Mental illness a serious
condition that can effect people in different ways. It can often have an effect
physically and also mentally. Mental illness can have an effect on our emotions
by effecting how we think and do certain things. It also can often effect how
we interact with other people , the way we handle stressful situations and
often the choices we make. In this essay I will explore some key concepts
impacting on people with mental health issues and their support.
These key aspects include
culture , age , stigma &discrimination,
People who face different
mental issues are often said to have abnormal behaviour/ thoughts to that which
is seen as a norm in the society they live in .
Abnormality is a term that
is difficult to define due to the wide range of behaviours displayed by
Subjective abnormality can
be defined as an individual feeling of abnormality, including feelings of
anxiety, depression and losing touch with reality. Szasz (1972) argues that
abnormality is created in order to label
people who do not conform to social norms or rules of different societies . The
American Psychiatric Society, for example, classified homosexuality as a mental
disorder until 1973 (Flanagan C et al ,2015).
Statistical Infrequency is
when the way an individual thinks and their behaviour is seen as abnormal
because it is not usual in the society which they are in (Cardwell,
The limitation of this
definition is that although some behaviours or traits may be rare or unusual,
it doesn’t take into consideration how desirable the particular behaviour may
be. For example using this term would mean that many people would argue that
someone with an IQ below or above the average level of IQ in society is
abnormal. However most would agree that, someone who has an IQ level above
the normal average wouldn’t be classified as abnormal in society, rather they
would be praised and acknowledged for it (Flanagan C et al ,2015).
There are four core ethics
which are essential to health care.
These are respect for
patient autonomy; the duty to act with beneficence; non maleficence; and
justice(Engelhardt H and Tristram J 1996). In order for these core ethics to be
properly met allowing patients to have the best possible care , it is essential for practitioners to understand
each patient and these key aspects have on their mental health and the support they receive .
Firstly cultural barrier and
misunderstanding between health care professionals and patients can have a
great impact on people with mental health issues and the support they receive.
This is because Social norms are specific to cultures,and may not be understood
by others when in a different environment/culture for example British
psychiatrists who are mainly male, white and middle class may not be able to
fully understand the behavior, emotions and motivations of individuals from
different cultural and social backgrounds.This could explain why Afro-Caribbean
immigrants are seven times more likely to be diagnosed with schizophrenia
Failure to Function
Adequately is when a person is
considered to have mental issues if they
are unable to cope with the demands of everyday life. They may be unable to
perform the behaviors necessary for day-to-day living such as self-care
and holding down a job(Cardwell,
Rosenhan & Seligman
(1989) suggest that the following characteristics define failure to function
adequately these are: Suffering, Unpredictably & loss of control,
Irrationality/incomprehensibility, Violates moral/social standards etc
It is important for health
professionals to understand the patients background to know whether they are
failing to act adequately according to the culture they are from before making
a diagnoses. Understanding the patients culture will help treatments to be best
tailored to suit them. Lack of understanding and awareness of the patients
origin can influence the individuals mental wellbeing and the support they receive.
It is important for
psychologists to understand the individuals culture in order to effectively
diagnose and support them. The article of unite for sight on the cultural
perspectives on mental health highlights how the view of mental illness may be
divided, even within the same culture.
Study by Abdullah et al.
(2011)explains how American Indians view mental illness. Some tribes do not
stigmatize mental illness, others stigmatize some mental illnesses, and other
tribes stigmatize all mental illnesses.This shows how even within the same
culture mental illness can be viewed differently. It is important for
practitioners to understand this and the influence it could have on the
individuals mental health, their
willingness to seek for help and ability to open up about their mental
illness (Flanagan C et al ,2015) .
Furthermore the differences in origins of the
health care professionals and their patients, may create misunderstanding of
the individuals mental illness and results in treatment often not been tailored
properly to meet the patients’ needs.
This could have an immense impact on the wellbeing of the patient if they are
misdiagnosed or given the wrong treatment plan to help them.
People from black and minority ethnic groups living
in the UK are more likely to be diagnosed with mental health problems, to be
admitted to hospital and to experience a poor outcome from treatment. It is
argued to be the case because often,
psychologists and their patient often come from different cultural backgrounds
, which makes it difficult for the
practitioner to know if what they are seeing is a symptom of a mental illness
or simply a different way of thinking, feeling or behaving linked to the
patient’s culture. This is why it is important for the health practitioner to
learn about their patients culture and consider the effects it has on them
before making diagnosis.
