M ENTAL I LLNESS Alison Hamilton - Kristy Rivers - Micaela Bates - Regan Burdick 1
Index Introduction to Mental Illness
4
Genetic Predisposition
5
Stigma
6-7
Ramifications
8-9
Solutions
10-12
Awareness
8
Advocacy
9
Resources
10-16
Our Team
16-21
Sources
22
2
Introduction to Mental Illness Mental illness affects people indiscriminately. There are many illness, disability or premature death within a population. different diagnoses with endless combinations of causes and severities. Mental health problems and substance abuse often go hand in No two illnesses are alike. Symptoms can range from chronic and debili- hand. Illegal drugs may cause people to experience the same symptoms tating to hardly noticed and easily overcome. of a mental health problem, and people with a mental health problem may misuse illegal drugs as a form of self-medication. In 2015, an estimated 43.4 million adults, 18 or older, in the United States diagnosed with mental illness that year. That number repTo be an effective ally of those with mental illnesses, one resents 17.9 percent of all U.S. adults. Mental illness can cause a myriad of other problems, like homelessness and substance abuse. needs to first understand the concept of mental health Neuropsychiatric disorders are the leading cause of disability in the U.S. at 13.6 percent of the population. The burden of disability associated with a disease or disorder can be measured in disability-adjusted life years (DALY’s), which represent the total number of years lost to an
literacy, which is defined as, “knowledge and beliefs about mental disorders which aid their recognition, management or prevention.” Mental health literacy increases personal awareness, provides more opportunities for public impact on mental health policy and improves the availability of resources that those with mental illnesses desperately need.
Mental and substance use disorders share underlying causes, like changes in brain composition, genetic vulnerabilities and early exposure to stress or trauma. More than one in four adults living with serious mental health problems also have a substance abuse problem – especially those with depression, anxiety, schizophrenia and personality disorders.
3
Genetic Predisposition Genetics and environment can predispose a person to mental illness. It was not until the start of the 21st Century that genetic variants and environmental exposure were proven to be causes of mental illness, but the studies that have been done suggest biology interplays with environment to mold a person's mental processes into healthy or disordered states. This agrees with the observation that some people are resilient to adversity while others are more sensitive.
However, genetics and environment are only small pieces of the large and complicated puzzle that is mental illness. Scientists are studying and debating the effect of gene-environment interactions in order to determine what factors are stronger. There are five perceived causal attributions which add a layer of risk for having mental illness. They are genetics, abuse, life stress, family environment and perceived causal mechanisms.
A study showed that participants who carried the higher risk variant gene (s/s) and were provided with this information, ranked 'earlier intervention and potential to prevent the onset of depression', meaning one of the most important benefits of an individual being provided with their genetic risk status for mental illness is the chance it affords them to fight back against the condition as early as possible. However, caution is needed in terms of marketing genetic tests for psychiatric disorders to the public, without medical supervision. This raises concerns about the psychosocial impact of risk disclosure without proper knowledge and feedback from a medical professional.
4
Stigma Stigma is defined as a mark of disgrace associated with a particular circumstance, quality or person. It is a method some use to excuse themselves from associating with people different from them. Stigma against those with mental illnesses can not only harm their self-esteem and feeling of community acceptance, but it can also create barriers for proper treatment . The health care system is not without fault here. More and more we are seeing an increase of discriminative behavior from health care professionals towards patients with mental illnesses. Educating the population on the affects of stigma is not enough—interventions are now necessary to reinforce anti-stigma policies. As there are many types and combinations of mental illnesses, there are different levels of stigma. These include external stigma, internal stigma and tribal stigma.
External Stigma: Communally defined social stigmas. This stigma establishes an “in” group from an “out” group. The “in” group avoids all contact with the “out” group (i.e. those with leprosy in biblical times) Internal Stigma: A single person defines stigma and internalizes it, convincing themselves that they are inferior to others, thus leading them to isolate themselves from society. Tribal Stigma: Defined by things that are passed on genetically (race, ethnicity). Anyone not of a similar race, ethnicity, background are considered inferior (i.e. racism).
