Mental health is something all of us want for ourselves, whether we know it by name or not. There are no easy answers here – mental fitness is the awkward stepchild you sent away to the state hospital in the country and visited once a year.

In fact good mental health is an integral part of good overall health for people with HIV. Primary Care Mental Condition is a new, peer-reviewed journal on research, education, development and delivery of mental health in primary care. But mental health is far more than merely the absence of mental illness.

Depressions are the greatest Problem

People are four times more likely to break off a romantic relationship if their partner is diagnosed with severe depression than if they develop a physical disability. Overall, the two strongest predictors for thinking about suicide were depression and substance abuse.

Through compelling personal stories told through television, video, the Internet, and print media, the campaign encourages men to recognize depression and its impact on their work, home, and community life. However it will also enable Cam-mind to launch a project designed to help employers tackle stress, anxiety and depression in the workplace. But what’s the difference between “normal” feelings of sadness and the feelings caused by depression.

Topics covered vary widely, from healthy self esteem in adolescence and signs of depression to resources for diagnosing mental health problems in children.

Problems about Mental Condition

Those with schizophrenia are particularly likely to face problems: 20% of women said they would break up with a partner who was diagnosed with the condition. The research team have also found that stress at work is associated with a 50 per cent excess risk of coronary heart disease, and there is consistent evidence that jobs with high demands, low control, and effort-reward imbalance are risk factors for mental and physical health problems (major depression, anxiety disorders, and substance use disorders).

The Mental Condition and Poverty Project called on the SAHRC to consider setting up a commission that will primarily focus on the needs of people with mental health problems. Even the best-trained psychiatrists do not necessarily have an internship in the problems of normal living. “What many people don’t realise is that we all have mental health – just as we have physical health – and that mental health problems can affect anyone, whatever their age or background.

Psychological therapies are based on talking and working with people to understand the causes and triggers of mental health problems and on developing practical strategies to deal with them.

Searching for Information

The first step is to reduce the stigma surrounding mental illnesses, using targeted public education activities that are designed to provide the public with factual information about mental illnesses and to suggest strategies for enhancing mental fitness, much like anti-smoking campaigns promote physical health.

It therefore makes good sense for people with HIV to have information about the ways in which HIV can affect their mental health and about common mental fitness issues such as depression, anxiety and emotional distress. This comprehensive information resource for child mental Condition and parenting information includes articles, resources, a glossary, an Ask the Expert section, a disorder guide, publications, and FAQs.

Offers useful information explaining educational evaluations, and also lists interventions that may be used to address various mental fitness conditions, including anxiety, obsessive-compulsive disorder, depression, bipolar disorder, ADHD, autism spectrum disorders, and more.

Mental Condition is more important than physical health. Mental fitness is more than the absence of mental disorders Mental health can be conceptualized 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.

Mental health is simply the state of successful performance of all our mental functions. This is difficult to describe but when one is mentally healthy one is able to perform there day to day activities successfully and is able to manage healthy inter personal relationship, be able to cope with change and handle diversity. While in our normal day to day life we do not observe what mental health is all about it, we only get curious about it once we notice something is wrong or the absence of good mental health and even then most of the times we choose to ignore it.

Good mental health is something that has been ignored by most of us, while we do notice a slight headache we ignore to recognize sudden mood swings, low tolerance levels, being gloomy and blue all the time as a sign that something may be wrong with our mental health. More people worldwide suffer from mental illness than is ever understood, in the United States alone every year around 6% of the population goes through some form or the other of depression and depression is just one of the many mental disorders that exist. Most of the times our failure to recognize this stems from being unaware or being ashamed of admitting that “something is wrong with my mind”.

Is Mental Health separable from physical health?

While popularly it is thought that mental and physical health are separate in most cases one’s mental illness is caused by some physiological changes in the body and indeed many cases of depression in women are caused in and around the time of menopause or in men when they are going through nights when they don’t get enough sleeps because of work pressures. The body goes through stress and is fatigued by it and because of that the mind also reacts to it and develops some sort of disorder.
The other way round is more obvious and when the mental health of people deteriorates the body takes its toll and that is more visible.
What this essentially means is taking care of ourselves physically is also an important aspect of maintaining our mental health.

Public Attitude about Mental Health and Illness

Even in developed societies like the United States where there are a large number of information sources and any one can just go to the internet and take self diagnostic tests to see whether they are suffering from any form of mental disorder a large number of cases go unreported. This is because of the public opinion that mental health is a given and there is some degree of stigma associated with the fact that a person’s mental health is suffering from one reason or the other.

People suffering from one type of disorder therefore will go through a long phase of denial where in they will refuse to acknowledge that something seems to be out of ordinary. This will translate into the patients developing multiple disorders which will become more difficult to cure or even diagnose. It will also result in the disorder getting deeper entrenched and will make it that much more difficult to cure it as well.

Use the Internet

Awareness is the key to fight mental illness, awareness about the fact that more people than you can imagine suffer from it in some point or the other in their lives and awareness about the fact that once diagnosed it can be easily treated through a combination of talk therapy and medication.
Internet is a good source of information and you should learn to leverage it to your best use. The first step is to understand what changes in behavior are you experiencing which is possible to do for most people in the early stages. The next step after making a list of symptoms is to take a few self diagnostic tests which you can do anonymously and see where it takes you. There are a host of mental disorders and chances are that after taking a few of these tests you would be led to specifically one or the other. Then you can do more in depth study about it and even if you think it not necessary visit a doctor at least once to double check whether you are suffering from that particular disorder, something else or it was just a false alarm.

Please do not feel ashamed or offended by the conditions of women in mental health, when applied to you / ourselves. After 40 years, so what happens to us, so many changes and transitions. We do not understand what’s happening in our bodies. This means that parts of physical, mental, emotional and spiritual body.

A discussion about the mental health of women is usually the result of art therapy There is no way to avoid it. Ö.K.?

In this article, try to see links between mental health of women and their families. This is a party and a senior member. They may have personal problems and mental health of their children and family. Women have an enormous burden on the shoulders – and their mental health is strained and affected, to say the least.

What is therapy?

psychological therapy for women is a way to help you better understand and better managed. As in the therapy does not mean you’re crazy. Everyone has problems. Therapy is a way to help solve your problems.

Some problems can be helped by treatment include:

* Depression
* Fear
* The abuse of alcohol or drugs
* Eating Disorders
* Sleep problems
* Anger
* Grief

There are many different types of psychological therapies for women who are good for everyone. One type of treatment might be more convenient for you, like play therapy for young children or family therapy for family conflicts. The type of therapy that suits you best depends on what best meets your needs.

What types of psychological therapies are women?

The most common types of treatment are:

Art therapy. Drawing, painting or working with clay with an art therapist can help you express what you are taking may not be able to put into words. Art therapists work with children, adolescents and adults, including people with disabilities.

Behavior therapy is good for women about mental health issues. This type of therapy is very structured and goal oriented. It starts with what you do now and then helps you change your behavior. behavior therapists, techniques such as:

* The exposure or desensitization therapy. First, you learn to relax. Then you learn to face your fears while practicing this relaxation.
* Aversive therapy. This pairs something unpleasant with a behavior in order to stop the behavior. For example, for something that tastes bitter to help a child thumb sucking his thumb.
* Role play. This can help you more confidence or resolve conflicts between family members.
* Self-monitoring, or keep a diary of your daily activities. This can help determine what behaviors it causes problems.

Biofeedback. This type of therapy can help you learn to control body functions like the waves of muscle tension or brain. Biofeedback can provide to help with anxiety and physical symptoms such as headaches.

Cognitive therapy. This type of therapy is the approach the way you think affects how you feel and behave. This therapy helps you recognize unhealthy ways of thinking, that you hold. They learn to identify negative automatic thoughts such as:

* “I never do anything right”
* “The world is always against me”
* “If I fail every time I am a failure.”

You learn to change their minds and this can lead to behavior change. It can also improve self-esteem and confidence. Cognitive behavioral therapy combines the methods of cognitive behavioral therapy.

EMDR (Eye Movement Desensitization Reprocessing). In EMDR, the therapist helps you cope with feelings and thoughts too embarrassed about past events. Move your eyes back and forth, usually following the therapist’s hand or pen, you will remember the event. This type of therapy is considered by many to be experimental.

the mental health of women and family or couples therapy. Family therapists view the family as a system. They work with the whole family, not a single person. The goal is for family members to openly express their feelings and find ways to change negative family patterns.

the mental health of women in the context of couples therapy helps partners improve their ability to interact with each other. It can help you decide what changes in the relationship and the behavior of each partner is required. Both partners then work to learn new behaviors. There are different forms of couple therapy.

Women’s mental health group therapy /. In group therapy, a small number of people (6-10) meet regularly with a therapist. There are several types of therapy groups. Some focus on a specific problem, such as anger management. Process groups do not focus on one theme, but to explore issues raised by members. Short-term problems of focus groups and make for a limited time only 6 to 12 weeks. long-term groups are dealing with topical issues such as self-esteem.