The psychologist needs to be
aware of how the culture the person comes from has an affect on their
experience of mental illness before
making a diagnosis. In the unite for sight article about cultural
perspective of metal health, Baley et al highlights how culture influences how
people view mental illness, for example African Americans have negative
attitudes towards health care professionals which is effected by their
religious beliefs, distrust of medical profession and communication barriers .
Knowing the impact this has on patients will help health care
professionals to better approach their
patients and being able to have a better understanding of the origin of the
patients behaviour before making a
Health care professions
should study the the social norms which
the individual is coming from and avoid making judgments and comparison based
of European social norms. Another articles by Dr Lea on cultural difference in
mental health , highlights the importance of taking into consideration the
social norms of the individuals culture before making a diagnosis as this also
differs from culture to culture .
A Recent immigrant to a
European country may seem abnormal and failing to function adequately, but
could just be facing the very different cultural landscape of their new home.
Practitioners needs to have an understanding of these multicultural issues in
order to detect whether the problem is one that need treatment or adjustment.
Must treatment systems are
developed in the West and cannot serve as a universal framework for all
cultures because what is deemed as abnormal could be normal in a another..
For example if an individual
said they could hear the voices of their dead ancestors ,Whether they would be
considered as mentally ill or not would depend on the country and culture they
lived in .
The psychologist should
avoid jumping to conclusions about the individual and what they believe to
avoid offending them. Misunderstandings or ignorance may be seen as a lack of
respect and lead to physical violence and other issues.
Gender is another concept
which has an impact on people with mental health issues and their
support.The article on 7 reasons why depression is more common in women outlines
how gender influences the likeliness of men and women developing depression .
It is essential for
practitioners to know how each sex is effected differently, in order to
effectively diagnose and help them individually. The treatment the individual receives
could be effected by whether they are male or female as the nature and effect
of the mental illness may be different for each gender.
Biological explanation for
depression explains why women are likely to develop mental illness. This is
because compared to men; women are more likely to develop depression based on
their genetic makeup. Compared to men, women’s
hormones are more likely to rise and fall irregularly especially around the
time of childbirth and at menopause. This
fluctuation in hormone levels is often associated with an increased risk of
developing depression Cave s (2005).
Depression is a chronic
disorder which has often been linked to symptoms relating to mental illness,
which if not treated immediately could lead to a poor quality of life. This is because it has a significant effect on the
individuals social life and ability to socialise effectively with others. It
can also have an effect on their
emotions and ability to control it , and can often also effects them physically and mentally.
Studies suggest that the interaction of both
the psychological and biological factors contribute to the progression of
depression (Flanagan C et al ,2015). Psychological explanation of depression
can occur as a result of prolonged exposure to countless negative life events which
builds up, until the personl is not able to cope anymore .
For example working in an
environment which is always stressful and demanding can often trigger
depression. People who are depressed are often likely to believe that they can’t
do anything to help themselves and therefore suffer for long periods of time
often without seeking the right help to support and help them. The majority of
people who are constantly working in stressful environments have a higher risk
of developing depression (Cardwell,
For example working in an
office in a stressful environment can lead to depression due to the demanding
nature of the work with heavy workloads and tight deadlines. This could then
make the person feel that they have lack of control over they work and can’t do
much about it. This feeling of lack of control would them unhappy and the
constant feeling of this lack of control and increased of dissatisfaction would
increase the likeliness of being depression.
According to the National
Institute of Mental Health around 5 percent of men reported that they had
experienced depression in the past year. However many have argued that this
percentage is not very accurate and should in fact be much more than the
findings suggest. A reason which may explain such a low percentage in the
number of men admitting to experiencing depression could be due to the pressure
which is put on men at work and at home to conform to the image of a macho man
who doesn’t show or talk about his feelings, unlike women who are often very
open about how they feel , which is why they are often represented high as
experiencing mental illness.
Men on the other hand often
hide how they feel and choose not to talk about their mental issues. From a
very young age men have been taught to suppress any feeling such as sadness as
it portrays them as weak. This means that even though depression is as common
among men as in women, often many are not willing to open up about it , which
again explains the low findings of men who admitted to being depressed .
