INSET_Discussant_Mental Health Awareness Program.ppt

Mental Health Awareness for Teachers and Students

4. ‘Health is a state of complete physical, mental
and social well-being and not merely the
absence of disease’ (WHO, 2008 – Mental
Health)
Wellbeing: Reflects values, norms human needs
etc. as perceived by people themselves (Diener
and Suh, 2000; Prlleltensky et al. 2000; Myers
et al. 2005).

5. 
Understandings of ‘mental health’ and ‘mental illness’ Understandings of ‘mental health’ and ‘mental illness’
determined by meanings given to experiences and determined by meanings given to experiences and
feelings in a context of people’s culture feelings in a context of people’s culture (Marsella and White, (Marsella and White,
1982; Kakar, 1984; Kleinman, 1988a,b; Gaines, 1992; Fernando, 2002).1982; Kakar, 1984; Kleinman, 1988a,b; Gaines, 1992; Fernando, 2002).

Mental health is not just a Mental health is not just a technicaltechnical matter but matter but
connects with ways of life, values, and worldviews that connects with ways of life, values, and worldviews that
vary across cultures.vary across cultures.

Understanding of ‘wellbeing’ (in development studies) Understanding of ‘wellbeing’ (in development studies)
reflects range of human experience - social, mental, reflects range of human experience - social, mental,
spiritual, material. spiritual, material. (Chambers 1997).(Chambers 1997).

6. Community perceptions of mental Community perceptions of mental
health and wellbeinghealth and wellbeing

Material wellbeing Material wellbeing

Social wellbeing Social wellbeing

Security Security

Physical, mental and moral/spiritual Physical, mental and moral/spiritual
wellbeing wellbeing

7. Material wellbeingMaterial wellbeing

having stable having stable
employment/livelihoodsemployment/livelihoods

having stable cash incomes having stable cash incomes

access to adequate landaccess to adequate land

having permanent, secure and having permanent, secure and
spacious house spacious house

8. Social wellbeingSocial wellbeing

providing good education and socialization for providing good education and socialization for
childrenchildren

caring for childrencaring for children

unity and harmony within family unity and harmony within family

unity and harmony within community unity and harmony within community

unity and harmony with neighbouring unity and harmony with neighbouring
communities/host communities communities/host communities

9. Social wellbeingSocial wellbeing

access to services access to services

self-respect and dignityself-respect and dignity

clean and free environment clean and free environment

free of alcohol and drug abuse free of alcohol and drug abuse

10. Security Security

a secure environment for their living a secure environment for their living
without fear and outside threats without fear and outside threats

a secure physical environment and a secure physical environment and
protection from natural disasters and protection from natural disasters and
conflictsconflicts

free movement and living without being free movement and living without being
subject to suspicionsubject to suspicion

11. SecuritySecurity

a a peaceful peaceful atmosphere free of regular atmosphere free of regular
checks and intimidation from security checks and intimidation from security
forces.forces.

secure and strong houses to prevent secure and strong houses to prevent
intrudersintruders

houses that ensure privacy and personal houses that ensure privacy and personal
safety safety

community members coming together to community members coming together to
intervene and resolve problems and issuesintervene and resolve problems and issues

12. Physical, mental and moral and Physical, mental and moral and
spiritual wellbeingspiritual wellbeing

living without illness and sufferingliving without illness and suffering

having mental happiness having mental happiness

having good thoughts/feelings towards others having good thoughts/feelings towards others

living with courage/endeavour, self-initiative and drive living with courage/endeavour, self-initiative and drive

living with wisdom (not acting on emotions/rational living with wisdom (not acting on emotions/rational
behaviour)behaviour)