Massage therapy. Massage therapy can help reduce anxiety and stress.

the mental health of women and pharmacotherapy (medication). Medications can help your mental well-being. They may be prescribed by a psychiatrist or doctor. Your supplier to work with you well the right medication for you. There are several types of psychotropic drugs.

* Antipsychotics can help to psychosis or other conditions.
* Mood-stabilizers are used to treat mood disorders such as bipolar disorder.
* Antidepressants can help with depression or anxiety.
* anxiety medications can be prescribed to treat anxiety disorders.

The right medication can improve symptoms while other treatments more effective. Medications can also be used alone.

Play therapy play therapy allows children to act, its problems with games and toys. Play therapists help a child feel more secure and less fearful.

Psychoanalytic therapy. This type of therapy was developed by Sigmund Freud. In this type of therapy, you work to find things in your past that affect your thoughts, feelings and behaviors. This type of therapy can take years. It usually involves meeting several times a week. It can be very costly.

Psychodynamic therapy. This type of therapy helps you make your true feelings to the surface. If you refuse to remove (forgotten on purpose) or painful thoughts, feelings and memories, they can affect your quality of life. Once you know these repressed thoughts, feelings and memories, they will be less painful.

Psychoeducational therapy. This type of therapy, vocational education to speak to a customer. You can learn more about diseases, treatment options, and how to treat the symptoms. Therapists can provide useful information or help you acquire different skills. They work with individuals and groups.

Incoming search terms:

art therapy womens mental health (1) , WOMEN MENTAL HEALTH (1) , Womens mental health issues after 40 (1)

Positive mental health is a good way to ensure you live a long, happy and healthy. Maintaining your mental health is easier than most people think and will have a significant impact on your daily life.

If you have more energy? What is a good night’s sleep? How do you go one year without suffering from the flu again? The realization of the mental health status will not be a good guarantee of these things, but it will certainly help.

Here are the top 5 things you can to promote mental health in yourself and your children:

1. Eat healthy foods. fast food meals 3 times a week and Downing could be a little cold before going to bed more easily than a home-cooked food and drinking more fun than a glass of cold water, but it does is not so much for your health. Eating home cooked food (especially fruits and vegetables) and stay away from fast food will help the healthy lifestyle you want.

2. Drink plenty of water. To maintain a healthy lifestyle is the average person expects to consume at least eight glasses of water a day. And all this sounds a lot, it is not. Almost the equivalent of eight glasses of bottled water go your bottle a few times between waking and in bed. Remember, if you exercise, you must increase your water intake for water than you burn during exercise to compensate. Potable water is to detoxify your body and return to health – especially after drinking coffee or alcoholic beverages.

3. Kick bad habits. We have already pointed out, have a couple of times, but the elimination of alcohol use significant positive outcomes for mental health. Similarly connect other bad habits like smoking and drinking large quantities of coffee will also help your mental health at its best.

4. De-stress. Stress is a major cause of poor mental health. If you’re stressed, your body must work harder to maintain, and overtime, it will take its toll on your body and your brain. The next time something stressful happens, try lighting some candles and take a bath. If this does not work for you, try to unwind by going to the gym or jogging. Keep a positive attitude to promote good mental health and eliminate unnecessary stress on the brain.

5. Make checks. Unfortunately, you can do all the things listed above and do not suffer from mental health problems. In fact, you do not even know a mental illness. Ensuring mental health is in good regular appointments with your doctor. He / she will be able to confirm if you’re healthy lifestyle, or determine where you need to make some changes.

Incoming search terms:

What are three things that will promote good mental health (10) , What are three things that will promote good mental health? (6) , 20 things that promote good mental health (4) , which three mental quantities help to promote good health? (2) , 5 ways of promoting mental health (2) , 3 things that will promote good mental health (2) , what are three ways to promote good mental health (2) , three things that promote mental health (1) , three things that will promote good mental health (1) , three ways to promote good mental health (1) , ways to promote mental health at work (1) , what are 3 ways to promote good mental health (1) , What are the ways to promote good mental health if stressed (1) , what are three ways to prmote good mental health (1) , three mental quantities to promote good health (1) , things that will promote good mental health (1) , things that promote mental health (1) , 3 mental quantities help to promote good health (1) , 3 things that promote mental health (1) , 5 things that maintain mental health (1) , Five ways of promoting mental health (1) , foods promote mental health (1) , fun ways to promote mental health (1) , fun ways to promote positive mental health (1) , list five ways that promote good mental health (1) , list of ways to promote good mental heath (1) , things that promote good mental health (1) , 20 thing that promotes good mental health (1)

Due to greater understanding of how many Americans live with mental illnesses and addiction disorders and how expensive the total healthcare expenditures are for this group, we have reached a critical tipping point when it comes to healthcare reform. We understand the importance of treating the healthcare needs of individuals with serious mental illnesses and responding to the behavioral healthcare needs of all Americans. This is creating a series of exciting opportunities for the behavioral health community and a series of unprecedented challenges Mental health organizations across the U.S. are determined to provide expertise and leadership that supports member organizations, federal agencies, states, health plans, and consumer groups in ensuring that the key issues facing persons with mental health and substance use disorders are properly addressed and integrated into healthcare reform.

In anticipation of parity and mental healthcare reform legislation, the many national and community mental health organizations have been thinking, meeting and writing for well over a year. Their work continues and their outputs guide those organizations lobbying for government healthcare reform. .

MENTAL HEALTH SERVICE DELIVERY

1. Mental Health/Substance Use Health Provider Capacity Building: Community mental health and substance use treatment organizations, group practices, and individual clinicians will need to improve their ability to provide measurable, high-performing, prevention, early intervention, recovery and wellness oriented services and supports.

2. Person-Centered Healthcare Homes: There will be much greater demand for integrating mental health and substance use clinicians into primary care practices and primary care providers into mental health and substance use treatment organizations, using emerging and best practice clinical models and robust linkages between primary care and specialty behavioral healthcare.

3. Peer Counselors and Consumer Operated Services: We will see expansion of consumer-operated services and integration of peers into the mental health and substance use workforce and service array, underscoring the critical role these efforts play in supporting the recovery and wellness of persons with mental health and substance use disorders.

4. Mental Health Clinic Guidelines: The pace of development and dissemination of mental health and substance use clinical guidelines and clinical tools will increase with support from the new Patient-Centered Outcomes Research Institute and other research and implementation efforts. Of course, part of this initiative includes helping mental illness patients find a mental health clinic nearby.

MENTAL HEALTH SYSTEM MANAGEMENT

5. Medicaid Expansion and Health Insurance Exchanges: States will need to undertake major change processes to improve the quality and value of mental health and substance use services at parity as they redesign their Medicaid systems to prepare for expansion and design Health Insurance Exchanges. Provider organizations will need to be able to work with new Medicaid designs and contract with and bill services through the Exchanges.

6. Employer-Sponsored Health Plans and Parity: Employers and benefits managers will need to redefine how to use behavioral health services to address absenteeism and presenteeism and develop a more resilient and productive workforce. Provider organizations will need to tailor their service offerings to meet employer needs and work with their contracting and billing systems.

7. Accountable Care Organizations and Health Plan Redesign: Payers will encourage and in some cases mandate the development of new management structures that support healthcare reform including Accountable Care Organizations and health plan redesign, providing guidance on how mental health and substance use should be included to improve quality and better manage total healthcare expenditures. Provider organizations should take part in and become owners of ACOs that develop in their communities.

MENTAL HEALTHCARE INFRASTRUCTURE

8. Quality Improvement for Mental Healthcare: Organizations including the National Quality Forum will accelerate the development of a national quality improvement strategy that contains mental health and substance use performance measures that will be used to improve delivery of mental health and substance use services, patient health outcomes, and population health and manage costs. Provider organizations will need to develop the infrastructure to operate within this framework.

9. Health Information Technology: Federal and state HIT initiatives need to reflect the importance of mental health and substance use services and include mental health and substance use providers and data requirements in funding, design work, and infrastructure development. Provider organizations will need to be able to implement electronic health records and patient registries and connect these systems to community health information networks and health information exchanges.

10. Healthcare Payment Reform: Payers and health plans will need to design and implement new payment mechanisms including case rates and capitation that contain value-based purchasing and value-based insurance design strategies that are appropriate for persons with mental health and substance use disorders. Providers will need to adapt their practice management and billing systems and work processes in order to work with these new mechanisms.

11. Workforce Development: Major efforts including work of the new Workforce Advisory Committee will be needed to develop a national workforce strategy to meet the needs of persons with mental health and substance use disorder including expansion of peer counselors. Provider organizations will need to participate in these efforts and be ready to ramp up their workforce to meet unfolding demand.

