Bipolar Support Groups.com blog

Mental Health Indicators

In the health care and public health arena, more emphasis and resources have been devoted to screening, diagnosis, and treatment of mental illness than mental health. Little has been done to protect the mental health of those free of mental illness. Researchers suggest that there are indicators of mental health, representing three domains.^6-8 These include the following:

• Emotional well-being
  • such as perceived life satisfaction, happiness, cheerfulness, peacefulness.
• Psychological well-being
  • such as self-acceptance, personal growth including openness to new experiences, optimism, hopefulness, purpose in life, control of one’s environment, spirituality, self-direction, and positive relationships.
• Social well-being
  • social acceptance, beliefs in the potential of people and society as a whole, personal self-worth and usefulness to society, sense of community.

The former surgeon general notes that there are social determinants of mental health as there are social determinants of general health that need to be in place to support mental health. These include adequate housing, safe neighborhoods, equitable jobs and wages, quality education, and equity in access to quality health care.

Learn more details on mental health promotion.

The term mental health is commonly used in reference to mental illness. However, knowledge in the field has progressed to a level that appropriately differentiates the two. Although mental health and mental illness are related, they represent different psychological states.

Mental health is “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.”¹ It is estimated that only about 17% of U.S adults are considered to be in a state of optimal mental health.² There is emerging evidence that positive mental health is associated with improved health outcomes.

Mental illness is defined as “collectively all diagnosable mental disorders” or “health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.”² Depression is the most common type of mental illness, affecting more than 26% of the U.S. adult population.³ It has been estimated that by the year 2020, depression will be the second leading cause of disability throughout the world, trailing only ischemic heart disease.⁴

Evidence has shown that mental disorders, especially depressive disorders, are strongly related to the occurrence, successful treatment, and course of many chronic diseases including diabetes, cancer, cardiovascular disease, asthma, and obesity⁵ and many risk behaviors for chronic disease; such as, physical inactivity, smoking, excessive drinking, and insufficient sleep.

What Are Brain Disorders?

Your brain is your body’s control center. It’s part of the nervous system, which also includes the spinal cord and a large network of nerves and neurons. Together, the nervous system controls everything from your five senses to the muscles throughout your body.

When your brain is damaged, it can affect many different things, including your memory, your sensation, and even your personality. Brain disorders include any conditions or disabilities that affect your brain. This includes those conditions that are caused by illness, genetics, or traumatic injury.

This is a broad category of disorders, which vary greatly in symptoms and severity. Keep reading to learn about some of the largest categories of brain disorders.

Advertisement

Part 2 of 5

What Are the Different Types of Brain Disorders?

Brain Injuries

Brain injuries are often caused by blunt trauma. Trauma can damage brain tissue, neurons, and nerves. This damage affects your brain’s ability to communicate with the rest of your body. Examples of brain injuries include:

• hematomas
• blood clots
• contusions, or bruising of brain tissue
• cerebral edema, or swelling inside the skull
• concussions
• strokes

Examples of the symptoms of a brain injury include:

• vomiting
• nausea
• speech difficulty
• bleeding from the ear
• numbness
• paralysis
• memory loss
• problems with concentration

Later, you may develop:

• high blood pressure
• a low heart rate
• pupil dilation
• irregular breathing

Depending on the type of injury you have, treatment might include medication, rehabilitation, or brain surgery. About half of people with severe brain injuries need surgery to remove or repair damaged tissue or to relieve pressure. People with minor brain injuries may not need any treatment beyond pain medication.

Many people with brain injuries need rehabilitation. This can include physical therapy, speech and language therapy, and psychiatry.

Learn more about concussions

Brain Tumors

Sometimes, tumors form in the brain and can be very dangerous. These are called primary brain tumors. In other cases, cancer somewhere else in your body spreads to your brain. These are called secondary or metastatic brain tumors.

Brain tumors can be either malignant (cancerous) or benign (noncancerous). Doctors classify brain tumors as grades 1, 2, 3, or 4. Higher numbers indicate more aggressive tumors. The cause of brain tumors is largely unknown. They can occur in people of any age.

Symptoms of brain tumors depend on the size and location of the tumor. The most common symptoms of brain tumors are:

• headaches
• seizures
• numbness or tingling in your arms or legs
• nausea
• vomiting
• changes in personality
• difficulty with movement or balance
• changes in your hearing, speech, or vision

The type of treatment you’ll receive depends on many different factors, such as the size of the tumor and your age and overall health. The main types of treatment for brain tumors are surgery, chemotherapy (medication), and radiation therapy.