5
Ramifications One in five American adults experience some form of mental illness in any given year. Ramifications of mental illness include an increases in the likelihood of homelessness, stress on families, substance abuse and negative portrayals from society, as the illness can take over a person’s life. According to “Collaborative Care: Working together to Address Mental Health”, mental illness conditions account for four of the 10 leading causes of disability and are responsible for more lost workdays and work impairment than any other chronic health condition. In the article, “Mental Illness and Homelessness”, the National Coalition for the Homeless states, “ mental illnesses disrupt people’s ability to carry out essential aspects of daily life”, which includes managing households and relationships. A study of people in California with one or more mental illnesses, showed that 15 percent were homeless at least once in a yearlong period. Mental illness has been labeled as one of the top three reasons for homelessness. Mental illness affects sufferers’ ability to perform essential aspects of everyday life. Mental illness disrupts a sufferer’s familial relationships. Oftentimes, mental illness causes sufferers to misinterpret how others are trying to help them and cause sufferers to push others away who are trying to help them. While family members try to understand and help sufferers work through their daily battle, but there isn’t a way for the sufferer to explain to family members what it feels like to have a mental illness. The website www.independent.co.uk describes suffering from depression as “a suffocating feeling of dread and foreboding that affects you physically as well as mentally…it can feel like it’s hard to breathe and your heart might be racing even though you’re just sitting at your desk. It can be very isolating when loved ones don’t understand or tell you to snap out of it or pull yourself together.” 6
On the other hand, suffering from anxiety “is the opposite; [you] care about everything…[you] start to panic and have plenty of physical sensations that seem to reinforce that [you’re] about to die at any second.” Family members don’t understand the overwhelming feeling of constant sense of fear and worry that those with mental illnesses have regularly. Family members end up feeling frustrated and exhausted with the daily stress of never knowing if their family member with mental illness is having a good day or a bad day. There is found to be a higher level of substance abusers among those with mental illnesses. Substance abuse isn’t always a result of the mental illness but can actually be a catalyst. Having a mental illness as well as a substance abuse problem is called a co-occurring disorder. Either disorder can present first, they both exacerbate the other, and they both make the symptoms of the other worse. According to a 2014 National Survey on Drug Use and Health, 7.9 million people in the United States experience a dual disorder. Society tends to give mental illness a negative face. Oftentimes those who suffer from mental illness are portrayed as deviant and not able to function appropriately in society; as criminals or those that should be admitted to a mental hospital. Everyone requires a social network to satisfy the human need to be cared for, accepted, and emotionally supported, particularly in times of stress. Research has shown that strong social support may significantly improve recovery from both physical and mental illnesses. Changes in society have diminished the traditional support once offered by neighbors and families. As an alternative, self-help groups and mutual aid groups have sprung up throughout the country.
7
Solutions Awareness
Advocacy
Resources
8
Awareness Understanding one’s own mental health, including risk factors and tendencies is one key; the other key is recognizing that mental illness is as real as any physical illness and often requires professional treatment in order to recover from it and/or for the sufferer to be able to lead a normal life. One of the quickest and easiest ways to determine whether you may be experiencing symptoms of a mental illness is to take an anonymous screen. Many websites like ‘www.mentalhealthamerica.net ‘ have online screening tools. After completing their screening, individuals receive immediate results, education, resources and linkage to affiliates.
“To date, depression screens account for more than half of the screens completed. Of all respondents, 67 percent scored moderate to severe for any of the conditions, and of those, 65 percent report they had never been diagnosed. These statistics demonstrate the need to promote early education and intervention.”
Heightened awareness of one’s personal risk of mental illness can encourage people to seek earlier intervention and find ways to prevent such conditions, resulting in a healthier lifestyle to modify stress levels.
