Community Psychiatry –

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Community Psychiatry Perspectives :

Community Psychiatry Perspectives RIAZ .K.M Assistant professor Govt. College Of Nursing THRISSUR.

What is a mental illness?:

What is a mental illness? It is when someone lacks the ability to manage day to day events and/or control their behavior so that basic physical and emotional needs are threatened or unmet.

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These disorders can affect persons of any age, race, sex, religion, or income. Mental illnesses are not the result of a personal weakness, lack of character, or poor upbringing.

Why should I care?:

Why should I care? Because understanding of mental health issues brings awareness to the community and our surrounding environment. We will become a society that is accepting of others who do not fit our idea of a perfect population.

What is mental illness like?:

What is mental illness like? Mental illness is a physical condition just like asthma or arthritis. But still society believes that a person who is mentally ill needs to show more willpower - to be able to pull themselves out it.

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….. It is also like telling a person who has an amputated leg to run across the room. But a person who has mental health issue has a “broken brain”.

Myths of Mental Illness:

Myths of Mental Illness Mental illness is caused by bad parenting. Fact: Most diagnosed individuals come from supportive homes. The mentally ill are violent and dangerous. Fact: Most are victims of violence. People with a mental disorder are not smart. Fact: Numerous studies have shown that many have average or above average intelligence.

Psychiatry in india:

Psychiatry in india Charak Samhita designated Psychiatry as ‘Bhuta Vidya’. Atharva-Veda, mentions that mental illness may result from divine curses The Bhagavad Gita is a classical example of crisis intervention psychotherapy.

Sushruta pillars of the therapy:

Sushruta pillars of the therapy the physician (chikitshak), the drug (dravya), the attendants or the nursing personnel (upasthata), and the patient (rogi)

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tridoshic philosophy

Unani system of medicine:

Unani system of medicine Najabuddin Unhammad (1222 AD), described seven types of mental disorders; Sauda-a-Tabee (Schizophrenia); Muree-Sauda (depression); Ishk (delusion of love); Nisyan (Organic mental disorder); Haziyan (paranoid state) and Malikholia-a-maraki (delirium). Psychotherapy was known as Ilaj-I-Nafsani

Psychiatry in India:

Psychiatry in India it was believed that sin and witchcraft are responsible for mental illness and the mentally ill were chained in jails and asylums. Then with the advent of psychoanalysis, etiology of psychiatric disorders was explained. Third was the development of community psychiatry

India :

India mental disorder, is prevalent among 1.1 percent of the total population lifetime prevalence rate of mental disorders is 10-12 percent. depression - affects one out of every five women and one in every 12 men. 36% of people still live below poverty line continuous migration of rural people into urban slums multicultural traditional society where people visit religious and traditional healers for general and mental health related problems

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The word community generally used to denote a particular geographical and administrative area, a relatively integrated neighborhood and locality. simply areas outside big hospitals.

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“Community psychiatry principles:

“Community psychiatry principles (i) establishing population-based needs for treatment and care; (ii) providing a service system linking a wide range of resources of adequate capacity, operating in accessible locations and (iii) delivering evidence based treatments to people with mental disorders

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Responsibility to a population, usually a catchment area defined geographically Treatment close to the patient’s home Multi-disciplinary team approach Continuity of care Consumer participation Comprehensive services

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We need to try again & again if we have to success

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As I was passing the elephants, I suddenly stopped, confused by the fact that these huge creatures were being held by only a small rope tied to their front leg. No chains, no cages. It was obvious that the elephants could, at anytime, break away from their bonds but for some reason, they did not.

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I saw a trainer near by and asked why these beautiful, magnificent animals just stood there and made no attempt to get away. “Well,” he said, “when they are very young and much smaller we use the same size rope to tie them and, at that age, it’s enough to hold them. As they grow up, they are conditioned to believe they cannot break away. They believe the rope can still hold them, so they never try to break free.”

