Mental Health - an overview (2022)

Mental health is defined by WHO as “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 contribute to his or her community” (as quoted in Herrman et al., 2005: p.

From: International Encyclopedia of Public Health (Second Edition), 2017

Procedures Pertaining to Hypothermia and Hyperthermia

James R. Roberts MD, FACEP, FAAEM, FACMT, in Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care, 2019

Malignant Hypertension (MH)

MH is a pharmacogenetic disease attributable to a medication that triggers a life-threatening, hypermetabolic syndrome.179 It results from a rare inherited autosomal dominant abnormality in the skeletal muscle membrane and has an incidence of 1 in 50,000 in adults.151 In response to certain stresses or drugs (Box 65.1), patients with this disorder sustain a potentially lethal hypermetabolic reaction with massive efflux of calcium from the skeletal muscle sarcoplasmic reticulum. This results in contraction of the sarcomeres, skeletal muscle rigidity, increased skeletal muscle metabolism, elevated serum creatine kinase levels, heat production, and finally, systemic hyperthermia.180,181 Hyperthermia is a late development and occurs after rigidity has been present for some time and the body's normal heat dissipation mechanisms are overwhelmed. The earliest signs of MH are increased carbon dioxide production, muscle rigidity, and tachycardia.182 Cardiac output and cutaneous blood flow also increase to maximize the heat loss. Diagnosis of MH is based on the clinical triad of (1) exposure to an agent or stress known to trigger the condition, (2) skeletal muscle rigidity, and (3) hyperthermia.

MH is usually encountered in the operating room while patients are undergoing general anesthesia, particularly with halogenated inhalational agents and depolarizing muscle relaxants. Heat production in anesthetized patients can be profound with as much as a fivefold increase in oxygen consumption.181 Cases of MH may be encountered anywhere that general anesthetics or neuromuscular blocking agents are used.181,182 A massive increase in creatine kinase is a strong indicator of an MH reaction.179

As with heatstroke, treatment of MH requires rapid cooling and supportive care for the sequelae described previously. Unlike heatstroke, MH requires specific pharmacologic therapy to stop excessive heat production by skeletal muscle. Dantrolene sodium induces muscle relaxation in patients with MH by blocking release of calcium from the muscle cell sarcoplasmic reticulum.183 In all cases of MH, the inciting stimulus should be discontinued immediately and dantrolene therapy administered. A dantrolene bolus of 2.5 mg/kg should be started and repeated at 5-min intervals until normalization of the hypermetabolic state is achieved and all MH symptoms disappear.183 Procainamide has been used successfully when dantrolene is unavailable.183

It has been suggested that dantrolene administration speeds cooling of heatstroke victims by reducing skeletal muscle heat production.183 A randomized, controlled trial of the use of dantrolene for heatstroke found no difference between the treatment and placebo groups in terms of cooling time, complications, or length of stay.184 In 2005, a meta-analysis concluded that there was no role for the use of dantrolene in the management of heatstroke.185 Currently, dantrolene administration is best reserved for patients with clinical muscle rigidity or suspected MH. Routine use of this drug in heatstroke patients is not recommended.185 New and promising treatments of MH are being investigated. Researchers have discovered mutations in the gene coding for the ryanodine receptor calcium release channel (RyRI) in families with MH, which may be the functional basis for MH. Some studies have examined the effects of MH mutations on the sensitivity of the RyRI to drugs and endogenous channel effectors, including Ca2+ and calmodulin.186

Mental Health

Jack E. James, in The Health of Populations, 2016

15.2.2 WHO Framework for Mental Disorders

In 2013, the WHO launched the Mental Health Action Plan 2013-2020, designed to guide national initiatives in all countries with the aim of addressing worldwide unmet need for mental health promotion, prevention, and intervention. The action plan is intended for all countries for the express reason that there are current major shortfalls in mental health action worldwide. Although the shortfall is greatest in developing countries, where between 76% and 85% of people with severe mental disorders receive no treatment, a large shortfall of between 35% and 50% is also characteristic of high-income countries (WHO, 2013). Moreover, despite the fact that less than 2% of the health budget in most countries is allocated to mental health, about two-thirds of that already meager allocation goes to standalone mental hospitals. It is known, however, that such facilities are associated with poor health outcomes and frequent human rights violations (WHO, 2013). Therefore, even without increasing budgets, redirection of funding toward community-based services, including the integration of mental health into general health care, would create access to better and more cost-effective interventions for many more people than at present.

WHO initiatives for mental health have evolved against a background of increased awareness of the interdependence between physical health and mental health. Notably, some of the major risk factors for physical diseases are recognized as also being risk factors for mental disorders (e.g., physical inactivity predisposes to depression). Additionally, it is acknowledged that the simultaneous experience of physical and mental disorders is not merely a matter of comorbidity, but that considerable reciprocal causation also occurs between physical diseases and mental disorders. For example, depression predisposes to cardiovascular disease and cardiovascular disease increases the likelihood of depression. Consequently, strategies that decrease the incidence of physical health problems will inevitably also contribute to reduced incidence of mental disorders, and vice versa. In addition, both physical health and mental health are influenced by a wide range of shared psychosocial variables. For example, the social determinants that contribute to increased risk of harmful consumption of alcohol simultaneously contribute to a host of health problems, both physical (e.g., cardiovascular diseases) and psychosocial (e.g., depression and violence).

