Mental Health and Wellbeing

Dr Karen AdamConsultant in Public Health Medicine

Dr Mhairi HepburnClinical Fellow in Medical Education

and Specialist Registrar in Old Age Psychiatry

YouTube- Schizophrenic Man Terrifies Kids At Party

What is mental illness?

Mood disorders

Schizophrenia

Anxiety disorders

Dementia

Personality disorders

Learning disability

Autism

ADHD

Eating disorders

Addictions

Response to traumaSexual disorders

25%

What is depression?

Depression- key messages

• It is an illness, not a variant of normal• It is not the same as feeling “down” or “fed up”• It is common- 14-18% will get it at some point• It’s even more common in medical students• Treatments for depression are very effective

If your friend had depression, what

might they notice and what might you

notice?

Depression

“We take people in who have doused themselves with petrol, who have tried jumping off flats, who have taken vast amounts of paracetamol, who do not want to live any more, and we bring those people in, and I would say that nine and a half out of ten punters leave here happy and well. If that isn’t a result I don’t know what is.

Pessimism has always dominated our thinking about mental illness, it’s just like the ghost of stigma reinventing itself as despair in this particular case. The idea that there’s nothing you can do, that’s complete nonsense.”

Mark Salter, consultant psychiatrist

Depression is important wherever you end up working

20% of patients develop depression after a heart attack

25-30% of patients have depression following a stroke

Over half of cases of depression in the general hospital go undetected

90% of people with mental health problems are cared for entirely in primary care

10% of women develop depression after having a baby and suicide is one of the leading causes of maternal death

10% of five to fifteen year olds have a mental health problem. Childhood abuse and neglect are major risk factors for adult mental illness.

Self harm is one of the five most common reasons for A+E attendance

15% of patients develop depression after successful surgery for lung cancer

20% of patients with no previous depression suffered from depression in the six months after surgery for hip fracture

Mentally Flourishing

We wish to see a Scotland where we all understand that there is no health without good mental health, where we know how to support

and improve our own and others’ mental health and wellbeing and act on that knowledge and

where our flourishing mental health and mental wellbeing contributes to a healthier, wealthier

and fairer, smarter, greener and safer Scotland.TAMFS Scottish Government 2008

Wellbeing

3 dimensions:emotional, social and psychological This includes our ability to cope with life’s problems and make the most of life’s opportunities; to cope in the face of adversity and to flourish in all our environments: to feel good and function well, both individually and collectively.

Mental wellbeing ranges from good or high mental health, or flourishing, at one end of a continuum to poor mental health, or languishing, at the other end of the continuum.

TAMFS Scottish Government 2008

The WHO Triangle

DisorderLanguishingModerateFlourishing

Population Approach

Population mental health: emotional, psychological, social

(Keyes, 2002; Rose 2003; Huppart 2005)

DisorderLanguishingModerateFlourishing

Population Approach

Population mental health: emotional, psychological, social

(Keyes, 2002; Rose 2003; Huppart 2005)

DisorderLanguishingModerateFlourishing

Population Approach

Population mental health: emotional, psychological, social

(Keyes, 2002; Rose 2003; Huppart 2005)

The Continua of Disorder and Health

Flourishing

Mental Health

Diagnosed disorder but copes well; has

POSI TI VE MENTAL HEALTHMaximum

Mental

DisorderPOOR

MENTAL HEALTH

and diagnosis of disorder

No illness or disorder

POSI TI VEMENTAL HEALTH

POOR MENTAL HEALTH

but no diagnosis of disorder

Languishing

Mental Health

Minimum

Mental

Disorder

Invest to Save: Best Buys in Economic Research 2007

• Supporting parents and early years: parenting skills training/pre-school education• Supporting children and young people: health promoting schools and continuing education• Improving working lives: employment/ workplace• Positive steps for mental health: lifestyle (diet, exercise, sensible drinking and social support)• Supporting communities: environmental improvements

Evidence of What Works

• New Economic Foundation (2009) Social economics of languishing Levers for change

- connect - be active - take notice - keep learning - give

Mental Capital and Wellbeing – Government Office for Science report (2008). 400 world experts say priority for children, young people, mental health, work, older years.

Evidence of What Works

• Positive stepssupportive contactactivitynaturecreativitygood dietalcohol senselifelong learning

Effects – Teenage Births

Eff ects of I nequality: Teenage births

Effects - Obesity

Eff ects of I nequality: Obesity

Effects – Drug abuse

Eff ects of I nequality: Drug abuse

Effects: Imprisonment

Eff ects of I nequality: I mprisonment

Effects: Violence

Eff ects of I nequality: Violence

Effects: Mental Health

Eff ects of I nequality: Mental health

Effects: Child Wellbeing

Eff ects of I nequality: Child wellbeing

Effects: Social Mobility

Eff ects of I nequality: Social mobility

Patient Doctor

30%

What can I do now? Follow Dundee

Psychiatry on Twitter @DundeePsych

Join the RCPsych as a Student Associate (for free!)

Reduce stigma by starting a conversation about mental health

Look after yourself and your colleagues

Looking after self and colleaguesStudent support services

www.dundee.ac.uk/studentservices/

Your GP/ University Health Service

Mental Health Training

Doctors Support Network www.dsn.org.uk