HLTHAGE 2G03 Lecture Notes - Lecture 2: Gross National Happiness, Mental Disorder, Traumatic Brain Injury

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2G03 Mental Health
Concepts:
Why mental Health?
Line between physical and mental not as clear as dualists would assume, e.g.
cause, experience, and symptom expression. Whether it’s how you
experience these things (physical symptoms of depression, heart rate,
respiration, nervous system may al reflect mental phenomena). So why do
we create this division?
Despite the links between body and mind, physical state cannot necessarily
give an indication of mental health. Whether tense shoulders or shortness of
breath, myriad explanations. Thus, mental health is almost entirely self
reported because we cannot read the body we have to rely on first person
accounts and this is signification because this changes everything. When we
thin about medical signs they have been about objective reading of the body
and to think about intrusmental things such as a thermom. Are important
because it allows the doctors to tap into that persons body but with mental it
depends on what the person has to say. So mental health enters the social
world in a way physical health doesn't.
When we say mental health we are referring to feelings, thoughts,
cognistion, and self-concept.
What does good mental health mean?
If theres no objective measurement, we can say that this is a construct, so
what do we mena by good mental health?
It is not possible to say with certainty that a person has good mental health.
Minimalist: absence of mental disorders. This means, if a person is not
diagnosable than we would say that person is mentally healthy. A lot of
people wouold say that's too basic of a definition.
Broader considerations:
o the ability to get on in every day life, the ability to connect with other
people (getting a job, being social etc.). that's socially constructed
because in different cultures expect different things so someone may
be healthy in one culture and not another. Another indicator is a
persons ability to have strong relationships with other people. Be
able to enjoy oneself, the ability to handle stress, discomfort, and
change. If a person is denied some personal necessities to enjoy
himself or herself does that mean that they aren’t mentally well? The
ability to handle the punches life throws at us. The ability to pursue
goals and interests, sense of psychological and emotional wellbeing,
sense of capability and flexibility. Therefore, mental health is not just
individual. It is linked to others. We must consider mental health in a
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social context. In order to kow if a person is mentally healthy we must
know the social aspect.
Ways of Thinking about Poor Mental Health
Distress model (dimensional): mental illnesses do not exist as independent
entities, rather, all people score on a continuum of psychological distress
instead all people experience some level of mental distress on a continuum
and everyone will fall somewhere ont hat continuum. Sensations such as
sadness, worry, hostility, anger frustration, tension, loneliness, mistrust are
part of everyday life. The question is, is there a line that distinguishes
pathological beings and a healthy state? The distress model says that's a
much harder thing than we think. Those who experience substantial
amounts of these negative phenomena may be considered unwell or
distressed but disease may be a misnomer. But we should think of te
mentally ill versus the healthy.
Disorder model (categorical): suggest that people are either healthy or not
healthy. Assumes mental illnesses exist as discrete categories, one has it or
one does not. We say a people has an eating disorder or has schizophrenia or
does not. This uses the language of main stream medicine. Based on disease
model specific causes, specific treatments.
Everyday life is naturally full og some degree of negative affect, stress, worry
concern…..
The DSM
the official list of mental disorders gateway to treatment. It says here is
a list of disorders and for each disorder it lists the criteria that a person has
to display to get that diagnoses. So what are the symptoms a person must
meet to get a diagnosis? It is the thing that facilitates health insurance; the
DSM must recognize your illness. So it is very powerfully social.
Produced by the APA, disorders drawn up on by committiees. So you have a
committee on al the disorders. It means that, at some point people are sitting
around a big table and theyre deciding what counts and what doesn't count
surrounding mental illness. Thus these people have a very important task,
they decide who is sick and who is healthy.
What it doesn't do: it does not talk about cause because we do not know how
they are caused and treatment, the DSM does not talk about that either.
Where do day to day experiences fit into the DSM? Are disorders simply
extensions or more intense versions of common experiences like stress,
sadness, worry, distraction? Someone has to make a value judgment about
whter or not if a persons sadness etc., meets the criteria for a mental
disorders. Even more severe experiences, like psychosis (has delusions or
hilusinaion) are not entirely atypical.
Criticisms: lacks validity because we cant test for it in an objective way. The
symptoms change with each new DSM, we are now on DSM 5. It doenst tell
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much about personal experience, reduces highly personal experience to
simple checklist. Measures whether a person matches particular types of
disorders, does little consider broader notion of mental health. its restrictive.
How a Diagnosis is Formed
Diagnosis a result of interview more so than physical exam. They ask you a
bunch of questions and how you answer those will determine your diagnosis
so it goes past the body.
So usually asked about past life, to finish a scale (likert scale).
Thus, diagnosis primarily made by self-reporting, observations of friends and
family can figure into equation.
Results checked against DSM criteria, use of scales, clinical experience, etc.
What emerges is not objective fact, but rather an interpretation grounding in
value judgment. This doesn't mean its worthless but we have to understand
that context because if we don't were doing a dis service to the concepts.
Factors that drive Mental Health and Ilness
Social determinants: person’s location in their social life. So this includes
anything from the geography of neighborhood to income level to race and
class etc., these are major predictors.
Individual experiences: a person who enjoys success after success is more
like to be more mentally healthy and have positive self outlook
Biological factors: person genetics to traumatic brain injury.
We’ve create these binaries to define these things. Socially, we have
constructed labels to describe these experiences as health. Unhealthy,
dangerous/safe
As social constructions, our understanding about these issues differs
according to time and place. We should not assume universal portability to
concepts.
The Individual and Society
Mental health not merely experienced by the individual as social beings, it
describes relationships and connection to others.
Abnormality requires the presence of another person to deem it as such.
What might be signs of good societal mental health?
StabilitySocial cohesion Productivity
Bhutan and Gross National Happiness
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Document Summary

Line between physical and mental not as clear as dualists would assume, e. g. cause, experience, and symptom expression. Whether it"s how you experience these things (physical symptoms of depression, heart rate, respiration, nervous system may al reflect mental phenomena). Despite the links between body and mind, physical state cannot necessarily give an indication of mental health. Whether tense shoulders or shortness of breath, myriad explanations. Thus, mental health is almost entirely self reported because we cannot read the body we have to rely on first person accounts and this is signification because this changes everything. When we thin about medical signs they have been about objective reading of the body and to think about intrusmental things such as a thermom. Are important because it allows the doctors to tap into that persons body but with mental it depends on what the person has to say. So mental health enters the social world in a way physical health doesn"t.

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