This article focuses on the need for mental health nurses to promote sexual health. As a mental health nurse I have observed that during practice, nurses are encountering problems dealing with sexual health issues in mental health. Clients have experienced sexual health needs that nurses failed to meet and many nurses have experienced that they are out of depth.

Lomas (2009) carried out a survey with at least 283 mental health professionals of which half of them were nurses.  Evidence from the research showed that even though 80% of the participants were in support of the idea that sexual health promotion was a vital part of their role, only 30%, representing less than half the participants regularly discussed sexual health with mental health patients, (Lomas 2009).   A revelation also made by Lomas (2009), survey suggested that 92% of respondents had no clue that people with schizophrenia were at an increased risk of contracting HIV than the general population, 72% were not even convinced that they were more likely to engage in high-risk sexual behaviour.   From the participants, 14%  felt uncomfortable discussing sexual health issues with mental health patients, gay and lesbian issues was a very uncomfortable topic for 13% of them.  This queries whether mental health nurses are well equipped to promote sexual health, (Lomas 2009),

Through this, mental health nurses must  learn to appreciate the clause from the National Midwifery Council (2004) stating that health care professionals are expected to continuously update knowledge and skills throughout our working life and regularly take part in learning activities that develop our competence and performance.  In support to this, Higgins et al (2006)suggested that individuals with `severe’ mental health problems will most likely end up engaging in high-risk sexual activities creating the susceptibility to sexually transmitted infections.  In Higgins et al (2006)literature review from 1980 to 2005 focusing on sexual health education and sexual dysfunction emanating from prescribed medication, it was confirmed that sexual health education programmes were beneficial.   Education proved to produce a reduction in sexual risk activities compared to complete cessation. This undoubtedly highlights the issue that mental health professionals should make an effort to deliver holistic care that includes sexual health promotion (Higgins et al 2006)

In a similar study conducted but this time it included Glove-wearing Hughes and Gray (2009) states that only 61% of the participants reported wearing gloves whilst administering an injection.  Hughes and Gray (2009) continue to say that the nurses are also risking infection by not wearing gloves.

Bahrick and Harris (2009) emphasises that antidepressants are a popular cause for sexual dysfunction.   This suggests that reassurance and advice from nurses becomes a necessity.  Having an understanding of sexual health would make it easier for nurses to offer appropriate advice because sometimes this becomes debilitating for the mental health clients and therefore requires intervention Bahrick and Harris (2009).  Hughes and Gray (2009) mentioned that the lack of awareness and knowledge of sexual health does not only leave the clients disadvantaged by not having reasonable access to sexual health services or relevant information on sexual health.  Hughes and Gray (2009)   goes on to say that by this level of lack of knowledge, the mental health nurses continue to place themselves at risk.

In a study conducted by Cochran and Mays (2000), evidence was transparent that there was an escalated risk of suicide symptoms among homosexually experienced men.  Cochran and Mays (2000), further explains that some gay men also reported the risk of recurrent depression as slightly increased.  This again makes it a necessity for mental health nurses to be aware and well equipped w ith sexual health knowledge in order to be able to holistically assist their clients in a non judgmental manner. (Cochran and Mays 2000)

Interestingly MIND (2008) highlighted another good reason for mental health nurses to be aware of sexual health issues.  MIND (2008) explained that the distress experienced by some lesbians, gay men as well as bisexual’s mental distress is not due to their sexuality instead it is seen as the impact of heterosexism and homophobia,  MIND (2008).  As a result of this, many lesbians, gay men as well as bisexual’s find it a daunting task for fear of being seen as abnormal as well as not being understood.  MIND (2008) confirms that there is evidence that these concerns or worries are not baseless as homosexuality used to be seen as a psychiatric diagnosis in 1993.  Although nowadays there is an improvement in the awareness in the mental health field, it would be more beneficial for mental health nurses to be well equipped to deliver sexual health to clients with serious mental health problems (Mind 2008)

 

Implications for practice

This exercise has made it possible to identify gaps in service provision.  From my own experience, I have witnessed situations were mental health clients bring contraceptive pills on the ward and the nurses role is to administer them.  This questions whether these clients suffering from severe mental illness are aware of other sexual health issues other than pregnancy.  In support to this, The Royal College of Nursing (2001) has highlighted that contraception alongside teenage pregnancies and sexual infections are some of the significant issues that have a great impact on health care practice. The Royal College of Nursing (2001) has highlighted that “sexual health is about the holistic care of patients and clients”, it was also brought to attention that Clinical practice, Clinical education practice and Clinical policy development are essential in ensuring holistic care in sexual health. This has proved that evidence based practice is essential in delivering successful holistic care.  This includes sexual health for mental health patients facilitated by mental health nurses.  In support to this, Dawes et al (2005) emphasises that evidence based-practice ensures that individual health professionals practice based on sound research and successful outcome.  Every registered nurse needs to consider the evidence-based for practice in a multitude of areas as this is a requirement of Nursing and Midwifery Council (NMC 2004).

Having a good knowledge base on sexual health promotion will not only help to educate mental health clients on sexual health but when health promotion is carried out by mental health nurses, it could become cost effective.  This will also be supporting the Government in fulfilling its pledge in the NHS Plan to make progress in the amelioration of ill health.  The Royal College of Nursing (2001).

Through undertaking a literature review, this has also provided guidance that will enable us as mental health nurses to be keen on development and evaluation of sexual health education programmes that will be beneficial for our service users.  However, this also enlightens us to the fact that mental health nurses need to prioritise sexual health training and practice development or make an effort to make it part of their personal development plan in order to bridge the theory and practice gap. It should also be noted that they are also some hindrances. It is obviously a rather daunting task after considering the financial issues faced by the government as a result of the recession.   The Royal College of Nursing (2001) has highlighted that a lack of interest to develop knowledge in sexual health has been one of the hindrances.  On the other hand, another advantage brought about by continuing professional development is that resources are utilised more effectively. This is confirmed by the Chartered Institute of Professional Development (CIPD 2010), continuing professional development makes staff become more productive and work with efficiency by focusing on their own learning through reflection, (CIPD 2010).

The health care delivery system is plagued by lack of resources. Updating knowledge and skills ensures that the best use of these resources is put into practice. A continuing professional development allows the individual to work out what area of practice requires development in this case sexual health promotion by mental health nurses, This will be made possible through highlighting gaps in their knowledge and experience.therefore giving the individual a chance to compare what knowledge and skills they possess, and what is expected at their level of professional practice, (CIPD 2010).

Sexual health skills are required or desirable to meet the demands of the promotion of sexual health.  It also serves as a way of improving one’s competences to ensure satisfactory performance during sexual health promotion.  Enhancing knowledge and skills for mental health nurses allows the individual to engage in evidence based practice. Simpson and Dodds (2004).  This promotes conventionality minimising ambiguity and rendering information shared between health professionals and clients.  Improving teamwork this way reflects a climate that best supports a therapeutic environment (Simpson and Dodds, 2004).  Another vital point to make is that this form of practice could be useful to bridge the theory – practice gap as research evidence have proved that mental health nurses certainly need to be better equipped to promote sexual health.  Hughes and Gray (2009) argue that it is essential for policies to improve in order to extend on the achievements of the National Service Framework for Mental Health. The New Horizons programme is a programme that was launched by the Department of Health in 2009; this is a 10-year strategy to continue to improve the mental health services offered by 2020. However, this does not mention sexual health, (NHS Choices 2010)

The Royal College of Nurses (2001), states that health promotion policies that dispel inequalities in sexual health should be put in place and utilised. In addition to this, Gray et al (2002) pointed out that the sexual health policies of several mental health NHS Trusts are completely out dated, Gray et al (2002) further says that most of these policies simply states that patients are not permitted to have sex whilst on the ward.  Gray et al (2002) gave as an example a policy from a mental health Trust that simply states that ‘Sexual activity involving patients on hospital premises is not an acceptable form of behaviour’.

Developments and improvements in practice need to be made.  In order to achieve safe effective nursing practice, it is paramount to be able to enhance knowledge, skills, values and attitudes towards professional practice. This could be done through staff training and adopting a learning culture. However, time and duties need to be well managed in order to make this a success.  In addition to this, Nurse Week (2005), points out that nurses tend to spend most of their time in administrative and managerial duties which prevent them from spending time engaging in more therapeutic work with patients.  A learning culture is a practice of a ‘no blame’ approach to management which according to Collier (2005) generally translate theory and directives into practice in a meaningful way.

Conclusion

In conclusion, this article has demonstrated the relevance of mental health nurses having a good knowledge base of sexual health and the benefits of it and substantiated it with evidence   The literature used during this exercise highlights the need for mental health nurses to have sexual health knowledge and how much the mental health patients will benefit from sexual health education.  It has also proved that with sexual health education, evidence shows that they can be a reduction in sexually transmitted infections.   It is important to state finally that this exercise has given me a clear understanding of the importance of mental health nurses being able to promote sexual health.    It is clear that clients with mental health problems are more likely to experience problems with their sexual health.