moral behaviour of community members moral behaviour of community members

careful spending careful spending

living religiouslyliving religiously

13. What reduces community What reduces community
mental health and wellbeing?mental health and wellbeing?

political violence and natural political violence and natural
disastersdisasters

displacement displacement

povertypoverty

poor housing conditionspoor housing conditions

conflicts within family and conflicts within family and
communitycommunity

social exclusion and isolationsocial exclusion and isolation

14. What reduces community What reduces community
mental health and wellbeing?mental health and wellbeing?

injustice and discrimination injustice and discrimination

urbanization urbanization

communicable diseases communicable diseases

work stresswork stress

alcoholism, drug abuse and sexual alcoholism, drug abuse and sexual
abuseabuse

15. Psychosocial context of Psychosocial context of
mental health and wellbeingmental health and wellbeing
(source: Prof. A.J.Marsella)(source: Prof. A.J.Marsella)
Factors affecting mental Factors affecting mental
health & wellbeing health & wellbeing
Implications for mental Implications for mental
health & wellbeing health & wellbeing
Cultural abuse, destruction and Cultural abuse, destruction and
collapsecollapse
Confusion and conflict Confusion and conflict
Oppression and domination Oppression and domination Anger, hate & domination Anger, hate & domination
Humiliation Humiliation Rage and revenge Rage and revenge
PowerlessnessPowerlessness Helplessness and despair Helplessness and despair
Poverty Poverty Hopelessness and misery Hopelessness and misery
Denigration Denigration Low esteem and worthlessnessLow esteem and worthlessness
Racism, sexism and agesim Racism, sexism and agesim Fragmentation and restrain Fragmentation and restrain
opportunity and denies choiceopportunity and denies choice

16. Stigma Stigma
People with mental health problems (studies in UK)People with mental health problems (studies in UK)
84 % experience problems in getting jobs, healthcare, mortgages 84 % experience problems in getting jobs, healthcare, mortgages
(Mind survey, 2004)(Mind survey, 2004)
55 % young people would not want anyone else to know about 55 % young people would not want anyone else to know about
illnessillness
(NUS and Rethink, 2001)(NUS and Rethink, 2001)
49% have been harassed or attacked 49% have been harassed or attacked
(Mind, (Mind, Not Just Sticks and Stones, Not Just Sticks and Stones, 1986)1986)
33% report having been dismissed or forced to resign from jobs33% report having been dismissed or forced to resign from jobs
(Read and Baker, 1996)(Read and Baker, 1996)
Source: Dr Suman FernandoSource: Dr Suman Fernando

17. Stigma – researchStigma – research
Stigma absent when mental illness is attributed to Stigma absent when mental illness is attributed to
‘spirit possession’ (in Sri Lanka)‘spirit possession’ (in Sri Lanka)(Waxler, 1974)(Waxler, 1974)
‘‘brain-disease’ view of mental health problems brain-disease’ view of mental health problems
increases stigma (in Germany)increases stigma (in Germany)
(Angermeyer and Matschinger, 2005)(Angermeyer and Matschinger, 2005)
‘‘bio-genetic cause’ view of mental health problems bio-genetic cause’ view of mental health problems
positively related to stigmapositively related to stigma
Source: Dr Suman FernandoSource: Dr Suman Fernando

18. Social costs and stigmaSocial costs and stigma

Social costs of illness are high in terms of family breakdown, isolation, Social costs of illness are high in terms of family breakdown, isolation,
disharmony, poverty and deprivation disharmony, poverty and deprivation
Social stigma prevented many patients and their families seeking treatment Social stigma prevented many patients and their families seeking treatment
from ‘Angoda hospital’from ‘Angoda hospital’

Many patients preferred to go to general hospitals (psychiatry units) or Many patients preferred to go to general hospitals (psychiatry units) or
private hospitals/doctors to avoid getting them labeled private hospitals/doctors to avoid getting them labeled
Forceful admissions result in anger and hostile relationships between patient Forceful admissions result in anger and hostile relationships between patient
and families and families
Source: Dr Rasitha PereraSource: Dr Rasitha Perera

19. Care givers were reluctant to take the patient Care givers were reluctant to take the patient
home and desired a long stay when home and desired a long stay when
patients:- patients:-

were aggressive at homewere aggressive at home

do not take treatment as prescribeddo not take treatment as prescribed

mess up family/home affairsmess up family/home affairs

do not have a care giver at homedo not have a care giver at home
Dr Rasitha PereraDr Rasitha Perera
Family response to persons with mental
illness

