Day 3 MH and Stima Final Roohullah Shabon

Mental Health and Addiction : 

Mental Health and Addiction Dr. Roohullah Shabon Date: January 28, 2010 Seneca College, King Campus

Medical definition of Mental Illness : 

Medical definition of Mental Illness Mental Illness is diagnosed based on behaviors and thinking as evaluated by a Psychiatrist, Psychologist, Licensed Professional Counselor, Licensed Social Worker, or other qualified professionals using a tool known as the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, most commonly called the DSM-IV. (American Psychiatric Association, Updated, 1999)

Common Mental Illnesses : 

Common Mental Illnesses Anxiety Disorders - General Anxiety Disorder Obsessive Compulsive Disorder Phobias and Panic Disorders Post Traumatic Stress Disorders B. Mood Disorders Depression Bipolar Disorder E. Attention Deficit Disorder D. Eating Disorder C. Schizophrenia D. Psychosis G. Concurrent Disorder H Seasonal Affected Disorder

General Anxiety Disorder : 

General Anxiety Disorder

Obsessive Compulsive Disorder : 

Obsessive Compulsive Disorder

Phobias and Panic Disorders : 

Phobias and Panic Disorders

Post Traumatic Stress Disorders : 

Post Traumatic Stress Disorders

Mood Disorder-Depression : 

Mood Disorder-Depression

Bipolar Disorder : 

Bipolar Disorder

Attention Deficit Disorder : 

Attention Deficit Disorder

Eating Disorder : 

Eating Disorder

Schizophrenia : 

Schizophrenia

Psychosis : 

Psychosis

Paranoid: : 

Paranoid: Tendency to interpret the actions of others as deliberately threatening or demeaning Expectations to be used or harmed by others Perceives slights from other people

Alzheimer’s Disease : 

Alzheimer’s Disease Disease of the brain Causes injury to nerve cells in the brain Results in disrupted memory, thinking and functioning Somewhat greater risk for people with family history of Alzheimer's disease Race or ethnicity does not seem to be a factor 17

Dementia : 

Dementia Neurological disorder that causes general and progressive problems affecting Memory Learning new information Communicating Making good judgments Coordination Usually accompanied by personality and behavior changes Onset is gradual Condition gets progressively worse Other medical conditions such as hypothyroidism and B12 deficiency are ruled out Alzheimer’s disease is the most common form of dementia 18

Concurrent Disorder (CD)? : 

Concurrent Disorder (CD)? Any combination of: Mental health disorders (MHD +substance use disorders (SUD) There may be more than one mental health problem and more than one substance involved

Personality Disorders : 

Personality Disorders Personality disorder is a collection of personality traits that have become fixed and rigid. Personality disorders are considered serious psychiatric conditions because of their associated symptoms.

Seasonal Affected Disorder(SAD) : 

Seasonal Affected Disorder(SAD) Those with SAD typically experience symptoms that come and go with seasons. These symptoms usually develop gradually, beginning in the fall, and worsen during the winter. However, a rare type of SAD called “Summer Depression” can occur during the beginning of Spring, and worsen during the Summer months.

Who is Likely to Suffer from SAD? : 

Who is Likely to Suffer from SAD? 2% - 3% of Ontarians have SAD Up to 15% have experienced “winter blues” Tends to begin in people over 20 yrs old Risk of SAD decreases with age More common in girls than boys More common in Northern areas People who live in urban areas

Stigma : 

Stigma Stigma (anatomy), a small spot, mark, scar, or minute hole Stigma of the original sin in Christianity Stigma of the forehead spot in Indian Caste Badge of shame, a mark of infamy or disgrace Social stigma, a severe social disapproval of personal characteristics or beliefs that are against cultural norms. Weight stigma, negative attitudes towards overweight/obese individuals Leprosy stigma, negative attitudes towards patients with leprosy. also called leprosy related stigma, stigma of leprosy, leprostigma. In sociology Stigma (sociological theory), the phenomenon whereby an individual with an attribute, which is deeply discredited by his/her society, is rejected as a result of the attribute

Slide 24: 