The WHO (2013) framework recognizes that physical and mental health are influenced by common social and economic determinants. Both benefit from higher per capita income; employment; education; material standard of living; and family cohesion. Both are also harmed by social exclusion; violations of human rights; and adverse life events including sexual violence, child abuse, and neglect. As such, physical and mental health are cross-cutting issues linking diverse personal and social processes. Inclusion of mental health in frameworks for action will help to achieve global priorities for development in such areas as poverty reduction, economic development, and protection for the most vulnerable in society (Eaton et al., 2014). Similarly, interventions that improve social and economic determinants benefit physical and mental health. Thus, the Health in All Policies framework (WHO, 2014) discussed in the preceding chapter, if applied generally would do much to enhance individual achievement, personal security, and social harmony, all of which underpin population mental health as well as physical health.

WHO recommendations urge early intervention with evidence-based psychosocial and other mostly nonpharmacological interventions to avoid medicalisation of mental health problems. Although these initiatives represent a landmark for global mental health, major ongoing effort will be necessary to achieve stated goals, especially in relation to population-wide implementation of preventive interventions and access to individualized psychosocial interventions when needed. Success in those endeavors depends on discouraging the use of medications as first-line interventions for mental health problems, and ensuring that when pharmacological intervention is indicated that it is time-limited and adjunctive to psychosocial intervention.

The WHO Mental Health Action Plan 2013-2020 is predicated on a vision of the world in which mental health is valued, those with mental health problems are supported in exercising the full range of human rights, and culturally appropriate care is available and accessible for those in need (WHO, 2013). The overall goal of the framework is to promote mental health and well-being; prevent mental disorders; provide care to foster recovery from mental health disorders; promote human rights; and reduce mortality, morbidity, and disability associated with mental disorders. The action plan has the following objectives:

to strengthen effective leadership and governance for mental health;

to provide comprehensive, integrated, and responsive mental health and social care services in community-based settings;

to implement strategies for promotion and prevention in mental health; and

to strengthen information systems, evidence, and research for mental health.

(Video) What Is Mental Health?

The action plan builds upon but does not duplicate an earlier initiative, the Mental Health Gap Action Program (mhGAP), which is ongoing. Taking account of the limited mental health budgets of most countries, mhGAP was launched in 2010 to counter the idea that improvements in mental health require sophisticated and expensive technologies and highly specialized staff. Because about three-quarters of people suffering mental health problems are in developing countries, mhGAP is particularly focused on strategies for expanding mental health services in low resource settings. A guide, the mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-Specialized Health Settings (mhGAP-IG) (http://www.ncbi.nlm.nih.gov/books/NBK138690/), has been developed as a technical tool for facilitating delivery of mental health services by nonspecialist health-care personnel.

mhGAP-IG aims to encourage access to psychosocial intervention and adjunctive medication for tens of millions of people suffering from depression, psychosis, bipolar disorders, epilepsy, developmental and behavioral disorders in children and adolescents (e.g., autism), dementia, alcohol and drug use disorders, self-harm and suicide, and common emotional problems. In addition, mhGAP-IG promotes the use of “advanced” psychosocial interventions “that take more than a few hours” of a health-care provider’s time to learn and typically “more than a few hours to implement” (see Box 15.1). Advanced psychosocial interventions are intended to be suitable for delivery in nonspecialized care settings, but “only when sufficient human resource time is made available.”

Box 15.1Adapted from WHO (2010).

Summary of the World Health Organization’s. Intervention Guide for Mental Health Problems in Non-Specialized Health Settings (mhGAP-IG)

Interventions recommended by mhGAP-IG cover both psychological and social domains requiring substantial dedicated time, which may be offered by trained and supervised nonspecialized health-care personnel. Psychological interventions are usually provided on a weekly basis over a number of months in either individual or group format. Some of the interventions (e.g., cognitive behavioral therapy and interpersonal psychotherapy) have been implemented successfully by health-care personnel in low-income countries as part of research initiatives (WHO, 2010). It is believed that with systematic use of detailed intervention protocols and training manuals scaling-up of interventions is feasible for nonspecialized health-care settings involving nonspecialized personnel under supervision.

