Describe the difficulty in defining mental health problems
Statistical infrequencies:
- normal distributed behaviour
- infrequency doesn’t make it a problem (and also mental health problems are becoming more commonly identified)
Violating social norms:
- It is too broad and too narrow; it would take into account the behaviour of criminals but not highly anxious individuals
- culturally subjective
- misses certain behaviour
Personal distress:
- too difficult to measure
- some disorders do not experience distress (psychopaths)
Dysfunctions:
- depends on value judgements
- internal mechanisms are not defined
Universality:
- differences with society, time, ethnics (e.g. are visions wise or psychotic?)
Describe the key elements of the DSM-5’s definition of mental health problems
Disturbance:
- disruption to every day; flashbacks, physiological reactions
- personal and present distresses (although not all mental disorders exhibit distress, not all distress is disordered)
Disability and dysfunction:
- impairment in an area, something not working as it should - based on social norms
- but not all disorders impair lives - bulimia patients lead normal lives whilst bingeing in private
Violation of social norms:
- too broad (criminals won’t be considered as much in psychopathology and too narrow because highly anxious people don’t violate norms)
- this changes depending on the time, ethnic group - cant be universal
- definition factors in discrepancies and is available on notion
What are some early views of mental illness (pre-15th century)?
- demons and supernatural powers (treated with exorcisms, trephination - holes in head, rituals)
- Early biological - Hippocrates (460BC) - classified mental disorder as an imbalance of bodily fluids
- mania, melancholia and phrenins and different treatments for each to balance the bodily fluids
- Kraeplin postulated a chemical imbalance as the cause of dementia praecox (SZ) and an irregularity in metabolism as the explanation of manic-depressive psychosis (bipolar).
- Lunacy trials - mental misalignment - dunking/tests
How did mental health asylums come about?
Leprosy hospitals became confinement/care for those mentally challenged
- usually crude, inhumane treatment of patients : Bedlam (tourist attraction/entertainment purposes)
Describe Pinel’s Reforms (1745-1826)
- Movement into the humane treatment of those with disorders (was said to have released prisoners at French asylum but was actually Pussin)
- approached disorders with dignity and better treatment - ALTHOUGH : better treatment reserved for upper classes - lower classes till treated like animals
Who is Dorothea Dix and what was she responsible for?
- Moral treatment: encouraging humane treatment, closer contact and less than 250 people per hospital for individual treatments; this was abandoned later
- Dorothea Dix (1802-1887) - protested for better treatment and rights with more hospital but small staff couldn’t accommodate the amount of patients, leading to less moral treatment)
Describe the modern outlook on mental health
- not as taboo but still stigmatised
- deinstitutionalization ; more community based
- medications, therapies, reintergration into society and managing day to day
What creates stigmas around mental illness?
- Distinguishing label
- Label = linked to undesirable attitudes
- Label = creates a divide with others
- Label evokes discrimination
Describe strategies to reduce stigmatisation of mental disorders (Hinshaw, 2007)
Community:
- Housing: improving housing for those with psychological disorders
- Education: learning/reducing hesitancy to speak about it
- Personal Contact: really effective, especially in informal settings
Health profession:
- Evaluations prior to onset (preventative measure) - avoiding seriousness
- Education/empirical evidence and understanding
Individual and family strategies:
- Education, alleviating blame, treatments (psychoeducation)
- Advocacy groups, blogs: emotional support and empowerment
Example efforts: creative socials, celeb endorse