9
Advocacy By defining stigma and consciously recognizing discriminatory behaviors and attitudes, stereotypes and social loss, one can more effectively reduce discriminatory behaviors in their own life. Stigma creates a major barrier for those with mental illnesses to receive the proper medical care. The health care system should be leading the anti-stigma charge by developing anti-stigma interventions. “Our hope is that these considerations provide a beginning platform from which to direct future empirical investigations and further theoretical development, and that they may also ultimately contribute to improved care and health outcomes of persons with mental illness.� Health care professionals are those who will have the most upto-date information on mental illnesses and how to reduce stigmas relating to those illnesses in order to better serve patients. Understanding people with mental illness is a great way to help overcome stigma. By creating opportunities for the public to hear more about a mental illness and the patients who live with those illnesses, the more people will understand the illness and reduce their own stigmas. The Arc program has many homes in different counties to help provide care to both young and old adults that have a mental illness. The adults that live in these homes are unable to take care of themselves due to their mental illness, but the Arc program helps them to have some learning ability to know what it is like to live on their own.
10
Resources In an interview with Jordan Peterson, Page High School psychologist, she stated that while it is important to understand the workings of mental illness, it is even more important to understand the different types of treatment that are available for those with mental illnesses. There are therapies available for family members of those with mental illnesses. Family therapy allows both the patient and their family members to share their feelings in a safe place. During this type of therapy, the therapist can teach communication skills, how to handle conflict in a productive way as well as how to problem solve. Institutions like specialized hospitals are equipped to treat more serious mental illnesses, such as schizophrenia, dissociative personality disorder or anti-social personalities. As therapy covers a wide variety of mental illnesses and a wide variety of symptoms, it can be difficult to find the most appropriate or effective type of treatment. Among the types of therapy that have shown to be effective for those with mental illnesses include: Psychodynamic therapy gives those with mental health issues a better understanding of how their unconscious emotions and motivations affect their thoughts and actions
Art therapy uses music, dance, drawing or other types of art as a way for those with mental health issues to express their feelings and work through them.
Cognitive behavior therapy has two sides. The cognitive side focuses on developing helpful beliefs about oneself while the behavior side helps the person with mental health issues learn to take healthier actions. This type of therapy works well for those with depression, anxiety and bipolar disorder.
Interpersonal therapy mainly focuses on expressing emotions in healthy ways and improving relationships with others. This type of therapy works well with those who have depression while a variation of this therapy called Interpersonal and Social Rhythm Therapy works well with those who suffer from bipolar disorder as it helps those with mental health issues create a daily schedule that supports their recovery.
11
Mental illness includes a wide variety of conditions and severities. The first step in solving a problem is a proper understanding of the problem—the right diagnosis. When a mental health professional is screening a patient, they will need to consider multiple environmental and genetic factors. They will consider the patient’s symptoms and medical history, giving special attention to alcohol and drug use, thoughts of death or suicide, family history of mental illness, sleep patterns and previous episodes of depression. The doctor may also perform specific mental health exams, focusing on detailed information about the patient’s speech, thoughts, memory and mood.
Treatments include anti-depressant medications, such as selective serotonin reuptake inhibitors, psychotherapy, electroconvulsive therapy, exercise, herbs and supplements, dietary changes and vagal nerve stimulation. Individuals can also reduce their chances of becoming depressed by being aware of their personal risks, having psychiatric evaluations and psychotherapy, developing social supports, learning stress management techniques, exercising regularly, avoiding the abuse of alcohol or drugs and getting adequate sleep, rest and recreation. Leila Hamzehgardeshi of Mazandaran University of Medical Sciences states that a key factor in successful treatment of mental illness is achieved through a combination of three perspectives: the lack of disease, a person’s physical and mental well-being and the person’s “participation and active involvement in decision-making and response to programs.”
