Presented by :Naku Masuku from CGMHS

Mental illness is also known as psychosocial disability.

Mental illnesses like bipolar mood disorder and schizophrenia resultfrom a chemical imbalance in the brain, and are health conditionssimilar to any other chronic physical illness, like diabetes, and ismanageable by medication.

Common mental illnesses include depression and anxiety disorder,and serious mental illnesses include schizophrenia and bipolar mooddisorder.

WHAT IS MENTAL ILLNESS

Psychosocial disability is “a clinically recognized condition or illness that affects a person’s thought processes, judgment or

emotions”

The World Health Organization describes mental health 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 her or his community”.

DEFINITION

Excluded from community life Institutionalization Control rather than management of mental illness Torture of experimental treatment Invasive and radical physical treatments, e.g. Lobotomy; Insulin Shock; Provided poor prognosis for patients Physical and emotional abuse within and outside of the mental health system Inequality and discrimination Abandonment by family Deprivation of liberty Deprivation of voice

“Ancient” approach – treatment of persons with mental illness:

PAST …

Lobotomies were performed on patients with mental illness as a treatment method (1935-1950).

TODAY IT WOULD BE CONSIDERED AS CRUEL AND

INHUMANE.

PRESENT …“Modern” approach – treatment of persons with mental illness:

Medical model prove effective Human rights application improve quality of life and equality in all aspects Peer support

DESPITE SIGNIFICANT ADVANCES IN MEDICINE RELATED TO MENTAL ILLNESS ANDLEGISLATION ENSHIRING THE RIGHTS OF PERSONS DIAGNOSED, SOCIETAL ATTITUDESREMAIN IN “ANCIENT TIMES” - perceiving persons with psychosocial disability incapable ofparticipating in life to their full potential. The contributing factor to this is: ignorance,leading to stigma and discrimination. Stigma and discrimination does have a severe impacton the individual’s recovery process and ability to manage her/his condition effectively.

The impact of mental health disorders spread across every part of an individual’s

life:If any of the links in the chain breaks,

MENTAL HEALTH is affected and if MENTAL HEALTH is affected, the links in the chain

breaks. This is often a result of stigma and related discrimination.

Mental health disorders are conditions that causes unique experiences to each

individual and a number of factors are involved that relates to how the individual

deals and manages their condition. Therefore requires a holistic intervention.

IMPACT …

Research indicates that people receiving treatment for a mental illness are nomore violent or dangerous than the general population.

Cultural and religious background mostly affects how people experience amental illness and how they understand and interpret symptoms.

Many people experiencing mental illness delay seeking help because they arefrightened by the illness and fear stigma and discrimination.

Anyone can develop a mental illness and no one is immune to mental healthproblems.

FACTS …

ANXIETY DISORDERSymptoms: Overwhelming feelings of panic and fear

Uncontrollable obsessive thoughts

Painful, intrusive memories

Recurring nightmares

Physical symptoms such as feeling sick to your stomach, heart pounding, startling easily, and

muscle tension

Anxiety causing individual to avoid certain situations that trigger symptoms

Individuals are likely to suffer from depression

Individuals are likely to abuse substances to easy symptoms

Deterioration in work/school performance and relationships

Types of anxiety disorders: Panic Disorder (Core symptom is panic attacks – feeling of dying)

Phobias(Excessive and persistent fear of a specific object, situation, or activity)

Obsessive Compulsive Disorder(Preoccupations with dirt or germs, nagging doubts, and a need to have things in a very particular order)

Post-Traumatic Stress Disorder(Extreme distress when in circumstances that remind them of the trauma)

Generalized Anxiety Disorder(Ongoing severe tension affecting daily functioning)

Symptoms:

Depression is a medical condition characterized by feelings of extreme sadness and rejection.

Not just the feeling of sadness we all experience at times. It is normal for most people to feel sad at times, particularly when faced with losses, or feelings of grief.

Causes both physical and psychological symptoms but, which, if detected, can be treated using a range of effective and safe treatment approaches.

Can “mask” itself as a physical illness (such as chronic pain, sleeplessness, or fatigue) - many people who suffer from depression are not treated and may suffer for years from what is a treatable condition.

Can contribute to, and be caused by, many physical illnesses. It is a major cause of health problems. Untreated depression can lead to the onset of medical problems.

DEPRESSION

Depression and Suicide:

Depression allows for suicidal thoughts and ideations. Although most depressed people are not suicidal, most suicidal people are depressed. Symptoms of withdrawal brings out isolation and perpetuates sadness and negative feelings,

making suicide a very real concern.

Factors of an increased risk of suicide in depression:

extreme anxiety agitation or angry behaviour excessive drug and/or alcohol use and abuse history of physical or emotional illness talking about of suicidal thoughts or ideas overwhelming feelings of worthlessness and guilt speaking and moving at an unusually slow pace.

BIPOLAR DISORDER

DEPRESSIVE EPISODE:When the individual is feeling down, all the generally recognized symptoms of depression are present. These include: Irregular sleeping patterns Irregular eating habits Loss of interest in life and other people Poor concentration Libidinal changes Social withdrawal Lack of energy, tiredness, exhaustion Feelings of hopelessness Overwhelming feelings of sadness or grief

MANIC EPISODE:The opposite feeling of depression is mania (hyper-elation). The symptoms include: A sense of being invulnerable and all

powerful, A belief that the world is the most wonderful

place, Full of exciting ideas, creative and

perceptive, An exaggerated sense of happiness &

euphoria, Speech may be accelerated, words come out

in a rush, Difficulty in going to sleep at night, Very vivid dreams, Increased strength and energy, Increased sexual drive.

