Context of Mental Health

This essay explores the key concepts related to mental health in the UK, including the definition, types, causes, effects, and approaches to treating mental health illness and support. It also covers the history and political changes to mental health services in the country.

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CONTEXT OF MENTAL HEALTH
by
Name of the Class
Professor
Name of the School
Date

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Introduction
The history of mental health in the UK is characterized by the confinement, mandatory
detention and mistreatment of mental patients who were always locked away in asylums. Before
the introduction of the Mental Health Act in 1959, mental health services in the country were
mostly governed by the Lunacy Act of 1890 which stated that all mentally ill patients should be
detained in mental asylums (Turner et al., 2015). The 1959 Mental Health Act did away with
mental asylums and compulsory detention, instead requiring all mental patients to be treated in
government run hospitals that were not under Board Control (Turner et al., 2015). In this essay, I
will explore the key concepts that are related to mental health with relation to the UK.
Definition of Mental Health and Illness
Mental health is a state of well-being where individuals realize and achieve their
potential, cope with stress and make meaningful contributions to society (WHO 2014).
According to Galderisi et al. (2015), this definition has lead to some misunderstandings because
well-being which is a key component of mental health is hard to reconcile with the challenging
situations that occur in life. Also, people can have good mental health but experience moments
of sadness, anger, grief or depression which further adds to the confusion (Galderisi et al. 2015).
Positive functioning which is part of the mental health definition can also lead to
misunderstandings and wrong conclusions especially for people with physical disabilities. This
group of people can be confused as suffering from a mental illness because they have a condition
that prevents them from being productive (Galderisi et al. 2015). The definition can also be
influenced by cultural backgrounds and religion where in some cultures people suffering from
mental problems are viewed as the undesirables in society (Galderisi et al. 2015).

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Types of Mental Illness/Disorders
There are many disorders classified under the DSM-5 criteria and of these is attention-
deficit/hyperactivity disorder (ADHD) which mostly affects children. It is mainly characterized
by inattentive behaviour, spur of the moment actions without thought and an excess of
movement not befitting the environment (American Psychiatric Association, 2015).This disorder
can disrupt the child’s development and cause undue stress on their parents. Behavioural therapy
can be used to treat and manage this disease (American Psychiatric Association, 2015).
Anxiety disorders are characterised by people having extreme feelings of fear, anxiety or
worry and they expect danger in the future. Examples are agoraphobia, social and separation
anxiety, generalized anxiety and panic disorders (American Psychiatric Association, 2013).
These disorders share the same symptoms which are extreme anxiety and fear, felt strongly by
the person despite the absence of a real threat or danger. Anxiety disorders can be treated with
medication and psychotherapy (American Psychiatric Association, 2015).
Schizophrenia is a personality disorder characterized by delusions, hallucinations and
disorganized speech. Delusions are seen to be bizarre and difficult to understand because they do
not arise from everyday life experiences. Hallucinations are vivid experiences that are perceived
to occur without any external stimulus affecting the person’s normal sensory and auditory
perceptions (American Psychiatric Association, 2013). Disorganized speech consists of
switching from one topic to another. Schizophrenia is mostly managed by taking medication and
talk therapy (American Psychiatric Association, 2013).

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Causes of Mental Disorders
While the exact cause of mental illnesses remains unclear, research into the field has
shown common causes of mental conditions to be social and/or environmental stressors,
psychological, physical and mental traumas or a history of mental illness in the family (Mind
Wise, 2018). The physical causes deal with the genetic composition of an individual and whether
this can lead to mental disorders. It also deals with whether their exposure to brain injuries or
traumas can alter their personality and in a few cases trigger mental illness (Mind, 2013). Head
injuries or a pre-existing neurological condition can also affect the behavior and mood of a
person leading to mental disorders (Mind, 2013).
Psychological traumas refer to traumatic experiences that have occurred in the past or
present which impact heavily on an individual’s mental and emotional health (Mind Wise, 2018).
Examples of these are sexual, physical or emotional abuse, social isolation, neglect and long-
term stress (Mind, 2013). Social and environmental stressors are those that exist in an
individual’s living and working environment that influence their mental health. Stressors such as
poverty, homelessness, debt, isolation, unemployment and bereavement can put significant
pressure on a person’s well-being (Mind Wise, 2018).
Effects of Mental Illness
People with moderate to severe mental illness face a reduced quality of life, lower
productivity, social problems and susceptibility to drug abuse. Mental disorders also lead to
unemployment, absenteeism and low productivity at work. A research study conducted in 2001
found that five to six million workers in the US between the ages of 16 to 54 years lost
employment or failed to seek work because of a mental disorder (Unite for Sight, 2015).A