12
Resources An important first step to receiving adequate help is full disclosure. “One reason to tell family and friends about your mental illness is to receive encouragement. Simply talking to someone sympathetic can reduce your stress level and improve your mood. You may also want to ask for concrete support, like help finding treatment or rides to appointments. Or maybe you want to share your crisis plan with a trusted family member.�
This is where the community can really step in to help. People in the community can volunteer and also be available to friends and family members who may be suffering in silence. People can help sufferers engage, rehabilitate and reach closure. This means to identify the people that need help, motivate them to participate in programs, encourage change and a desire to improve their social outlook by helping them to set attainable goals.
Keeping those with mental illnesses engaged in a prescribed treatment plan can be difficult. They need to feel responsible for their recovery, but sometimes, their mental capacity may prevent them from making sound decisions. However, the more we can raise the mental health literacy in communities, the more people will feel they have somewhere to go for help and are not ostracized from their community.
13
O UR T EAM Alison Hamilton - Kristy Rivers - Micaela Bates - Regan Burdick
14
Alison Hamilton Bio: I was born in Utah but raised in Eugene, OR. All through school I played water polo competitively and earned a spot on the Junior National Women’s Water Polo Team after high school. I’m now a wife of 23 years and a mother of five children, plus one son-in-law. I will graduate with my Bachelor’s degree in University Studies with a minor in English from Brigham Young University-Idaho in July 2018. Topic Selection: The topic of mental illness appealed to me because I have family members who have been diagnosed with various mental conditions. Because of this personal connection, I have a desire to raise awareness and help address an issue that is often regarded as taboo.
Tasks: I researched the areas of genetics and predisposition when it comes to mental illness. I submitted notes and graphics and provided feedback. Strategic Research: I gleaned information from academic articles and websites and interviewing a mental health professional. Personal reflection: The research I did on mental illness did not necessarily make me feel more informed. It’s such a widespread problem, with so many various and complicated facets, that it made me realize how much about the topic I do not know nor understand. I did as Elder Bednar has instructed and I looked for patterns and themes in my research. I found that mental illness often occurs simultaneously with another condition, such as chronic pain, substance abuse, sexual assault, family genetic history, eating disorders, etc. Because of this, I also learned how important it is to construct a personalized treatment plan customized to each individual. There is less room for generalized treatment of mental illness than other physical ailments. Finally, I understand that those who suffer from mental illness, of any form, often do so silently for fear of ridicule or discrimination or ostracism; for this reason, this cause is a worthy one to shine the light of awareness and understanding upon.
15
Kristy Rivers Bio: I am a mother of nine (five girls and two boys, and two sons-in-law) and a 28-year student at Ricks College (now Brigham Young University-Idaho). I work full-time for Page High School as registrar; I am Head of Designation for Special Olympics; I run the concessions for all high school sports and I’m the Laurel Advisor in my ward’s Young Women organization. In my free time, I like to read, sew and bake. I will be graduating in December with a Bachelor’s degree in Communications with minors in Business and Health. Topic Selection: Team members chose this topic because we have been affected by mental illness in one way or another. Group members chose which portion to write about based on which area we felt a particular attachment to.