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I was amazed. These animals could at any time break free from their bonds but because they believed they couldn’t, they were stuck right where they were. Like the elephants, how many of us go through life hanging onto a belief that we cannot do something, simply because we failed at it once before?

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Moral: Failure is part of learning; we should never give up the struggle in life. If we have failed once, it doesn’t means we can never do it again. We need to try again & again if we have to success !!

Advantages community psychiatry:

Advantages community psychiatry Stigmatisation of being a ‘mental patient’ is reduced. minimising the social and behavioural difficulties, as well as institutionalisation, The patient may be more willing to seek psychiatric help if it is available within the community, thus enabling early detection and treatment of psychiatric illnesses.

Disadvantages community psychiatry:

Disadvantages community psychiatry In Mental hospitals Can provide a supportive and protective environment. The risk of relapse due to environmental stressors is diminished. Disturbed patients are more easily contained. Concentration of resources and expertise and the Administrative structure is relatively easier to manage compared to community care. Patients may have poorer access to the community.

Family :

Family Prior to 1970 family as toxic 1970 family as cuase of relapse 1980 family as a carer 1990 family as partners

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House of 1000 Mirrors.

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Long ago in a small, far away village, there was place known as the House of 1000 Mirrors. A small, happy little dog learned of this place and decided to visit. When he arrived, he bounced happily up the stairs to the doorway of the house. He looked through the doorway with his ears lifted high and his tail wagging as fast as it could.

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To his great surprise, he found himself staring at 1000 other happy little dogs with their tails wagging just as fast as his. He smiled a great smile, and was answered with 1000 great smiles just as warm and friendly.As he left the House, he thought to himself, ” This is a wonderful place. I will come back and visit it often .”

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In this same village, another little dog, who was not quite as happy as the first one, decided to visit the house. He slowly climbed the stairs and hung his head low as he looked into the door. When he saw the 1000 unfriendly looking dogs staring back at him, he growled at them and was horrified to see 1000 little dogs growling back at him. As he left, he thought to himself, ” That is a horrible place, and I will never go back there again .”

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Psychophysiological Disorders Associated with Stress:

Psychophysiological Disorders Associated with Stress Asthma Cancer Depression Dysmenorrhea Exhaustion Hypertension Gastrointestinal problems Coronary heart disease Inflammatory bowel disease Skin disorders Headaches

Types of Community Psychiatric Services:

Types of Community Psychiatric Services Outpatient Services Domicilliary Visits Doctors/Psychiatrists Occupational Therapists Rehabilitation Day Centre Dementia Day Centres Support Groups Hostels Group Homes Hotlines and Counselling Service

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Enjoy your coffee

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The happiest people in the world are not those who have no problems, but those who learn to live with things that are less than perfect.”

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A group of graduates, highly established in their careers, got together to visit their old university professor. Conversation soon turned into complaints about stress in work and life. Offering his guests coffee, the professor went to the kitchen and returned with a large pot of coffee and an assortment of cups – porcelain, plastic, glass, crystal, some plain looking, some expensive, some exquisite – telling them to help themselves to the coffee.

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When all the students had a cup of coffee, the professor said: “If you noticed, all the nice looking expensive cups were taken up, leaving behind the simple and cheap ones. While it is normal for you to want only the best for yourselves, that is the source of your problems and stress. Be assured that the cup itself adds no quality to the coffee.

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In most cases, it is just more expensive and in some cases even hides what we drink. What all of you really wanted was coffee, not the cup, but you Consciously went for the best cups… Then you began eyeing each other’s cups.

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Now consider this: - Life is the coffee; the jobs, money and position in society are the cups. - They are just tools to hold and contain Life, and the type of cup we have does not define, nor change the quality of Life we live. - Sometimes, by concentrating on the cup, we fail to enjoy the coffee God has provided us. Enjoy your coffee!.”

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The happiest people don’t have the best of everything. They just make the best of everything.” 1. Live simply. 2. Love generously. 3. Care deeply. 4. Speak kindly. 5. Leave the rest to God.

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Thank you

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