Mental health is the state of emotional and social wellbeing. Mental health problems and issues relate to a broad range of conditions that can alter people’s perceptions and emotions. They can range from short term issues such as anxiety and stress through to more extreme clinical problems and psychosis. Most individuals will experience some mental health issues at some time. Examples of mental health problems and illnesses include depression, schizophrenia, personality disorders, major depression and post-traumatic stress disorder.
These illnesses are not only distressing to themselves, but are also distressing to others and often interfere with their social functioning and capacity to negotiate daily life. They may require treatment or rehabilitation, including hospitalisation. Extent of the problem (trends) The scope of mental illness was estimated in 1997 in the National Survey of Mental Health and Wellbeing as part of the National Mental Health Strategy. It showed a number of trends: * An estimated 20 per cent of the Australian population aged between 16 and 85 had a mental disorder in the 12 months prior to the survey. One in five Australian adults will suffer a mental illness at some stage in their life. * Women were more likely than men to have had symptoms of anxiety disorders and more likely to have mood disorders such as depression. * 27 per cent of young adults aged 18-24 years had a mental disorder which is the highest prevalence and could be related to high rates of substance abuse * The prevalence of mental disorders decreased with age apart from mental disorders such as dementia and Alzheimer’s. More recent data were obtained by the Australian Bureau of Statistics for the National Health Survey 2004.
It showed that: * About 2. 1 million of Australians said they suffered from a long-term mental or behavioural problem. * About 2. 9 of Australian respondents aged over 18 years said they used medication for mental well-being. This was more common in females than males. According to the AIHW, around 13 per cent of the disease burden in Australia in 2003 was due to mental ill health. It is a national health priority area because of the extent of its impact and because it is possible to reduce this impact through prevention and treatment.
The mortality rate for mental health conditions dropped substantially from the peak years of the mid to late 1990’s, and now appears to be plateauing which may be related to increased awareness and treatment. Risk factors and protective factors. Different mental health problems and illnesses have different risk factors. The risk factors are largely grouped in three main areas which include biological, psychological and environmental/social factors. Biological factors include those which arise from physiology, biochemistry and genetic history for example depression has a clear link to chemical imbalance in the brain.
Psychological factors include emotional experiences and interactions with people, the person’s upbringing, and stressful incidents for example depression that results from a tragic family death. Environmental/social factors are those associated with the person’s life situation, such as family relationships. Suicide is a major risk factor involved with mental illness. Many reasons for suicide have been suggested, including depression, mental illness, physical illness, marginalisation of some groups, and social isolation. The protective factors for suicide include: * Effective clinical care for mental, physical and drug abuse problems. Easy access to a variety of clinical interventions and support groups. * Strong family or friend connections * Enhancing resilience and skills in problem solving * Restricted access to means of harming yourself such as prescription medication and firearms. The sociocultural, socioeconomic, and environmental detriments Sociocultural detriments include: * ATSI peoples are more at risk of suicide and depression, due to higher levels of drug and alcohol abuse, compared to other Australians.
* People with a family history of mental illness are more at risk. People who have had a falling out with peers, or who have been exposed to bullying, are more at risk. Socioeconomic detriments include: * Those that are socioeconomically disadvantaged may experience more stressful circumstances linked to their poor financial status. * A lack of employment prospects. This can lead to increased stress levels among young people and the long term unemployed. Environmental detriments include: * Rural, young males are at a higher risk of suicide than urban, young males because they have less access to support services and fewer job prospects. Groups at risk * Those with a family history Those who are frequently exposed to a stressful environment * Those who have experienced a significant trauma in their lives * People suffering chronic depression * People with a physical illness, particularly a terminal illness * Young gay and lesbian people People with disabilities Diseases and injuries can often impair how a person functions for a while, but many people do recover fully. For some people the effect can be long term because there is residual damage or the health condition becomes chronic. Alternatively, a person may have permanent damage or loss of function from birth.
In these cases, the resulting disability may bring special needs for assistance in the person’s daily life. Many Australians live with long-term health conditions. Most of these conditions are not major causes of death, but they are common causes of disability and reduced quality of life. One in five Australians lives with some degree of disability. Disability can be defined in the following categories: * Severe or profound core activity limitation – where the individual sometimes or always needs help with at least one core activity such as self-care, communication or mobility. Moderate or mild core activity limitation, or schooling or employment restriction – where the individual does not need assistance but has difficulty performing a core activity or has no difficulty performing a core activity but uses aids or equipment because of disability, or has restriction in schooling or employment participation only. * No specific core activity limitation, or schooling or employment restriction – where the individual is identified by the ABS Short Disability Module as having disability but without having specific limitations or restrictions.
The large majority of disabilities are of a physical nature, including arthritis, respiratory diseases, circulatory diseases and musculoskeletal disorders. Diseases of the ear and eye are also common, as are mental disorders. Rates of having 2 or more conditions at the same time increase with the severity of disability. People with disabilities often experience inequities due to the socioeconomic circumstances they experience. These include factors such as a lack of access to employment opportunities and the need for ongoing health care.
People with disability also encounter more difficulty accessing health services, have lower life expectancy and experience poorer health across a range of areas. How people experience and cope with disability is greatly affected by the opportunities and services provided for them. For example, people needing wheelchair access need a variety of support including access to the wheelchair or other technical aids, accessibility to buildings and public transport can limit access to health services, job opportunities and support and policies that support employment. National action plan on mental health.
States that it is directed at achieving 4 outcomes * Reducing prevalence and severity of mental illness in Australia * Reducing prevalence of risk factors that contribute to the onset of mental illness and prevent longer term recovery * Increasing the proportion of people with an emerging or established mental illness who are able to access the right health care and other relevant community services at the right time * Increasing the ability of people with a mental illness to participate in the community, employment, education and training. Strategy, Ottawa charter, reasons for effectiveness of strategy.
Expanding early intervention services for youth in the early stages of their serious mental illness – developing personal skills – young people will be provided with information and skills to better manage their mental illness while being supported by health professionals Funding to support state wide 24 hour mental health access by telephone and web – creating supportive environments – people will have access to qualified counsellors at any time of the day to support them with advice Build the capacity of indigenous communities to provide culturally appropriate suicide prevention activities – strengthening community action – indigenous people will be able to have input into programs that will best address their needs while being culturally appropriate.
Better access to psychiatrists and general practitioners through Medicare – building public policy – the financial burden of seeking specialised care will be removed from people with mental illness Mental health content in tertiary curricula through mental health training modules – reorienting health services – more health workers will be trained in supporting people with mental illness. * Health promotion has an increased chance of success when individuals, communities, government and non-government organisations work together in partnership * A multifaceted health promotion campaign, including strategies that represent all five action areas of the Ottawa charter, has the greatest chance of improving the health of individuals and in turn entire communities * Individuals, communities, government and non-government organisations must take various levels of responsibility in actioning the Ottawa charter * All of the Ottawa charter are comprehensively addressed in any successful health promotion campaign.