20. Care givers were reluctant to take the Care givers were reluctant to take the
patient home and desired a long stay when patient home and desired a long stay when
patients:- patients:-

are dependent on others / lack of productivity are dependent on others / lack of productivity

misuse psychoactive substancemisuse psychoactive substance

show hostilityshow hostility

maintain poor self caremaintain poor self care
Source: Dr Rasitha PereraSource: Dr Rasitha Perera
Family response to persons with mental
illness

21. 
Illness was the major cause for many patients to remain single, separated Illness was the major cause for many patients to remain single, separated
or divorcedor divorced

50% of the patients experienced disharmony with their families 50% of the patients experienced disharmony with their families

1/31/3
rdrd
of the patients were considered a burden to the family of the patients were considered a burden to the family

Only 1/4Only 1/4
thth
of the patients received better family care of the patients received better family care

1/31/3
rdrd
of the care givers were not satisfied with the current status of the of the care givers were not satisfied with the current status of the
patient patient
Source: Dr Rasitha PereraSource: Dr Rasitha Perera
Family response to persons with mental
illness

22. Promoting mental health Promoting mental health
and wellbeing and wellbeing
InterventionsInterventions
SocialSocial
Medical (treatments)Medical (treatments)
Strengthening resilience and supportStrengthening resilience and support
IndividualIndividual
FamilyFamily
CommunityCommunity
Promoting recovery (Promoting recovery (‘‘recovery approachrecovery approach’’))
Developing hopeDeveloping hope
Overcoming barriersOvercoming barriers
Social inclusionSocial inclusion
Source: Dr Suman FernandoSource: Dr Suman Fernando

23. Mental Health Mental Health
Interventions Interventions
Medical model:Medical model:

Problems identified by symptoms of Problems identified by symptoms of
individualsindividuals

‘‘IllnessIllness’’ represents bio-medical pathology represents bio-medical pathology
Source: Dr Suman FernandoSource: Dr Suman Fernando

24. Mental Health Mental Health
InterventionsInterventions
Medical model:Medical model:

Help is via individual treatments Help is via individual treatments
- - Biological (medication, ECT)Biological (medication, ECT)
- Psychological (e.g. - Psychological (e.g. ‘‘talking therapiestalking therapies’’, CBT, CBT ) )

Environmental manipulation e.g. Environmental manipulation e.g.
therapeutic communities, advice, therapeutic communities, advice,
education, family supporteducation, family support
Source: Dr Suman FernandoSource: Dr Suman Fernando

25. Mental Health Mental Health
Interventions Interventions
Social modelSocial model::

Origin / cause of MH problems are Origin / cause of MH problems are
socialsocial

‘‘Illness’ is socially constructedIllness’ is socially constructed

Help is via social interventions and Help is via social interventions and
support involving family, community, support involving family, community,
living conditions etc.living conditions etc.
Source: Dr Suman FernandoSource: Dr Suman Fernando

26. Mental health promotionMental health promotion

develop ‘balanced care’ = hospital care + develop ‘balanced care’ = hospital care +
community care (mixture of medical and community care (mixture of medical and
social models)social models)

Work as multi-disciplinary teamsWork as multi-disciplinary teams

support traditional healing systems support traditional healing systems

promote family and community supportpromote family and community support

integrate with community development integrate with community development

social inclusion and participation social inclusion and participation

reduce risk factors reduce risk factors

27. Factors affecting mental Factors affecting mental
health and wellbeing of health and wellbeing of
children children

Lack of access to education and facilitiesLack of access to education and facilities

Child neglect, ill-treatment and poor careChild neglect, ill-treatment and poor care

Malnutrition Malnutrition

Traumatic experiences – loss of family members, Traumatic experiences – loss of family members,
displacement, detention, physical injuriesdisplacement, detention, physical injuries

Substance abuseSubstance abuse

Sexual abuse and child prostitution Sexual abuse and child prostitution

Child trafficking and labour Child trafficking and labour

Domestic violence Domestic violence

28. Factors affecting mental Factors affecting mental
health and wellbeing of health and wellbeing of
childrenchildren

Family break downs e.g. divorce, Family break downs e.g. divorce,
separation, desertion separation, desertion

