2. INTRODUCTION
WHO defined mental health as – A state of well being in which an individual
• realizes his/her own abilities,
• can cope with the normal stress of life and
• can work productively and
• is able to make contribution to his/her community
3. PROBLEM STATEMENT
• WHO analysis (GBD 2000) – point prevalence of 10% in adults
• 1 in 4 people in the world affected by mental or neurological
disorder at some point in their lives
• People with severe mental disorders die up to 20 years earlier
• SDG 3.4.2 (Goal 3, Target 3.4, Indicator 3.4.2)- suicide mortality rate
• INDIA –13.7% prevalence of mental health illness
[National Mental Health Survey 2016]
4. CHARACTERISTICS OF A MENTALLY
HEALTHY PERSON
• Feels comfortable about himself, secure, accepts his shortcomings, have self
respect
• Feels right towards others, love them, has satisfying friendships, trust others,
takes responsibility
• Able to meet demands of life, take own decisions, sets goals, not bowled by his
emotions
5. WARNING SIGNALS OF POOR
MENTAL HEALTH
• Are you always worrying?
• Are you unable to concentrate due to unrecognized reasons?
• Are you continuously unhappy without justified cause?
• Do you lose your temper easily and often?
• Are you troubled by regular insomnia?
• Do you have wide fluctuations in your moods from depression to elation, back to
depression, which incapacitate you?
6. • Do you continually dislike to be with people?
• Are you upset if the routine of your life is disturbed?
• Do your children consistently get on your nerves?
• Are you browned off and constantly bitter?
• Are you afraid without real cause?
• Are you always right and the other people always wrong?
• Do you have numerous aches and pains for which no doctor can find a physical
cause?
7. TYPES OF MENTAL ILLNESS
• Major (Psychosis)
oSchizophrenia
oManic depressive psychosis
oParanoia
• Minor
oNeurosis
oPersonality and character disorders
9. CAUSES OF MENTAL ILL HEALTH
Organic conditions Cerebral arteriosclerosis, neoplasms, metabolic disease, neurologic
disease, endocrine disease, TB, leprosy, epilepsy
Heredity 40 times chance in case of schizophrenia
Social pathological
causes
Worries, anxieties, stress, tension, unhappy marriages, broken homes,
poverty , industrialisation, economic
Environmental factors • Toxic substances – mercury manganese, tin
• Psychotropic drugs – barbiturates, alcohol
• Nutritional factors – deficiency of thiamine, pyridoxine
• Minerals – Iodine deficiency
• Infective agents – measles, rubella during pre & postnatal period
• Traumatic factors – road and occupational accidents
• Radiation
10. CRUCIAL POINTS IN THE LIFE CYCLE OF
HUMAN BEINGS
• Prenatal period
• First 5 years of life
• School child
• Adolescence
• Old age
11. PREVENTIVE ASPECTS
• Primary prevention – Improving the social environment
• Secondary prevention – Early diagnosis through screening programmes in
schools, industries, universities
• Tertiary prevention – reduce the duration of mental illness prevent further
breakdown and disruption
12. MENTAL HEALTH SERVICES
Early diagnosis and treatment
Rehabilitation
Group and individual psychotherapy
Mental health education
Use of modern psychoactive drugs
After-care services
13. COMPREHENSIVE MENTAL HEALTH
PROGRAMME
• The Government of India launched National Mental Health Programme (NMHP)
in 1982 keeping in view
Heavy burden of mental illness in the community, and
the inadequacy of mental health care infrastructure in the country
• Comprehensive mental health program all community facilities for prevention,
treatment and rehabilitation
14. Essential elements of
Comprehensive Mental Health Programme
In-patient
services
Outpatient
services
Partial
hospitalization
Emergency
services
Diagnostic
services
Pre-care and
aftercare services
Education
services
Training
Research and
evaluation
15. District mental health programme (DMHP)
DMHP was added to NMHP in 1996
Objective
• to provide Community Mental Health services and
• integration of mental health with General health
services
• through decentralization of treatment from
Specialized Mental Hospital based care to primary
health care services.