The experience I had made me realise that knowledge is power and when faced with situations were mental health clients have sexual health needs they do not have enough knowledge on.  Health promotion is also identified among the seven pillars of clinical governance initiative (DOH, 1998), in which I will be expected to engage in my professional practice as a registered nurse.  In order to practice ethically and to empower clients to live an independent life, mental health nurses need to have knowledge about how to respond to the needs of people with mental illness in an ethical, honest, and non judgemental manner and this includes sexual health.

By Beatrice Kungwengwe

Health Education as a core course for Teachers’ Education: to enhance the Mental Health of students

By

Akintunde, P. G. (Ph.D)

Department of Vocational & Special Education

University of Calabar

Calabar, Cross River State, Nigeria

And

Olanipekun, O. Fola

Olabisi Onabanjo University

Ago-Iwoye, Ogun State, Nigeria

 

Abstract

This paper is primarily concerned with the role of teachers in enhancement of mental health of students. It discuses the factual picture of the functions of the teachers in a changing social and education environment, identifying the social community in the actualization of the human need (mental health) that are otherwise ignored. It highlights the complex expectation of the public from the role of teachers. The expectation makes the duties of teachers diffused; they in some measures serve as social workers and perform in addition to duties other than classroom teaching. Their responsibilities for social training in a changing environment, particularly in the misconception of mental health are discussed and recommendation made.

Key Words: Health education for teachers’ education, educating teachers in mental health, health education a necessity for teachers.

 

Introduction

            The World Health Organization (WHO) (1946) adopts a definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity”, at the International Health Conference, New York; 19-22 June, 1946 signed on 22 July 1946 by the representative of 61 States (WHO official records No.2 100). It enters into force on 7th April 1948, thereby declaring health as a fundamental human right.

The complex nature of public expectation of teachers’ duties necessitates the need for them to have a social training that will make them meet the challenge resulting from changing environment. School health education aims at constituting healthy learning experiences, healthy environment (physical and mental health) and positive interpersonal relationships between Teachers and students, students and students inside and outside the school environment.

 Healthful school living which consists of emotional health, healthful interpersonal relationships, among others provide a safe and healthful environment. The three fold goal of environmental school health education is healthy people in healthy communities in a healthy environment.

Health lies in the functional interaction of the individual and his environment and not determined in terms of the individual isolation. A clinical picture shows the interplay of psychological, physiological and structural factors. The moment a man falls ill, he regresses in an infantile type of psychological condition, a type of adoption neurosis which is normal part of the patient’s reaction to his illness (Canestrari, 1963).

However, understanding of mental health by individual teacher and the society at large would be helpful in the conversion of weird and wild experience at early stage to greatness and responsibility in later life. Teachers are expected to have motivational impact on their students. Teachers have more vital role to play in student stress management. Students need to be educated on the effects of stress on achievement, and understand human behavior and how it affects other people in the environment (Olanipekun, 2006).

Key Words: Health education for teachers’ education, educating teachers in mental health, health education a necessity for teachers.

 

Mental Health

Mental health is a term to describe either a level of cognitive or emotional well-being or an absence of mental disorders. It may include an individual’s ability to enjoy life and procure a balance between life activities and efforts to achieve psychological resilience (About.com, 2006). It is regarded as expression of ones emotions which signifies a successful adaptation to a range of demands.

World Health Organization (2005) defines mental health as “a state of well-being in which the individual realizes his/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/her community”. However, the organization recognizes the fact that a complete definition may not be available because of cultural, religion and general environmental influences on determination, recognition of mental health and disorders. World Health Research (2001) explains that definition of mental health depend on cultural differences, subjective assessments, and competing professional theories because they all affect how mental health is defined.

 

Mental Disorders

The definition of mental disorders is a key issue for mental health and for users and providers of mental health services. Most international clinical documents use the term “Mental Disorders” and some define it as a psychological or behavioral pattern associated with distress or disability.

Mental disorders are conceptualized as disorders of the brain circuits likely caused by development processes shaped by a complex interplay of genetics and experience. It is psychological or behavior pattern associated with distress or disability that occurs in an individual and is not a part of normal development or culture (Yolken and Torrey, 1995).

The recognition and understanding of mental health condition has changed over time and across culture, there are still variations in the definition, assessment and classification of mental disorders, although standard guideline criteria are widely accepted. Diagnoses are made by psychiatrists or clinical psychologists using various methods, often relying on observation and questioning in interviews. Treatments are provided by various mental health professionals.   

            Yolken and Torrey (1995) records that there are some diagnoses, such as childhood conduct disorder or adult antisocial personality disorder or psychopath, which are defined by or inherently associated with conduct problems and violence. There are conflicting findings about the extent to which certain specific symptoms, notably some kinds of psychosis (hallucination or delusions) that can occur in disorder such as schizophrenia, delusional disorder or mood disorder, are linked to an increased risk of serious violence on average.

            Recently, the field of Global Mental Health has emerged, defined as ‘the area of study, research and practice that places a priority on improving mental health for all people’ (Patel and Prince, 2010). The mediating factors of violence acts, however, are most consistently found to be mainly socio-demographic and socio-economic factors such as age, gender, lower socioeconomic status and in particular substance abuse (including alcoholism) to which some people may be particularly vulnerable (Stuart, 2003).

 

Types of Mental Disorders

Mental disorders are in categories. There are many facets of human behaviors and personality that can become disorder. This paper sum them from the classifications given by Yolken and Torrey (1995), Kitchener and Jorm (2002) and Keyes (2002).

Anxiety disorder: when anxiety or fear interferes with normal functioning. This may include phobia, generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, obsession, compulsive disorder, and post traumatic stress disorder.

Affective disorders: Affective (emotion/mood) process can become disorders. These are mood disorder (unusual intense and sustained sadness, melancholia or despair) known as major depression or clinical depression (milder but still prolonged depression can be diagnosed as dysthymia).

Bipolar disorders (manic depression): It involves abnormally “high or pressured mood states, known as mania/hypomania, alternating with normal/depressed mood. Yolken and Torrey (1995) states that whether unipolar and bipolar mood phenomena represent distinct categories of disorder or whether they usually mix and merge together along a dimension or spectrum of mood is under debate in the scientific literature.

Pattern of belief, language use and perception can become disorder. Examples are delusion, thought disorder, and hallucinations. These are referred to as psychotic disorders (schizophrenia and delusional disorder).

Schizoaffective disorder:  It is a term use for those individuals showing aspects of both schizophrenia and affective disorders.

Personality disorders: paranoid, schizoid and schizotypal, antisocial, borderline, histrionic/narcissistic, avoidant, dependent/obsessive-compulsive.

Adjustment disorder: This is an inability to sufficiently adjust to life circumstances begins within three months of a particular event or situation, and ends within six months after the stressor stops or is eliminated.

Eating disorder: anorexia nervosa, bulimia nervosa, exercise bulimia or binge eating order.

Sexual disorder: gender identification disorder, dyspareunia, and ego-dystonic homosexuality.

Sleep disorder: insomnia

Tic disorder: Tourette’s syndrome, kleptomania, pyromania, gambling, substance dependence or abuse or addiction is in this category.

Conduct disorder: Inability to behave normally with expected discipline in the society. If this continues into adulthood, it may be diagnosed as anti-social personality disorder (psychopath).

 

Prevalence

            Mental disorders are common world wide. WHO (2000) records that one out of three people in most communities report sufficient criteria for at least one at some point in their life.

Sanfford (1978), states that many children have behaviors that conflict with a reasonable school environment which could not be described as a healthful one and invariably affects their performance and the adaptation of others to them. Carter, Briggs-Gowan, and Davis (2004) exclaims that many children exhibit a deviation from age appropriate behaviors which interferes with child’s own growth and development and/or the issue of others.

 

Causes of mental disorders

Mental disorders can arise from a combination of sources. In many cases there is no single accepted cause currently established. It is commonly belief that mental disorder results from genetic vulnerabilities exposed by environmental stressors.

WHO (2000) reveals that there is a strong relationship between the various forms of severe and complex mental disorder in adulthood and abuse (physical, sexual or emotional) or neglect of children during the developmental years. According to the report ‘children sexual  abuse’ alone plays a significant percentage of all mental disorder in adult females, most notable example being eating disorder and borderline personality disorder.

Jefferoate (1969) explains that environment can cause or trigger physical  or mental ill-health while psyche influences the development of organic disease in remote parts of the body, and illness begets anxiety and this in turn begets illness. The mental health of an individual depends on the continuous satisfaction of specials requisites in the pattern of his psychological stimulation, the opportunity to give and receive love and affection, to be dependent and be depended upon. When one or more of these is/are missing the level of mental soundness is altered resulting in mental illness.  

