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Models of mental health & illness

  1. SEMINAR ―MODELS OF MENTAL ILLNESS‖ Chairperson : Dr. K. S. Sengar Presentee : Sudarshana Das Gupta Discussant : Jaishankar Patel Venue : Conference Hall Time : 2:30 pm Date : 02.08.2012
  2. Presentation will be under the following headings:  Introduction  Concept of Health  Mental Health  Concept of Mental Illness  Mental health, Mental Ill-health and Mental Illness  History and significance of Mental Health  Perspectives of Mental Health  Criteria for Mental Health  Models of Mental Illness  Conclusion
  3. W.H.O.'s definition of Health: "A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."
  4. Mental Health is defined as ―A state of well-being in which every individual realizes his or her own potential, 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.‖
  5. Mental Illness is defined as ―Mental illness can be seen in purely sociological terms, as a deviation from socially approved standards of interpersonal behaviour, or as an inability to perform one’s sanctioned social roles. In social science literature it is generally agreed that the mental illness refers to dysfunctional interpersonal behaviour, judged to be dysfunctional in terms of the norms and values held by the observer‖ (International Encyclopedia of Psychiatry, Psychology, Psychoanalysis & Neurology, 1992).
  6. Mental Illness (Cont.) ―An illness with psychological or behavioral manifestation and/or impairment in functioning, due to social, psychological, genetic, physical or biological disturbances.‖ (American Psychiatric Association). ―Mentally ill person means a person who is in need of treatment by reason of any mental disorder other than mental retardation‖(Indian Mental Health Act, 1987).
  7. Mental health, Mental Ill-health and Mental Illness  It is a commonplace to view the relationship between health and illness — and, therefore, mental health and mental illness — as two ends of the same Trent (1992), The Canadian Ministry of National Health and Welfare (MNHW),1988 Downie et al (1990) Groder, (1977)
  8. History  In the mid-19th century, William Sweetzer was the first to clearly define the term "mental hygiene", which can be seen as the precursor to contemporary approaches to work on promoting positive mental health  An important figure to "mental hygiene", would be Dorothea Dix (1802–1887), a school teacher, who had campaigned her whole life in order to help those suffering of a mental illness, and to bring to light the deplorable conditions which they were put it in. This was known as the "mental hygiene movement".  At the beginning of the 20th century, Clifford Beers founded the National Committee for Mental Hygiene and opened the first outpatient mental health clinic in the United States of America.
  9. Significance  Evidence from the World Health Organization suggests that nearly half the world's population is affected by mental illness with an impact on their self-esteem, relationships and ability to function in everyday life.  ―There is growing evidence that is showing emotional abilities are associated with prosocial behaviors such as stress management and physical health‖ (Richards, Campania, & Muse-Burke (2010).  The importance of maintaining good mental health is crucial to living a long and healthy life.
  10. Perspectives  Sense of Responsibility  Sense of Self-reliance  Sense of Direction  A Set of Personal Values  Sense of Individuality  Mental Well-Being  Lack of a mental disorder  Cultural and religious considerations
  11. Maria Jahoda (1963) proposed the following six characteristics of the mentally healthy individual —  Environmental mastery  Undistorted perception of reality  Integration  Autonomy  Growth, self-development and self-actualization  Attitude towards Self
  12. Models of Mental Illness  Spiritual Model  Moral Character Model  The Statistical Model  The Disease/ Medical/ Biological Model — Genetics — Neuroimaging — Neurobiology  Psychological Models — Psychodynamic Model — The Behavioural Model • The Cognitive-behavioural Model — Existential / Humanistic Model  The Social Model  Psychosocial Model — The Social Learning Model  Family Therapy Model  Biopsychosocial Model
  13. Thinking Emotional Processes Processes Learned Biological Behaviours Processes
  14. Spiritual Model The first and oldest explanatory system for mental illness is spiritual. From a traditional spiritual perspective, consciousness is seen as resulting from or deeply connected to some supernatural force. Usually, there is a religious narrative that explains that there are good and bad forces in the world, and that suffering is a function of either being possessed by the bad, or through the idea that the afflicted have fallen out of favor with the good. This generally occurs because of sin or related concept of immoral behavior that leads to some form of badness or contamination.
  15. Moral Character Model The second explanatory system for mental illness is moral character. In a nutshell, the position of moral character is that there are virtues which one must learn, such as courage and fortitude, honesty and integrity, compassion and grace that enable on to live the admirable life.
  16. The Statistical Model Derived more from mathematics than from psychology, the statistical model concentrates on the definition of abnormality. According to this approach, abnormality is any substantial deviation from a statistically calculated average. Those who fall within the ―Golden mean‖ i.e. in short, those who do what most people do, are normal, while those whose behaviour differs from those of the majority are abnormal.
  17. The medical model attributes mental abnormalities to physiological, biochemical, or genetic causes and attempts to treat these abnormalities by way of medically grounded procedures such as psychopharmacology (drug therapy), electroconvulsive therapy (ECT), or psychosurgery (brain surgery). Genetic models of mental disorder suggest that psychopathology is inherited from parents, and there is certainly evidence for the familial transmission of many disorders.