Tasks: Ramifications of mental illness Strategic Research: I found my data from academic library listings, websites focused on the issue of Mental Illness and conducted an interview with a psychologist to gain ideas specific to treatment and recovery. Personal Reflection: I have two children (21 and 17) who suffer from mental illnesses. It is a trial every day to understand how their minds work. As a parent, it is difficult to watch your child suffer and not understand why or how to help them. Mental illness looks very different to the individual who has it. There are not many cases that are identical so it takes very individual assessment and therapy to learn to live with an illness that you will have your whole life. I think the biggest issue that plagues those suffering from mental illness is that it is a disease that can’t always be seen physically which makes it difficult for people to understand mental illness. I even have a hard time understanding why one of my children breaks out into tears that they can’t control or explain why they are upset. I learned through this experience that many things that contribute to mental illness are the ways that the world views it. Mental illness is typically portrayed in a negative light; one that tells the public that those with mental illness are people who have no sense of right from wrong. This portrayal causes those that suffer from mental illness to keep quiet and suffer in silence. I wanted to write about the ramifications of how society treats those with mental illnesses and how we can raise awareness and maybe work toward changing the negative stigma of mental health. 16
Micaela Bates Bio: I live in New York and have lived there most of my life. My husband and I have been married for two and a half years. I have two jobs and work hard to juggle both school and work. Topic Selection: As a team, we selected this issue because it is common and in something that most people know and understand. Tasks: Scope of mental illness. Strategic Research: I researched information in academic articles that focused on mental illness, and I interviewed a member of the Arc program, who works with people that have mental illness.
Personal Reflection: This was a great experience and I had the opportunity to learn that people discriminate those that have mental illness. They base it off of what they have and who they are as a person.
17
Regan Burdick Bio: I am a senior studying Communications-Public Relations at Brigham Young UniversityIdaho. Currently, I work as a Project Associate at Howard Consulting Group (HCG) where I assist in social media activity, general research, and communications outreach for our clients, as well as manage HCG’s internship program. I joined the firm in 2016. Topic Selection: Mental health has always been an important subject for me. I grew up babysitting a child with Autism and other children with developmental delays. I welcome the opportunity to dive into this topic with my team! Tasks: Editor
Personal Reflection: This was a tough project. Online classes are always tricky, especially with group work involved. It was rewarding, though, and I know I learned a lot reading through and pulling together our group’s material into a cohesive book.
18
Sources https://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-usadults.shtml
Ungar, Thomas, et al. "Theoretical and Practical Considerations for Combating Mental Illness Stigma in Health Care." Community Mental Health Journal, vol. 52, no. 3, Apr. 2016, pp. 262-271. EBSCOhost, doi:10.1007/s10597-015-9910-4.
https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition/Disclosing-toOthers https://www.nimh.nih.gov/health/statistics/disability/index.shtml http://slideplayer.com/slide/6340017/22/images/3/ Top+Ten+causes+of+DALYs+DALY+:+Disability+adjusted+life+year.jpg Uher, Rudolf. "The Changing Understanding of the Genetic and Environmental Causes of Mental Illness." Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, vol. 58, no. 2, Feb. 2013, pp. 67-68. EBSCOhost, byui.idm.oclc.org/login?url=https://search.ebscohost.com/ login.aspx?direct=true&db=cmedm&AN=23442891&site=eds-live. https://www.monarchnc.org/images/May_2015/info2.jpg Wilde, Alex, et al. "Community Attitudes to Genetic Susceptibility-Based Mental Health Interventions for Healthy People in a Large National Sample." Journal of Affective Disorders, vol. 134, no. 1-3, Nov. 2011, pp. 280-287. EBSCOhost, doi:10.1016/j.jad.2011.06.023. http://www.mentalhealthamerica.net/programs) https://image-store.slidesharecdn.com/eead46ec-e426-4e1f-bafd-7afd994137a6 Josephine G., Wong and Lieh-Mak Felice. "Genetic Discrimination and Mental Illness: A Case Report." Journal of Medical Ethics, no. 6, 2001, p. 393. EBSCOhost, byui.idm.oclc.org/login? url=https://search-ebscohost-com.byui.idm.oclc.org/login.aspx? direct=true&db=edsjsr&AN=edsjsr.27718798&site=eds-live.) Wilde, Alex, et al. "Community Attitudes to Genetic Susceptibility-Based Mental Health Interventions for Healthy People in a Large National Sample." Journal of Affective Disorders, vol. 134, no. 1-3, Nov. 2011, pp. 280-287. EBSCOhost, doi:10.1016/j.jad.2011.06.023.
19