Behavioral activationDerived from principles of behavior analysis and a component of behavior therapy and cognitive behavioral therapy for depression. Intervention focuses on activity scheduling to encourage involvement of the person in life activities that are personally rewarding. Recommended as an intervention option for depression, including bipolar depression, and other significant emotional or medically unexplained complaints
Cognitive behavioral therapy (CBT)Based on the idea that feelings are affected by thinking and behavior. People with mental disorder tend to have unrealistic or distorted thoughts, which if unchecked can lead to unhelpful behavior. CBT typically has a cognitive component (helping the person to develop the ability to identify and challenge unrealistic negative thoughts) and a behavioral component (behavioral activation). Recommended as an intervention option for depression, including bipolar depression, behavioral disorders, alcohol use or drug use disorders, and as an intervention option for psychosis after the acute phase
Contingency management therapyA structured method of rewarding specified desired behaviors, such as attending treatment sessions, active participation in treatment, and avoiding harmful substance use. Introduced rewards for desired behavior are reduced over time as natural rewards, especially from the social environment, become established. Recommended as an intervention for people with alcohol use or drug use disorders
Family counseling or therapyInvolves multiple planned sessions, usually more than six, over a period of months. Can be delivered to individual families or groups of families. It has supportive, educational, and treatment functions. It often includes negotiated problem solving or crisis management. Recommended as an intervention for families of people with psychosis, and alcohol use and drug use disorders
Interpersonal psychotherapy (IPT)Designed to help a person identify and address problems in their relationships with family, friends, partners, and other people. Recommended as an intervention option for depression, including bipolar depression
Motivational enhancement therapyA structured therapy, typically lasting four sessions or less. Uses motivational interviewing, which is a goal-directed client-centered method for encouraging behavior change by helping the person to resolve ambivalence regarding reasons for change. Recommended as an intervention to help people who are dependent on substances
Skills training for parents of children with behavior problemsFocuses on positive parent-child interactions, the importance of parenting consistency, discouraging harsh punishments, and the practicing of new skills by parents with their children during training. The content should be culturally sensitive, but should not allow violation of children’s basic human rights according to internationally endorsed principles
Skills training for parents of children and adolescents with developmental disordersInvolves culturally appropriate training to improve development, functioning, and participation of the child within families and communities. Derived from behavioral principles, applied behavior analysis is used to teach specific social, communicative, and behavioral skills (e.g., by rewarding appropriate behavior and carefully analyzing aspects of the person’s environment that trigger problem behavior). Invention involves support for parents (during training and ongoing) of children with different levels of intellectual disability and different specific behavior problems
Problem-solving counseling or therapyInvolves the counselor and client working collaboratively to identify and isolate key factors that might be contributing to the person’s mental health problems, to separate these into specific manageable tasks, and to develop strategies for solving or coping with each problem. Recommended as a treatment option for depression, including bipolar depression; as an intervention option for alcohol use disorders, drug use disorders, self-harm, and other significant emotional or medically unexplained complaints; and for parents of children and adolescents with behavioral problems
Relaxation trainingBreathing exercises and progressive muscle relaxation to elicit the relaxation response. Progressive relaxation teaches how to identify and relax specific muscle groups. Treatment usually consists of daily relaxation exercises for at least 1-2 months. Recommended as a treatment option for problems of anxiety and depression, including bipolar depression, and for other significant emotional or medically unexplained complaints
Social skills therapyHelps to develop skills and coping in social situations to reduce distress in everyday life. Uses role-playing, social tasks, encouragement, and positive social reinforcement to help improve ability in communication and social interactions. Can be done with individuals, families, and groups. Intervention usually consists of 45-90min sessions once or twice per week for an initial 3 months and then monthly. Recommended as an intervention option for people with psychosis or behavioral disorder

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Chronic Abdominal Pain

Mark Feldman MD, in Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 2021

Mental Health Referral and Psychological Treatments

Although augmentation therapy utilizing two pharmacological agents has been described above, another approach to augmentation is combination therapy with a pharmacological agent and a psychological treatment (seeFig. 12.5). The latter approach is theoretically appealing because psychological treatments work on higher cortical areas, whereas antidepressants target subcortical regions.27, 97 Patients may be reluctant to see a mental health provider because they lack knowledge of the benefits of referral, feel stigmatized for being thought to have a psychiatric problem, or see referral as a rejection by the medical physician. Psychological interventions are best presented as vehicles that are orchestrated in parallel with medical visits and are used to help manage pain and reduce the psychological distress caused by the symptoms.

The mental health provider may recommend any of several psychological treatments for pain management.98, 99 These psychological treatments derive their benefit from facilitating enhancement of higher brain function (e.g., cognitive adaptation to prior trauma and improvement in coping strategies).Cognitive behavioral treatment (CBT), which identifies maladaptive thoughts, perceptions, and behaviors, is applicable to CAPS in a program that combines psychoeducation and skills training (e.g., relaxation techniques).82 The evidence of benefit from CBT has been derived predominantly from study of patients with IBS.92, 100, 101 Evidence from functional brain imaging suggests that this psychological intervention decreases activation from rectal stimulation in the central emotional regions (e.g., amygdala, ACC, frontal cortex) that are typically hyperactive in chronic pain.102 CBT has been shown to be particularly helpful in the management of children with CAPS, and in one study, benefit was also derived from parental involvement in the treatment paradigm.103, 104Mindfulness-based stress reduction involves consciously attending to one’s moment-to-moment experience.105 Although not specifically studied in CAPS, this psychological construct, which is related to meditation, shows promise and has been shown to be of benefit in patients with IBS and other chronic pain syndromes.106Hypnotherapy, in which the focus is on relaxation of the intestine, has been investigated primarily in patients with IBS and found to be of benefit in that disorder.107, 108 A randomized controlled trial in children that included 31 patients with CAPS concluded that hypnotherapy is superior to standard medical therapy in reducing pain at 1 year.109 A follow-up study showed that after a mean duration of 4.8 years, hypnotherapy remained highly superior to conventional medical therapy, indicating that the beneficial effects of gut-directed hypnotherapy are durable.110 In general, cognitive factors such as confidence in and a positive perception of treatment contribute greatly to patient satisfaction with various therapeutic modalities in patients with CAPS.111

Mental health

ProfessorCrispian Scully CBE, MD, PhD, MDS, MRCS, FDSRCS, FDSRCPS, FFDRCSI, FDSRCSE, FRCPath, FMedSci, FHEA, FUCL, FBS, DSc, DChD, DMed (HC), Dr (hc), in Scully's Medical Problems in Dentistry (Seventh Edition), 2014

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’. Indicators of mental health 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.