Social stigma is severe social disapproval of personal characteristics or beliefs that are perceived to be against cultural norms. Examples of existing or historical social stigmas include mental illness, physical disabilities and diseases such as leprosy, about which leprosy stigma may also be called, [1], as well as illegitimacy, skin tone or affiliation with a specific nationality, religion (or lack of religion[2][3]) or being deemed to be or proclaiming oneself to be of a certain ethnicity, in any of a myriad of geopolitical and corresponding sociopolitical contexts in various parts of the world. The perception or attribution, rightly or wrongly, of criminality carries a strong social stigma. Stigma comes in three forms:[4] Firstly, overt or external deformations, such as scars, physical manifestations of anorexia nervosa, leprosy (leprosy stigma), or of a physical disability or social disability, such as obesity. Secondly, deviations in personal traits, including mental illness, drug addiction, alcoholism, and criminal backgrounds are stigmatized in this way. Thirdly, "tribal stigmas" are traits, imagined or real, of ethnic groups, nationalities, or religions that are deemed to constitute a deviation from what is perceived to be the prevailing normative ethnicity, nationality or religion. Stigma is generally based on stereotypical and uninformed impressions or characterizations of a given subject. Although the specific social categories that become stigmatized can vary across times and places, the three basic forms of stigma (physical deformity, poor personal traits, and tribal outgroup status) are found in most cultures and time periods, leading some psychologists[citation needed] to hypothesize that the tendency to stigmatize may have evolutionary roots. Origin: 1580–90; < L < Gk stígma tattoo mark, equiv. to stig- (s. of stízein to tattoo) + -ma n. suffix denoting result of action; see stick 2

Slide 25: 

25 Stigma The stigma attached to mental illness and to addiction represents one of the most common and serious barriers for people The stigma attached to concurrent disorders is compounded. 1+1= 3,4,5…

What is Stigma? : 

What is Stigma? A mark or token of infamy, disgrace, or reproach How does stigma affect us?

Slide 27: 

27 Why Does Stigma Occur? (1) Fear (2) Myths about the disorder depression seen as a character flaw persons who use substances are manipulative, unmotivated and using out of weakness (3) Society’s attitudes (4) Media

Slide 28: 

28 How to Combat Stigma: Reflect on your attitudes, values & beliefs (2) Promote understanding tolerance and support (3) Dispel myths

Slide 29: 

The stigma attached to mental illness and addiction represents one of the most common and serious barriers to help-seeking & diagnosis, to effective treatment & quality of life, and to acceptance in families, communities, & the general public   “The serious stigma & discrimination attached to mental illnesses are among the most tragic realities facing people with mental illness in Canada” (Report on Mental Illnesses in Canada, 2002)   NOTE: People who are living with a concurrent disorder will experience compounded effects There may be more than one mental health problem and more than one substance involved The effects of one may make the effects of the other worse, thus exacerbating symptoms and making the person’s life more challenging. This could in turn put the individual at risk of losing his or her housing, job and perhaps social support networks. They may also be at risk for medical problems. (Beyond the Label: CAMH, 2005).

What is Stigma? : 

What is Stigma? Wikipedia - stigma is an attribute, behaviour, or reputation which is socially discrediting in a particular way: it causes an individual to be mentally classified by others in an undesirable, rejected stereotype rather than in an accepted, normal one.

World Health Organization : 

World Health Organization Stigma is a social process or related personal experience characterized by exclusion, blame, or devaluation that results from an adverse social judgment about a person or group. The judgment is based on an enduring feature of identity attributable to a health problem or health-related condition, and this judgment is in some essential way medically unwarranted.

Mental Health Commission of Canada : 

Mental Health Commission of Canada The Mental Health Commission of Canada has identified the elimination of stigma and the reduction of discrimination as one of the top three priority areas to be addressed as part of its federal framework for mental health.

