֍ Mental Health and Mental Illness ֎

---------------------------- « Karim Raafat » ----------------------------

Definitions :

Health : a state of complete physical, mental, & social wellbeing, not merely absence of disease or infirmity.

Mental Health : it is a state of emotional, psychological and social wellness evidenced by satisfying
interpersonal relationships, effective behavior and coping, a positive self-concept and emotional stability.

Mental Disorder : it is a clinically significant behavioral or psychological syndrome or pattern that occurs in
an individual and that is associated with present distress (e.g., a painful symptoms) or disability (i.e.
impairment in one or more important areas of functioning) or with a significantly increased risk of suffering
death, pain, disability or important loss of freedom.

Mental Disorders : they are health conditions characterized by alterations in thinking, mood, or behavior.
They are associated with distress or impaired functioning.

Components of Mental Health :

1) Self-Governance : the person demonstrates autonomy.

2) Growth Orientation : progress toward self-realization, maximization of capacities.
3) Tolerance of Uncertainty : The person faces the uncertainty of living.
4) Self-Esteem : built on self-knowledge and awareness of talents, abilities, and limitations.
5) Mastery of Environment : capable, competent & creative in dealing with & influencing environment.
6) Reality Orientation : distinguishes.
7) Stress Management : experiences.

Factors influencing Mental Health :

A. Inherited characteristics.
B. Nurturing during childhood.
C. Life circumstances (success in school, financial security, good physical health or successful marriage).

General Characteristics of Mentally Healthy Individual :

Mentally healthy individual …

01. Is able to work alone and with others.

02. Accepts responsibility for his actions.
03. Is able to give and receive.
04. Is optimistic.
05. Is able to express feelings.
06. Is able to solve problems.
07. Is able to benefit from rest and sleep.
08. Can recognize limitations (abilities and deficiencies).
09. Is able to form meaningful relationships.
10. Is able to make sound judgments and decisions.
11. Can take care of his hygiene and clothes in a manner, which conforms to the standards of his society.
12. Is able to cope success fully with stress (can return to normal functioning if temporarily disturbed).
13. Is able to distinguish fact from fantasy or the real world from a dream.
General Criteria & Characteristics to Diagnose individuals with Mental Disorders :

When an individual …

01. Is not able to view himself clearly, feels inadequacy or has a distorted view of self, has poor self-
concept and dissatisfaction with one's characteristics, abilities and accomplishment.
02. Is unable to maintain satisfying personal relationships and unable to cope and exhibits maladaptive
behavior and dissatisfied with one's place in the world.
03. Displays poor judgment.
04. Ineffective coping with life events.
05. Lack of personal growth.
06. Unable to accept responsibility for action.
07. Is pessimistic.
08. Does not recognize limitations (abilities and deficiencies).
09. Exhibits dependency needs because of feelings of inadequacy.
10. Is unable to perceive reality.
11. Does not recognize potential and talents because of poor self-concept.
12. Avoid problems rather than coping with.
13. When his behavior is deviated sufficiently from normal to indicate disorganization of the self.

Possible Signs of Mental Illness :

01. Marked personality changed over times.

02. Confused thinking, as grandiose ideas.
03. Prolonged severe depression and apathy.
04. Excessive anxiety, fear or suspiciousness, blaming others.
05. Withdrawal from society, friendlessness, abnormal self-center.
06. Thinking or talking about suicide.
07. Denial of obvious problems, strong resistance to help.
08. Numerous, unexplained physical ailments.
09. Marked changes in eating or sleeping patterns.
10. Anger or hostility out of proportion to the situation.
11. Delusions (false beliefs that are firmly maintained even though they are not shared by others).
12. Abuse of alcohols or drugs.
13. Hallucination (perceptual distortions, arising from any of the senses, hearing voices, or seeing images
that others don't hear or see).
14. Growing inability to cope with problems and the daily activities as school, jobs or personal needs.

Practice that Decrease Mental Health :

1) Diet : Over eating, eating cooked food, as improper food eating cause depression, anger, fear,
instability anxiety and other forms of emotional dysfunction. The brain and body are nutritionally
interrelated and interdependent. Also deficiencies of vitamin B 1 , B 3 , B 6 and C, calcium and
magnesium cause mental illness.
2) Chemistry : Mental illness can be caused by chemical imbalances in brain , by the transfer of drugs
across placental barrier or by organic changes with in the brain.
3) Situations : If the person is unsuccessful in dealing with environmental stresses, poor nurturing
during childhood or negative life circumstances.
Practice that Increase Mental Health :

1) Diet : Fasting and eating sparingly, eating raw fruits and vegetable diet (fasts and/or eat a proper diet
will not have any negative emotions).
2) Sleeping and Awaking : Obtaining sufficient sleep , meditation, being aware, vigorous exercise ,
receiving adequate sunshine , in taking fresh air, being free of toxins, daily mental exercises, self-
confidence and self-mastery.
3) Keep Calm : in nervous , depressed, phobic, neurotic or psychotic cases, feel better and get well by
closing your eyes and keep them closed. Closing the eyes rests the brain and mind.
4) Exercise : Taking moderate physical activities and exercises (nervous energy is used up by physical.
5) You are in Control : Nobody can make you mentally ill with their verbal abuse to you. No one can
take advantage of you without your permission. Nothing can bother you unless you let it. Self control
is the great law of mental health.

Diagnosis and Statical Manual of Mental Disorders ( DSM – IV – TR ) :

Axis I : it is for identifying all major psychiatric disorders except mental retardation and personality disorders
(as depression, schizophrenia, anxiety, and substance related disorders).

Axis II : it is for reporting mental retardation and personality disorders as well as prominent maladaptive
personality features and defense mechanisms.

Axis III : it is for reporting current medical conditions that are potentially relevant to understanding or
managing the person’s mental disorder as well as medical conditions that might contribute to understanding
the person (as Diabetes Mellitus).

Axis IV : it is for reporting psychosocial and environmental problems that may affect the diagnosis,
treatment, and prognosis of mental disorders. Included are problems with primary support group, social
environment, education, occupation, housing, economics, access to health care, and legal system.

Axis V : it presents a Global Assessment of Functioning (GAF), which rates the person’s overall psychological
functioning on a scale of 0 to 100 . This represents the clinician’s assessment of the person’s current level of
functioning; the clinician also may give a score for prior functioning (for instance, highest GAF in past year or
GAF 6 months ago).

Axis I Axis II Axis III Axis IV Axis V

- Mental Retardation Global Assessment
All major psychiatric
- Personality Disorders Psychosocial and of Functioning
disorders (except Medical
- Defense Mechanisms Environmental (person’s overall
mental retardation & Conditions
- Prominent maladaptive Problems psychological
personality disorders)
personality features functioning)

Psychiatric Mental Health Nursing :

Psychiatric Mental Health Nursing : it is a specialized area of nursing practice that employs theories of
human behavior as its science and the purposeful use of self as its art. It is the diagnoses and treatment of
human responses to actual or potential mental disorders and their long-term effects. Interventions include
the continues and comprehensive primary health care services necessary for the promotion of optimal
health, the prevention of mental illness, rehabilitation from mental disorders, and health maintenance.

 Psychiatric mental health nursing is an integral part of the continuum of nursing practice.