(Video) We All Have Mental Health

Social well-being: social acceptance, belief in the potential of people and society as a whole, personal self-worth and usefulness to society, sense of community. The social determinants of mental health include adequate housing, safe neighbourhoods, equitable jobs and wages, quality education, and equity in access to quality health care.

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Gay, Lesbian, and Bisexual Adolescents

Robert M. Kliegman MD, in Nelson Textbook of Pediatrics, 2020

Mental Health

Awareness of mental health and social problems is important when caring for GLB youth, as for all youth. Clinicians should monitor for depression, suicidality, anxiety, and substance abuse and know their community's mental health resources. Minor psychosocial problems might be handled by referral to a support group for patients (e.g., GLSEN, formerly known as the Gay, Lesbian and Straight Education Network) or for parents and others (e.g., Parents, Families and Friends of Lesbians and Gays). In some communities, agencies and organizations serving the GLB community can help with social, educational, vocational, housing, and other needs.

Individuals or families who harbor negative attitudes may inquire about mental health treatment to avert or change a homosexual or bisexual orientation. However, a GLB orientation is not an illness, and leading health organizations, including the American Academy of Pediatrics, American Academy of Family Physicians, Society for Adolescent Health and Medicine, American Academy of Child and Adolescent Psychiatry, and American Medical Association, have concluded that such change is neither possible nor warranted. It is important to distinguish between a GLB orientation, which is not a mental illness, and mental health problems (e.g., depression) for which GLB youth are at elevated risk. While understanding different families’ values, clinicians must recognize the morbidity and mortality associated with stigma and attempt to foster physical and emotional health. Individual or family therapy might be indicated.

Clinicians should also monitor for specific stressors, such as bullying and other homophobic victimization, family nonacceptance, and abuse. Failure to confront harassment constitutes tacit assent.

Anticipatory guidance, referral, and substance abuse treatment should be considered for the subset of GLB youth who use alcohol, drugs, or tobacco, some of whom may be using these to manage painful feelings related to conflicts over their sexuality.

Adolescents with serious psychiatric symptoms, such as suicidality, depression, and substance abuse, should be referred to mental health specialists with competency in treating GLB adolescents. It is essential to know how to recognize and manage psychiatric emergencies such as suicidal thoughts and attempts (seeChapter 40).

Bibliography is available at Expert Consult.

Mental Health

B.G. Knight, L. Lee, in Encyclopedia of Gerontology (Second Edition), 2007

Introduction

Mental health can be defined as freedom from mental illness. It can also be considered well-being or life satisfaction. The focus of this article is on the system developed to provide services to alleviate psychological suffering in older adults. Mental health care of the older adult in its optimum form is interdisciplinary, involving psychology, social work, psychiatry, and other fields, intertwined in a mental health-care system that delivers a wide variety of services. To more fully describe the mental health system in the context of older adults, the article discusses the populations of older clients in need of mental health services, what services are offered, the various systems set up to provide this care, and the financial incentives that shape mental health-care services for the elderly (see Life Satisfaction; Psychological Well-Being).

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Mental Health

Paul Cerrato, John Halamka, in The Transformative Power of Mobile Medicine, 2019

How Strong Is the Evidence?

While RCTs are considered the gold standard by which physicians judge medical interventions, a meta-analysis, which combines the results of several RCTs, might be called the “platinum” standard. Its advantage is that it combines analyses of the individual populations studied in each RCT, thus increasing the sample size that can be evaluated, which in turn can increase statistical and clinical significance. Joseph Firth, with NICM, School of Science and Health, Western Sydney University, Campbelltown, Australia, and his colleagues recently conducted a meta-analysis of smartphone apps designed to treat depression [12]. They were able to combine the results of 18 RCTs on 22 mobile mental health apps that generated outcome data for over 3400 users. They found that overall, the apps significantly reduced depressive symptoms with a moderate positive effect size when compared to inactive control participants (g=.56). Participants who had been classified as inactive had received no intervention during their respective studies, as opposed to active participants, who either used a smartphone app not designed to treat depression, received face-to-face intervention, or had other types of activity. Firth et al. found less impressive differences between subjects who used mental health apps and active controls (g=.22).

A closer look at this meta-analysis, including several subgroup analyses, reveals important insights. The RCTs that looked at smartphone apps lasted from 4 to 24 weeks, and depressive symptoms were measured using a variety of well-documented tools, include the Depression Anxiety Stress Scale, the Patient Health Questionnaire (PHQ-9), and the Beck Depression Inventory II scale. The analysis also found that the mobile apps were only effective in users who had self-reported mild-to-moderate depression. They had no significant impact on patients with major depression, bipolar disorder, or anxiety disorders. Some of the subgroup analyses were unexpected. Apps that did not involve any in-person feedback generated statistically significant moderately positive effects, while those that did include human feedback did not. Apps that delivered their content entirely through a mobile device appear to have been more effective than those that were not self-contained, though the difference was just short of reaching statistical significance (P=.07). Finally, those apps that offered cognitive training had less of an impact on users than those that focused more generally on mental health.

