Mental Health and Illness

An Epidemiological Perspective

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 Mental Health-Everybodys
Business
Peter Sims
Professor of Public Health
medicine
University of Papua New
Guinea
<petersims@upng.ac.pg>

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 Teaching and Learning Aims
There is ignorance,
superstition, stigma and
fear around Mental Illness
Aetiology, pathogenesis
diagnosis and treatment
are imperfect.
There is a different
paradigm and a less
rigorous epidemiology
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 Often sad,sometimes
mad,occasionally bad
The medical model is
insufficient
Diagnosis is largely
clinical and
experiential

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 More of an art than a science
Treatment is
pragmatic
Prevention is about the
politics of health
populations,people
pressures, poverty

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Mental Health is a worldwide
problem

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Mental illness is common 6 in 10 women and 4 in 10 men
in Western Europe and North America will have a
significant mental illness during their lifetime

Mental illness can affect any one of us

Mental illness occurs in all societies and cultures

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We are all vulnerable

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 A Holistic Approach
BODY
Arrow of Time

CULTURE

MIND SPIRIT
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 Intelligence

IQ = 100

IQ

I.Q. = the Mental Age x 100

the Chronological age
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 Personality
Each human being is
unique
We all have different
personalities
My personality
reflects genetic
inheritance and
Environment

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 Behaviour

SUPER-EGO The Parent

EGO The Adult

The Child
ID

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The Subconscious Mind

The Conscious

The Subconscious

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 A Classification
Affective Disorders Substance abuse problems
Anxiety,depression,mania,obsessional Drugs, alcohol
disorders
Learning disorders
Subnormality
Schizophrenia
Simple,Hebephrenic,Catatonic,paranoid

Organic states
Delirium,dementia

Personality Disorder
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Abnormal personality,Psychopathy
 The Classification of Mental Illness:

The Neuroses
Depression, Anxiety, Mania, Obsessions and compulsions
(usually the patient retains insight and orientation; they
experience deep distress and may commit suicide)

The Psychoses

Schizophrenia, puerperal psychosis

(the patient is disorientated, deluded, and lacking in insight)

The Dementias

Progressive deterioration with loss of recent memory and

deterioration of a normal personality,
They may be primary or more commonly secondary to
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another condition e.g. alcohol, stroke
Clinical Diagnosis

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 The Classification of Mental Illness

Drug Problems

Addictive drugs, (Heroin, Cocaine, Amphetamines,) alcohol

and drug related illness-psychosis, delirium and dementia

Personality Disorders
A personality and behaviour that is damaging to the individual
and/or to society and which is not tolerated by the dominant
culture

Mental subnormality/learning disorders:

Problems around intelligence and ability to learn on the basis
of teaching and experience 17
 Aetiology
Inheritance-Genetics/Intra-
uterine environment Drug Abuse
Schizophrenia,Huntingtons
Alcohol,Heroin etc
Upbringing Neurological diseases
Mothering,education, MS,Brain tumour
parenting
Trauma/head injury Biochemistry/metabolic
Porphyria,Diabetes
Infections-
HIV,Syphilis,CJD Vascular-CVA
Nutrition/PCM 18
 Treatment and Care

Hospital Care

Community Care

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 Preventive Networks
Church,Family, Home, Friends,
Work

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 The Mental Health Act

Compulsory Psychiatric
Treatment
Criminal responsibility
Power of attorney

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 Mental Handicap/learning disability

The mind of a young child in the body of an adult

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Canst thou not minister to a mind diseased,
Pluck from the memory a rooted sorrow,
Raze out the written troubles of the brain,
And with some sweet oblivious antidote
Cleanse the stuffd bosom of that perilous stuff
Which weighs upon the heart?
Macbeth 23