NRS473

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CHAPTER TWO
NTRODUCTION TO MENTAL
HEALTH AND MENTAL
ILLNESS
MENTAL HEALTH
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Mental health and mental illness are difficult to define
precisely because it is a dynamic and ever changing state
People who can carry out their roles in society and whose
behaviour is appropriate and adaptive are viewed as healthy.
Conversely those who fail to fulfill roles and carry out
responsibilities or whose behavior is inappropriate are viewed
as ill.
The culture of any society strongly influences its values and
beliefs, and this in turn affects how that society defines health
and illness.
What one society may view as acceptable and appropriate,
another society may see as maladaptive or inappropriate.
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The World Health Organization (WHO) defines health as:
“A state of complete physical, mental, and social wellness, not
merely the absence of disease or infirmity”
 People in a state of emotional, physical, and social well-being
fulfils life responsibilities, functions effectively in daily life, and
is satisfied with their interpersonal relationships and
themselves.
 No single, universal definition of mental health exists.
 Generally a person’s behavior can provide indicators to his or
her mental health.
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Because each person can have a different view or
interpretation of behavior (depending on his or her values and
beliefs), the determination of mental health may be difficult.
Mental Health can also be defined as:
“A state of emotional, psychological, and social wellness
evidenced by satisfying interpersonal relationships, effective
behaviour and coping, positive self-concept, and emotional
stability”
Components of Mental Health
1.
Autonomy and independence
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2.
Maximization of one’s potential

3.
The person is oriented toward growth and self-actualization
Tolerance of life’s uncertainties

4.
The person who is autonomous and independent can work
interdependently or cooperatively with others without losing his or
her autonomy
The person can face the challenges of day-to-day living with hope
and a positive outlook despite not knowing what lies ahead
Self-esteem

The person has a realistic awareness of his or her abilities and
limitations
5.
Mastery of the environment
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6.
Reality orientation

7.
The person can deal with and influence the environment in a
capable, competent, and creative manner
The person can distinguish the real world from a dream, fact from
fantasy, and act accordingly
Stress management

The person can tolerate life stresses, appropriately handle anxiety
or grief, and experience failure without devastation. He or she uses
support from family and friends to cope with crises, knowing that the
stress will not last forever
Factors Influencing Mental Health
There are three categories of factors influencing Mental Health
Individual Factors
1.
Person’s biologic makeup
2.
Sense of harmony in life
3.
Vitality
4.
Ability to find meaning in life
5.
Emotional resilience or hardiness
6.
Spirituality
7.
Positive identity
Interpersonal Factors
1.
Effective communication
2.
Ability to help others
3.
Intimacy
4.
A balance of separateness and connection
Social/Cultural Factors
1.
A sense of community
2.
Access to adequate resources
3.
Intolerance of violence
4.
Support of diversity among people
MENTAL ILLNESS

The American Psychiatric Association defines mental disorder
as:
“A clinically significant behavioural or psychological
syndrome or pattern that occurs in an individual and that is
associated with present distress (e.g., a painful symptom) or
disability (i.e., impairment in one or more important areas of
functioning) or with a significantly increased risk of suffering
death, pain, disability, or an important loss of freedom”
General Criteria to Diagnose Mental Disorders
Dissatisfaction with one’s characteristics, abilities, and
accomplishments
2. Ineffective or non-satisfying relationships
3. Dissatisfaction with one’s place in the world
4. Ineffective coping with life events
5. Lack of personal growth
1.
Factors Contributing to Mental Illness
 Also can be viewed within individual, interpersonal, and
social/cultural categories
Individual factors
1. Biologic makeup
2. Anxiety
3. Worries and fears
4. A sense of disharmony in life
5. A loss of meaning in one’s life
Interpersonal factors
1. Ineffective communication
2. Excessive dependency or withdrawal from relationships
3. Loss of emotional control
Social and cultural factors
1. Lack of resources
2. Violence
3. Poverty and Homelessness
4. Discrimination such as racism, classism, ageism, and sexism
Diagnosing Mental Illness
 There are two systems that are in use internationally to
diagnose Mental Illness (Disorders): DSM-V and ICD-10
Diagnostic and Statistical Manual of Mental Disorders (DSM-V)

The Diagnostic and Statistical Manual of Mental Disorders,
Fifth Edition (DSM-V) is taxonomy of Mental Disorders
published by the American Psychiatric Association (APA) on
May, 18th 2013 as an update to the previous DSM-IV-TR
published in 2000.
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In most respects DSM-V is not greatly changed from DSM-IVTR.
In the United States the DSM serves as a universal authority for
psychiatric diagnosis.
Treatment recommendations, as well as payment by health
care providers, are often determined by DSM classifications,
so the appearance of a new version has significant practical
importance.
The development of the new edition began with a conference
in 1999, and proceeded with the formation of a Task Force in
2007, which developed and field-tested a variety of new
classifications.
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It describes all mental disorders, outlining specific diagnostic
criteria for each based on clinical experience and research
All mental health clinicians who diagnose psychiatric disorders
use the DSM-V
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ICD-10 (International Statistical Classification of Diseases and
Related Health Problems (ICD).
ICD-10 is the 10th revision of the International Statistical
Classification of Diseases and Related Health Problems (ICD),
a Medical Classification list by the World Health Organization
(WHO).
It contains codes for diseases, signs and symptoms, abnormal
findings, complaints, social circumstances, and external causes
of injury or diseases.
The code set allows more than 14,400 different codes and
permits the tracking of many new diagnoses.
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a)
b)
c)
d)
e)
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The codes can be expanded to over 16,000 codes by using
optional sub-classifications.
The WHO provides detailed information about ICD online, and
makes available a set of materials online, such as:
An ICD-10 online browser
ICD-10 Training
ICD-10 online training
ICD-10 online training support
Study guide materials for download
•
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It comprises 22 chapters, ranging from infectious diseases to
external causes of morbidity and mortality
Chapter 5 addresses Mental and Behavioral Disorders
There are 10 disorder grouping in ICD classification, plus an
“unspecified diagnostic category”
Each discrete disorder within each category is coded
Each disorder is defined in short description, and-where
appropriate- advised about exclusion criteria
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