Although Firth et al.’s exhaustive review of mental health apps did not uncover any that had a significant therapeutic effect in patients with major depression, the Patient Health Questionnaire (PHQ-9), designed as a professional assessment tool for major depressive disorder, has been validated as a smartphone app. It is available in Depression Monitor and MoodTools [13]. However, Michael Van Ameringen, MD, with the Department of Psychiatry and Behavioural Neurosciences at McMaster University, and his colleagues did not find any studies validating assessment apps for anxiety disorders, bipolar disorder, or obsessive compulsive disorder in their review of the literature. A mobile version of an assessment tool for posttraumatic stress disorder does exist, called PTSD Checklist-Civilian. It is used in PTSD Coach and PE Coach, both of which were developed by the US Department of Veterans Affairs.

RCTs and meta-analyses give clinicians the most assurance of efficacy, but less rigorous studies should not be ignored when evaluating a mental health app. Consider Mobilyze, for example, an app developed by the Center for Behavioral Intervention Technologies (CBITS), Northwestern Medicine. In a small, controlled trial that evaluated this depression-management tool, seven patients with major depression experienced significant improvements in depressive and anxiety symptoms by the end of the 8-week experiment and no longer met the criteria for depression (PHQ-9 scores had dropped from 17.1 in week one to 3.6 by week 8 P<.0001) [14]. Like many other mental health apps, Mobilyze required patients to log their thoughts, mood, and activities; it also provided reminders to help them cope with their feelings. Equally important, the app provided “context sensing.” With the help of a mobile phone’s GPS, Bluetooth, and accelerator, the app was able to make predictions about a person’s emotional state based on their location, movements, and daily rhythms. While the small number of patients involved in the trial limits its generalizability, the rationale and mechanics of the app are scientifically sound.

Although Mobilyze is no longer available from the App Store or Google Play, Northwestern University and Northwestern Medicine have developed several next generation “intellicare” apps to take its place, including Worry Knot, Boost Me, Thought Challenger, and iCope [15].

There is little doubt that evidence-based mental health apps can help many patients, but most make the same mistake that health apps focusing on physical disease make. They fail to see the whole person and ignore the fact that psychiatric disease is a systemic problem that requires systemic solutions. These solutions require addressing a long list of contributing causes, including psychosocial stress—which many existing apps do address—and physical stress, dietary deficiencies, sleep deprivation, adverse reactions to medication, genetic predisposition, and lack of physical activity—which they do not. A case in point is vitamin B12 deficiency. A mobile app that teaches patients CBT techniques will have a very limited impact on someone experiencing the psychiatric effects of a cobalamin deficit. By one estimate, the deficiency affects about 12% of older, noninstitutionalized adults [16]. Among vegetarians, the prevalence ranges between 21% and 85% [17]. It can cause a variety of neuropsychiatric signs and symptoms, including cognitive impairment, irritability, peripheral neuropathy—a sensation of pins and needles in the hands and feet—and weakness. Patients taking metformin, one of the most commonly prescribed drugs for type 2 diabetes, are at risk for B12 deficiency, but too few clinicians take the time to order a serum B12 level for patients on the drug to monitor for the problem. How many mental health mobile apps ask providers or patients to consider this problem as they search for solutions?

Similarly, any disorder that causes chronic pain has to be viewed as a potential cause of depression and anxiety. Patients experiencing chronic pain are three times as likely to develop depression or anxiety and a mobile app that does not factor in pain or other physical stressors as triggers does not provide a holistic approach to mental health. The same can be said for insomnia.

As developers embrace the concept of systems biology and take a more holistic approach, it is likely we will gradually see mobile apps to address all these issues and more.

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Mental Health

Jane Buckle PhD, RN, in Clinical Aromatherapy (Third Edition), 2015

Depression

The number of people taking antidepressant drugs in the Western world has increased exponentially. According to the Center for Disease Control and Prevention (CDC), the increase is 400% since 1998. However, some people may confuse being depressed with what is really an inability to cope, or loneliness. In the words of Patch Adams, a medical doctor who is also a famous clown (1997), “Prozac has replaced a hug.” It is in this shadowy area of mild depression where aromatherapy may help. Although all the hi-tech advances in the world cannot rewire the brain, something as simple as an essential oil may enable the brain to reregulate itself (Alexander 2001).

There are been several published studies on aromatherapy and depression in humans: Table 15-4. Most of these studies have involved massage. Most of them have looked at depression as a symptom of a specific illness such as cancer or in hospice patients. There is a lack of evidence for using inhaled essential oils in depression in a clinical way. This is surprising as it has been shown that inhaled aroma has a rapid effect on mood and this effect is measurable by EEG (Diego etal 1998). Itai etal’s study (2000) concluded that inhaled aroma was an effective, noninvasive way of treating depression. Perry and Perry (2006) wrote in their review of aromatherapy in mental health that there were some promising results and suggested concentrating on inhaled aromas studies for depression. Van der Watt also asks for more inhalation studies to support the use of aromatherapy in mental healthcare (2008). Dobetsberger and Buchbauer (2010), several years later, state that research proves that essential oils can influence the central nervous system, but again calls for more research.

