INTRODUCTION TO MENTAL HEALTH

BY

ARYEK-KWE JOSEPHINE
MENTAL HEALTH

• WHO defines it as the capacity of an individual to form

harmonious relationship with others and the ability to
participate constructively in a changing environment.

CHARACTERISTICS OF A MENTALLY HEALTHY PERSON

• Person is free from internal conflict. He is not at war with
himself
• He is well adjusted and able to get along with others, form
effective relationship and accepts criticism without getting
easily upset.
• He searches for identity
• He has strong sense of esteem
• He knows himself, his needs, problems and goals
• He has good control over his behavior
• He is productive; he faces problems and tries to solve them
intelligently i.e has ability to cope with stress and anxiety
MENTAL ILLNESS:
• Mental illness is a disorder of the mind, OR any disease or
condition affecting the brain that influences the way a
person thinks, feels behaves and/or relates to others and to
his or her surroundings.

• Although the symptoms of mental illness can range from

mild to severe and are different depending on the type of
mental illness, a person with an untreated mental illness is
often unable to cope with life’s daily routines and demands.
CHARACTERISTICS OF MENTAL ILLNESS;
- When one’s behavior is causing distress and suffering to the
individual and/or around him.

- Abnormal changes in ones thinking, feeling, memory,

perception and judgement, resulting in change in the
persons talk and behavior.

- Abnormal behavior causing disturbance in the persons day to

day activity, job and interpersonal relationship.
MISCONCEPTION ABOUT MENTAL
ILLNESS:
• Mental illnesses are caused by gods as punishment for sin, or
by ghosts, black magic, evil spirits and powers or witchcraft.

• Mental patients are different from other people.

• Mental patients never get well, once mentally ill they are
always mentally ill.
Misconception contd….
• Mental patients should take medication throughout their lifestyle.

• Mental patients are always violent and dangerous.

• Professionals like psychiatrists, psychiatric nurses who work with

the mentally ill persons are likely to become disturbed themselves.

NB; Its our role to provide clarification and appropriate information.

AETIOLOGY (CAUSES) OF MENTAL ILLNESS:
• Causes of mental illness are multiple and complex.

• Although the exact cause of most mental illnesses is not

known.

• It is clear through research that many of these conditions are

caused by a combination of genetic, biological, psychological
and environmental factors.
These causes are grouped into three major areas namely;
predisposing, precipitating and perpetuating factors
1) Predisposing factors:
These are factors that are within an individual that make him
or her more susceptible to certain types of mental illness.
These include the following.

i) Genetic or hereditary factors;

Sometimes they are genetically determined that is they run in
families through transmission of genes from parents to their
off springs.
ii) Biochemical and brain damage.
Biochemical abnormalities in the brain or brain damage.

iii) Physiological changes e.g during puberty, menstruation,

pregnancy, delivery and peuperium.

2) Precipitating factors;
These are environmental or extrinsic factors. These include
brain damage, early childhood experiences or upbringing,
psychosocial stressors.
3) Perpetuating or maintaining factors.

These are factors that tend to keep the illness permanently in a person.
They include; drug abuse, psychosocial stress or lack of social support,
domestic violence, stigmatization.

Protective factors have also been added where an example is religion.

CLASSIFICATION OF MENTAL DISORDERS;
• Mental disorders are classified according to the international
classification of diseases (ICD-10) or according to the diagnostic
and statistical manual (DSM-IV).

• ICD- 10 INTERNATIONAL CLASSIFICATION OF DISEASES.

The ICD is an international standard diagnostic classification for a

wide variety of health conditions.
It focuses on mental and behavioral disorders and consists of 10
main groups.
 F0: Organic mental disorders where there is actual damage to
the brain tissue. Examples include delirium and dementia.
ICD- 10 contd…
 F1: Mental and behavioral disorders due to use of psycho active substances
e.g alcohol dependency.

 F2: Functional or non organic disorder e.g schizophrenia, schizotypal and

delusional disorders.

 F3: Mood or affective disorders

 F4: Neurotic, stress related and somatoform disorders e.g anxiety and panic
disorders, phobias, OCD, conversion disorders, PTSD, hypochondriasis

 F5: behavioral syndrome associated with physiological disturbances and

physical stress
ICD- 10 Contd….
 F6: Personality disorders e.g paranoid personality, schizoid,
antisocial, dependent, emotionally unstable.