Keep reading about brain tumors

Neurodegenerative Diseases

Neurodegenerative diseases cause your brain and nerves to deteriorate over time. They can change your personality and cause confusion. They can also destroy your brain’s tissue and nerves.

Some brain diseases, such as Alzheimer’s disease, may develop as you age. They can slowly impair your memory and thought processes. Other diseases, such as Tay-Sachs disease, are genetic and begin at an early age. Other common neurodegenerative diseases include:

• Huntington’s disease
• amyotrophic lateral sclerosis
• Parkinson’s disease
• all forms of dementia

Some of the more common symptoms of neurodegenerative diseases include:

• memory loss
• forgetfulness
• apathy
• anxiety
• agitation
• a loss of inhibition
• mood changes

Neurodegenerative diseases cause permanent damage, so symptoms tend to get worse as the disease progresses. New symptoms are also likely to develop over time.

There’s no cure for neurodegenerative diseases, but treatment can still help. Treatment for these diseases tries to reduce symptoms and maintain quality of life. Treatment often involves the use of medications to control symptoms.

Learn more about Alzheimer’s disease

Mental Disorders

Mental disorders, or mental illnesses, are a large and diverse group of conditions that affect your behavior patterns. Some of the most frequently diagnosed mental disorders are:

• depression
• anxiety
• bipolar disorder
• post-traumatic stress disorder
• schizophrenia

The symptoms of mental disorders vary based on the condition. Different people can experience the same mental disorders very differently. You should talk to your doctor if you notice a change in your behavior, thought patterns, or moods.

The two major types of treatment for mental disorders are medication and psychotherapy. Different methods work better for different conditions. Many people find that a combination of the two is the most effective.

If you think you might have a mental disorder, it’s important to talk to your doctor to come up with a treatment plan that works for you. Don’t try to self-medicate.

There are many types of mental health care professionals who can help you achieve your recovery goals. Finding the right one is easier when you know about their different treatment roles. If you have insurance, your plan needs to offer you the care providers you need. If a doctor does not accept insurance, he or she is obligated to find you another. Speak with your health insurance provider for more information.

Prescribe and Monitor Medication

The following professionals are able to prescribe medication. They may also provide assessments, diagnoses and therapy.

Primary Care Physicians

Primary care physicians and pediatricians can prescribe medication but it may be wise to consider a visit to someone who specializes in mental health care. Primary care and mental health professionals should work together to determine the best treatment plan for each person. Shortages of health care professionals are not uncommon in many parts of the country. As a consequence, more primary care physicians are being trained and equipped to provide mental health care.

Psychiatrists

Psychiatrists are licensed medical doctors with medical and psychiatric training. They can diagnose mental health conditions and prescribe and monitor medications. Psychiatrists are also able to offer counseling and provide therapy. Some have special training in child and adolescent mental health or substance use disorders or geriatric psychiatry.

Psychiatric or Mental Health Nurse Practitioners

Psychiatric or mental health nurse practitioners with a master’s or doctoral degree and specialized training can provide assessment, diagnosis and therapy for mental health conditions or substance use disorders. In some states, they are required to work under a psychiatrist’s supervision.

In some states physician assistants or nurse practitioners are also qualified to prescribe medication.

Therapy and Assessment

A therapist can help someone better understand and cope with their thoughts, feelings and behaviors. The therapist can provide guidance and help improve the ability to reach recovery goals. These mental health professionals may also help assess and diagnosis mental illness.

Clinical Psychologists

Clinical psychologists with a doctoral degree in psychology are trained to make diagnoses and provide individual and group therapy. Some may have training in specific forms of therapy like cognitive behavioral therapy or dialectical behavior therapy, along with other behavioral therapy interventions.

Psychiatric or Mental Health Nurses

Psychiatric or mental health nurses may have various degrees ranging from a nurse with an associate’s degree to a nurse with a doctorate degree as a Doctor of Nursing Practice. Depending on their education and licensing, services can include assessment and treatment of mental health conditions, case management and therapy.

School Psychologists

School psychologists with advanced degrees in psychology are trained to make diagnoses, provide individual and group therapy and work with parents, teachers and school staff to ensure a healthy school environment. They may also participate in the development of individualized education plans (IEP) to help improve the school experience of the student with a mental health condition.

Counseling

Working with a counselor can lead to better ways of thinking and living. Counselors assist with developing life skills and improving relationships.

Clinical Social Workers

Clinical social workers have a master’s degree in social work and are trained to make diagnoses and provide individual and group counseling, case management and advocacy. Clinical social workers often work in hospitals or clinics or in private practice. Licensed, independent social workers (LICSW) have undergone an extra certification process.