Clearly, inhaled essential oils for depression would be an exciting area of study. It would also be interesting to explore how an inhaled essential oil might impact a conventional antidepressant drug. It would be possible to add ambient aroma to psychotherapy counseling and give the patient the same aroma to inhale on a regular basis to measure if this enhanced the therapy session. Another idea would be to use the individual aroma pouches that are now available or to explore the impact of using a diffuser at night on prn medication.

Essential oils applied topically (but without massage) have also been shown to affect mood. Hongratanaworakit and Buchbauer (2006) found that ylang ylang applied to the skin had a relaxing effect. Two years earlier, these two scientists had evaluated the effect of ylang ylang when inhaled (Hongratanaworakit & Buchbauer 2004).

Depression has been linked to the inability to give up smoking in a Korean study (Kim etal 2013), so inhaling a mixture of specific essential oils could be an excellent way to reduce both depression and smoking.

Okomoto etal (2005) explored the effect of aromatherapy massage on mild depression. Five patients (aged 31 to 59) who had a diagnosis of depression took part in the study. No patient was taking antidepressants or receiving psychotherapy. Each patient was given a 30-minute aromatherapy massage with a mixture of essential oils (geranium, basil and sweet orange) twice a week for 4 weeks (eight massages in total). Outcome measures were Hamilton Depression Rating (HDR) scale and Profile of Mood (POM) scale. The measures were taken before the first session and after the eighth session. Data was examined using Wilcoxin matched pairs test. Ham score and the confusion-bewilderment (C-B) score that are part of POMs were significantly improved (P = 0.039 and 0.043, respectively). This suggests that there was both subjective and objective improvement.

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Mental Health Promotion

Helen Herrman, ... Atsuro Tsutsumi, in International Encyclopedia of Public Health (Second Edition), 2017

Abstract

Mental health is a set of positive attributes intrinsic to the health of individuals and communities. Poor mental health is associated with relative social disadvantage in whole populations and vulnerable subgroups. Adverse conditions such as poverty, discrimination, and violence have a powerful influence on mental health in high- and low-income countries. Conversely, mental health is linked with human, social, and economic development. Mental health promotion is integral to the new public health and health promotion. Evidence is available on the effectiveness of public health and social interventions for enhancing the mental health of populations in locally devised and culturally appropriate ways.

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Military Mental Health and Combat Deployments

C.A. Castro, A.M. Hassan, in Encyclopedia of Mental Health (Second Edition), 2016

Early Identification

Mental health screening is one of the most widely used methods for identifying service members returning from combat who might need help for a mental health issue (Wright et al., 2002; Bliese et al., 2006). The United States was the first country to employ mental health screening on a wide basis (Wright et al., 2002), with many other militaries following suit. Benefits of mental health screening include: providing a formal process for introducing early mental health intervention; reducing stigma and barriers to care for mental health issues; providing service members an opportunity to self-identify for a mental health issue that is concerning them; familiarizing service members with the military mental health care system; and helping to change the military culture around mental health care (see Wright et al., 2002). Despite inherent issues associated with mental health screening, such as low specificity and sensitivity (Rona et al., 2005), mental health screening remains the preferred method for early identification of service members with mental health issues.

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FAQs

What is the overview of mental health? ›

Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.

What is a good mission statement for mental health? ›

Mission Statement

To be committed to the wellness of individuals, their families, and the community through prevention, intervention, treatment, and education.

How do I write a mental health discussion? ›

Let people know you're willing to talk about #MentalHealth.

The easiest way to let people know you're willing to talk about mental health is to be open about your own. Try to think of it in the same way you think about your physical health. Allow it to come up naturally in conversation in the same way.

Why is it important to study mental health? ›

Attending a course on mental health will give you the ability to see just how pervasive the problem can be to those who are experiencing it, and will allow you to develop a different perspective on all the ways that it can influence their lives.

What is the importance of mental health awareness? ›

Mental Health Awareness Month provides a timely reminder that that mental health is essential and that those living with mental health issues are deserving of care, understanding, compassion, and pathways to hope, healing, recovery, and fulfillment.

How mental health is important with reference to the present context? ›

It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in. Mental health is a basic human right. And it is crucial to personal, community and socio-economic development.

What are the values of mental health nursing? ›

The unique value of mental health nursing

Mental health nurses provide a range of functional interventions, advice, support and assessment that assist service users and their families, at the most vulnerable times in their lives, through recovery to maintain independence and quality of life.

What is the vision statement? ›

A vision statement is a business document that states the current and future objectives of an organization. A company's vision must align with its mission, strategic planning, culture, and core values.

How do you start a mental health presentation? ›

How to start a speech
  1. Point to their problem or opportunity. Putting your finger on your audience's pain point is another way of gaining their attention because you're triggering an emotional reaction again. ...
  2. Start with a video. ...
  3. Ask the audience questions. ...
  4. Statistics.
27 Jun 2018

How do you explain mental illness to someone who doesn't understand? ›

  1. Try to manage your expectations. Sometimes, people who have never experienced mental health issues find it tricky to understand what you are going through. ...
  2. Prepare what you're going to say. ...
  3. Have the support to back you up. ...
  4. Ask open questions. ...
  5. End the conversation the correct way.
16 May 2018

Why is it so hard to talk about mental health? ›

Why is it so hard to talk about mental health? The prevalence of stigma and discrimination toward people with mental illness makes it difficult to have a transparent conversation about how we feel. But an open dialogue about mental health can help everyone heal.

