/
Public Mental Health Public Mental Health

Public Mental Health - PowerPoint Presentation

pasty-toler
pasty-toler . @pasty-toler
Follow
370 views
Uploaded On 2017-12-13

Public Mental Health - PPT Presentation

Dr Anindya Das AIIMS Rishikesh Disclaimer Open as read only file when asked for password Learning objectives Role of extramedical measures in influencing health gains in general Social determinants of health SDH ID: 614835

mental health disorders amp health mental amp disorders suicide social life ref unemployment mortality sdh source disease mckinlay determinants public study services

Share:

Link:

Embed:

Download Presentation from below link

Download Presentation The PPT/PDF document "Public Mental Health" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript

Slide1

Public Mental Health

Dr. Anindya DasAIIMS Rishikesh

Disclaimer: Open as read only file when asked for passwordSlide2

Learning objectives

Role of extra-medical measures in influencing health gains in generalSocial determinants of health (SDH)Definitions of health and mental healthBurden of disease study and mental healthSDH and mental healthMental health services in IndiaPrevention in Mental HealthSlide3

Public Health

≈ 70%↓mortality Ann decline rate: .22/1000

.04/1000

`40%

Ref:

McKinlay

JB,

McKinlay

SM. The questionable contribution of medical measures to the decline of mortality in the

US in

the

20

th

century

. Milbank Memorial Fund Quarterly Health & Society. 

1977;55:405-28

.

(90% of

↓ prior to 1950)Slide4

Ref:

McKinlay JB, McKinlay SM. The questionable contribution of medical measures to the decline of mortality in the United States in the twentieth century. Milbank Memorial Fund Quarterly Health & Society. 1977;55:405-28.Public HealthSlide5

Social determinants of Health

Health equitySocial stratificationLife course perspectiveIssue of globalizationSlide6

defining Health

Critiques: “state” vs dynamic interacn. btwn individuals’ potentials, life’s demands & social/environmental determinants“complete”… unrealistic (e.g. chronic disease) “….mental /social/emotionl./spiritual/cultural wellbeing” ?? spiritual doubt, aging, poverty, crime can be medically treated?Slide7

Mental Health

Cultural relativism“MH is a state of well-being …[to] realizes [one’s] own potential, …[to] cope with the normal stresses of life, …work productively & fruitfully, & …contribution to …[one’s] community”Subjective wellbeingPerceived self-efficacyAutonomyCompetenceIntergenerational dependenceSelf-actualizing of ones potentialSlide8

Burden:

DALYDALY: Years of life lost due to premature mortality (YLL) in the population + the years lost due to disability (YLD) for incident caseYLL= number of deaths at each age á X standard life expectancy at age áYLD= prevalence of different disease/injury sequel X disability weight for that sequel World Health Report, 2010Slide9

2010 mean ranks among health conditions that cause disability, global estimate, all age groups

Available at:

http://vizhub.healthdata.org/irank/arrow.phpSlide10

Prevalence of major mental disorders: India

DisordersPrevalence rate / 1000 populationMood, stress related & anxiety disorders12.3 - 20.7Disorders of childhood

16.5

Psychoactive substance use

6.9

Personality disorders

2-10

Development Disorders

4.2 (1.4 - 25.3)

Psychotic disorders

2.7

Organic disorders (dementia, delirium)

0.4

Ref: Reddy &

Chandrashekhar

1998,

Murali

2001, Anita 2003, NCMH 2005,

Saha

2005Slide11

All mental disorders: 13% global burden of disease

Leading cause of death 15-45 yrs.: suicideInverse care law treatment gap serious mental disorders HICs: 35.5-50.3% LMICs: 76.3-85.4% (Ref: World Mental Health Survey, 2004) Slide12

Inequality and

Mental Illness12r = 0.73 Income inequality & proportion of adults mentally ill in the prior 12mts. in rich countriesSource: Prickett & Wilkinson. Inequality: an underacknowledged source of mental illness and distress. BJP; 2010Slide13

Unemployment & suicide

136mts. time advanced non-leniar relationship of suicide to unemploymenthigher effects for lower baseline unemployment ratesRR of suicide X unemployment was

↑by

20–30% in all world regions

Source:

Nordt

et al.

Modelling suicide

& unemployment

: A longitudinal analysis covering 63 countries,

2000-11.

The Lancet

Psychiatry

;

2015Slide14

Source

: Rubio-Codina et al, London: Mimeo Institute for Fiscal Studies, 2013.14SDH and Mental Health (MH)Slide15

Interrelationship of mental & physical disorders

Premature mortality in mental disorders (in developed nations die ≥10 years younger than general pop.) (other than from suicide/ substance use disorders)Adverse health behaviour: also patterned by SDHIatrogenic effects of psychotropic useDiscrimination in general health services: availability & use?? Additional explanationsStudy of Nordic mental health system & deinstitutionalization (Ref: Wahlbeck et al, Outcomes of Nordic mental health systems: life expectancy of patients with mental disorders. BJP; 2011)Slide16

Mental health services

Evolution of the community mental health program in IndiaDe-institutionalization movementNational Mental Health Program, 1982 Mental Health Act, 1987→ 1993 Erwadi fire incident, 2001 NHRC commissioned study of mental hospitalsMental Health Care Bill/Act (2017)Global Mental Health for LMIC/Scale up strategiesSlide17

Prevention

Mothers: pregnancy & perinatal periodParenting skill, child-parent interaction, early stimulationGrowth monitoring &nutrition of children: cognitive capacityChildren & adolescentsschool based programs for building resilience, life skills trainingSuicide prevention: access to meansAlcohol policiesSocial DeterminantsSlide18

Thanks

Bibliography:Oxford Textbook of Public HealthNew Oxford Textbook of Psychiatry