Unit 4: AOS 2: What influences mental wellbeing?

1. Unit 4: AOS 2: What influences mental wellbeing?

2. Brainstorm • What do you think A mentally healthy person looks, feels, sounds like? • What about a mentally unhealthy person?

3. DP 1: Mental health as a continuum (mentally healthy, mental health problems, mental disorders) influenced by internal and external factors that can fluctuate over time Key Points: • Our Mental Health fluctuates along a continuum that may range from Mentally healthy down to mental health disorders • Internal and External factors affect where a person is on this continuum

4. Mental health as a continuum • Mentally healthy: emotional and social wellbeing in which individuals realize their own abilities, can cope with the normal stresses of life, work productively and contribute to their community. • Mental health problem: Negatively affects a persons thoughts, feelings and behaviors, but is usually shorter and less serious than a mental disorder. • Mental disorder: also called mental illness is asignificant personal distress caused by thoughts, feelings or behaviors which impair their ability to function in everyday life., • The term is most commonly used in relation to a clinically diagnosable disorder involving mental health, such as schizophrenia, major depressive disorder (commonly called depression) or an anxiety disorder

5. Mentally healthy = Occasional stress to mild distress. • FOR EXAMPLE: Spiders scare me because I don’t know which are dangerous and which are not (and they have too many legs for my liking) • EQUALS = no impairment! Mental health problem = Mild to moderate distress. FOR EXAMPLE:  If there is a spider in the room I need to keep my eyes on it at all times so I know it is not coming closer to me.  It would be better if someone else could take it out of the room. In fact, I won’t go into the room unless someone gets rid of it EQUALS = mild or temporary impairment Mental disorder = Marked Distress. FOR EXAMPLE: I avoid situations where I might be near a spider that I can’t see so I don’t go on picnics. OR. I don’t walk into the library because there is a poster with a picture of a spider on it. EQUALS = moderate to debilitating or chronic impairment (behaviour is maladaptive).

6. Mental Health Problems Mentally Healthy Mental Disorders

7. Mental health continuum

8. Influenced by internal and external factors that can fluctuate over time... The location of an individual’s mental health on the continuum is unstable. This means that it is not fixed because it may vary or fluctuate over time depending on circumstances. An interplay of several internal and external factors combine to influence our mental health at different points in time. Create a list of these internal and external factors.

9. Mental health as a product of internal and external factors Internal Factors External Factors Interpersonal relationships School and work related factors Support available Education Employment Risk of violence Values and traditions Exposure to stressors Stigma Attachment Socio-economic status/poverty • Genes • Gender • Substance use • Hormones • F-F-F • Beliefs & attitudes • Personality predisposition • Prior learning • Perception • Self-esteem • Decision making & problem solving

10. Factors that affect mental health and wellbeing • Internal factors– influences that originate from within an individual e.g. self esteem • External factors – influences that originate from the persons environment (outside the individual) e.g. family circumstances Exam question – Distinguish between internal and external factors. (2 marks) Internal factors – influences that originate from within an individual eg self esteem, whereas external factors are influence that originate from the persons environment, eg: family circumstances.

11. A way of thinking about internal and external factors is through the biopsychosocial model of health and illness is a framework that states that interactions between biological, psychological, and social factors determine the cause, symptoms, and possible treatments for wellness and health. a) Biological – (internal) bodily systems or physiologically based systems b) Psychological – (internal) cognitive and / or mental processes c) Social – (external) environment factor Discuss: Are any difficult to categories? Or possible fit into more than one category?

12. Biopsychosocial model of Mental health Identify which ones are Internal and which ones are External – highlight the internal in one colour and external in another colour.

13. Case Study • Read the case of Michael on the next slide • Copy out a table similar to this in your books: • identify the biological, psychological and social factors contributing to his mental disorder.

14. Case Study Michael is a 26-year-old male who has been diagnosed as having schizophrenia. He finished year 10 at school before completing a bakery apprenticeship in the regional town where he grew up. At age 20 he moved to Melbourne to get work but struggled to establish friendships and was not happy despite enjoying his work. He was diagnosed with a psychotic episode at 21, when he was experiencing auditory hallucinations and delusional beliefs. He has a first cousin who was diagnosed with schizophrenia, and his grandfather committed suicide in his mid-twenties. Michael has had difficulties coping with stress and used cannabis in his later teens to avoid dealing with issues and to ‘chill out’. His family connected him to a mental health support service after his manager noticed odd behaviours and deterioration in his previously good work habits. Michael has had to be hospitalised three times due to his symptoms but has not been to hospital for two years. He generally experiences few symptoms, and takes antipsychotic medication regularly. He currently works as a baker but reports recent trouble with his boss. He broke up with his girlfriend last month. Michael has had increased auditory hallucinations and hasn’t slept for two nights.