 

The following are considered as contributing factors or causes of mental disorder (WHO, 2000; Steadman, Mulvey, Monahan, Robbins, Appelbaum, Grisso, Roth, and Silver, 1998; and Kitchener and Jorm, 2002):

Studies have shown that genes often play an important role in the development of mental disorder, although the reliable identification of connections between specific genes and specific categories of disorder has proven more difficult.

Environmental events surrounding pregnancy and birth have been implicated.

Traumatic brain injury may increase the risk of developing certain mental disorder.

There has been some tentative inconsistent links found to certain viral infections, to substance misuse, and to general physical health.

Social influences have been found to be important, including abuse, bullying and other negative/stressful life experiences.

Wider community vices/problems such as unemployment/employment problems, socio economic inequality, and lack of socio cohesion have been attributed also to mental disorder.

.

Society response to mentally ill people

Response of people to mentally ill persons or people with nervous breakdown is pathetic and unhealthy. A study reported by Times Online (2009) note that assistance given by extended families that often help and supportive religious leaders who listen with kindness and respect often contrast with usual practice in psychiatric diagnosis and medication. Due to lack of proper education and ignorance on causes of mental illness and emotional problems, prevention approach and treatment, the public fail to understand the true nature of many of these mental illnesses and fail to seek the available services. Thus rather than helping to reduce/cushing the effect of the problem or the cause of the problem, the condition of the affected individuals are worsen. Some conditions are not as bad as people look at them and if they are well handled the situation may change for better.

Murray, Lopez, and World Health Organization (1996) reports:           

 

“The burden of mental illness on health and productivity throughout

the world has been profoundly underestimated. Data developed by

the massive Global Burden of disease study, conducted by the WHO,

the World Bank, and Harvard University revealed that mental illness,

including suicide, rank second in the burden of disease in established

market economics, … It further revealed that nearly two third of  all

the people with diagnosable mental disorders do not seek treatment. It

is believed that when people understand that mental disorders are not

the result of moral failings or limited will power, but are legitimate

illnesses that are responsive to specific treatments, much of the

negative stereotyping may dissipate”

 

They report further that the 10 leading causes of disability (counting lost years of healthy life) at age 15-44 were: major depression, alcohol use, road traffic accident, schizophrenia, self inflicted injuries, drug use, bipolar disorder, obsessive-compulsive disorders, osteoarthritis, and violence.

            Thompson (2010) in his study ‘Addressing Suicide: is treatment more important than therapist?’  reports a study by Dr. Marsha Linehan at the University of Washington who suggested that “type of treatment may make a big difference for people who have borderline personality disorder (BPD), a chronic condition associated with difficulty in effectively managing one’s emotions., multiple suicide attempts, physical self harm (e.g. cutting on oneself) and impulsive, often destructive actions.”

            Stigma remains a serious problem, with many cases of human rights violations like chaining or beating experienced by people with mental illness. Perpetrators are rarely brought to justice.Royal College of Psychiatrist reported that research has shown that there is stigma attached to mental illness.

There are on-line psychiatric or mental illness self-diagnose available now stating the weekly changes in individual mental health and quality of life. Report has it that annual expenditure on health in Nigeria is less than 3% of Gross Domestic Product, amounting to per capita, mental health services received only a very small part of this total health budget.

 

Factors underlying people’ behavior towards mental ill people

Many factors have been attributed to uncaring attitude of people to the mentally ill people. These include:

Predisposition factors: The antecedents to behavior. What provide the rationale or motivation for the behavior (e.g. knowledge, beliefs, values, attitudes, confidence, and existing skills).
Enabling factors: The conditions in the environment that enable the motivation to be realized. These factors may be availability, accessibility to facilities for caring for the affected (finance, psychiatric care, etc).
Reinforcing factors: What follow the behavior (acceptance of the patient that he/she needs help).
Knowledge: It is necessary for a conscious action to take place; knowledge can be gained from information provided by health professionals, parents, teachers, books and mass medial or other sources through experience.
Belief: A conviction that a phenomenon or object is true or real. Most of them are derived from parents or other respected people in the life of the beholder.
Values: The value given to things tends to cluster within ethnic group and across generations of people sharing a common history and geographical identity.
Attitude: This reflects likes/dislikes towards certain categories of objects, persons/situation. It is sometimes based on limited experience. It may be formed without understanding the whole situation.
Relationships and morality: Clinical conceptions of mental illness also overlap with personal and cultural values in the domain of morality, so much so that it is sometimes argued that separating the two is impossible without fundamentally redefining the essence of being a particular person in a society.

 

            Tilbury and Rapley (2004) and Karasz (2005), agree that in clinical psychiatry, persistent distress and disability indicate an internal disorder requiring treatment; but in order context, the distress and disability can be seen as an indicator of emotional struggle and the need to address social and structural problems. The poor economic situation has affected the standard of living of many people especially those we can class as poor.

The unchecked wide gap between the rich and the poor has resulted in some cases to family disintegration, with adverse effect on children who are being abused. These and other factors have led to increase in mental illness of many young ones within school age.

If their society cannot accommodate them, schools have no choice, and they cannot be discriminated against. Every child has right to education in Nigeria. Therefore schools should learn how to accommodate and integrate them into the system. 

 

Psychotherapy

            Psychotherapy involves a variety of treatment techniques, often used along with medication. There are many ways of treating mental disorders, some of which are stated below (general and specific):

General

Individual: involving only the patent and the therapist.

Group – involving two or more patient in the therapy at the same time. It gives them the opportunity to share experiences and learns and appreciates how others feel too.

Marital or couples: helping spouses and partners understand why their loved one has a mental disorder, what changes in communication, how behaviors can help and what they can do to cope.

Family/relation: Involvement of family or a close relation that has influence or has much information on the patient in improving the condition of patient is vital and recognized. They need to understand what their loved one is going through, how they themselves can cope, and what they can do to help.

Specific

Psychoanalytic – the first approach, the patient’s thoughts are verbalized including free associations, fantasies, and dreams, from which the analysis formulates the nature of the unconscious conflicts which are causing the patient’s symptoms and character problems. It addresses the underlining psychic conflicts and defenses.

Behavior therapy/applied behavior analysis – focuses on changing maladaptive patterns of behavior to improve emotional responses, cognitions, and interactions with others.

Cognitive behavioral therapy – It is based on modifying the patterns of thought and behavior associated with a particular disorder. It seeks to identify maladaptive cognition, appraisal, beliefs and reactions with the aim of influencing destructive negative emotions and problematic dysfunctional behaviors.

Psychodynamic – a dept psychology with primary aim to reveal the unconscious content of a client’s psyche in an effort to alleviate psychic tension. It gets its root from psychoanalysis.

Existential therapy – It is based on the existential belief that human beings are alone in the world. This association leads to meaninglessness, which can be overcome only by creating one’s own values and by meanings. It is philosophically associated with phenomena.

Systemic therapy or family therapy – a process where a net-work of significant others as well as an individual are addressed.

Humanistic Approach – a psychological approach that is a value oriented, holds a hopeful, constructive view of human beings and of their substantial capacity to be self determining, guided by a conviction that intentionality and ethical values are strong psychological forces, among the basic determinants of human behavior.

Eclectic/integrative approach – a combination of two or more therapy techniques for treatment of mental disorder.

Counseling and co-counseling – a psychological approach too but in this case advice and suggestion are given base on the observation and information available to the counselor(s).

Psycho education – This program provides people with the information to understand and manage their problems.

Creative therapies – This involves art works such as music and drama therapies.

Lifestyle adjustments and supportive measures – personal adjustment to situations.

 

School connection and nature of teachers’ duties

WHO (2000) reveals that there is a strong relationship between the various forms of severe and complex mental disorder in adulthood and the abuse (physical, sexual/emotional/neglect of children during the developmental years); and records that sexual abuse of children alone plays a significant percentage of the mental disorder in adult females, most notable examples being eating disorders and borderline personality disorder should be a thing of serious concern to our education institutions. There were records of various abuses of children in our environment, many of which could have been averted if they were well enlightened on how to relate in the society, the self protection or prevention of some of the vices in our society and even counseling for victims.

The socio economic and family problems has made many school children and even the grown ups exhibit some emotional and behavioral problems. Children are the life wire of schools. Therefore, identification and management of emotional and behaviorally disturbed children is very important since teachers are dealing with them directly in schools (Akintunde and Akintunde, 2010)). It is not economically possible for each school to have a psychiatrist as a permanent staff. This inability to have such specialist necessitates equipping teachers with essential knowledge capable of assisting in identifying and administering mental health problems to some extent (Akintunde, 2007).

The more teachers know about how to identify the children mental problems the better and easier for them to deal with such situations when they arise. Their relationship with the students and the community will improve and help tremendously in improving the performance of the students. They will even be in position to enlighten parents of these children and the public in general (Akintunde, 2007).