Recruitment as child soldiers / Child LaborRecruitment as child soldiers / Child Labor

Parents working abroad Parents working abroad

Competition and pressures for Competition and pressures for
‘achievement’‘achievement’

Disabilities Disabilities

29. Mental health problems Mental health problems
of children (1)of children (1)
May present as:May present as:

emotional problems emotional problems such as phobias, excessive such as phobias, excessive
anxiety, depression, irrational fears anxiety, depression, irrational fears

Unusual behaviour / conduct Unusual behaviour / conduct such as such as
aggressiveness, timidityaggressiveness, timidity

Inattention / overactivity Inattention / overactivity at school or homeat school or home

30. Mental health problems Mental health problems
of children (2)of children (2)
May present as:May present as:

Difficulties / delay in Difficulties / delay in acquiring certain skills such as acquiring certain skills such as
speech, writing, readingspeech, writing, reading

Problems in attachment Problems in attachment to parents or caregivers to parents or caregivers
such as not showing or responding to affection such as not showing or responding to affection
(when severe may be autism)(when severe may be autism)

Food fads / eating problems Food fads / eating problems such a refusing to eat, such a refusing to eat,
induced vomiting (may be anorexia)induced vomiting (may be anorexia)

31. Mental health problems Mental health problems
of children (3)of children (3)

sleeping problemssleeping problems such as excessive such as excessive
sleepiness, sleepiness, insomnia (may be sign insomnia (may be sign
of more severe illness)of more severe illness)

Post traumatic problems Post traumatic problems such as re-such as re-
living traumatic living traumatic incidents (may incidents (may
become ‘post traumatic stress become ‘post traumatic stress
disorder’ – PTSD)disorder’ – PTSD)

32. Dealing with Mental health Dealing with Mental health
problems of children problems of children
Try to pick up:Try to pick up:

Special needs that child may have such as Special needs that child may have such as
early learning difficulties, dyslexia early learning difficulties, dyslexia
(recognition of words and writing letters), (recognition of words and writing letters),
hearing loss (early deafness), visual hearing loss (early deafness), visual
impairmentimpairment

Problems in the child’s interactions with Problems in the child’s interactions with
other children, teachers and others in other children, teachers and others in
authorityauthority

33. Dealing with Mental health Dealing with Mental health
problems of childrenproblems of children

Family problems at homeFamily problems at home

Difficulties in socialization (not Difficulties in socialization (not
mixing, isolating)mixing, isolating)

34. How can the teachers How can the teachers
help?help?

Paying more attention to children Paying more attention to children
with special needs or ‘problems’ (20-with special needs or ‘problems’ (20-
30 percent of children)30 percent of children)

Providing a safe context for children Providing a safe context for children
to talkto talk

Listening and talking to childrenListening and talking to children

35. How can the teachers help?How can the teachers help?
(2)(2)

Making referrals to relevant specialists Making referrals to relevant specialists
(e.g. children with severe emotional (e.g. children with severe emotional
disturbance, post traumatic states, disturbance, post traumatic states,
eating disorders, deafness, autism, eating disorders, deafness, autism,
family issues)family issues)

Enabling children to develop appropriate Enabling children to develop appropriate
life-skills, self-esteem and resiliencelife-skills, self-esteem and resilience

36. Prevention of mental Prevention of mental
health problems (1)health problems (1)

Acquiring professional skills in Acquiring professional skills in
understanding child development and understanding child development and
mental healthmental health

Creating a supportive school Creating a supportive school
environment that is conducive to environment that is conducive to
learning and developing life skillslearning and developing life skills

Providing mental health education, Providing mental health education,
knowledge, attitudes and behaviours knowledge, attitudes and behaviours
to all childrento all children

37. Prevention of mental Prevention of mental
health problems (2)health problems (2)

Educating parents and community Educating parents and community
members on risk and protective members on risk and protective
factors of mental health factors of mental health

Identifying factors that place Identifying factors that place
children at risk and reinforcing children at risk and reinforcing
protective factorsprotective factors

38. Challenges for Teachers Challenges for Teachers

How can we provide a safe and How can we provide a safe and
supportive environment in which all supportive environment in which all
students can maximize their learning?students can maximize their learning?

