Mental Health, state characterized by psychological well-being and self-acceptance. The term “mental health” usually implies the capacity to love and relate to others, and the willingness to behave in a way that brings personal satisfaction without encroaching upon the rights of others—to be well adapted and emotionally well adjusted. In a clinical sense, mental health is the absence of mental illness.
Concern for the mentally ill has waxed and waned through the centuries, but the development of modern-day approaches to the subject dates from the mid-18th century, when reformers such as the French doctor Philippe Pinel and the American doctor Benjamin Rush introduced humane “moral treatment” to replace the often cruel treatment that then prevailed. Despite these reforms, most of the mentally ill continued to live in jails and poorhouses—a situation that continued throughout the 19th century.
II SCOPE OF THE PROBLEM
According to a common estimate, at any one time 10 per cent of the population has mental health problems serious enough to warrant care; recent evidence suggests that this figure may be closer to 15 per cent. Not all the people who need help receive it, however. One major reason for this is that people still fear the stigma attached to mental illness and hence often fail to report it or to seek help.
Analysis of the figures on mental illness shows that schizophrenia afflicts an estimated 180,000 people in Britain alone—with at least the same number likely to suffer from severe depressive disorders. Organic mental states causing dementia, delirium, memory loss, mild or moderate depression, anxiety, and other types of emotional problems are also very common—one in ten people in Britain suffers from some form of depression. Alcohol abuse is on the increase in many countries, and it is likely that many more abuse drugs. The list of mental health problems can also be extended beyond identifiable psychiatric conditions to include the damage to mental health associated with unrelenting poverty, unemployment, and discrimination on the basis of race, sex, class, age, and mental or physical handicaps.
Care of the mentally ill has changed dramatically in recent decades. Drugs introduced in the mid-1950s, along with other improved treatment methods, enabled many patients who would once have spent years in mental institutions to be treated as outpatients instead. The few remaining mental hospitals in Britain now also give some patients complete freedom of buildings and grounds and, in some cases, freedom to visit nearby communities. This move is based on the conclusion that disturbed behaviour is often the result of restraint rather than of illness.
Treatment of patients with less severe mental disorders has also changed markedly. Previously, patients with mild depression, anxiety disorders, and other types of neurosis were treated individually with psychotherapy. Although this form of treatment is still widely used, alternative approaches are now available. In some instances, a group of patients meets to work through problems with the assistance of a therapist; in other cases, families are treated as a unit. As in the serious mental illnesses, the treatment of milder forms of anxiety and depression has been furthered by the introduction of new drugs, such as Prozac, that help to alleviate symptoms.
The release of large numbers of patients from state mental hospitals, however, has caused significant problems both for the patients and for the communities that become their new homes. Adequate community services often are unavailable to former mental patients, a large percentage of whom live in nursing homes and other facilities that are not equipped to meet their needs. Most of these patients have been diagnosed as having schizophrenia, and only 15 to 40 per cent of schizophrenics who live in the community achieve an average level of adjustment. Those who do receive care may in some countries visit a clinic at periodic intervals for brief counselling and drug monitoring.
Many different sciences contribute to knowledge about mental health and illness. In recent decades these sciences have begun to clarify basic biological, psychological, and social processes, and they have refined the application of such knowledge to mental health problems.
Some of the most promising leads have come from biological research. For example, brain scientists who study neurotransmitters—chemicals that carry messages from one nerve cell to another—are contributing to knowledge of normal and abnormal brain functioning, and are on the way to discovering better treatment methods for some forms of mental illness. Other researchers are trying to discover how the brain develops—they have learned, for example, that even in adults some nerve cells partially regenerate after being damaged—and such research adds to the understanding of mental retardation, untreatable forms of brain damage, and other conditions.
Psychological research relevant to mental health includes the study of perception, information processing, thinking, language, motivation, emotion, abilities, attitudes, personality, and social behaviour. For example, researchers are studying stress and how to cope with it.
Research in the social sciences focuses on problems of individuals in contexts such as the family, immediate environment, and work setting, as well as the culture at large. One example of such work is epidemiological research, which is the study of the occurrence of disease patterns, including mental illness, in an area or country.