 F7: Mental retardation

 F8: Disorders of psychological development.

 F9: Behavioral and emotional disorders with onset usually

occurring in childhood and adolescence eg autism, ADHD.

 In addition, a group of unspecified mental disorders e.g eating

disorders, disorders of sleep, disorders of memory among others.
Diagnostic and Statistical Manual IV:
The DSM-IV organizes each psychiatric diagnoses into five
levels (axes) relating to different aspects of disorder or
disability called the multi axial system.

Multi axial system;

• Axis I: Clinical disorders, including major mental disorders.
This includes all mental disorders except personality and
mental retardation.

• Axis II: Personality disorders and mental retardation.

Multi axial system contd……
• Axis III: Acute medical conditions and physical disorders e.g
RTAs leading to brain damage

• Axis IV: Psychosocial an environmental factors contributing

to the disorder.
These include problems related to social environment,
occupation, access to health care services.

• Axis V: Global assessment of functioning.

 GENERAL SYMPTOMATOLOGY
• Some mentally ill persons may have many of the following signs and
symptoms and some may have only one or two.
a) General behavior
Sleep disturbance
• Difficulty falling asleep or waking up in the early hours of the
morning. This is called insomnia. Some patients may sleep a great
deal.
Loss of appetite and refusal of food.
This may be due to
• Having no interest in food because they are depressed
• Not feeling hungry at all
• Too busy to find time to eat e.g in mania
• They may feel the food is poisoned e.g in paranoid disorder
Personal appearance
• May be neglected. Some may be unwilling to bath, shave or change
clothing or some may dress colorfully while others may keep their
appearance seductive.
Lack of interest in sex
• Some feel not at all interested in usual sexual life or lose libido.
Lost or poor interpersonal relationship
Lost of interest in work, hobbies and surroundings
b) THOUGHT DISORDERS:
• Disturbance in thinking is characteristic of mental illness. Externally its observed in the way
a person speaks.

• People with mental illness tend to have trouble concentrating and maintaining a train of
thought.

• They may respond to queries with an unrelated answer, start sentences with one topic and
end somewhere completely different, or speak incoherently.

• Thought disorders can occur in the stream of thought or content of thought.

Disorders of stream of thought;
Thought block
Their train of thought may stop suddenly in the middle of a sentence.
Thought insertion
Feel like all their thoughts are being inserted by an external force and its not their own.
Thought withdrawal; thoughts being removed.
Thought broadcasting; things being broadcasted for instance on
television or radios are their own thoughts.