  18. The Medical Model (Cont.) Neuroimaging This system explains causation of mental illness in terms of structural changes in different parts of brain. It suggest that in various mental illness certain ventricular atrophy, volumetric changes, reduction in cortical volume can be seen which may be one of the various contributory factors behind the causation of illness.
  19. The Medical Model (Cont.) Neurobiology • Here the belief is that the human is an organism that consists of natural functions designed by nature (i.e., natural selection operating on genetics) and mental illness is the breakdown of such functions. Thus, just as a heart attack is a biological disease characterized by the breakdown of the functioning of the circulatory system, mental illness stems from malfunctioning neurophysiological processes.
  20. Psychological Models  An important explanatory system for mental illness is psychological in nature. The general model here is that the individual develops along a path and attempts to adapt to their environment. However, if the individual fails to learn certain crucial elements or learns the wrong responses to new situations or adopts short term solutions that have long term maladaptive consequences, then suffering and dysfunction result.  Psychodynamic Model  The Behavioural Model  The Cognitive-behavioural Model  Humanistic / Existential Model
  21. Psychodynamic Model  The core assumption of this approach is that the roots of mental disorders are psychological. They lie in the unconscious mind and are the result the failure of defence mechanisms to protect the self (or ego) from anxiety. Problems are determined by the history of a person’s prior emotional experiences, especially the childhood ones or to be more specific, the negative childhood experiences.
  22. The Behavioural Model This system believes that, only the study of directly observable behavior, the stimuli and reinforcing conditions that control it could serve as a basis for understanding human, behaviour, normal or abnormal. The behavioural perspective is organized around a central theme: the role of learning in human behaviour.  The Cognitive-behavioural Model The cognitive model understands mental disorder as being a result of errors or biases in thinking. It explains how thoughts and information processing can become distorted and leads to maladaptive emotions and behaviour. Our view of the world is determined by our thinking, and dysfunctional thinking can lead to mental disorder. Therefore to correct mental disorder, what is necessary is a change in thinking.
  23. Humanistic / Existential Model The humanistic model sees mental health problems as a signal that an individual is failing to reach his or her potential and that psychological growth has stopped.The humanistic perspective views human nature as ―basically good‖. It emphasizes present conscious processes – paying less attention to unconscious processes and past causes – and places strong emphasis on each person’s inherent capacity for responsible self-direction. Its emphasis is thus on growth and self-actualizing rather than on curing diseases or alleviating disorders. The humanistic model does not believe in labeling people by diagnosing them as having specific mental disorders.
  24. The Social Model The social model suggests that the ways in which societies are organized, not just biological and psychological characteristics of individuals, must be considered as causal factors in mental illness. It does not argue that people should not be held responsible for their behaviour because they are victims of ―society‖, but they do suggest that social structure imposes restrictions on behaviour as surely as biological inheritance and that the effects of social conditions on mental illness need to be understood, to explain both individual distress and how that distress might be related to larger forces. The social model regards social forces as the most important determinants of mental disorder.
  25. Psychosocial Model This model explains the causation of mental illness due to the effect of interaction of psychological and social factors. Psychosocial factors are those developmental influences that may handicap a person psychologically, making him or her less resourceful in coping with social events.
  26. Psychosocial Model (Cont.) There are four basic categories of psychosocial causal factors:  Early deprivation or trauma  Inadequate parenting styles  Marital discord and divorce  Maladaptive peer relationship  The Social Learning Model:
  27. Family Therapy Model Laing & Esterson (1964) were among the first British writers to express the view that individuals with mental illness were the victims of a pathological family process. Family therapy usually begins by an approach that encourages all members of the family to work together in resolving the conflict. The process is designed to identify and change relationships where necessary. Attention is paid to family interactions, especially to alignments and discord and the engagement and disengagement of the different group members.  Double Bind  Schisms and Skewed Families  Pseudomutual and Pseudohostile Families  Expressed Emotion
  28. Biopsychosocial Model  Integration of:  Biological  Social  Psychological (Esp. cognitive & behavioral)  Abnormality caused by:  Interaction of these factors – no one cause  Relative importance of each factor depends on individual and environment
  29. Biopsychosocial Model Feedback Loops Psychological Biological Emphasis on Emphasis on psychological biological factors, such as early processes (e.g., childhood genetics) experience and self- concept Feedback Loops Feedback Loops Social Emphasis on interpersonal relationships and social environment
  30. Biopsychosocial Model (Cont.)  Explanations of mental illness: Diathesis / Stress  Physiological, sociocultural or genetic predisposition to develop disorder  Stressor that triggers manifestation of disorder
  31. MODELS OF ABNORMALITY Behavioural Thinking & emotional processes Biological processes processes Conscious Unconscious Learning of behaviour Faulty thinking & perception Repressed memories & emotions Genetics Structural damage Chemicals
  32. Conclusion  Current trends in delivery of care emphasize a collaborative team approach  The diverse explanations provide a range of models that influence and direct current approaches in the treatment and management of people with mental health problems. The dominance of the biomedical model is increasingly being challenged by other professional groups.
  33. THANKS…!!