15. DP 2: The typical characteristics of a mentally healthy person, including high levels of functioning, social and emotional well-being and resilience to life stressors Key Points • What makes a mentally healthy person? • Level of functioning • Social and Emotional health • Resilience

16. Typical characteristics of a mentally healthy person • High level of functioning • High levels of social and emotional wellbeing • Resilience to life stressors

17. Levels of Functioning Everyone is presented with stressors at some point in their lives but our ability to deal with the stressor can be seen in our level of functioning for daily activities. The higher the person’s level of functioning would indicate they towards the mentally healthy person on the Continuum.

18. High level of functioning • Functioning = independently performing in their environment. • Can meet the ordinary demands of everyday life • Able to adapt to changing demands and challenges in life. • Interpersonal relationships • School and work settings • Leisure/recreational activities • Daily living skills • Cognitive skills • Emotions

19. High levels of social and emotional wellbeing • EMOTIONAL WELLBEING: • Develop awareness and understanding of their own emotions • Regulate emotions & exercise control • Express a range of emotions in a suitable manner • Identify emotions and empathise. • Have a positive attitude • Accept mistakes/setbacks • Make decisions with minimal worry • Consider others’ feelings • Manage stress responses • Take on challenges & risks • Take responsibility for their actions. • SOCIAL WELLBEING: • Develop and maintain healthy relationships with family and friends • Socially interact with others in appropriate ways • Respect and understand individuals • Respect the cultural identity of others • Competently resolve conflict • Effectively manage unhealthy relationships • Spend time with loved ones • Feel self-confident alone or with others.

20. Social and emotional wellbeing

21. Resilience to life stressors Resilience is the ability to cope with stress and catastrophe and to adapt to overcome adversity. • Sometimes resilience is influenced by a person’s personality predisposition. • Although resilience can be considered both an internal and protective factor, other influences include: positive and supportive family relationships, strong friendships with peers, sense of belonging at school as well as cultural and spiritual beliefs.

22. Some tips for mental wellbeing • Look after your physical health – diet, sleep & exercise • Be social – invest time in your connections and give to others • Do something you enjoy – hobbies, creative pursuits and learning • Have down time – time for self • Take notice – take action • Remember A-B-C: Act–Belong–Commit. Being active, having a sense of belonging and having a purpose in life all contribute to happiness and good mental health. Images used under license from Pixabay

23. Mental illness • 1 in 5 adults each year in Australia • 15% of adolescents • Anxiety disorders the most common in women, while substance abuse disorders are most common in men • Age of onset varies for each disorder • Young people aged 18-24 have the highest prevalence • Genetic or environmental inheritance • Fluctuations over time

24. DP 3: Ethical implications in the study of, and research into, mental health, including informed consent and use of placebo treatments. Key knowledge • How can someone give informed consent if they are not mentally stable? • What are the positive and negative implications of using placebos in mental health research?

25. Case study: Jani’s story Video source: https://www.youtube.com/watch?v=UTUMt05_nCI Article source: http://www.huffingtonpost.com/michael-schofield/january-first-child-with-schizophrenia_b_1753687.html

26. Ethical implications

27. Ethical implications in mental health study and research • Informed consent: the process by which a researcher discloses appropriate information to a potential research participant so the person may make a voluntary and informed choice about whether to participate or not. • Placebo treatments: Commonly used in research studies and clinical trials to determine the efficacy (effectiveness) of new or improved medication or other treatment such as psychotherapy, diet or surgery.

28. Informed Consent Definition: the process by which a researcher discloses appropriate information to a potential research participant so that the person may make a voluntary and informed choice about whether or not to participate. • If a participant suffers from a mental disorder it can therefore interfere with their capacity to give genuine consent as it may prevent them from fully understanding some or all of the details of what it is that are actually consenting to. • In the event that a potential participant is unable to give informed consent, this can be obtained from their legal guardian or any person or organisationauthorised by law to do so on the participant’s behalf

29. Placebo treatments • Used in clinical trials • Placebo treatment appears real, but is actually neutral. • It may cause the placebo effect – improvement in wellbeing, caused by the participants belief in the treatment and their expectation of relief. • Often a double-blind procedure is used, with random allocation. • Can cause unwanted side-effects: nausea, allergies, skin rashes. • Linked closely to informed consent – including possible side-effects • Some concerns: • All people in the trial genuinely need the treatment, but some do not receive them meaning they stay unwell, especially if they are unable to take their normal medications • Prolonged trials = participant attrition (reduction in effectiveness) – this makes them more likely to withdraw. • Use of deception.

30. Use of placebos Benefits • Research shows that mental disorder symptoms can actually be relieved by taking a fake substance – this is called the Placebo effect • The research had good validity as the use of a placebo reduces any other variables affecting the results. Risks • Researchers intentionally withhold an effective treatment from people which intentionally allows them to remain unwell and they may even suffer. • Possibility of symptoms that are under control, reappearing or worsening • Placebo group participants are also not given the “new” treatment being offered and so are being intentionally denied access to a treatment that they most likely need and gain some benefits from.