Mental HealthCommission of Canada : 

Mental HealthCommission of Canada “Stigma is typically a social process, experienced or anticipated, characterized by exclusion, rejection, blame or devaluation that results from experience or reasonable anticipation of an adverse social judgment about a person or group.” A Time For Action: Tackling Stigma and Discrimination – MHCC Neasa Martin & Valerie Johnston-- 06/11/2007

Effects : 

Effects Stigma, they suggest, offers a basis for devaluing, rejecting and excluding. Human beings instinctively create hierarchies, and the connection with an undesirable characteristic provides a rationale for moving someone downwards. First the person experiences structural discrimination: which is not the same thing as stigma, although it is one of its consequences. Expectations are lowered in terms of job opportunities, marriage possibilities and housing. Eventually, stigmatized people come to internalize the stereotyping they receive, and to believe it. To the extent that stigmatized groups accept the dominant view of their lower status, they are less likely to challenge structural forms of discrimination Bruce G Link and Jo C Phelan, Conceptualizing Stigma. Annual Review of Sociology 2001, 27: pp 363-385

Effects of Stigma : 

Effects of Stigma Prejudice and discrimination (in school, medical care, housing, employment) Negative feelings about self (self-stigma) Tendency to avoid seeking help, and to keep symptoms and/or substance use a secret Social isolation and/or constricted social support network Poverty Depression Loss of hope for recovery Suicide

Three Types of Stigma Identified : 

Three Types of Stigma Identified “Health-Related Stigma” can lead to exclusion, rejection, blame or devaluation of the individual affected by stigmatized conditions at a time when they are most in need of inclusion, acceptance and compassion. Negative social judgments about the conditions themselves can have significant implications for social and health policy. In addition to mental illness, contemporary stigmatized conditions include sexual dysfunction, HIV/AIDS, leprosy and epilepsy. A Time For Action: Tackling Stigma and Discrimination – MHCC Neasa Martin & Valerie Johnston-- 06/11/2007

Three Types of Stigma Identified : 

Three Types of Stigma Identified “Self Stigma” describes the process by which individuals internalize negative attitudes about their own condition, concluding that they are unworthy of anything other than poor treatment. They come to expect rejection, and they receive it – an experience which then reinforces the original expectation. In response, they develop coping strategies which often include secrecy and withdrawal. A Time For Action: Tackling Stigma and Discrimination – MHCC Neasa Martin & Valerie Johnston-- 06/11/2007

Three Types of Stigma Identified : 

Three Types of Stigma Identified “Courtesy Stigma” describes the stigma-by-association experienced by those who are closely associated with stigmatized people. Families, friends and mental health professionals – all of whom may experience courtesy stigma – may be seen by the rest of society, as “normal yet different”, by virtue of their affiliation. To protect themselves against the negative social judgment implicit in that label, close associates - including mental health professionals - may distance themselves from the stigmatized person, thus reinforcing the “us/them” dichotomy of which people with mental illness are so acutely aware. Some theorists suggest that chronic under-funding of psychiatric services and research is, at least in part, a manifestation of courtesy stigma on the part of policy makers. A Time For Action: Tackling Stigma and Discrimination – MHCC Neasa Martin & Valerie Johnston-- 06/11/2007

Summary from Current Literature:Approaches : 

Summary from Current Literature:Approaches The variability of those programs speaks to the range of approaches currently employed. Around the world, anti-stigma efforts focus on a variety of objectives, some of which are defined as follows: To provide education, challenge stereotypes and dispel myths of mental illness To help change public perceptions and attitudes about mental illness To increase access to health care for individuals experiencing mental illness To decrease discrimination and promote inclusion To promote accurate and positive media portrayals of people with mental illness To encourage self-confidence and self esteem in people with mental illness To focus on recovery and the message of hope To provide a forum for families to speak candidly about their experience of stigma To encourage students to seek help To encourage legislative change

Attitude ShiftHow to Make Changes : 

Attitude ShiftHow to Make Changes In general, however, we know that there is no quick fix and no single answer. Instead, many authors suggest a three-pronged approach: Education: to dispel commonly held myths about mental illness Protest: to suppress discriminatory attitudes and challenge commonly held stigmatizing images Contact: to put a human face on mental illness; whether that of celebrities or of the not-so-famous