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reduced income and lack of employment increases the risk of poverty and it has been linked to
high rates of homelessness amongst the mentally sick (Unite for Sight, 2015).
Mental disorders also affect the family because it is burdensome caring for a mentally ill
person. The expenses that come from treatments and other healthcare costs place a financial and
economic strain on the patient’s family. They cannot work at full capacity because their time is
mostly spent caring for their sick family member (Unite for Sight, 2015). Untreated mental
disorders place significant economic and financial costs to the society. WHO estimates for 2001
showed that the healthcare expenditure of treating mental disorders cost developed countries 3%
to 4% of their gross national product (Unite for Sight, 2015).
Approaches to Treating Mental Health Illness and Support
In my research, I found cognitive behavioural therapy (CBT) as one approach that is
effective for treating anxiety and depression (Langrial, 2018, p.7). CBT is based on the notion
that because certain cognitive functions can be intentionally modified through cognitive
restructuring, it is possible to change the person’s irrational thoughts to more rational and
balanced ones, leading to positive behaviours and relief from their symptoms (Langrial, 2018,
p.3). Psychiatric medications are the most commonly used treatment for mental patients. It
should be noted that these drugs are used to relieve the symptoms associated with mental
diseases and are therefore not a cure (Mind, 2017). Examples are antidepressants used to treat
depression, anxiety disorders and obsessive-compulsive disorders; antipsychotics which reduce
distressing symptoms associated with schizophrenia and psychosis; mood stabilizers like Lithium
which treat bipolar disorder and mania (National Institute of Mental Health, 2016).

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Creative art therapies can also be used as a form of support and treatment where patients
use music, painting, dancing or drama to express their feelings in an environment supervised by
a mental professional (Mind, 2017). Mind-body approaches such as acupuncture, yoga, hypnosis,
and meditation are alternative forms of treatment that focus on both the mind and body (Burnett-
Zeigler et al., 2016). Traditional healers and religion also form part of mind-body
complementary approaches to treatment. These treatments have increased in popularity and
based on patient reviews, mind-body treatments such as Yoga have been found to be more
effective in improving and reducing symptoms associated with depression and anxiety (Burnett-
Zeigler et al., 2016).
The religious approach in mental health offers spiritual guidelines that help patients set
up a plan for their lives. Having religious faith allows patients to handle the stresses and strains
that come with their condition (Behere et al., 2013). Meditation is a common religious practice in
the Hindu community and it is seen to be an effective tool in managing mental symptoms
because it reduces stress, tension and anxiety as well as improve symptoms associated with
depression, panic attacks and anxiety disorders (Behere et al., 2013).
Rationale for Treatment
The prevalence of mental disorders globally has gone up over the years. Despite this,
many people who suffer from mental conditions don’t seek help. One of the major reasons for
this is the stigma that surrounds mental diseases (Lehigh Center, 2018). Stigma refers to the
negative attitudes people have that create a barrier to the effective treatment of mental
conditions. A study done by the Journal of Health psychology and Behavioural Medicine in 2014

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found that stigma was the main reason patients refused to seek treatment for their condition
(Lehigh Center, 2018).
Research has shown that getting timely treatment is important especially in reducing the
severity of the disease. For example, studies on schizophrenia have shown huge differences in
patient outcomes reliant on how quickly the patient began treatment for their first psychotic
episode (Giliberti, 2017). Getting treatment for mental conditions helps patients manage their
condition and also improve their quality of life. People can go back to their normal routines and
experience improvements in their work, educational and personal lives (Lehigh Center, 2018).
Role of the Mental Health Nurse
Mental health nurses or psychiatric nurses provide healthcare to mental patients by
establishing therapeutic relationships with the aim of aiding their recovery. These nurses work
beside psychiatrists and other mental health clinicians to develop treatment plans and help
diagnose mental disorders (Drew 2014). Mental health nurses have training in asking appropriate
questions which help them in diagnosing mental illnesses. Diagnosing mental disorders is
different from other medical conditions because the diagnosis is based on the information
supplied by the patient. In medical conditions, the diagnosis is based on both the patient’s
information and a physical assessment (Drew, 2014).
Once the patient has been diagnosed, the nurse develops a care plan which incorporates
the patient’s needs to effectively treat their condition. Some mental health nurses have the ability
to prescribe medication to patients without a psychiatrist’s supervision or approval. These nurses
can also offer primary care services such as psychotherapy, counselling and health evaluations
without the presence of a psychiatrist or physician. They are referred to as mental health

