Community mental health
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COMMUNITY MENTAL HEALTH. What is Mental Health?. The emotional and social well-being of an individual, including one’s psychological resources for dealing with the day-to-day problems of life. Good Mental Health is the Ability to:. Function under adversity Change or adapt to changes

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COMMUNITY MENTAL HEALTH

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Community mental health

COMMUNITY MENTAL HEALTH


What is mental health

What is Mental Health?

  • The emotional and social well-being of an individual, including one’s psychological resources for dealing with the day-to-day problems of life.


Good mental health is the ability to

Good Mental Health is the Ability to:

  • Function under adversity

  • Change or adapt to changes

  • Maintain control over one’s tension and anxiety

  • Find more satisfaction in giving than receiving

  • Show consideration for others

  • Curb hate and guild

  • Love others


Classification of mental disorders

Classification of Mental Disorders

  • Diagnostic and Statistical Manual of Mental Disorders, fourth addition

    http://www.psychologynet.org/dsm.html

    • Anxiety Disorders

    • Childhood Disorders

    • Eating Disorders

    • Mood Disorders

    • Personality Disorders

    • Psychotic Disorders

    • Substance-Related Disorders

    • Other Disorders


Causes of mental disorders

Causes of Mental Disorders

  • Birth Defects

    • Inherited mental deficiency

    • Biologically caused mental retardation

  • Physical Impairment

    • Neurotransmitter failures related to psychotic episodes at puberty

    • Brain trauma due to accident

  • Psychological Causes

    • Being reared in economically deprived conditions

    • Parental abuse


Mental illness in america

Mental Illness in America

  • Four to five million adults have serious mental illness (SMI)

  • 15.4% of the U.S. population 18 and older have had one incident of mental illness in the past 30 days

  • 18.2 adults per 1,000 had experienced an episode of SMI in the past year


Social indicators of mental illness

Social Indicators of Mental Illness

  • There are approximate 30,000 suicides in the U.S. yearly

  • In 1991 the number 2 and number 3 leading cause of death among 15-24 year olds was homicide

  • In 1990 the divorce rate (4.7/1,000) was nearly half the marriage rate (9.8/1,000)

  • 4.5 million women of childbearing age were current users of illegal substances

  • 1,383 children died from abuse or neglect in 1991


Stress a contemporary mental health problem

Stress: A Contemporary Mental Health Problem

  • Stress is one’s psychological and physiological response to stressors

  • General Adaptation Syndrome (GAS) A three stage response to stressors

    • Alarm reaction

    • Resistance

    • Exhaustion

Fight or Flight


Mental health in america before world war i

Mental Health in America Before World War I

  • Care provided by families or private caretakers

  • Those not cared for in the home were sent to the poor houses or almshouses

  • In the late 19th century as the number of people increased in the poor houses and almshouses attempts were made to separate people by type of disability

  • In 1851 Dr. Thomas Bond visited the famous Bedlam Hospital in England and founded Pennsylvania Hospital the first institution in America for the care of the mentally ill.

    • Blood letting

    • Blistering

    • Emetics

    • Warm and cold baths


The moral treatment era for the well to do

The Moral Treatment Era for the Well-To-Do

  • William Tuke, and English Quaker, established moral treatment

    • Mental illness was caused by:

      • Infidelity

      • Being overworked

      • Envy

      • Gluttony

      • Drinking

      • Sexual excesses

  • Treated in an asylum with:

  • Rest

  • Light food

  • Exercise

  • Fresh air

  • Amusements


The state hospitals

The State Hospitals

  • Institutions became a place for those society did not want to have around

    • Prisoners

    • Orphans

    • Wayward youths

    • The mentally ill

  • The rationalization was that with small numbers of patients proper care could be provided

  • The numbers of patients grew very rapidly

  • In time the institutions became human warehouses


The mental hygiene movement

The Mental Hygiene Movement

  • Occurred during the first few decades of the twentieth century

  • Believed that early detection treatment was key to curing mental illness

  • Wanted to address the problem at a community level

  • Established local mental hospitals (Bellevue in NY)

  • This movement did nothing to address the State Hospital problem

  • By the 1940s state mental institutions had grown to nearly a half-million


Mental health care after world war ii

Mental Health Care After World War II

  • Psychiatrists came out of the war with new techniques called crisis management

  • In 1946 the National Institute of Mental Health was formed

    • Fostered research

    • Supported training

    • Improved clinical services


Deinstitutionalization

Deinstitutionalization

  • Discharging of patients from state hospitals and the relocating them in less crowded community settings

    • In 1955 558,922 resident patients

    • In 1970 337,619 resident patients

    • In 1980 150,000 resident patients

    • In 1990 110,000 resident patients


Deinstitutionalization forces

Deinstitutionalization Forces

  • Economics

    • States needed money for roads, education and welfare

    • There was a new profit motive to provide services for the mentally ill

  • Idealism: Keep people out of institutions

  • Legal considerations

    • Federal Legislation: Aid to the Permanently and Totally Disabled (APTD)

    • Welfare money could now be paid to discharged mental patients

  • Antipsychotic drugs

    • Chlorpromazine

    • Thorazine


Community mental health centers

Community Mental Health Centers

  • A Presidential commission recommended replacing all mental hospitals with community based mental health centers (1961)

  • Seen as secondary and tertiary prevention

  • The federal government became partially responsible for mental health care in the U.S.

  • Reduced budgets during the Regan years left community mental health centers understaffed and under utilized


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