Educating student teachers on mental health through school health education will go a long way not to assist both students and teachers. Teachers are also part of our community; they also operate under the same condition as their students and people in the community. Therefore they are faced with many challenges as those in the community.

Teachers have their personal problems that stress them up upon which they are still expected to accommodate students’ problems most of which are related to mental health problems. In order to make their job easy, they should be armed adequately with enough skills to handle those problems (Sanfford, (1978)).  

Although a lay man look at teaching as a job that any man can handle, forgetting that it is a 24hours job, not ending in school hours but continues as carry over after closing hour, the teacher has to prepare for the next day job and also finish assessment/marking of any assignment given to students as home work. The same person has domestic responsibilities to attend to.

In fact he has little or no time for himself talk less of recreation to recuperate him. If he does not know how to manage the situation, he may end up a psychiatric patient. The knowledge of symptoms, identification, management and therapy of mental disorders or illnesses will help him cope and adjust.

The knowledge of mental health will enable the teachers to know how far they can push the students in terms of discipline, academic activities, co-curricular activities and what to do to assist or step down the effect of mental illness on students. There are times that the attitude of some teachers (especially the untrained or half baked ones) can be very tormenting to the life of students. This is getting worse now that teachers indulge in all sorts of corruptions in schools.

 

Problems associated with integration of children with mental disorders into school system

According to WHO (2000) virtually everybody seems to experience mental disorder at one time or the other. All agents of enhancement of mental health are equally affected mentally too either directly or indirectly. Stress which is a booster of mental illness strikes on everyone; thus, there is need for all and sundry to understand and know how to manage stress.

Guardians’ services render by teachers stops in school but students still interact with the environment outside the school where the school is not in the knowing of the nature of the interaction. What happen to the child after school is not under the control of the school. This condition is worse now that almost all schools are operating as day school except few private schools. There is every possibility of the effort of school being rendered useless by counter interaction of the larger society.

The problem in our society is too heavy for individual to carry; talk less of adding another person’s problem. As a result of this, there is insufficient value base for a committed ethic of care in our society. Thus committed teacher are rare to find.

The differences in background, ethnicity, culture and other attribute that makes individual unique couple with the general society concept and stigma associated with mental illness/disorders makes individual nature complex.

If teachers are to be carried along in alleviating the problem of mental illness in our society, it means a change in teachers’ training curriculum. This is always a problem because generally people do not give in to changes easily. Before you know it Government will also give excuse of lack of money to finance the little alteration the change in curriculum will bring.

Some teachers are bad examples to students and they rather add to the existing problem than solve or reduce it. Whoever cannot manage himself cannot manage others or be a brothers’ keeper. Those in this category needs attention themselves and schools should take appropriate step to help them out before they influence the students.

There is no problem without solution. Sanfford (1978) adopts and adapts some psychotherapy techniques to suggest the following ten aids for teachers to actualize a healthy school environment:

Objectivity – To be objective about self and what to do towards what the student does.
Sharing – To share problems and experiences regularly with colleagues, parents and administrators, through conference, formal and informal meeting.
Feedback – Obtain feedback from observation of the child and suggestions from parents, teachers and administration.
Consultation – Where necessary consult expert like psychologist.
Collaboration – Loan out the child for sometime with other teachers, class and environment, then collate feedback on particular trait being addressed.
Observation – Use some observational techniques such as feedback interaction, analysis and other objective recording system.
Be artistic – Literature, theatres, good films, music and art, may somehow become more meaningful to the teacher when it comes to the issue of their children. People in different community are gradually getting used to using these media as tools for integration and communicative models.
Sense of humor – Maintain sense of humor.
Be Professional – maintain a strict sense of professionalizing while remain the personality the teacher is.
Reinforce – Seek reinforcement and assurance from the children in order to provide them with assurance and solid ground to fall on.

 

Benefit of making health education a core course for teacher education

The awareness and ability to understand the causes and problems associated with mental disorders goes a long way to prevention, management and treatment of these problems, making teaching and learning conducive, effective and enjoyable. Therefore there are lots to benefit from introducing school health education with emphasis on mental health into teachers curriculum. The summary of the benefits are these:

Teachers will be able to discover themselves and relate well with their colleagues and students.

It will enable teachers to understand their students’ inadequacies and problems.

Teachers will find it easy to assist their students in reducing the effects of their problems on their academic and relationship with other people inside and outside the school.

Students will have confidence in discussing their problems with their teachers, sharing their dreams with them with the aim of getting valuable advice and support from them.

Relationship between teachers and students will be more cordial, helpful and effective.

Both teachers and students will develop the ability to come to terms with the environment, adjust to situations and blend with people, their inadequacies not withstanding.

All these are attributes that can improve on teaching learning and lay solid foundation for development of a whole man in a child to meet society expectation.

 

 

 

References

 

Akintunde, P. G. (2007), Administrative Phalanx in Education. Calabar: University of

       Calabar Press. P. 134-169

Akintunde, P.G. and Akintunde, V.O. (2010), Duties of schools in national moral

        development. ArticlesBase SC #1805723

CAMH: Toronto Star Opinion. Editorial: Ending stigma of mental illness.

Canestrari, R (1963), Psychological Training of Medical Practitioners to facilitate good

       Doctor – Patient Relationship. Gazetta Sanitaria 12 (6)

Carter, A.S., Briggs-Gowan, M.J., & Davis, N.O. (2004), “Assessment of young

       children’s socials emotional development and psychopathology: recent advances and

       recommendations for practice” J Child Psycho Psychiatry 45 (1): 109-34. January.

Elbogen, E.B., & Johnson, S.C. (2009), The intricate link between violence and mental

      disorder: results from the National Epidemiologic Survey of Alcohol and Related

      Conditions” Arch.Gen. Psychiatry 66 (2): 152-61. Feb.

      dio:10.1001/archgenpsychiatry.2008.537. PMID 19188537.

Fazel, S., Gulati, G., Linsell, L.,  Geddes, J.R., & Grann, M. (2009), “Schizophrenia and

       violence: systematic review and meta-analysis” PLoS Med. 6 (8): e1000120. doi:

      10.1371/jornal. Pmed. 1000120. PMID 19668362

Jefferoate, T.N.A. (1969), Principles of Gynecology. London: Butterworth.

Karasz, A. (2005), “Cultural differences in conceptual models of depression”, Social

       Science in Medicine 60 (7): 1625-35; doi;10.1016/j.socscimed.2004.08.011, PMID

       15652693

Keyes, Corey (2002), ‘The Mental Health continuum: from languishing to flourishing in

       life’ Journal of Health and social behavior 43 (2) 207-222. doi:10.2307/3090197.

Kitchener, B.A., and Jorm, A.F. (2002), Mental Health First Aide Manual. Centre for Mental Health research, Canberra, p5.

Lakhan, S.E. & Vieira, K. F. (2008), “Nutritional therapies for mental disorders” Nutr J7:

       2. doi; 10.1186/1475-2891-7-2.   PMID 18208598. PMC 2248201.

Link, B.G., Phelan, J.C., Bresnahar, M., Stueve, A., & Pescosolido, B.A. (1999), “Public

       conception of mental illness: labels, causes, dangerousness, and social distance”. AM

       J Public health 89 (9):  1328-33. Sept. doi:10.2105/AJPH.89.9.1328.PMID

      10474548. PMC 1508784.

Mbanefo, S.E. (1991), Psychiatry in general medical approach practice in Nigeria.

       Ibadan: Tropical Medicine Series.

Murray, C.J.L., Lopez, A.D. and World Health Organization (1996) The Global Burden    

       of Disease table 5.4 page 270

Olanipekun, O. Fola (2005), Be a success without stress. Ibadan: Teesolf Publishers.

Patel, V., & Prince, M. (2010), Global Mental Health – a new global health field comes

       of  age, JAMA, 303, 1976 – 1977.

Philip W. Long M.D. (1995 – 2008) Internet Mental Health.

Sanfford, A.O. (1978), Teaching young children with special needs. St. Louis: The C.V.

       Mosby, Co.

Steadman, H.J., Mulvey, E. P., Monahan, J., Robbins, P.C., Appelbaum, P. S., Grisso,

       T., Roth, L.H., Silver, E. (1998), Violence by the people discharged from acute

       psychiatric inpatient facilities and others in the same neighborhoods.  Archives of

       General Psychiatry. May; 55 (5): 393-401.

Stuart, H. (2003),”Violence and mental illness: an overview” World Psychiatry2 (2):121-

      124. June. PMID 16946914.

Thompson, Brian (2010), Addressing Suicide: is treatment more important than therapist?

       August 2nd 2010.

Tilbury, F. Bapley, M. (2004) ‘There are orphans in Africa still looking for my hands’:

       African women refuges and the sources of emotional distress Health Sociology

       Review, Vol 13, Issue 1, 54-64.

