Learn how social factors promote mental health, influence the onset and course of mental illness, and affect how mental illnesses are diagnosed and treated. This course explores how our understanding of mental health and illness has been influenced by social attitudes and social developments in North America and around the world. The course begins by situating our contemporary mental health practices in historical context, then looks at different aspects of mental health, mental illness and mental health services and their connections to what’s going on in our social environment.
2.1 defining mental health
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En provenance du cours de University of Toronto
The Social Context of Mental Health and Illness
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What is mental health and what causes mental illness?
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Charmaine WilliamsAssociate Professor
Faculty of Social Work
Okay. We're going to start off by spending a
bit of time talking about the definition of mental health.
I find it's one of those terms that gets used to mean a lot of different things,
so it's helpful for us to have a sense of how we're using it in this course.
In this course, we'll be talking about mental health as
the mental component of an overall experience of health.
As we move through the course, you'll see that the division between mind and body,
mental and physical can sometimes feel kind of like an illusion,
but it can be helpful to make distinctions between what people are
experiencing physically and what they're experiencing mentally.
As the World Health Organization definition indicates, health refers to a
state of complete physical, mental, and social well-being.
They emphasize that it's not merely the absence of disease.
This is an important emphasis, because it communicates that health isn't just like
the opposite of illness and it also tells us that being free of a specific illness
or diagnosis is not enough for us to assume that a person is in a state of
health. These are actually very important ideas
that are being put forward in this definition.
I would also like to think that it suggests that the presence of an illness
or a diagnosis is not enough to suggest that a person is not able to also still
be experiencing aspects of health. And in fact, as you'll see, health has a
role to play in how people are able to deal with experiences of illness or
disease. Definitions of mental health have
responded somewhat to this overall focus in health care on well-being.
for example, we are seeing a lot of people moving towards definitions of
mental health that adjust the need to really make a clear distinction between
well-being and illness. In this paper that I'm signing here and I
will put the reference for that in the resource list they suggest that wellness
is defined in the ways that you see here. The emphasis is really on a person's
outlook, a lot of it's about being positive about
things and feeling enthusiastic about life,
feelings of self efficacy and confidence. These all seem like really good things,
positivy, autonomy, realistic assessment of your limitations, being able to cope
with stress. I mean, it all sounds good.
One of the things that I'm struck by, however, when I read it, is that it
really seems to be quite embedded in assumptions about individualism and
rationality that really reflect the cultural context in which this particular
definition of wellness was produced. In this case, we're talking about the
United States. If you think about the definition that
the World Health Organization developed, which I assume reflects an international
cooperative process they're thinking about social, physical, and emotional
well-being. It seems a little less vulnerable to
being culturally bound in a way that this one is.
However, I still think there is quite a bit of, of, of usefulness in ideas that
they're putting forward here because really, it's showing us that wellness is
something that is separate from what might specifically be going on with you,
physically. they further make the specific
distinction here that illness and mental illness really refers specifically to the
presence of disease. So they are putting these forward as two
separate dimensions, wellness and illness.
So in fact, it's possible to be dealing with a mental illness or disability while
also experiencing many components of wellness, as we already discussed.
mental illness is specifically defined as the diagnosis of a condition that affects
cognition and motion and behavior. I actually really appreciate that they
use the term diagnosis here, because given how unclear we are, and you'll see
this, how unclear we are about what mental ill,
illness is and why it happens on all those things really, mental illness at
this point in our history is, is defined by that diagnosis.
[LAUGH] That's the clearest thing that we have.
So really, they're saying that the diagnosis of the condition is what
defines mental illness. And then, disability refers to the types
of limitations that may occur or may be part of a person's experience because of
the experience of illness. So let's take a look at these two
diagnoses together. If you look at illness, which is defined
in terms of a specific diagnosis of a condition with specific markers, and
wellness that's about feeling positive and being able to cope and feeling able
to be autonomous. it's clear that they're very different
things. You can also see quite clearly that the
presence of illness can have an influence on the experience of wellness, but
wellness can also have an influence on the experience of illness.
So again, they are separate dimensions but certainly related to each other.
[SOUND] These also suggest that the recovery emphasis that we now see in the
way they we're talking about mental health and mental health treatment is
based on an understanding of this relationship between wellness and
illness. They see specifically that, when we talk
about recovery a recovery works by using health and wellness to compensate for or
lessen the difficulties that maybe experienced due to illness and disease.
There's certainly a lot of research that supports belief that promoting mental
health can make a difference in the experience of illness or disease.
Programs of what are being called positive mental health have been shown to
positively influence physical health, to positively influence the course of
illness, including mental illnesses like schizophrenia.
And there's also research that shows positive mental health interventions make
a difference on actual biological functioning, things like hormone levels
and brain function. [SOUND] Another aspect of positive mental
health that I think has had a huge influence is things like
mindfulness-based stress reduction and I have Jon Kabat-Zinn's names there,
because he's really somebody whose name is associated with this mindfulness-based
stress reduction. and it's his definition that I've got
there about mindfuless, meaning that we are paying attention in a particular way.
It's something that is it's hard to define,
you know, within the scope of a lecture like this.
But basically mindfulness has taken ideas that
originated in contemplative religious practice, mostly Buddhism, but there's
certainly contemplative traditions in many religious traditions, and, use that
to develop strategies that people can use to reduce their stress levels.
And the research on this has been really good in terms of demonstrating a positive
health outcome for people with all kinds of of illnesses and disorders.
So, if you are interested in mindfulness, I would, I would recommend just going to
the web and putting the term and there's lots of stuff there about it.
And there's also lots of stuff that talks about the research that shows the
incredible impact that this particular type of positive mental health
intervention has had on people's ability to feel well and feel well, even in the
context of having an illness or a disease.
So, that's the definition of mental health.
Next, we're going to talk about how we think about what is mental illness.
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