Context of Mental Health 8
advanced registered nurses who have undergone specialized training in mental health diagnosis
and treatment (Drew, 2014). Other roles of mental health nurses include; working with patients
in industrial therapy, working with social workers and public health nurses in the community and
engaging in the therapeutic relationships that are individual or group-based (Jones, Fitzpatrick
and Rogers, 2012)
History of Mental Health
The history of mental health in the UK is characterised by three things; de-
institutionalisation, development of care models and expansion of mental health services to meet
the community’s needs. De-institionalisation occurred in the 19th century during the industrial
revolution where publicly owned county asylums were constructed to house the mentally ill
(Gilburt et al., 2014). These institutions housed over 150,000 patients by 1954, making them
very overcrowded and underfunded. The introduction of advanced treatment such as
antipsychotic drugs in the 20th century made it possible for more people to be treated in the
community instead of the asylums (Gilburt et al., 2014).
The expansion of mental health services into the community led to the introduction of
care models such as the single care models to help patients with severe mental disorders in the
community (Gilburt et al., 2014, p.5). The care model offered intensive support for patients who
had complex needs within the community, home treatment and support so as to avoid the
admission of these patients into a health facility and early intervention teams who were able to
treat people experiencing their first psychotic episode (Gilburt et al., 2014, p.5). The expansion
of mental health services occurred because of community services that were designed to

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intervene during the early stages of an individual’s illness and also help patients within the
community manage their symptoms in a better way (2014, p.5).
Political and Current Changes to Mental Health
Mental health services have undergone rapid changes in the last 50 years with many
advances in the treatment of psychiatric disorders and a greater emphasis on protecting the basic
human rights of all mental health patients. This transformation has seen the shift from treating
mental patients in institutions to a community or home-based environment (Gilburt et al., 2014,
p.16). While there have been many changes, healthcare services in the country have been unable
to keep up with the increasing population, the burden of mental disorders and public expectations
of better healthcare. In the next 20 years, health and social services in the UK will face
significant financial problems, with a gap of 30million pounds by the year 2021 (2014, p.16).
The UK government has come up with mental health reforms to address issues that are
related to mental illness and improve delivery of healthcare to patients. The 2010 to 2015 mental
health service reform prioritizes mental health by improving access to services, reducing patient
wait times in NHS facilities, making mental health a priority for Public Health England
(Department of Health and Social Care, 2015), allocating 400 million pounds for psychological
treatments and providing 16 million pounds in funding for the Time to Change campaign for
over a period of four years to fight against the stigma associated with mental patients
(Department of Health and Social Care, 2015).
Tidal’s Model, Orem’s Nursing Theory, the Biomedical and Biopsychosocial Model
Dorothy Orem’s Self-care Deficit theory focuses on self-care deficiencies of patients
especially in psychiatric nursing. The theory recommends that patients who are unable to take

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care of their hygiene, safety and nutrition because of their illness require nursing care (Pehlivan
and Guner, 2016, p.103). Some concepts of the model are self-care, self-care agency, dependent-
care deficit, therapeutic relationships, nursing agency and systems (Ali, 2018, p.2).
The Tidal Model is based on the premise that the patient’s journey to recovery is assisted
by healthcare professionals who go through the experience together with the patient (Happell et
al., 2013, p.41). Major aspects I discovered were that the patient is at the centre of the care
process and their experiences define their understanding of the illness. Therapeutic relationships
are focused on shared decision-making and collaboration as well as a holistic assessment of the
patient and their illness (Happell et al., 2013, p.41).
The biomedical model focuses on the mechanisms that cause diseases and assumes that
psychological and social factors are not important when treating patients. This model is seen as
traditional because it’s strictly concerned with organ malfunction instead of the patient as a
whole (Farre and Rapley 2017). The biopsychosocial model was developed to challenge the
biomedical model by introducing social, psychological and behavioural factors which were seen
as contributors to illness. This model would allow clinicians to evaluate all the contributors to
disease instead of only focusing on biological factors (Farre and Rapley 2017).
W.H.O Global Policy on Mental Health
The World Health Organization (2018), views mental health policies as important in
coordinating services and activities meant to deal with mental disorders. These policies define
the future of mental health for the world’s population by identifying the frameworks that will be
used to manage and treat mental illnesses. Clearly conceptualized mental health policies are
meant to coordinate healthcare services to ensure patients receive proper treatment for their