Times Online, (2009), Psychiatric diagnoses are less reliable than star signs. Times

       Online, June

WEbMD inc (2005), Mental Health:  Types of Mental illness, Retrieved April

       19, 2007, July 01. From http;//www webmed.com/mental-health/mental-health-  

        types-illness

WORLD Health Organization (WHO) International health Conference, New York

       www.who.int/../print.html

WHO International Consortium Psychiatric Epidemiology (2000), Cross-national

       comparisons of the prevalence and correlate of mental disorders Bulletin of the

       World Health Organization v. 78 n. 4.

WHO (2005), Promoting mental health concepts, emerging evidence, practice: A report

      of the World Health Organization, department of mental health and substance abuse

      in collaboration with the Victoria Health Promotion Foundation and the University of

      Melbourne, WHO, Geneva.

World Health Research (2001), Mental Health – new understanding, New Hope, WHO

Yolken, R.H. & Torrey, E.F. (1995), “Viruses, schizophrenia, and bipolar disorder” Clin   

       Microbiol Rev. 8 (1): 131-45, 1st January. PMID 7704-891. PMC 172852.

http.//www.who.int/mental_health/prevention/genderwomen/en/

www.nami.org

234next.com/../story.csp  (2009), Facts on mental health in Nigeria ,  April 4, 2009

A mental health billing service covers many activities, but there is one main goal that any medical biller has, and that is to process treatment descriptions and file claims. A mental health billing service uses special software to handle all billing problems, generate cash flow reports or see what are the insurance contacts that generate the most money. Mental health billing services also include follow- ups in cases of overdue payments, answering insurance company or patients’ concerns or questions or even offer training to their clients.

There are several reasons why a professional should use mental health billing services instead of doing his/ her own mental health billing. First of all, a mental health billing service saves their practice a lot of time and money. A mental health professional’ s time is put to better use when he or she is seeing patients, instead of doing mental health billing. There are many time- consuming aspects to doing mental health billing and some of these aspects include looking into insurance benefits or appealing denied claims. This job is better done by a medical biller who has the required experience to easily obtain the necessary information. An experienced medical biller plays an important role in the mental health billing service provided to health professionals. Moreover, by using a mental health billing service, the health professional will spend less money than hiring his/ her own staff or doing the mental health billing by him/ herself. Investing in new employees’ training, wages and accommodation requires a substantial amount of money. If he or she decides to do mental health billing on their own, then precious time will be wasted, and time is money. The best solution would be to use a mental health billing service.

Second of all, a mental health billing service means less paperwork. The whole mental health billing process is done by using the computer, the internet and special software, which means that paperwork will be reduced considerably. Of course not all paperwork can be left in the hands of the medical biller, but much of the paperwork related to insurance can be handled by the biller. Moreover, whenever a new client comes, the medical professional has to do little else but send the form to his medical biller. He/ she will enter the information in a computer and the only task left for the medical professional is to send day sheets with the patients who kept their appointments or what services they have received. Moreover, if the mental health professional desires, he/ she can enter all this information in the computer, thus saving more time and paperwork.

Thirdly, by using a mental health billing service, a professional can gain more clients. The time spent on doing administrative work can be put to better use by developing great marketing strategies to attract clients. A medical biller can handle many of the administrative work, so the medical professional can learn how to improve his/ her practice and have more clients.

A mental health billing service gives any mental health professional the opportunity to grow and make a name for himself or herself in that business. Doing mental health billing for them is just one of the many services that a mental health billing service offers.

For more resources about mental health billing or even about Mental health billing service please review this website http://www.mymedicalbillingservice.com

Improving the Mental Health System

According to a news release that was dated May 9, 2006, the “Standing Senate Committee On Social Affairs, Science and Technology” in Canada recommended the creation of a Canadian Mental Health Commission that will be responsible for significantly upgrading the Canadian mental health system. As stated by Senator Michael Kirby, the Chair of the Committee, “The Senate Committee is committed to improving the range, quality and organization of health and support services that are required by the tens of thousands of Canadians who are living with mental illnesses and addictions.”

Funding The Proposed Change

Based on an extensive three-year study on mental health and addiction, the Committee determined that it will cost .36 billion over a 10-year period for this mental health system upgrade. Where will these funds come from? According to the Committee, the revenue will come from raising the excise tax on alcoholic drinks by 5 cents per drink.

Part of the rationale for the 5-cent increase per drink was obviously the goal of raising the needed funds for the proposed changes in the mental health system. Another justifying factor for the price increase, however, was the fact that since each alcoholic drink will cost more, Canadians will be more inclined to drink lower-alcohol products such as beer and wine instead of liquor.

Let’s Do the Math

At first glance, this proposal seems to make sense. Why shouldn’t those who drink help finance a program that will provide them with a better mental health system? Why not let those who are part of the “problem” become part of the “solution”? This logic seems sound until you do the math. If .36 billion is needed to help finance the upgraded mental health system, then how many drinks will have to be consumed in a ten-year period to reach .36 billion dollars? The answer: 107,200,000,000 drinks. That’s 107 billion, 200 million drinks.

To arrive at how many drinks this is per year, all we have to do is divide this number by 10 (for the ten-year program) and the result is 10,720,000,000. This is still a huge number that fortunately can be “massaged” even more. According to The World Factbook website, the population of Canada was estimated to be 33 million people in 2006. Dividing 10,720,000,000 by 33,000,000 equals 325. Putting this in terms that the average person can understand, every man, woman, and child in Canada will have to consume 325 alcoholic drinks per year for the next ten years to finance the new mental health system! Simply put, these numbers are not realistic.

More Flaws

The “logic” of this proposed mental health program also breaks down when it is examined more deeply. For instance, why would people drink lower-alcohol products such as beer if the increased excise tax applies to all alcoholic drinks? To help understand this better, let’s use an example. Let’s say that the average shot in Canada currently costs .00 and the average beer costs .00. Based on the proposed price increase, if Joe drinks an average of 5 shots per week, his weekly average alcohol expenditure will be .25. When the numbers are calculated, this figures out to be 1.7% more than Joe would have spent before the proposed tax increase. Let’s do a similar exercise with beer. Based on the projected price increase, if Pete drinks an average of 5 beers per week, his weekly average alcohol expenditure will be .25. When the numbers are calculated, this figures out to be 5% more than Pete would have spent before the proposed tax increase. The point: since the proposed price increase affects higher-alcohol products (such as shots) proportionately less than their lower-alcohol counterparts (such as beer), why would Canadians switch to lower-alcohol products?

Alcohol and Mental Health

Another question. What if tens of thousands of Canadians, realizing that drinking alcohol is not good for their “mental health,” significantly reduce their alcohol intake or quit drinking alcoholic beverages altogether? Where will the money come from to offset this lack of revenue? In a similar manner, what if thousands upon thousands of Canadians who drink alcoholic beverages decide that they don’t want to pay the extra excise tax and, as a result, stop drinking alcoholic beverages? If this happens, where will the government get the money needed to transform the mental health system? In other words, does the Canadian government have a realistic “plan B” for this major transformation?

A Logical Contradiction

From a different perspective, isn’t it rather ironic that those who drink alcoholic beverages will pay for the revamped mental health system? Isn’t there a contradiction in logic somewhere in this proposal? Stated differently, if tens of thousands of Canadians have mental illnesses or are addicted to alcohol or drugs, wouldn’t the government want Canadians to drink LESS alcohol in order to reduce the existing alcohol abuse, alcoholism, and alcohol-related mental health problems? Yet according to the current mental health proposal, from strictly a financial standpoint, it would appear that the Canadian government is banking the entire mental health system upgrade on historical data that strongly suggests that Canadians will continue to drink at their current or even higher levels of consumption.

Budgetary Miscalculations

What happens, for instance, if there are cost overruns in the proposed mental health system? There are, of course, two “easy” solutions to this problem: increase the excise tax on each drink or motivate Canadians to drink even more alcoholic beverages. Either “solution,” however, is predicated on the fact that in order to “work,” the upgraded mental health system needs to be funded by Canadians who continue to drink alcoholic beverages.

Conclusion

It appears logical to conclude that the Canadian mental health system is in need of a major overhaul. As with most comprehensive government programs, however, the issue of funding becomes a major obstacle to overcome. The proposed Canadian mental health system upgrade is no exception. Based on the reasons given above, it seems obvious that the Canadian government needs to come up with alternate sources of revenue generation for this worthwhile project. Indeed, to point out one of the major “flaws” in the current proposal, consider the following question: When is more drinking a “good thing?” Answer: when it finances a nationwide mental health system upgrade. Something tells me that Andy Rooney from “60 Minutes” would have a lot of fun with this.

Copyright 2007 – Denny Soinski. All Rights Reserved Worldwide. Reprint Rights: You may reprint this article as long as you leave all of the links active, do not edit the article in any way, and give the author credit.