Disorders of thinking can also be manifested in speech. This is common

in schizophrenia and they include:
• Loose associations- Rapidly shifting from topic to topic, with no
connection between one thought and the next.
• Neologisms - Made-up words or phrases that only have meaning to
the patient.
• Perseveration -Repetition of words and statements; saying the same
thing over and over
• Circumstantiality- The individual disgraces into unnecessary details
before coming to the issue or point being discussed.
• Tangentiality- This differs from Circumstantiality in that the
person never really gets to the point of the communication.
Unrelated topics are introduced and the original discussion is
lost.
• Mutism- is an individual’s inability or refusal to speak.
• Clang association- Meaningless use of rhyming words (“I said
the bread and read the shed and fed Ned at the head.").
• Word salad- is a group of words that are put together
without a logical connection.
 Disorders of content of thought
• DELUSIONS
Delusions are false fixed beliefs that are firmly held by the patient, not shared by
members of the same community and is not corrected by reason or logical thinking.
This is evidence of an altered content of thought. Examples of delusions include. Can
be primary or secondary.
Types of delusions;
Paranoid delusions or (Persecutory delusions):
These are the most common type of delusions and involve the theme of being
followed, harassed, cheated, and poisoned or 'drugged', conspired against, spied on,
attacked, or obstructed in the pursuit of goals.
Grandiose delusion:
An individual exaggerates his or her sense of self-importance and is convinced that
he or she has special powers, talents, or abilities. Sometimes, the individual may
actually believe that he or she is a famous person (for example, a rock star or Christ).
Delusional jealousy (or delusion of infidelity):
A person with this delusion falsely believes that his or her spouse or lover is being unfaithful or is
having an affair. A person can gather evidence of a non existent affair.
Delusion of control:
This is a false belief that another person, group of people, or external force controls one's thoughts,
feelings, impulses, or behavior. A person may describe, for instance, the experience that aliens
actually make him or her move in certain ways and that the person affected has no control over the
bodily movements.
Nihilistic delusion:
A delusion whose theme centers on the nonexistence of self or parts of self, others, or the world. A
person with this type of delusion may have the false belief that the world is ending.
Delusion of guilt or sin (or delusion of unworthiness):
This is a false feeling of remorse or guilt. A person may, for example, believe that he or she has
committed some horrible crime and should be punished severely. Another example is a person who is
convinced that he or she is responsible for some disaster (such as fire, flood, or earthquake) with
which there can be no possible connection.
Hypochondriacal delusions:
Some false belief that he has some incurable disease or could also think the body is diseased or
infested with lies for example.
c) Disturbance of perception
• Illusions;
The misinterpretation of a real sensory stimulus e.g on seeing a snake one
mistakes it for a snake.
• Hallucinations;
These are sensory perceptions without external stimulus. Hallucinations are
perceptions that are experienced only by the person with mental illness and
are not shared by other people.
They are frightening, especially initially, but then the individual may find some
way to contain them into his altered reality in an effort to make it more
comprehensible.
Hallucinations can affect all the different senses of the body in the following
way;
• Auditory hallucinations: The person hears voices or sounds that aren't there.
Visual hallucinations:
• The person sees something that isn't really there. Visual delusions may be visions or
signs to which the individual with mental disorder attaches great meaning or
significance.
Olfactory hallucinations:
• The person smells odors, commonly bad ones, like rotting organic matter that no
one else smells.
Tactile hallucinations:
• The person feels the presence or touch of somebody or something when no one is
actually present.
• People with both mental disease and substance-use disorders commonly feel bugs
crawling over their bodies (occasionally as a result of using cocaine).
Gustatory hallucinations:
• Usually the person has a peculiar taste in the mouth. This is also occasionally
present in epilepsy.
d) Disorders in memory:
The ability to remember events can be affected in many psychiatric
disorders.
• Amnesia.
Total loss of memory for a certain period of time of a persons waking life.
Can mainly occur in organic disorders e.g after a head injury, after a seizure,
after ECT.
• Dysamnesia (Paramnesia):
Failure of the memory to recall events that happened minutes or hours ago.
• Organic memory impairment:
Inability to recall events accurately. Recent events are more difficult to recall
than past events.
e) Disorders of consciousness:
• Apart from unconsciousness which is a complete loss of awareness,
the following conditions are sometimes seen.
• Confusion;
A confused patient is bewildered by his environment. He finds it
difficult to express himself properly or be able to only a few words.
Some may wander around not knowing rally where they are.
• Disorientation;
A disoriented person may not really know the time or place, fail to
recognize a known person or even fail to recognize their own selves.
f) Disturbance in affect or mood:
• Mood refers to the internal emotional state of an individual whereas
affect refers to the external expression of emotional content.
• The common emotional mood states include;
Elation or extreme happiness’
This is an abnormal mood when it occurs without specific reason. It’s a
state marked with extreme cheerfulness associated with increased activity.
Common in mania.
Depression;
A state of extreme sadness. It’s a symptom of mental illness when it occurs
without a specific cause, becomes abnormally severe or prolonged. It’s a
state of dejection, hopelessness, sadness and misery.
Anxiety;
Its an unpleasant state with anticipation of something harmful. Its vague
fear in the absence of immediate danger. Its severe in the mentally ill.
Inappropriate affect;
When the patient reacts with the wrong emotion to a particular event.
E.g laughing on hearing abot the death of a loved one.
Apathy;
This refers to the patients loss of interest in his surrounding and inability
to express feelings. They show little or no emotions in situations which
would arouse normal people.
Incongruous affect;
The persons emptions do not work in harmony with his thoughts e.g
someone sheds tears when talking about an amusing event.
g) Disturbance in motor activities:
• Motor behavior sometimes reflect mental functions. Some of these abnormal motor activities
include;
Catalepsy;
A general term for immobile position that is constantly maintained.
Posturing;
It is voluntary assumption of inappropriate or bizarre posture and maintaining it for long periods of
time.
Negativism;
Motiveless resistance to all attempts to be moved or to all instructions.
Stupor;
Lack of reaction to and awareness of the surrounding
Echopraxia;
The individual purposelessly imitates movement made by others
Waxy flexibility:
The Patient allows his body part to be placed in bizarre or uncomfortable position which is then
maintained.
THANK YOU FOR LISTENING.

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