Counselors

Counselors are trained to diagnose and provide individual and group counseling. Counselors may focus on different areas and can have titles such as: Licensed Professional Counselor, Mental Health Counselor, Certified Alcohol and Drug Abuse Counselor, Marital and Family Therapist.

Pastoral Counselors

Pastoral counselors are clergy members with training in clinical pastoral education. They are trained to diagnose and provide counseling. Pastoral counselors are members of the Association of pastoral Counselors (AAPC) and can have equivalents to a doctorate in counseling. Chaplains are trained in Clinical Pastoral Education (CPE).

Peer Specialists

Peer specialists have lived experience with a mental health condition or substance use disorder. They have often received training and certification and are prepared to assist with recovery by developing strengths and setting goals.

Social Workers

Social workers (B.A. or B.S.) provide case management, inpatient discharge planning services, placement services and other services to support healthy living.

Psychiatric Pharmacists

Psychiatric pharmacists work directly with patients and caregivers to apply specialized clinical knowledge and skills to impact treatment outcomes. Psychiatric pharmacists are often doctoral and resident trained to provide comprehensive medication management which involves assessing the efficacy of psychiatric medications, performing medication histories, and providing treatment strategies for a therapeutic plan. Psychiatric pharmacists are most often employed within health care systems such as Veterans Affairs, hospitals, and clinics, and serve as a member of the treatment team in conjunction with a physician.

– See more at: http://www.nami.org/Learn-More/Treatment/Types-of-Mental-Health-Professionals#sthash.y1avrazl.dpuf

The great majority of people who experience an episode of mental illness recover and have productive working lives. In some cases, such an episode can act as a trigger for a career or lifestyle change that benefits the person in the long term.

However, a small minority of people take sick leave and do not return to work at all. This can have lifelong effects on social and family relationships, financial circumstances and quality of life. People in this situation have said that they realise that if they or their employers had done things differently they would not find themselves in such difficult situations.

In general, the longer a person is off work the harder it is to return. It is very important for employers and employees to address barriers to return to work as early and effectively as possible.

Key issues

• work issues (real or perceived) that may have contributed to the person’s absence. These may include bullying
• stigma and lack of understanding of mental health problems and their effects on work performance
• mistrust or suspicion about whether the employee’s illness is ‘real’
• poor or non-existent planning for return to work
• low self-esteem or poor self-confidence

Tips for overcoming barriers to return to work

• If you are a supervisor, don’t get caught up in the issue of whether an illness is ‘real’ or not. Focusing on the return-to-work process and approaching an employee from a position of care and concern are much more likely to lead to successful return to work.
• Attempt to explore and address any work-related contributors or causes of stress, including bullying. Employers and employees should work together to prioritise solutions. This can be done in return-to-work discussions and as part of the process of making reasonable adjustments.
• Develop a clear, written return-to-work plan. Again, employers and employees should work together to do this.
• Supervisors and employees (and colleagues where appropriate) should make an effort to find out about mental health problems and their effects on work performance.
• Employers and employees should agree on who might need to know about the employee’s condition and what information should be given. Confidentiality and privacy should be respected.
• Employees should work with their health professionals to address self-confidence or other work-related issues.

Key facts

• Mental health is more than the absence of mental disorders.
• Mental health is an integral part of health; indeed, there is no health without mental health.
• Mental health is determined by a range of socioeconomic, biological and environmental factors.
• Cost-effective public health and intersectoral strategies and interventions exist to promote, protect and restore mental health.

Mental health is an integral and essential component of health. The WHO constitution states: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” An important implication of this definition is that mental health is more than just the absence of mental disorders or disabilities.

Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.

Mental health and well-being are fundamental to our collective and individual ability as humans to think, emote, interact with each other, earn a living and enjoy life. On this basis, the promotion, protection and restoration of mental health can be regarded as a vital concern of individuals, communities and societies throughout the world.

Determinants of mental health

Multiple social, psychological, and biological factors determine the level of mental health of a person at any point of time. For example, persistent socio-economic pressures are recognized risks to mental health for individuals and communities. The clearest evidence is associated with indicators of poverty, including low levels of education.

Poor mental health is also associated with rapid social change, stressful work conditions, gender discrimination, social exclusion, unhealthy lifestyle, risks of violence, physical ill-health and human rights violations.

There are also specific psychological and personality factors that make people vulnerable to mental disorders. Lastly, there are some biological causes of mental disorders including genetic factors which contribute to imbalances in chemicals in the brain.

Mental health promotion and protection

Mental health promotion involves actions to create living conditions and environments that support mental health and allow people to adopt and maintain healthy lifestyles. These include a range of actions to increase the chances of more people experiencing better mental health.