Symptoms: It is a mood disorder characterized by extreme swings from depression (feeling down) to mania (feeling 'high' on life).

SCHIZOPHRENIA

Schizophrenia is a psychotic disorder where the person loses touch with reality. This illness is characterized by extreme disruptions of:

Thought; Perception; Behaviour and Emotion.

Schizophrenia means deterioration from a previous level of social functioning combined with delusions/hallucinations and/or grossly

disordered behaviour or thought processes.

How is schizophrenia recognized?The symptoms of schizophrenia can be classifiedinto positive symptoms (symptoms which appearduring an active episode of the illness – i.e.something that is added on to your usualfunctioning e.g. hearing voices) and negativesymptoms (those which are missing from thenormal range of functions – generally appearafter the first episode and is seen as somethingtaken away from your normal range of functionse.g. loss of energy).

POSITIVE SYMPTOMS:Hallucinations: are thought to be an over sharpening of the senses and of the brain's inability to interpret and respond appropriately to incoming messages. There are several types of hallucinations: Auditory (hearing voices); Visual (seeing things); Tactile (feeling things on skin); Olfactory (smelling things); and/or Gustatory (tasting things).

Delusions: are strange and steadfast beliefs that are held only by the observer and that remain despite obvious evidence to the contrary. Delusions are resistant to reason.

Thought disorder: The way in which thoughts are organized. Thinking is disorganized and fragmented and the person's speech is often incoherent and illogical. This can often be accompanied by inappropriate emotional responses e.g. laughing in a sad situation.

Altered sense of self: Blurring of the ill person's feeling of who he or she is. It may be a sensation of being bodiless or non-existent as a person.

NEGATIVE SYMPTOMS:Lack of motivation: Lack of interest or energy in life that is often confused with

laziness. This often results in the person being unable to fulfil their responsibilities atschool, work or home.

Blunted feelings or blunted effects: Refers to a flattening of emotions. Facialexpressions and hand gestures may be limited or non-existent and the person isunable to express their emotions and feelings outwardly.

Depression: Involves feelings of helplessness and hopelessness. Often the personbelieves that he or she has behaved badly, has destroyed relationships and isunlovable. Biological changes in the brain may also contribute to depression.

Social withdrawal: Person may lack the resources needed to show interest insocializing.

Lack of self-care: Person has decreased interest in caring for him/herself. Theydo not feel the desire to bath/shower or to brush their hair, change their clothingetc. This often results in the person looking unkempt.

TREATMENTMental disorders can be managed effectively for most, via various treatment options and/or a combination of these:

Pharmacology/ Medication Psychotherapy Occupational therapy Electroconvulsive Therapy (ECT)

But also a vital component to recovery is: Family/friends support and understanding Routine and structure Self-esteem and self-worth Positive mind set

Mental illnesses have been in existence dated back to ancient times and thousand yearslater, misperceptions of these conditions still exist despite the major strides made inmedical science.

Common perceptions of persons with mental illness include, that they are: Intellectually incapable of making their own decisions or think for themselves Unable to participate in their own lives, at all levels Unable to live independently or take care of themselves Untreatable Damaged for life with no hope for recovery Demon possessed Cursed Punished by the ancestors for doing wrong or the family has done wrong Dangerous and prone to commit crimes To be locked away To be institutionalized …

SOCIETY’S PERCEPTIONS

These misperceptions are the core drive of stigma and related

discrimination, which often causes more

disabling affects to the individual diagnosed than the symptoms of the condition itself.

Political incorrect terminology can lead to the promotion of stigma anddiscrimination, humiliation and dehumanization of persons with mental illness. Itis important to remember to consult a mental health organization for correctterminology when reporting on mental illness or mental health related matters.

TERMINOLOGY

Person with psychosocial disability Person with mental illnessMental health care user

Crazy, nuts, lunaticMentally challengedMentally illMental patient

According to the WHO:

Depression is the leading cause of disability worldwide 33% of countries have no mental health budget 1 in 4 people will be affected by a mental disorder at some point in their lives Every 40 seconds someone commits suicide 4 out of 5 people with mental disorders in developing countries don’t receive

treatment Almost 50% of all mental disorders begin before the age of 14 2.5 million deaths per year are due to the harmful use of alcohol 80% of the global burden of disease due to mental disorders is found in low-and-

middle income countries Among all disabilities, mental disorders are associated with the highest rates of

unemployment, between 70% and 90% Up to 63% of HIV-positive people in low-and middle-income countries also have

depression.

STATISTICS

One of the most devastating results of mental illness or the stigma and discrimination attached to it, is suicide:

Suicide in young people age 10-14 has more than doubled over the past

15 years.

There are 23 suicides every day.

There are 230 attempted suicides every day.

9.5% of all teenage deaths are related to suicide.

The youngest suicide victim was only 7 years old.

1 in 5 young people have considered attempting suicide.

1 in 6 young people have made plans to commit suicide.

1 in 6 young people have attempted suicide.

PSYCHOSOCIAL DISABILITYIN THE WORKPLACE

Challenges:

Psychosocial disability not being considered a disability

Employers not aware of “disability rights” specific to psychosocial disability

Employers not aware of reasonable accommodations applicable

Lack of needs-specific support structures within workplace but also within

community

Disclosure vs not disclosing = implications

Reasonable accommodations in workplace, e.g.:

Quiet workspace – limited distractions

Flexi-time

Tasks conveyed via email/ in writing

One task at a time

Assistance with prioritising

Work from home opportunities when required

Frequent breaks

Time off for monthly/ weekly follow-up visits and medication collection

Extended sick leave when relapse to recovery

QUESTIONS AND ANSWERS…….

THANK YOU!