The Four Quadrant Model is a proposed model for the clinical integration of mental health and behavioral health services. A focus on the prevalence of co-occurring disorders (i.e. depression and alcoholism) is paramount in this model. The Four Quadrant Model builds on the 1998 consensus document for mental health and substance abuse/addiction service integration. This model for a comprehensive, continuous and integrated system of care describes differing levels of mental health and substance abuse integration and clinician competencies based on the four-quadrant model, divided into severity for each disorder:

>    Quadrant I: Low mental health – low substance abuse, served in primary care
>    Quadrant II: High mental health – low substance abuse, served in the mental health system by staff who have substance abuse competency
>    Quadrant III: Low mental health – high substance abuse, served in the substance abuse system by staff who have mental health competency
>    Quadrant IV: High mental health – high substance abuse, served by a fully integrated mental health and substance abuse program

The Four Quadrant model is not intended to be prescriptive about what happens in each quadrant, but to serve as a conceptual framework for collaborative planning in each local system. Ideally it would be used as a part of collaborative planning for each new behavioral health and community mental healthcare site, with the local provider(s) of public behavioral health services using the framework to decide who will do what and how coordination for each person served will be assured.

The use of the Four Quadrant Model to consider subsets of the population, the major system elements and clinical roles would result in the following broad approaches:

QUADRANT I

Low behavioral health – low physical health complexity/risk, served in primary care with behavioral health care staff on site; very low/low individuals served by the principle care provider, with the behavioral health care staff serving those with slightly elevated health or behavioral health risk.

The principle care providers give primary care services and uses standard behavioral health screening tools and practice guidelines to serve most individuals in the primary care practice. Use of standardized behavioral health tools by the principle care providers and a tracking/registry system focuses referrals of a subset of the population to the behavioral health clinician. The role of the primary care based behavioral health clinician is to provide formal and informal consultation to the principle care providers as well as to provide behavioral health triage and assessment, brief treatment services to the patient, referral to community and educational resources, and health risk education. Behavioral health clinical and support services may include individual or group services, use of cognitive behavioral therapy, psycho-education, brief substance abuse intervention, and limited case management. The behavioral health clinician must be competent in both mental health and substance abuse assessment and service planning. The principle care provider prescribes psychotropic medications using treatment algorithms and has access to psychiatric consultation regarding medication management.

The consumer of care, by seeking care in primary care, has selected a “clinical home.” Consistent with appropriate clinical practice, that should be honored. The primary care and specialty behavioral health system should develop protocols, however, that spell out how acute behavioral health episodes or high-risk consumers will be handled. This will also lead to clarity regarding the “clinical home” of consumers with serious persistent mental illness who are currently stable, which should be based upon consumer choice and the specifics of the community collaboration.

QUADRANT II

High behavioral health – low physical health complexity/risk, served in a specialty behavioral health system that coordinates with the principle care providers.

The principle care provider provides primary care services and collaborates with the specialty behavioral health providers to assure coordinated care for individuals. Psychiatric consultation for the principle care providers may be an element in these complex behavioral health situations, but it more likely that psychotropic medication management will be handled by the specialty behavioral health system. The role of the specialty behavioral health clinician is to provide behavioral health assessment, arrange for or deliver specialty behavioral health services, assure case management related to housing and other community supports, assure that the consumer has access to health care, and create a primary care communication approach (e.g., e-mail, v-mail, face to face) that assures coordinated service planning, especially in regard to medication management.

Specialty behavioral health clinical and support services will vary based upon state and county level planning and financing; some localities may encompass the full range of services offered by specialty behavioral health systems including:

Specialty Mental Health Services

>    Crisis respite facilities
>    24/7 crisis telephone
>    Crisis residential facilities
>    Mobile crisis team
>    Crisis observation 23 hour beds
>    Urgent care walk in clinic
>    Locked sub-acute residential
>    Inpatient (voluntary and involuntary)
>    Dual diagnosis inpatient
>    Hospital discharge planning
>    Partial hospitalization
>    In-home stabilization
>    Outreach to homeless shelters
>    Outreach to jail/corrections
>    Outreach to other special populations
>    Individual/family treatment /counseling
>    Group treatment/counseling
>    Dual diagnosis treatment groups
>    Multifamily groups
>    Psychiatric evaluation/consultation
>    Psychiatric prescribing/management
>    Advice nurse (medication issues)
>    Psychological testing
>    Services for homebound frail or disabled
>    Specialized services for older adults
>    Brokerage case management
>    24/7 intensive home /community case management
>    School-based assessment and treatment
>    Supported classroom
>    Stabilization classroom
>    Day treatment (adult, adolescent, child)
>    Supported employment /supported education
>    Transitional services for young adults
>    Individual skill building /coaching
>    Intensive peer support
>    After school structured services
>    Summer daily structure and support

Specialty Substance Abuse Services
>    Sobering sites
>    Social detoxification/residential
>    Outpatient medical detoxification
>    Inpatient medical detoxification
>    Pre-treatment groups
>    Intensive outpatient treatment
>    Outpatient treatment
>    Day treatment
>    Aftercare/12 step groups
>    Narcotic replacement treatment

Residential Services
>    Boarding homes
>    Adult residential treatment
>    Child/adolescent residential treatment
>    Transitional housing
>    Adult family homes
>    Treatment foster care
>    Low income housing (dedicated to behavioral health consumers)

Supports for Serious Persistent Mental Health Populations
>    Representative payee/financial services
>    Time limited transitional groups
>    Parent support groups
>    Youth support groups
>    
Dual diagnosis education/support groups
>    Caregiver/family support groups
>    Youth after school normalizing activities
>    Youth tutors/mentors

The behavioral health clinician must be competent in both mental health and substance abuse assessment and service planning. A specific standard of practice should be adopted that defines the methods and frequency of communication with principle care providers. Note that this quadrant is where most public sector behavioral health consumers currently can be found.

QUADRANT III

Low behavioral health – high physical health complexity/risk, served in the primary care/medical specialty system with behavioral health staff on site in primary or medical specialty care, coordinating with all medical care providers including disease managers.

The principle care providers provides primary care services, works with medical specialty providers and disease managers (e.g. diabetes, asthma) to manage the physical health issues of the individual and uses standard behavioral health screening tools and practice guidelines to serve most individuals in the primary care practice. Use of standardized behavioral health tools by the principle care providers and a tracking/registry system focuses referrals of a subset of the population to the behavioral health clinician. The role of the primary care or medical specialty based behavioral health clinician is to provide behavioral health triage and assessment, consultation to the principle care providers or treatment services to the patient, referral to community and educational resources, and health risk education. Behavioral health clinical and support services may include individual or group services, use of cognitive behavioral therapy, psycho-education, brief substance abuse intervention, and limited case management. The behavioral health clinician must be competent in both mental health and substance abuse assessment and service planning. The principle care provider prescribes psychotropic medications using treatment algorithms and has access to psychiatric consultation regarding medication management.

Depending on the setting, the behavioral health clinician may also serve as a health educator regarding lifestyle and chronic health conditions found in the general public (diabetes, asthma) or conditions found in at-risk populations (Hepatitis C, HIV). These population-based services, as articulated by Bob Dyer, would include: patient education, activity planning; prompting; skill assessment; skill building; and, mutual support. In addition to these disease management services, the behavioral health clinician might serve as a physician extender, supporting efficient use of physician time by problem solving with acute or chronic patients, as well as working with patients on medication compliance issues.

Specialty healthcare and disease management programs could also integrate depression screening into a wide array of self management and rehabilitation programs, building on current research findings regarding the frequency and impact of depression in cardiovascular or diabetes populations.

QUADRANT IV

High behavioral health – high physical health complexity/risk, served in both the specialty behavioral health and primary care/medical specialty systems; in addition to the behavioral health case manager, there may be a disease manager, in which case the two managers work at a high level of coordination with one another and other members of the team.

The principle care providers works with medical specialty providers and disease managers (e.g. diabetes, asthma) to manage the physical health issues of the individual, while collaborating with the behavioral health system in the planning and delivery of behavioral health clinical and support services, which include those listed in Quadrant II. Psychiatric consultation is a key element in these most complex situations. The role of the specialty behavioral health clinician is to provide behavioral health assessment, arrange for or deliver specialty behavioral health services, assure case management related to housing and other community supports, and collaborate at a high level with the healthcare system team. The behavioral health clinician must be competent in both mental health and substance abuse assessment and service planning.

In some settings, behavioral health services may be integrated with specialty provider teams (for example, Kaiser has behavioral health clinicians in OB/GYN working with substance abusing pregnant women). With the extension of disease management programs into Medicaid health plans, there is the likelihood of coordinating with disease managers in addition to healthcare providers. The behavioral health clinician and disease manager should assure they are not duplicating tasks, but working together to support the needs of the consumer. A specific standard of practice should be adopted that defines the methods and frequency of communication.