What is the most common mental health problem? ›

Depression. The main symptoms are feeling 'low' and losing pleasure in things that were once enjoyable. These symptoms may be combined with others, such as feeling tearful, irritable or tired most of the time, changes in appetite, and problems with sleep, concentration and memory.

Who suffers from mental health the most? ›

Young adults aged 18-25 years had the highest prevalence of SMI (9.7%) compared to adults aged 26-49 years (6.9%) and aged 50 and older (3.4%). The prevalence of SMI was highest among the adults reporting two or more races (9.9%), followed by American Indian / Alaskan Native (AI/AN) adults (6.6%).

What is the best way to improve your mental health? ›

10 tips to boost your mental health
  1. Make social connection — especially face-to-face — a priority. ...
  2. Stay active. ...
  3. Talk to someone. ...
  4. Appeal to your senses. ...
  5. Take up a relaxation practice. ...
  6. Make leisure and contemplation a priority. ...
  7. Eat a brain-healthy diet to support strong mental health. ...
  8. Don't skimp on sleep.
4 Oct 2018

Why mental health is important for leading a happy life? ›

Maintaining a positive mental health and treating any mental health conditions is crucial to stabilizing constructive behaviors, emotions, and thoughts. Focusing on mental health care can increase productivity, enhance our self-image, and improve relationships.

What causes mental health issues? ›

For example, the following factors could potentially result in a period of poor mental health: childhood abuse, trauma, or neglect. social isolation or loneliness. experiencing discrimination and stigma, including racism.

How can we prevent mental health? ›

Here are some ways people have found to stay mentally well.
  1. Talk about your feelings. ...
  2. Get a good night's sleep. ...
  3. Eat well. ...
  4. Stay active. ...
  5. Practice mindfulness, a way to be fully engaged and present in the moment.
  6. Keep in touch.
4 Oct 2021

Who defines mental health? ›

The World Health Organization (WHO) conceptualizes mental health as 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”.

Why is mental health not taken seriously? ›

Perhaps because mental illnesses are simply not as concrete as physical illnesses, they are often not taken as seriously. Contrary to this popular belief, mental illnesses are actual diseases that must be treated as seriously as a physical disease, such as cancer or heart disease.

What is the relationship between mental health and well-being? ›

Wellbeing and mental illness are correlated with depression and anxiety, which are associated with low levels of wellbeing8. mental disorder. Most associations are only moderately altered by adjusting for severity of mental disorder9. Good health is also correlated with higher life satisfaction10.

What are skills in mental health? ›

The most important skills to have working in Mental Health include, but are not limited to the following: client rapport, empathy, compassion, active listening, organization, record keeping, information technology savvy, healthy professional boundaries, strong ethics and a desire to help one's fellow human beings.

What are the qualities of a good mental health nurse? ›

Your personality and communication skills are crucial components of being a mental health nurse. You'll need a good knowledge of mental health problems and how to apply it in practice. You'll be warm and engaging while showing real empathy with service users and their individual circumstances.

What makes a good mental health support worker? ›

Mental Health Support Worker skills and qualifications

Empathy and interpersonal and relationship building skills. Excellent psychological skills to understand the mental state of patients. Excellent problem-solving skills and ability to work in stressful situations. Ability to support patients with mental illnesses.

What is a good mission statement? ›

A good business mission statement should be between one and three sentences and never exceeds 100 words. This means they're a little longer than most company slogans, but they're still short, catchy, action-focused statements that encapsulate what your business does and what its values are.

What is your personal vision? ›

A personal vision statement is a statement that describes your personal values, your strengths, and your goals. It can be focused on life or professional goals, and it is intended to orient you toward your long-term dreams.

How do you start a mission statement? ›

How to write a mission statement in 5 steps
  1. Free write about starting your company. ...
  2. Explain what your company does. ...
  3. Describe your ideal customer. ...
  4. Define your core values. ...
  5. Revise and condense your mission statement.

How can I start my presentation? ›

How to start a presentation
  1. Tell your audience who you are. Start your presentation by introducing yourself. ...
  2. Share what you are presenting. ...
  3. Let them know why it is relevant. ...
  4. Tell a story. ...
  5. Make an interesting statement. ...
  6. Ask for audience participation.
30 Aug 2021

How do you start a presentation about yourself? ›

Here's a list of steps on how to do a presentation about yourself:
  1. Consider the setting of your presentation. ...
  2. Choose a presentation format. ...
  3. Create a short segment to engage the audience first. ...
  4. Offer basic information. ...
  5. Include a case study. ...
  6. Develop a section for frequently asked questions.
12 May 2022

How do you explain social anxiety to someone who doesn't have it? ›

In summary, when trying to explain anxiety to someone who doesn't have it, focus on the cognitive model. It starts with a distressing situation/trigger → which causes a person to have negative thoughts → this causes negative emotions and physical distress → which leads to negative behaviors.