An environment that respects and protects basic civil, political, socio-economic and cultural rights is fundamental to mental health promotion. Without the security and freedom provided by these rights, it is very difficult to maintain a high level of mental health.

National mental health policies should not be solely concerned with mental disorders, but should also recognize and address the broader issues which promote mental health. These include mainstreaming mental health promotion into policies and programmes in governmental and nongovernmental sectors. In addition to the health sector, it is essential to involve the education, labour, justice, transport, environment, housing, and welfare sectors as well.

Promoting mental health depends largely on intersectoral strategies. Specific ways to promote mental health include:

• early childhood interventions (e.g. home visits for pregnant women, pre-school psycho-social activities, combined nutritional and psycho-social help for disadvantaged populations);
• support to children (e.g. skills building programmes, child and youth development programmes);
• socio-economic empowerment of women (e.g. improving access to education and microcredit schemes);
• social support for elderly populations (e.g. befriending initiatives, community and day centres for the aged);
• programmes targeted at vulnerable groups, including minorities, indigenous people, migrants and people affected by conflicts and disasters (e.g. psycho-social interventions after disasters);
• mental health promotional activities in schools (e.g. programmes supporting ecological changes in schools and child-friendly schools);
• mental health interventions at work (e.g. stress prevention programmes);
• housing policies (e.g. housing improvement);
• violence prevention programmes (e.g. reducing availability of alcohol and access to arms);
• community development programmes (e.g. integrated rural development);
• poverty reduction and social protection for the poor;
• anti-discrimination laws and campaigns;
• promotion of the rights, opportunities and care of individuals with mental disorders.

Mental health care and treatment

In the context of national efforts to develop and implement mental health policy, it is vital to not only protect and promote the mental well-being of its citizens, but also address the needs of persons with defined mental disorders.

Knowledge of what to do about the escalating burden of mental disorders has improved substantially over the past decade. There is a growing body of evidence demonstrating both the efficacy and cost-effectiveness of key interventions for priority mental disorders in countries at different levels of economic development. Examples of interventions that are cost-effective, feasible, and affordable include:

• treatment of epilepsy with antiepileptic medicines;
• treatment of depression with psychological treatment and, for moderate to severe cases, (generically produced) antidepressant medicines;
• treatment of psychosis with older antipsychotic medicines and psychosocial support;
• taxation of alcoholic beverages and restriction of their availability and marketing.

A range of effective measures also exists for the prevention of suicide, prevention and treatment of mental disorders in children, prevention and treatment of dementia, and treatment of substance-use disorders. The Mental Health Gap Action Programme (mhGAP) has produced evidence based guidance for non-specialists to enable them to better identify and manage a range of priority mental health conditions.

WHO response

WHO supports governments in the goal of strengthening and promoting mental health. WHO has evaluated evidence for promoting mental health and is working with governments to disseminate this information and to integrate effective strategies into policies and plans.

In 2013, the World Health Assembly approved a “Comprehensive Mental Health Action Plan for 2013-2020”. The Plan is a commitment by all WHO’s Member States to take specific actions to improve mental health and to contribute to the attainment of a set of global targets.

The Action Plan’s overall goal is to promote mental well-being, prevent mental disorders, provide care, enhance recovery, promote human rights and reduce the mortality, morbidity and disability for persons with mental disorders. It focuses on 4 key objectives to:

• strengthen effective leadership and governance for mental health;
• provide comprehensive, integrated and responsive mental health and social care services in community-based settings;
• implement strategies for promotion and prevention in mental health; and
• strengthen information systems, evidence and research for mental health.

Particular emphasis is given in the Action Plan to the protection and promotion of human rights, the strengthening and empowering of civil society and to the central place of community-based care.

In order to achieve its objectives, the Action Plan proposes and requires clear actions for governments, international partners and for WHO. Ministries of health will need to take a leadership role and WHO will work with them and with international and national partners, including civil society, to implement the plan. As there is no action that fits all countries, each government will need to adapt the Action Plan to its specific national circumstances.

Implementation of the Action Plan will enable persons with mental disorders to:

• find it easier to access mental health and social care services;
• be offered treatment by appropriately skilled health workers in general health care settings; WHO’s Mental Health Gap Action Programme (mhGAP) and its evidence-based tools can facilitate this process;
• participate in the reorganization, delivery and evaluation of services so that care and treatment becomes more responsive to their needs;
• gain greater access to government disability benefits, housing and livelihood programs, and better participate in work and community life and civic affairs.

WHO MEDIA CENTRE….