It is not always possible to differentiate mental illness from normal behavior. For example, it can be difficult to differentiate between normal grief caused by grief and depression itself in people who have suffered a significant loss, such as the death of a spouse or child, because both include sadness and depressed mood. Likewise, deciding whether the diagnosis of an anxiety disorder applies to people who are worried and stressed due to their work can be challenging most people will experience at some point. The dividing line between having certain personality characteristics (for example, being methodical or organized) and having a personality disorder (for example, obsessive-compulsive disorder) can be tenuous. Thus, it is better if mental illness and mental health are considered to be part of a continuous spectrum. An eventual dividing line is usually based on the following requirements:
The Severity Of The Symptoms
- How long the symptoms last
- How symptoms affect the ability to function in daily life
- Currently, mental illness is considered to be caused by a complex interplay of factors, including factors:
- Biological (physical factors)
- Environmental (including social and cultural factors)
Research has shown that genetic factors influence many mental health disorders. Often, a mental health disorder occurs in a person whose genetic makeup makes them vulnerable to these disorders. This vulnerability, together with the stresses of life, for example, problems with family or work, can give rise to the development of a mental disorder.
Besides, many experts believe that a dysfunction in the control of chemical messengers in the brain (neurotransmitters) can contribute to mental health disorders. Diagnostic imaging techniques, such as magnetic resonance imaging (MRI) and positron emission tomography (PTE), often show changes in the brains of people with a mental health disorder. For this reason, many mental health disorders appear to have a biological component, similar to disorders that are considered neurological (for example, Alzheimer’s disease ). However, it is not yet clear whether the changes seen in imaging studies are the cause or result of mental health disorders.
In recent decades, a movement has emerged to bring mentally ill people out of institutions (deinstitutionalization) and support them so that they can live in a community. This movement was made possible with the development of effective drugs in conjunction with some changes in attitude towards the mentally ill. Due to this movement, a greater emphasis was placed on the view that people with mental illness belong to families and communities. A US Supreme Court decision in 1999 contributed significantly to this change. This decision, called the Olmstead decision, requires states to provide mental health treatment in communities whenever this initiative is considered medically appropriate.
Research shows that certain interactions between a person with severe mental illness and family members can improve or worsen mental illness. In this sense, family therapy techniques have been developed that avoid the need to readmit people with chronic mental illnesses in mental health institutions. Today, the family of a person with a mental illness is more involved than ever in treatment, as an ally. The general practitioner also plays an important role in the reintegration of the person with mental illness into society.
Besides, since there has been an improvement in the effectiveness of pharmacotherapy, there is a lesser chance, compared to what was formerly, that people with mental illness who needed to be hospitalized need to be placed in isolation or containment. Besides, they are often discharged and transferred to daycare centers within a few days. These daycare centers cost less than institutions that inpatient patients because they need less staff, emphasize group therapy instead of individual therapy, and patients spend the night at home or in hostels instead of in the hospital.
However, deinstitutionalization has brought its problems. The necessary treatment and protection against damage that used to be offered in institutions have not been properly replaced by community mental health services due to a lack of financial resources. Thus, many people have failed to receive the mental health care they need. Besides, current laws now prevent people with mental illness who do not pose a risk to themselves or society from being admitted to mental health institutions or medicated against their will. Thus, many people who fall ill again outside the hospital become homeless or end up in prison. Many of them die young due to exposure to the elements, infection, or medical problems without proper treatment.
Due to problems related to deinstitutionalization, new types of treatment, such as assertive community treatment (ACT), have been developed. They assist in forming a safety net for people with serious chronic mental illness. TCA uses a team of social workers, rehabilitation specialists, counselors, nurses, and psychiatrists (a multidisciplinary team). The team provides individualized services to people who suffer from severe mental illness and who cannot or do not want to seek medical help or a clinic. The services are provided in the person’s own home or the neighborhood, for example, in restaurants, parks, or nearby stores.
Where does the treatment have to be? In the community. Hence this idea of territorial, community treatment. You have to know more closely what is happening in the neighborhood, what is happening inside that house, in that person’s life, so that solutions can arise and you can contribute with some kind of solution to what we call crises.
In the understanding of a psychosocial model of care, which governs psychiatric reform, it is a model that does not believe that illness is the result of only neurochemical deregulation. We are biology. No one is denying that. On the contrary, there is no such separation. The human being is a darn complex animal. He has emotions, affections, and cultural issues. You don’t get sick the same in all cultures. If you go there with indigenous peoples or other communities, you will see that the ways of suffering are not the same.