31. Story of StAN Stan is an elderly man who was diagnosed with depression in his early twenties. He has tried numerous anti-depressant medications over the years and continues to use them despite his belief that ‘they have not cured me’. Stan has been asked to participate in research on a new drug for depression that has been trialled with animals and since been approved for human trials. The study involves hospitalisation for a 4-week period during which Stan must not take any medication at all. Volunteer participants willthen be assigned to either an experimental group (who will be given the new drug) or a control group (who will be given a placebo treatment). Stan agrees to participate in the study, commenting that, ‘I don’t care anymore. I don’t care if I get the medicine or the placebo. What difference does it make anyway?’ However, he has previously made it clear when he had a ‘pretty good day’ that he continues to hold some hope for ‘a magical cure’. What are the benefits and risks of Stan participating in this Research?

32. Stan continued Benefits: • Human research on Mental health disorders need participants with mental health issues for them to gain a better understanding of how to help other suffers. Risks: • Could make Stan’s symptoms worse if he is un-medicated for a long period of time. • Participants like Stan are more vulnerable than others who do not have mental Health disorders So with this in mind specific ethical standards have been put in place to help protect people like Stan.

33. Case study • What was the aim • Identify the operationalised IV and DV • Formulate a Research hypothesis that would be supported by the results • Was a single or double blind procedure used? • Describe the results obtained • Identify one possible limitation • Describe 3 relevant ethical considerations Bigger version of Case study on next slide

35. Practice Questions

36. Question 1 In the language of mental health, a mental disorder may be defined as: • a set of psychological symptoms that cause considerable distress to the individual and interfere with the individual’s daily functioning. • a condition with a known cause, predictable symptoms and course, and standard treatment protocols. • physical symptoms that interfere with normal daily living and affect the individual’s ability to function. • a specific profile of psychological symptoms.

37. Question 1 Solutions In the language of mental health, a mental disorder may be defined as: • a set of psychological symptoms that cause considerable distress to the individual and interfere with the individual’s daily functioning. • a condition with a known cause, predictable symptoms and course, and standard treatment protocols. • physical symptoms that interfere with normal daily living and affect the individual’s ability to function. • a specific profile of psychological symptoms.

38. Question 2 The biopsychosocial model is used as a framework to • classify mental disorders • understand the many factors that may contribute to the state of mental health of an individual • understand the many factors that may contribute to the state of mental and physical health of an individual • understand the many factors that may contribute to the state of physical health of an individual

39. Question 2 Solution The biopsychosocial model is used as a framework to • classify mental disorders • understand the many factors that may contribute to the state of mental health of an individual • understand the many factors that may contribute to the state of mental and physical health of an individual • understand the many factors that may contribute to the state of physical health of an individual

40. Question 3 Olivia has developed satisfying interpersonal relationships with a diverse range of people, which makes her feel good about herself. It is likely that Oliva has a _______ level of ____ wellbeing. • low; social • high; emotional • low; emotional • high; social

41. Question 3 Solution Olivia has developed satisfying interpersonal relationships with a diverse range of people, which makes her feel good about herself. It is likely that Oliva has a _______ level of ____ wellbeing. • low; social • high; emotional • low; emotional • high; social

42. Question 4 A mental health continuum can be used to show: • internal and external factors influencing mental health. • biopsychosocial factors influencing mental health. • the variability of mental health. • impairments in the ability to function effectively in everyday life.

43. Question 4 Solutions A mental health continuum can be used to show: • internal and external factors influencing mental health. • biopsychosocial factors influencing mental health. • the variability of mental health. • impairments in the ability to function effectively in everyday life.

44. Question 3 Adrianna is a first-year psychology student at university who has just moved from the country in order to live on campus. Adrianna has found university life to be challenging and at times misses her family but has managed to make new friends from within her course and maintain steady grades. Describe three characteristics of behaviours demonstrated by Adrianna that would support the assessment that she is experiencing good mental health. (3 marks)

45. Question 3 solution Adrianna is a first-year psychology student at university who has just moved from the country in order to live on campus. Adrianna has found university life to be challenging and at times misses her family but has managed to make new friends from within her course and maintain steady grades. Describe three characteristics of behaviours demonstrated by Adrianna that would support the assessment that she is experiencing good mental health. (3 marks) • A high level of functioning: Academically, Adrianna can handle the demands of her course. (1 mark) • Social and emotional wellbeing: Adriana can mix with other students, make new friends and handle minor conflicts. (1 mark) • Resilience to life stressors: For example, the occasional poor mark, a lack of money or cramped living conditions on campus. (1 mark) NB: Must describe, not just identify