How can we remain accessible and How can we remain accessible and
responsive to their needs?responsive to their needs?

How can we assist our students to How can we assist our students to
develop their ability to cope with develop their ability to cope with
challenges and stress? challenges and stress?

39. Providing supportive Providing supportive
context for childrencontext for children

Liaising with families, parents and care-Liaising with families, parents and care-
givers e.g. home visits givers e.g. home visits

Fostering partnerships between school Fostering partnerships between school
and community agencies, service and community agencies, service
providers etc. providers etc.

Strengthening community support Strengthening community support
networksnetworks

40. Factors that enhance Factors that enhance
resilience among childrenresilience among children

Positive role modelsPositive role models

Positive self-esteemPositive self-esteem

Supportive relationships with Supportive relationships with
teachers and friends teachers and friends

A sense of hope and purposeA sense of hope and purpose

Belief in one’s selfBelief in one’s self

Strong social skills Strong social skills

Good peer relationships Good peer relationships

41. What are Life-Skills? What are Life-Skills?
Skills that enable people to:Skills that enable people to:

Live in harmony with parents, teachers and others in authorityLive in harmony with parents, teachers and others in authority

Live in harmony with peers from various communities and social Live in harmony with peers from various communities and social
classesclasses

Make socially & culturally appropriate relationshipsMake socially & culturally appropriate relationships

Make decisions that are in keeping with social and cultural norms Make decisions that are in keeping with social and cultural norms
(ethical values, expectations of kith and kin, worldviews, etc.)(ethical values, expectations of kith and kin, worldviews, etc.)

Maintain a sense of self-worth as well as respect for othersMaintain a sense of self-worth as well as respect for others

Deal with adversity in socially acceptable and culturally appropriate Deal with adversity in socially acceptable and culturally appropriate
waysways

42. Western and Non-Western Western and Non-Western
Understandings of Life SkillsUnderstandings of Life Skills
WesternWestern Non-westernNon-western
Decision-making and problem solving Decision-making and problem solving

analyzing information and analyzing information and
experiences objectively and experiences objectively and
making decisions based on facts making decisions based on facts

adherence to cultural norms and adherence to cultural norms and
seeking guidance from elders seeking guidance from elders
and spiritual influencesand spiritual influences
CommunicationCommunication

ability to express views and ability to express views and
opinions directly opinions directly

indirect expression of views, indirect expression of views,
respecting views of other people, respecting views of other people,
and dependence on familyand dependence on family
IndependenceIndependence

Depend on oneself primarily and Depend on oneself primarily and
maximize self-confidencemaximize self-confidence

respecting opinions of others respecting opinions of others
and more accepting of and more accepting of
dependence on othersdependence on others

43. Western and Non-Western Western and Non-Western
Understandings of Life SkillsUnderstandings of Life Skills
WesternWestern Non-westernNon-western
Coping with emotionsCoping with emotions

Recognizing emotions, Recognizing emotions,
controlling emotions and controlling emotions and
expressing emotions in expressing emotions in
acceptable waysacceptable ways

wide cultural variation in wide cultural variation in
expression of emotions and expression of emotions and
need to control emotionsneed to control emotions
Coping with stressCoping with stress

Understanding causes of Understanding causes of
stress and controlling stress stress and controlling stress

cultures vary a great deal in cultures vary a great deal in
ways of dealing with stress ways of dealing with stress ––
some prefer acceptance of some prefer acceptance of
controlcontrol

44. Workshop and Teachers Workshop and Teachers
OutputOutput

45. LESSON PLANLESSON PLAN
Include the following in your content Include the following in your content
areas:areas:
1.1.Psychosocial Activities for our studentsPsychosocial Activities for our students
2.2.Health related concerns to address the Health related concerns to address the
needs of our students.needs of our students.