How do you explain what anxiety feels like? ›

Let us break down how to describe what anxiety feels like.
  1. It Can Feel Physically Suffocating. ...
  2. Things Can Feel Great One Day and Terrible the Next. ...
  3. The Desire to Numb or Escape It Can Be Incredibly Tempting. ...
  4. It Can Feel Just Like Depression. ...
  5. The Shame Often Feels Worse Than the Anxiety Itself. ...
  6. Final Thoughts.
14 Jun 2020

Can talking about mental health make it worse? ›

Among the common depression myths are the belief that talking about the disorder makes it worse, but research shows the opposite. Talking to a trusted friend or adult is a good place to start, but sharing with a professional is even better.

Is it good to talk about mental health? ›

Talking about mental health in general encourages us to seek treatment, especially once we realize we're not alone. Millions of adults live with mental health issues in the U.S, and the more we talk about it, the more likely we'll feel comfortable seeking care and support.

How does the public view mental illness? ›

Mental health as a health problem

Given widespread personal experience, it is not surprising that a majority see mental illness as a serious public health problem. A 2013 Pew poll found that 67% of the public believed that mental illness was an extremely or very serious public health problem.

What is normal mental health? ›

According to the World Health Organization (WHO), 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).

What is the difference between mental illness and mental disorder? ›

Mental illness is a health problem that affects how a person thinks, behaves and interacts with others. Mental illness is a group of illnesses that are often diagnosed through standard criteria. The term 'mental disorder' refers to the same health problems.

What are the top 3 mental health issues? ›

The most common are anxiety disorders major depression and bipolar disorder.

When do mental health issues start? ›

Fifty percent of mental illness begins by age 14, and three-quarters begin by age 24.

Can mental illness cause death? ›

Although these diseases can affect anyone, they make for a particularly lethal combination among people with serious mental illness. In fact, people with serious mental illness die 10 to 25 years earlier than the general population.

Why is mental health important for students? ›

The importance of mental health for students

Our mental health has a direct impact on our ability to take in new information, understand new concepts and master new skills. When struggling with depression, anxiety or other mental health issues, working on assignments and attending classes can become impossible.

What are the 4 types of mental health? ›

anxiety disorders. personality disorders. psychotic disorders (such as schizophrenia) eating disorders.

What is the problem of mental health? ›

What are mental health problems? Mental Health problems are difficult experiences that make it harder for us to get on with our lives. They include the painful feelings and thoughts that we all have at times – including periods of sadness, hopelessness and fear.

What are the examples of mental health? ›

This page lists some of the more common mental health issues and mental illnesses.
  • Anxiety disorders. ...
  • Behavioural and emotional disorders in children. ...
  • Bipolar affective disorder. ...
  • Depression. ...
  • Dissociation and dissociative disorders. ...
  • Eating disorders. ...
  • Obsessive compulsive disorder. ...
  • Paranoia.

What affects the mental health? ›

There are many different factors that can affect your mental health, including: Biological factors, such as genes or brain chemistry. Life experiences, such as trauma or abuse. Family history of mental health problems.

What is the biggest mental illness? ›

Depression. Impacting an estimated 300 million people, depression is the most-common mental disorder and generally affects women more often than men.

What are the 7 major mental disorders? ›

What Are the 7 types of Mental Disorders?
  • Anxiety Disorders.
  • Mood Disorders.
  • Psychotic Disorders.
  • Eating Disorders.
  • Personality Disorders.
  • Dementia.
  • Autism.
6 Apr 2021

How can we prevent mental health? ›

Here are some ways people have found to stay mentally well.
  1. Talk about your feelings. ...
  2. Get a good night's sleep. ...
  3. Eat well. ...
  4. Stay active. ...
  5. Practice mindfulness, a way to be fully engaged and present in the moment.
  6. Keep in touch.
4 Oct 2021

How does mental health impact society? ›

Unaddressed mental health problems can have a negative influence on homelessness, poverty, employment, safety, and the local economy. They may impact the productivity of local businesses and health care costs, impede the ability of children and youth to succeed in school, and lead to family and community disruption.

How does mental health affect quality of life? ›

Conversely, a poor quality life, often experienced by those with severe mental health difficulties, was characterized by feelings of distress; lack of control, choice and autonomy; low self-esteem and confidence; a sense of not being part of society; diminished activity; and a sense of hopelessness and demoralization.

How many people suffer from mental health issues? ›

Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020).

Where does mental illness come from? ›

Mental illness itself occurs from the interaction of multiple genes and other factors -- such as stress, abuse, or a traumatic event -- which can influence, or trigger, an illness in a person who has an inherited susceptibility to it.

What are the main causes of mental illness in youth? ›

Physical, emotional and social changes, including exposure to poverty, abuse, or violence, can make adolescents vulnerable to mental health problems.

How can mental health be improved? ›

Be physically active

Evidence also shows it can also improve your mental wellbeing by: raising your self-esteem. helping you to set goals or challenges and achieve them. causing chemical changes in your brain which can help to positively change your mood.

Why is it called mental health? ›

Mental health refers to cognitive, behavioral, and emotional well-being. It is all about how people think, feel, and behave. People sometimes use the term “mental health” to mean the absence of a mental disorder. Mental health can affect daily living, relationships, and physical health.

Why mental health is important for leading a happy life? ›

Maintaining a positive mental health and treating any mental health conditions is crucial to stabilizing constructive behaviors, emotions, and thoughts. Focusing on mental health care can increase productivity, enhance our self-image, and improve relationships.

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