School mental health services
College counselling services
Work place stress
management
Suicide prevention services
16. DMHP’s Targetted Interventions
• THALIRU – School Mental Health Programme
• THANAL – Geriatric Mental Health Programme
• JEEVARAKSHA – Suicide Prevention Programme
• MUKTHI – Substance Abuse Prevention Programme
• BODHANA – Stress Management Programme
• SANTHWANAM – Occupational Therapy Units
• Street play as a tool for mental health awareness in the community.
17.
18. ALCOHOLISM AND DRUG DEPENDENCE
• Drug – Any substance that, when taken into the living organism, can modify one
or more of its functions [WHO]
• Drug abuse – self administration of a drug for non-medical reasons, in quantities
and frequencies which may impair an individual’s ability to function effectively,
and which may result in social, physical or emotional harm
19. • Drug dependence –
oA state psychic and sometimes also physical, resulting from the interaction
between a living organism and a drug
oCharacterised by behavioural and other responses that always
oInclude a compulsion to take the drug on a continuous or periodic basis in
order to experience its psychic effects
oSometimes to avoid the discomfort of its absence
oA person may be dependent on more than one drug
20. Agent factors
• Alcohol
• Opioids (Heroin)
• Cannabinoids (Marijuana)
• Sedatives or hypnotics (Barbiturates)
• Cocaine
• Stimulants including caffeine
• Hallucinogens (LSD)
• Tobacco
• Volatile solvents
• Drugs used in combination
21. Alcohol
• CNS depressant with physical dependence and psychic dependence
• Sedative, tranquilizer, hypnotic or anaesthetic
• Worldwide – 2.3 million die from alcohol
• Alcoholism is a disease
• Leads to suicides, domestic violence, psychosis, economic crisis in family, road traffic accidents
• Gastritis, pancreatitis, cardiomyopathy, peripheral neuropathy, STDs
• Total family disorganisation, crime and loss of productivity for society
22. Tobacco
• Prevalence of tobacco use in India –
• Smoke tobacco and smokeless tobacco
• More death than all substance combined
• 30% of all cancer death
• Women at higher risk than men – adverse effects of oral contraceptives
• Withdrawal continues for >1 month
• Passive smoking (Second hand tobacco smoke) – dangerous for non-smokers
• Heart disease and stroke
23. Host factors
• Pleasure, desire to experiment
• Desire to escape
• Unwilling to accept minor discomforts
• Looking to drugs for solutions
24. Symptoms of drug addiction
• Loss of interest in sports and daily routine
• Loss of appetite and body weight
• Unsteady gait, clumsy movements, tremors
• Reddening and puffiness of eyes, unclear vision
• Slurring of speech
• Fresh numerous injection marks on body and blood stains in clothes
• Nausea vomiting and body pain
25. • Drowsiness or sleeplessness, lethargy and passivity
• Acute anxiety, depression, profuse sweating
• Changing mood, temper, tantrums
• Depersonalization and emotional detachment
• Impaired memory and concentration
• Presence of needles, syringes and strange packets at home
26. Environment factors
• Unemployment
• Living away from home
• Migration to cities
• Relaxed parental control
• Alienation from family
• Early exposure to drugs
• Leaving school early
• Broken homes
• One parent families
• Large urban environments
• Areas where drugs are sold, traded or produced
• Certain occupations (tourism, drug sale/production)
• Areas with high rates of crime or vice
• Areas where there are drug using gangs
• Areas where delinquency is common
27. Prevention
Legal approach
• Anti-smoking measures suggested are
• Prohibition of sale of tobacco products to minors
• Prohibition of smoking in public
• Insisting on placing of mandatory health warning on cigarette packs
• Minimum age at which minors may legally access to alcoholic beverages, has
been raised in some countries
• Mandatory jail sentence for drunken driving
28. Educational approach
• Educational programmes for school children
• Public information campaign on electronic media
• Message should provide specific advice information new to audience
capable of provoking action
• Cinema theatre advertisements
29. Community approach
• Preventive interventions in the community
• Provision of teen centres (athletics, sports, music activities)
• NGOs play a crucial role
30. Treatment
• Identification and motivation
• Detoxification
• Post detoxification and follow up
• Simultaneous environment and social intervention
31. Rehabilitation
• Mature attitude and avoiding discrimination
• Preventing relapse through vocational training and work
• Proper follow up
