Flashcards in Chapters 1-5 Deck (91)
Although mental disorders is 4th in the causes of disability worldwide, WHO did not identify it within the WHO millennium development goals, why not?
What is the issue with the health care systems for mental health and physical health?
They are constantly competing for scarce resources.
What should policies surrounding mental health address?
Advocacy (for patients), promotion, prevention,treatment, and rehabilitation
What 5 things should a mental health policy be influenced by and keep in mind?
- ideas of mental health and illness
- treatments available
What is the first step to policy development?
Identify the problems!
What are the steps in the process of developing a policy?
1. Formulation of the proposed solution (what does this mean exactly?)
2. Following the political process: evaluation of cost, power dynamics, evaluation of potential impact, ideological interests, financial interests
3. Legislation: determines principles and objectives of the policy, may or may not fund the initiative >> unfunded mandates are useless policy
Recap: Formulation, political process, legislation
What are the necessary processes for development of health policies as determined by WHO?
1. Engagement of ministry of health
2. Strategic timing during periods of opportunity
3. Plan to share united vision, attract foreign donations, controlling decision making
4. Strategic planning for ongoing programme support
5. Development of stakeholder groups and organizing service users
RECAP: talk to health ministry, good timing, plan for united mssg, foreign loot and control, plan for ongoing programmes, development of stakeholders and organizing users
What are the 4 main groups a policy needs to make happy?
- tax payers
Why is it not possible to have mental health practitioners as primary healthcare providers?
Physical health care providers tend to spend little time on each patient, where as a mental health provider would have to be able to spend more time and get to know his patients much better
What is the history of mental health in Canada like?
1. Britian passes the country asylum act
2. Ontario created criteria for who could be commited
3. Involuntary admission allowed if 2 physicians agreed
4. Reduced the grounds of involuntary admission
5. Safety was defined as "likelihood of serious bodily harm to self, others or serious impairment due to lack of competence to care for self" (late 70s)
6. Legal aid must be provided (late 80s)
7. Period of involuntary admission reduced from 5 to 3 days
Which 5 people can refer a person for involuntary admission?
- Family member
- Community mental health worker
- Police officer
What are the requirements of the charter with respect to involuntary admission?
- Person must be advised of the reasons for detention
- Given immediate access to legal counsel
- Have validity of the detention reviewed and determined
- if a patient says the are willing to be admitted they can not be involuntarily detained
What are patient rights when it comes to psychiatric treatment?
Untill the 1960s everywhere in Canada patients had not right to refuse treatment. Now everywhere except for BC they have the right to refuse medication even under involuntary admission
Why did WHO say that there is not just one definition of mental health?
Because there are cultural differences and competing
How does the WHO define mental health?
A state of emotional and psychological well being in which an individual can use his or her cognitive and emotional capabilities to function in society and normal everyday life
What capabilities did the Canadian senate report as being essential to good mental health?
- Understand oneself and one's life
- Relate to other people
- respond to one's environment
- experience enjoyment and pleasure
- handle stress and withstand discomfort
- evaluate challenges and problems
- pursue goals and interests
- explore choices and decisions
What did the Canadian senate note good mental health was associated with?
- positive self esteem
- interest in life
- work satisfaction
- mastery and sense of coherence
- realizing potential
- ability to contribute to society
- good physical health
So strongly correlated with quality of life
What does the mental status examination consist of?
- structured questions
- tests of concentration, memory, and other mental function
Define the "mind" and explain how it's different from the "brain"
The mind is a a set of functions and experiences that come from brain activity and environment
What 4 aspects are said to affect mental health?
Biology, Family and childhood, Culture, Politics and Economy
Why might defining depression as "a chemical imbalance in the brain" and inept, or problematic definition?
It's too much of a simplification, it doesn't represent the overall causes effectively
The proportion of individuals in a population that have a certain health condition
Explain the difference between point prevalence and one-year prevalence?
Point prevalence is the prevalence in a population at a given point in time, where as one-year prevalence is the prevalence in a population over the period of a year
The proportion of people that who have new cases of a certain illness
What does YLD stand for?
Years lived with disability
How is YLD estimated?
Multiply the number of incident cases of a certain illness in a certain population by the average duration of the condition and a factor that represents the average degree of disability caused by the condition
What is the measure YLL?
A measure of the number of years of life lost in a population because of premature death
How is YLL calculated?
Multiply the years of death with the estimated number of years of life lost to premature death
What does DALY?
Disability adjusted life years