LIFE SPAN APPROACH TO POSITIVE MENTAL HEALTH BY: DR SNEHAL MODERATOR: DR RANJAN SOLANKEY.

LIFE SPAN APPROACH TO POSITIVE MENTAL HEALTHBY: DR SNEHAL MODERATOR: DR RANJAN SOLANKEY

WHAT IS A LIFE SPAN ?

Infants and young children (0-5 , 6-11)

Young people / adolescents/ entering adulthood (12-17 )

Young adults / child rearing age (18-15)

Middle age( 36 -64)

Older people /retirement (64-80 , 80+)

Life span from 0 – 103 years

WHAT IS MENTAL HEALTH ?• A state of well-being in which the individual realises his or her

own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

(World Health Organization ).

WHAT IS MENTAL HEALTH PROMOTION?• Mental health promotion aims • To promote positive mental health by increasing psychological

well-being, competence and resilience, and • By creating supporting living conditions and environments

[while] . . . • Mental disorder prevention has as its target the reduction of

symptoms and ultimately of mental disorders. • Mental health promotion when aiming to enhance positive

mental health in the community may also have the secondary outcome of decreasing the incidence of mental disorders.

• (World Health Organization 2004a: 17)

Five key principles of health promotion:

• It should involve the population as a whole rather than focusing on people at risk for specific diseases.

• It should be directed towards action on the determinants or causes of health and required therefore, cooperation of sectors beyond health services.

• It should combine diverse, but complementary, methods including communication, education, legislation, organizational change and community development.

• It should aim at effective and concrete public participation. • Health promotion was not a medical service but health

professionals had an important role in nurturing and enabling it and had a special contribution in education and health advocacy.

The key action elements of health promotion • Building healthy public policy• Creating supportive services • Strengthening community action • Re-orienting health services • Developing personal skills

How does mental health promotion work? • Strengthening individuals: increasing emotional resilience

through interventions designed to promote self esteem, life and coping skills, such as communicating, negotiating, relationship and parenting skills.

• Strengthening communities: this involves increasing social inclusion and participation, improving neighbourhood environments, developing health and social services which support mental health, anti-bullying strategies in schools, workplace health, community safety, childcare and self-help networks.

• Reducing structural barriers to health: through initiatives to reduce discrimination and inequalities and to promote access to education, meaningful employment, housing services and support for those who are vulnerable

INFANCY AND CHILDHOOD (0-5YRS AND 6-12YRS)

WHY CHILDREN?• A focus on mental health in childhood is important for

childhood itself as well as building a foundation for the whole of the lifespan.

• There are historical and contemporary differences in conceptions of the nature of children and childhood.

• A number of disciplines, including psychology and sociology have contributed to the theory of childhood.

• A balance has to be reached between meeting the protection needs of children and allowing the development of autonomy.

• There is some commonality between key concepts of the ‘new paradigm’ of childhood and health promotion.

indicators of positive child mental health

• Individual and family • Individual: sense of belonging; self-esteem; engagement, self-

determination; control and quality of life; resilience; empowerment.

• Family: parental mental health; freedom from violence; family cohesion; parent– child attachment; use of appropriate parenting practices; providing safe, secure

• Organizational and community• Safe supportive environments; quality of social and learning

environments to enhance development of self worth and skills; children’s rights met; presence of policies to promote equity and justice, ensure child protection and minimize violence and bullying.

Societal indicators of positive child mental health

• Societal indicators of positive child mental health • Resource poor countries: access to essential requirements of

water, adequate food and safe shelter; primary education and primary health care; protection against conflict and violence.

• Countries with basic resources: equity and social participation for parents; societal valuing and protection of children; integrated and supportive child public health policy; strong legislative platform for child mental health issues; adequate resource allocation for child mental health

Determinants and influences of child mental health

CHALLANGES• problems at school; • isolation from children of the same age and other family

members; • lack of time for play, sport or other leisure activities; • conflict between the needs of persons being helped and their

own needs, leading to feelings of guilt and resentment;• feeling that there is no one there for them, that professionals

do not listen to them; • lack of recognition, praise or respect for their contributions;• feeling that they are different from other children and unable

to be part of groups; • feeling that no one else understands their experience.