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condition while preventing ineffective healthcare systems (WHO, 2018). Three
recommendations developed by WHO that are important in policy development for mental health
include; the deinstitutionalization of mental healthcare, the development of community services
that are focused on mental health and the integration of mental health into general healthcare.
Recovery in Mental Health
The concept of recovery has many definitions in mental health. One definition is that
recovery encompasses a full remission of symptoms where the individual is able to actively
engage in work or education and live independently without any supervision for a period of two
years (Slade, Oades and Jarden, 2017, p. 24). Another definition views recovery as a personal
process that is unique to an individual’s feelings, attitudes and beliefs, providing a way for them
to live a satisfied, hopeful and fulfilled life despite the limitations of their disease (2017, p.25).
Recovery in mental health is a term that has two different meanings which are clinical recovery
and personal recovery.
Clinical recovery means that a patient has recovered from their illness and it is guided by
four key features which are; the recovery is seen to be an outcome or a state, it is rated by a
clinician with experience in the field, it is objective rather than subjective and the definition of
recovery is the same for all patients (2017, p.24). Personal recovery differs from clinical
recovery because recovery is defined by the person, making it subjective rather than objective
(2017, p.25). It is seen as a continuous process that is rated by the patient who is regarded as the
expert and it has a different meaning to various people despite the fact certain aspects are shared
amongst many people (Slade, Oades and Jarden, 2017).
Discussion

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In my research I discovered that stigma was a key factor that affected many mental
patients worldwide because despite the continued awareness of mental health, many people in
society still discriminate on people with mental disorders. Currently, over 40% of people in the
world have been diagnosed with a mental disorder and only a third of that percentage has
received treatment (Gaebel, Rossler and Sartorius, 2017). These statistics basically mean that
everyone around the world knows someone with a mental illness. But despite this, there have
been no significant changes in the stigmatization of mental patients.
In my analysis of stigma, I found that it takes two forms which are social stigma and
perceived or self-stigma. Social stigma refers to how society’s prejudiced attitudes and
discriminatory behaviour are directed towards people facing mental problems (Davey, 2013). In
understanding social stigma, a survey conducted by Crisp et al. in the UK of over 1700 adults
found that they believed mental patients to be dangerous and that some of their conditions were
self-inflicted, especially those with eating disorder. More recent research has also shown that the
public believes mental patients are unpredictable and dangerous especially if they are
schizophrenic (Davey, 2013).
But what causes stigma? I found that stigma is a concept that dates back hundreds of
years and throughout history, mental patients were always treated badly and differently. Such
treatment came from misguided views that they were possessed by the devil, were more violent
and unstable than normal people (Vrklevski, Eljiz and Greenfield, 2017). So how can we change
these perceptions? In the UK, there is a campaign known as “Time to Change” which attempts to
address stigma by raising awareness of mental health through audiovisuals. There are also
campaigns by trained mental health professionals and mental patients to interact with members

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in the society to improve their attitudes towards mental health and promote anti-stigma
behaviour (Davey, 2013).
Conclusion
The focus of this assignment was on key concepts that are related to mental health.
Mental health deals with the emotional and psychological well-being of individuals, affecting
their behaviour, emotions, thoughts and actions. Many people suffer from mental health
problems and about a third of these people don’t receive treatment for their disorders. As I found,
a major reason for this was stigmatization from the society. Creating awareness of mental health
conditions will go a long way in reducing stigma and encouraging mental health patients to seek
treatment. Also, the introduction of mental health days in workplaces around the world is
encouraging more people to focus on their mental health and seek help if they are mentally ill.

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