Mental Health and Well Being

Prof.Yan He-Qin

Shanghai Mental Health Center

Jiao-Tong University

School of Medicine

..Definition of Health

WHO:(1948)

Health is a state of complete physical,mental and social well-being and not merely the absence of disease or infirmity

Well Being include:

Normal Intelligent Nice mental state Harmony personal relationship Good social function Strong-Willed Stable Personality.

Noble Morality.

Social Development and Stress

Great Change Competitions Stress Various inference Family structure change One child family Aging problem Big City problem Unemployed etc.

Psychological Problems in each period Infantile period:

Child period:

Adolescent period:

Adult period:

Involution period:

Senile period:

Mental Health Problems

Psychoses ： Schizophrenia ,Manic-Depression disorder, Alzheimer

Disease etc

Neuroses ： Depression ,Anxiety,, Obsession, Neurasthenia etc

Psychological disorder ： Adjustment Disorder, Alcohol and Drug

Addiction etc

Psychosomatic Disorder ： Hypertension, Asthma ,Peptic Ulcer etc.

Personality Disorder: Antisocial. Paranoid, Schizoid, Histronic etc.

Stress and Health

Appropriate stress can improve one’s adaptation.

Excessive stress cause over reaction, exhaustion and death

Psychological stress cause change of neuro-endocrine, immunity function, neurotransmitters, NGF and Brain neuron

Medication, Psychological management, Relaxations procedure and Exercise help to recover

Statistics according to DALY (Disability Adjusted Life Years )

sequence disorders percentage to all burdens % treatment %

1. chronic lung obstruction 8.5 502. depressive disorders 6.2 53. lower respiratory tract infection 5.7 ?4. brain vascular disorders 5.2 505. self hurt 3.9 ?6. ischemic anemia 3.2 ?7. ischemic heart disorders 2.9 508. falling down 2.2 ?9. drowning 2.1 ?10. traffic accident 2.1 ?11. tuberculosis 2.0 ?12. liver cancer 1.9 3013. diarrhea 1.8 ?

DALY(1990)Percentage of Reduction of Disability Adjusted Life Years

brain vasculardisorders3.2%

cancer5.8%malaria2.8%

other infectiousdisorders5.3%

heart disease4.4%

respiratorysystemproblems9%

women rinatalperiod problems9.5%

mental healthproblems 8.1%

behavior relateddisorders 34%(infecteous andnon-infectious )

other non-infectiousdisorders 18%

(World Bank, 1993)

Mental Health ProblemsPrevalence of Mental Illness (USA)ECA/DIS/DSMIII

disorders month Life time prevalence

Any DIS disorder 15.4 32.2

Alcohol and drug dependence

3.8 16.4

Anxious disorders 7.3 14.6

Depressive disorders

Mental disorders

2.2

0.7

5.8

1.5

Social Burdens from Mental Illness

Mental illness is common disease : high incidence, often relapse, behaviors out of control, lack of insight, harmful to society, family and persons( making troubles), eg: schizophrenia, mood disorders, paranoid disorders .

Personality disorders: unstable emotions, compulsive behaviors, unable to learn a lesson, harmful to others and himself, unstable factors to the society. eg: compulsive personality disorder,paranoid personality disorder, obsessive-compulsive personality disorder and perversion ,etc.

Depression

Report by WHO:1.5 billions Affective Disorder in the World

Austraria(1995)prevalence rate of Depression” 1.32%

South Korea :3.1-5.5%

Hong Kong :2.4-5.2%

576 out patient clinic of internal medicine in Shanghai:4%

Incidence of Depression

0% 10% 20% 30% 40% 50%

parksinsonism

milcardial infraction

stroke

inpatients with cancer

outpatiets with cancer

geriatric inpatients

inptietns

chronic dieorders

common people

incidence

Depression of Inpatients in Internal Medicine Word

hematology, endocrine department 44.7% neurology department 37.5% cardiovascular department 34.5% gastrointestinal department 30.4% tumor department 20-40% related disorders: stroke 26-34%, rheumatoid arthritis 2

0%, parkinsonism 40%, cardiovascular diseases 19%

Definite Diagnosis Rates of Depression in General Hospitals

WHO survey in 15 countries and areas :

incidence of psychological disorders 24%

average recognition rate of general practioner 48.9%

Analysis in 576 cases in Shanghai:

incidence of psychological disorders 9.7%

major depressive disorder 4%

recognition rate of physicians 15.9%

Problems and Propose Problems: Knowledge of Mental Health still not

popular. General medical staff lack of mental health

training High prevalence rate, High death rate, High

disable rate Mental Health need legislation to guarantee Stigma and privileges still exist in society

Treatment of Mental Diseases

Drugs therapy: Antipsychotic drugs Antidepressant Antianxiety Hypnotic etc. Psychotherapy ： Psychoanalytic, Cognitive-

behavior, Interpersonal relationship, Family therapy, Relaxation therapy, Group therapy etc

Physic therapy: ECT, Biofeedback etc Social support and management

Prevention Mental Illness

Primary prevention: to increase protective factors and reduce risky factors for mental illness .

Secondary prevention: to reduce harm through early discovery, early diagnosis and treatment

Tertiary prevention: to train the patients to improve their abilities of looking after themselves, adapting to society and occupational skills in order to reduce disability and social dysfunctions, promote rehabilitation and prevent relapse.

Methods to Promote Mental Health

Foster healthy personalities Healthy life methods and behavior habits Improve adaptation to natural and social

environment Improve coping abilities to mental stresses Reduce negative influences, prevent mental

disorders and psychosomatic disorders Develop community psychiatric services

Methods to Promote Mental Health(Cont.)

To have knowledge of oneself To accept oneself To explore one’s potential abilities and keep

contacts with reality through practices To build positive interpersonal relationships To seek help and support To improve adaptation and coping skills

Learning Self Management

Methods to control emotions : distraction, dissociation, weakening, empathy, sublimation, undoing, catharsis, etc

Learn to be patience and tolerant Treat frustration and unfortunate things correctly Properly adapt “The method of mental victory” Pay an attenuation to train strong will and build up

scientific world view.

Ways to reduce mental Stress Talk to a person you trust Try a change of pace Take one step at a time Get rid of anger safely Take it easy Do something for yourself Do something for someone else

Propose: to guarantee society harmony and stabilization and people’s health

To widespread mental health knowledge , everybody needs

mental health (especially for weak populations ） Both governmental and non-governmental branches and

organizations need to participate and cooperate in mental health To be against stigma and insult to patients with mental illness To popularize methods of prompting psychological health To include mental health to construction of spiritual civilization To expand and make the mental health service system perfect

Thank you ！