Mental Health – Public Health Perspective

General Overview:

Mental illness affects one in every four people. Surprised? Mental illness cuts across socioeconomic status, professions , countries and cultures. Of course, in certain countries, cultures, and socioeconomic levels, mental illness is accepted and resources are allocated for individuals who fall into the category of the mentally ill.

Unfortunately, the public perception of the mentally ill is often one tied to the unkempt individual that is out of touch with reality or society. Many are often so caught up in their idea of what the mentally ill looks like, that they refuse to acknowledge that mentally ill individuals might have ‘normal’ faces and be quite hidden within society. Because, mental health issues are not as in your face as physical disabilities, it has been a struggle getting attention on the issues of mental health  in terms of funding.

How is  mental illness defined?

There are several definitions out there for mental illness but the definition preferred on this blog is that mental illness is a chemical imbalance that causes an individual to produce behavioral changes (feels, acts, behaves, thinks) that might be considered as being outside the scope of normality for an extended duration of time.

Now, one will assume that with mental illness being a common occurrence in every society that there will be more acceptance ; unfortunately, because many societies are not fully equipped or ready to handle this issue, many of the mentally ill either fall through the cracks, hide in shadows (particularly if they can pass off as being ‘normal’ ) or are abandoned.

It is particularly saddening that in many developed countries those that seem to fall through the cracks tend to be those from lower socioeconomic levels. Often, because they cannot afford to pay for help, or therapy is not supported in their communities.

Who are the Mentally ill?

The mentally ill ranges from the professional who seems to have it all together to the homeless individual that you see having an interesting conversation with an invincible person. There is a broad spectrum for what could be termed mental illness and this ranges from schizophrenia, bipolar disorder, depression, OCD etc.

A Special Note on Substance Abuse:

In many cases substance abuse is grouped with mental illness because substance abuse can be the doorway into mental illness or could be the way that individuals cope with their mental illness. Substance abuse could be a coping strategy. For example, that person that is addicted to prescription pills might be dealing with depression. Another example, could be that person that abuses alcohol could be using alcohol to lessen the sound of voices talking to him/her.

What are the issues for many with mental illness?

a) Lack of awareness: Many do not know about mental illness or they are stuck on their perception of mental illness.

b)Lack of acceptance: Many have learned how to hide their struggles to fit in.

c)Lack of inclusion: Many are scared that they will lose their loved ones if they admit to struggling with mental illness and many have lost their loved ones because of mental illness.

d)Lack of facilities and trained mental health professionals: There is a dearth of professionals trained to work within this field and in some parts of the world, facilities are lacking to handle this population.  In addition, there are countries that prefer not to take care of this population for cultural reasons.

e)Isolation: The mentally ill is often isolated from the rest of society. Often, there are no programs in place to include them into society during and after treatment.

f)Lack of understanding: There are societies in which religion is often the way used on the mentally ill but it is imperative that there is a balance between religion and other initiatives. After the religious process, the individual will still need to see a therapist, will still need to be trained on how to behave in society/work in society, will still need to be supported through the inclusion process. It is very important that all those who played a supportive role in the healing process get some therapy. In developing countries, caregiver burden is seen as normative, but no one asks about support for the caregiver.   There is a need for supportive networks in developing countries for the mentally ill and their loved ones.

g) Lack of training: Those who educate and those who hire need to be trained in ways of creating special accommodations for these individuals. They also need to be trained on how to communicate with these individuals. In the United States, a lot of work is being done in this area by training those who work in the field of education.

What should the lay person do?

a) Provide support:  Many of those who struggle with mental illness beyond needing a therapist or professional that can provide psychological or psychiatric support,  also need a friend that will see them through the dark times.

b) Many need to be included. The idea of excluding individuals who struggle with mental illness in certain countries/cultures need to be abolished. Those who struggle with mental illness are still members of society and as such special accommodations should be created to include these individuals. Many of these individuals with mental illness are skilled workers or people who have the potential to be trained in special skills, so it becomes worrisome when one wonders, how many highly skilled individuals in high employment need based areas  have been abandoned  because of this special circumstance. Further more, it is interesting to note that many in our prison systems around the world, are individuals who struggle with mental illness. It makes one wonder, if the reason they got themselves into certain ‘situations/scenarios’ was because of this condition.

Fortunately, United States Of America provides for inmates who struggle with mental illness. It has been noted, that there are cases of family members /loved ones calling for the apprehension of their  mentally ill  because they cannot provide the kind of care needed and the prison system is set up to provide the best care.  But, this is in the United States, and is probably not the case in developing countries.

c)Support government and community led initiatives that will create programs that help these individuals. If you can vote – then vote the right individuals who show concern about the invincible in society and have a workable plan in place to help/support these individuals.  If you can not vote, get involved in outreach programs. Get involved in promoting mental health. Educate individuals on mental health and its impact on community health.

d)Encourage these individuals to get diagnosed. Get them to understand that getting diagnosed is the first step towards healing. Do not self-diagnose.

Why is this a Public Health Issue?

a) This is  a global health issue that affects individual, organizational and population health around the world.  Every country is affected.

b) It includes socioeconomic disparities and affects the powerless and the voiceless.

c)It has far-reaching impact.

d)It involves health care reforms.

e) It involves collaborating with different communities , religious institutions and health systems to take care of a particular population.

For those in the United States, please check out www.samhsa.gov.

 

FYI:  May is Mental Health Month in the United States.

 

 

 

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