WHAT TO DO ?• FOR 0-5 YRS

• Preparation for parenting • Physical health

• FOR 6-12 YRS• Environmental actions to facilitate mental health promotion in

this age group

COMMUNITY PROGRAMES

Child to child School based programmes

• Culturally relevant programs• Antibullying interventions• Child experiencing major life events• Children in health care setting

INTERVENTIONS

Books for young children Training of teachers

ADOLESCENCE AND EMERGING ADULTHOOD (12-17YRS AND 18-24YRS )

WHY ADOLESENCE ?• A major mental health issue for young people is experiencing

bullying and harassment. • Discrimination and social exclusion in varying forms are highly

correlated with mental health problems• One in twenty young people worldwide experience

developmental, emotional or behavioural problems. • Young adults have particularly high levels of mental health

problems and illnesses. • Viewing young people through the lens of risk limits mental

health promotion action. • Intersectoral action is crucial for mental health promotion for

young people. • Labelling young people in terms of risk and problems can be

stigmatizing.

DETERMINANTS• Personal• Social • Impact of gender• Education• School to university transition • School to work transition • Economic• Builts evirontment

CHALLENGES• Absence of attention to the needs of particular groups who

fall into a gap in accessing mental health services because of their age

• Source of vulnerability is life circumstances that create adver- sity

WHAT TO DO ?• Developing social, emotional and behavioral skills• Working with young people• Reach out• Kids help line• Building a data resource for mental health promotion

ADULTHOOD: INCREASING RESPONSIBILITY AND MIDDLE AGE(25-45YRS AND 45-65YRS )

WHY ADULTHOOD ?• Adulthood presents particular demands, responsibilities and

achievements• As with other age groups, accounts of the state of mental

health frequently start from consideration of its converse – ill health

• Suicide is a major contributor to mortality from all causes in some age groups and an important public health concern

WHY ADULTHOOD ?• Increasing responsibility, 25–45 years: • having and bringing up children; • workplace security/insecurity; • relationship issues

• Middle-age, 45–65 years• bringing up a family; • work and community responsibilities; • caring for ageing parents; • preparing for retirement

• Adulthood, 25–65 years:• changing family structures;• individual and social transitions, life events; • age/sex/race discrimination; • conflict and violence

DETERMINANTS

WHAT TO DO ?• Parenting• Workplace• Loss of employement• Domestic violence• Community based programmes• Good housing, architecture, space and design• Homelessness• Exercises• Informal carers

INTERVENTIONS

Family support Mass media

OLDER PEOPLE: THE RETIREMENT YEARS (65-80YRS AND 80+YRS )

WHY OLD AGE ?• Although many mental health issues span all age groups, there

are some that are of greater relevance at this stage in people’s lives.

• In the 65–80 year age group retirement is a major factor which impacts on people’s mental health

• Other factors include deterioration in physical capability and health, changing environments (for example moving home), and the sense of loss of social, physical or psychological factors.

• For people aged 80 years and over the sense of loss may become more chronic through the loss of their partners or close friends, their functional ability and a sense of purpose in life.

CHALLENGES• Although many mental health issues span all age groups, there

are some that are of greater relevance at this stage in people’s lives

• For people aged 65–80:• Retirement; positive active ageing or loss of social networks and a

role in life. • Deterioration in physical capability and physical health.• Changing environments, moving home.• Sense of loss; of social networks, ‘significant others’, physical

capability, or perceived belonging.

• For people aged 80 years and over:• Sense of loss more chronic; loss of ‘significant others’; sense of

purpose; and loss of independence• Loneliness and social isolation.• Caring for someone with dementia or someone who is becoming

increasingly frail. • Facing end of life; dealing with bereavement, death and dying.

DETERMINANTS• Social determinants, such as education, literacy, human rights,

social support, prevention of violence and abuse. • Factors in the physical environment, such as urban/rural

settings, housing, injury prevention. • Personal determinants, such as biology and genetics,

adaptability. • Economic determinants, such as income, work, social

protection. • Health and social services, such as health promotion, disease

prevention, long-term care, primary care. • Behavioural determinants, such as physical activity, healthy

eating, cessation of tobacco use, control of alcohol problems, inappropriate use of medication.

WHAT TO DO ?

Home support Group activites Exercise and Music

Carers support Volunteering Computer technology

LIFE LONG LEARNING

INTERVENTIONS• Rasing awareness• Care for older people• Community involvement• Prevention of depression• Supporting independence• Supporting isolated older people• Sucide prevention

References• A Report of the World Health Organization,Department of Mental Health and Substance Abuse in

collaboration with the Victorian Health Promotion Foundation and The University of Melbourne 2004.

• RISKS TO MENTAL HEALTH: AN OVERVIEW OF VULNERABILITIES AND RISK FACTORS ,Aug 2012.

• Mental Health Promotion A Life Span Approach: Mima Cattan and Sylvia Tilford, Berkshire England 2006.

THANK YOU