Health into PHC
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MH into PHC: Why ? (III)
MH in PHC is complementary to secondary
and tertiary level mental health services
General hospital services:
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Manage acute episodes of MI
Do not provide for chronic disorders
(revolving door syndrome)
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37. MH into PHC: How ? Integration of Mental Health into PHC
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MENTAL HEALTH
Integration of
Mental Health into PHC
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MH into PHC: How ?
Putting in place strategies to
Prevent MI
Manage MI
Adequate training of PHC workers to apply key psychosocial and behavioral science skills,
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Interviewing
Counseling
Interpersonal skills
Use of a holistic, comprehensive approach to Diagnose and Treat MI
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38. MH into PHC: How ? Integration of Mental Health into PHC
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MENTAL HEALTH
Integration of
Mental Health into PHC
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MH into PHC: How ?
Policy and plans: to incorporate MH into PHC.
Advocacy is required to shift attitudes and behavior.
PHC tasks must be limited and doable.
Specialist mental health professionals and facilities must be available to support PHC.
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39. MH into PHC: KSA Attempt .
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MENTAL HEALTH
Integration of
Mental Health into PHC
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MH into PHC: KSA Attempt .
Primary care physicians provide basic mental health services through primary care
Selected primary care physicians, who have received additional training, serve as referral sources for complex cases
A community mental health clinic provides complementary services, such as psychosocial rehabilitation
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40. MH into PHC: KSA Results .
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MENTAL HEALTH
Integration of
Mental Health into PHC
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MH into PHC: KSA Results .
As a result of training and ongoing support by mental health specialists based at the Community Mental Health Clinic:
Physicians’ knowledge and management of mental disorders have improved.
Many people with mental disorders, who otherwise would have been undetected or hospitalized, are now treated within the community.
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41. MH into PHC: Conclusion .
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MENTAL HEALTH
Integration of
Mental Health into PHC
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MH into PHC: Conclusion .
Needed and cost effective
Require certain skills and competencies to diagnose, treat and refer people with MI.
Most successful when incorporated into health policy and legislation, and supported by senior leadership, adequate resources and governance.
Must be coordinated with a network of services at different levels of care and complemented by broader health system development.
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MENTAL HEALTH
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The Takeaway
Academic performance is enhanced by physical and emotional health
We can learn to recognize problems much earlier
Depression, Anxiety and Stress are treatable
Education, Psychotherapy and Medication are all effective
Self Care--eat, sleep, exercise--is a cornerstone of health (for all of us!)
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MH into PHC is needed and cost effective
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