Mental health

Mental health is a concept that refers to a human individual's emotional and psychological well-being. Merriam-Webster defines mental health as "A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life."

According to the World Health Organization (WHO), there is no one "official" definition of mental health. Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined. In general, most experts agree that "mental health" and "mental illness" are not opposites. In other words, the absence of a recognized mental disorder is not necessarily an indicator of mental health.

One way to think about mental health is by looking at how effectively and successfully a person functions. Feeling capable and competent; being able to handle normal levels of stress, maintain satisfying relationships, and lead an independent life; and being able to "bounce back," or recover from difficult situations, are all signs of mental health.

Overview

Most experts consider mental health as a continuum. One individual can "have his shit together" even more than another individual, even if both are mentally healthy. Thus, an individual's mental health may have many different possible values. Mental wellness is generally viewed as a positive attribute, such that a person can reach enhanced levels of mental health, even if they do not have any diagnosable mental illness. This definition of mental health highlights emotional well being, the capacity to live a full and creative life and the flexibility to deal with life's inevitable challenges. Many therapeutic systems and self-help books offer methods and philosophies espousing strategies and techniques vaunted as effective for further improving the mental wellness of otherwise healthy people. Positive psychology is increasingly prominent in mental health.

World Health Organization definition of mental health

"Mental health has been defined variously by scholars from different cultures. Concepts of mental health include subjective well-being, perceived self-efficacy, autonomy, competence, inter-generational dependence, and self-actualization of one's intellectual and emotional potential, among others. From a cross-cultural perspective, it is nearly impossible to define mental health comprehensively. It is, however sometimes used as a broader definition, and professionals generally agree that mental health is broader than a lack of mental disorders." [1]

Mental hygiene concept

Mental health was first described as "mental hygiene" by Clifford Whittingham Beers in 1908, who founded the National Committee for Mental Hygiene in 1909 and actively campaigned for the rights of the mentally ill. Dr. William Glasser, a psychiatrist, described 'Mental Hygiene' in his book Mental Health or Mental Illness (1961), following the dictionary definition of hygiene as the establishment and maintenance of health, i.e. mental health.

Mental health, as defined here, is distinct from mental illness. Enhancement of mental health is not the primary goal of some mental health professionals more concerned with treating illnesses and restoring function. Psychiatry relies primarily upon the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or ICD-10, as well as continually updated best-evidence guidelines such as the Texas Medication Algorhithm Project (TMAP) to diagnose and treat mental illnesses and disorders. Mainstream mental health consumer community services are an adjunct to psychiatry, not an alternative.

Psychopathology

Some mental health advocates, such as the Critical Psychiatry Network, Scientology, and MindFreedom, do not accept mental illness as brain-based. They oppose the "chemical imbalance theory" and claim the DSM-IV involves oversimplified causes and treatments for mental illness.

This strain of advocacy is not representative of most established mental health consumer organizations, such as the National Mental Health Association, Depression and Bipolar Support Alliance, Canadian Mental Health Association, Rethink, and others. It is, however, in line with 12 step peer support groups that utilize "surrendering to a higher power" and self-shaming as treatment.

Essentially this is a conflict between religion and science. One view is that mental health is determined by spiritual or environmental (psychosocial) factors alone. The scientific position views disorders as neurobiological, but more than neurochemistry. Other brain functions identified as contributing to mental illness include circadian rhythms, neuroplasticity, ion channel signal transduction, cognitive processing, brain networks] and more. Brain imaging studies demonstrate physical changes in neuroanatomy accompanying disorders such as schizophrenia Regional deficits in brain volume in schizophrenia: a meta-analysis of voxel-based morphometry studies, Honea et al., Am J Psychiatry. 2005 Dec;162(12):2233-45, autism and bipolar disordercite. As well, environmental, developmental and interpersonal factors have been studied, and research is ongoing. Best-evidence medicine as defined by the independent National Institute for Health and Clinical Excellence (NICE) treatment guidelines indicate that bipolar disorder, for example, requires a combination of medication, psychotherapy, self-help and social supports. Mental health agencies are increasingly involved and promote self-reliance and peer support.

Opposition to biological psychiatry

Opposing viewpoints to biological psychiatry theories include those of anti-psychiatry advocates, some of whom are psychiatrists, who contend psychiatric patients do not necessarily have a mental illness, but in fact are individuals who do not ascribe to the conventional belief system, or consensus reality, shared by most other people in their culture or race.

According to Dr. Glasser, a critic of psychiatry, the Public Health model is an established model delivering physical health to millions of people. He advocates to have this model expanded into a Public Mental Health Delivery model to put into practice by mental health professionals and institutions, by hiring mental health professionals (as defined by Glasser, not the established industry of mental health professionals such as psychiatric nurses and counsellors) to deliver services without diagnoses or first-line medication to people who need professional help.

This model does not provide adequate treatment for consumers with severe, persistant, genetic mental illness who are unable to take care of themselves, even to direct a self-empowering treatment plan. Lack of insight is a key definition of psychosis and mania in which the person does not believe (s)he is ill and refuses or does not comply with treatment.

Mental health promotion

Mental health promotion works from the principle that everyone has mental health needs, not just people who have been diagnosed with a mental illness. Mental health promotion is essentially concerned with making changes to society that will promote people's mental well-being.

Positive psychology is also concerned with mental health and enhancement rather than treating illness.

Mental health promotion is a term that covers a variety of strategies. These strategies can be seen to occur at three levels:

• Individual - encouragement of individual resources by promotion of interventions for self-esteem, coping, assertiveness in areas such as parenting, the workplace or personal relationships.
• Communities - increasing social inclusion and cohesion, developing support structures that promote mental health in workplaces, schools and neighbourhoods.
• Government reduce socioeconomic barriers to mental health at governmental level by promoting equal access for all and support for vulnerable citizens.

See also

Links to those opposed to biological psychiatry:

• Anti-psychiatry
• CAMHS
• International Center for the Study of Psychiatry and Psychology
• Thomas Szasz
• World Mental Health Day

Mainstream mental health links:

• Psychiatry
• Mental Health Professional
• 12 steps
• Sanity
• Mental health law
• Parental Consent Act of 2005 (HR 181)

External links

• MentalHealth.org - National Mental Health Information Center, US Department of Substance Abuse and Mental Health Services Administration
• APA.org - 'APA Online', American Psychological Association
• Psychology Today's Therapy Directory - 'Psychology Today's Therapy Directory: Find a Therapist'
• MentalHealth.com - 'Internet Mental Health'
• About Mental Health
• MHSelfHelp.org - 'National Mental Health Consumers' Self-Help Clearinghouse'
• PsychCentral.com - 'Dr. John Grohol's Psych Central: Celebrating a decade as one of the largest and fastest growing psychology sites online'
• WFMH.org - World Federation for Mental Health
• Mental Health Recovery and WRAP Wellness Recovery Action Plan, a peer counselling model.
• Texas Medication Algorithm Project
• www.depressionforums.org A peer to peer support group for people with Mental Health issues.