“Male depression sometimes manifests through
the ‘male code’ that says you cannot show weakness, sadness, or vulnerability,”
This has a great impact on
their mental health and the support they receive because instead seeking for
help, men would tend to get angry at themselves and often throw themselves into
other things to avoid facing their mental issues, such spending more time on
their work or developing negative habitssuch as drinking or smoking .They see this
way of coping as more socially acceptable rather then sitting down with a stranger and opening up about
their feelings to get rid of it. “That’s
why, in part, women are diagnosed with depression more than men,” says
The University of Michigan did a research which surveyed more than 5,600 men and women . They
used symptoms which were most common in men as the basis for depression diagnosis. The result of
the findings showed that 26 percent of men met the criteria of symptoms of
depression compared to 22 percent of women. However when the traditional
symptoms of depression were used , more women fit the criteria than men.
This shows that gender has
an impact on mental issues and on the support which men and women get. Knowing
the effect gender has on individuals mental health can help practitioners provide better health
care for each individual (Flanagan C et al ,2015).
Stigma and discrimination
also have an impact on people with mental health issues and their support.
Although they are many
options and help available for people facing mental issues many people often don’t
seek for help due to the discrimination and stigma attached to mental illness,
instead get worse and suffer in silence. This is evident in the findings such
as that of 2011,which showed that a low percentage of only 59.6% of individuals
with a mental illness reported receiving treatment.
Stigma has a big influence
on the patient and the care they receive because the stigma associated with
those with mental illness can be used against them. The stigma associated with
those with mental illness can be used to exclude and marginalise those
suffering from it. This type of treatment can have an effect on the mental
health of the individual by making it harder for them to live with their mental
issues and to seek help in the future. Stigma can also have an impact on the treatment
and the way health care practitioners support individuals seeking help , for
example if a health practitioner has a stigma that patients suffering from certain
mental illness are more aggressive it may have an effect on the type of
treatment given to the patient. Stigma often also has an impact on those suffering
from mental illness as it can often prevent them from getting certain jobs
which they may be qualified to do , it
can further prevent people with mental health problems from playing an active
role in their community, which is the reason most people choose to not seek for
help and instead try to deal with their mental issues through other means such
as over drinking instead of being
labelled as mentally ill.
People in society often have
a stigma of people with mental health illness as being dangerous, aggressive, unpredictable,
responsible for their illness, or incompetent to be a member of society and
take part in certain things.This can lead to active discrimination, such as
excluding people with these conditions from employment and social or
educational opportunities which they may actually be able to do. In medical
settings, negative stereotypes can also have an effect on the treatment given
The displays of
discrimination as outlined above can become internalized, which means that the
person with the mental illness may begin to believe the
negative stereotypes and opinions of others and then start to believe that they will never
be able to fully recover, that they are undeserving of care, dangerous, or
responsible for their illnesses. This can make them have very low self-esteem
and make their mental illness worse .
Lastly lack of NHS funding
for the mental health department as a whole also has an impact on people with
mental health issues and their support.
Aneurin Bevan formally
launched the NHS on the 5th of July 1948
. It was founded on three main principles that have shaped its development in
the last sixty years. These principles are that it should meet the “needs of
everyone”, be “free at the point of delivery” and be based on “clinical need,
not ability to pay” . It came into place at a time when Britain saw health care
as essential especially during post war reconstruction where many would suffer
and die from minor and chronic diseases.
Prior to the reforms, the
poor often went without medical treatment, relying instead on sometimes
dangerous home remedies or on the charity of doctors who gave their services
free to their poorest patients.
Although the NHS has been
envied in the past by many and said
to be the best health system in the
world, With people now living on average at least 10 years longer than they did
in 1948, many critics argue that Nevertheless, although the NHS had developed,
transformed and improved the lives of
many. Certain groups of individuals such as those with mental illness were neglected.
This due to the NHS was focusing must of
its funds on physical illness.
Bevan argued that the mental
health service had been neglected , this
may explain why mental health is currently the biggest burden on the NHS, as
the attention it deserved was not given from the beginning.
Spending on mental health services
is being cut in five regions of England, new figures have revealed – despite
Government pledges to “transform” the way mental health problems are dealt
Theresa May has promised
to tackle the
“stigma” around mental health and NHS England said in February
last year an extra £1 billion a year should be invested in mental health
services by 2021.
But clinical commissioning
groups (CCGs) in Sefton, Scarborough, the Isle of Wight, St Helens and Walsall
are set to reduce spending on mental health by £4.5m, according to Freedom of
Information data obtained by Pulse magazine.