lundi 6 février 2012

Healthy mind, healthy body' programme launched

Times NIE, Tupperware India joined hands in making the youth of India healthy, reports Ainee Nizami

With assignments to complete, deadlines to meet, classes to attend and pressure to perform well, students today have no time to spare for their health. The fast paced lives they lead leave no room to consider the harmful effects that junk food, lack of sleep and stress leads to,. Keeping this in mind, Times NIE and Tupperware India have decided to embark on a health mission which stresses upon the importance of leading a healthy lifestyle.

Healthy Heart: Avoid Trans Fat

On December 5, 2006, the Board of Health approved an amendment to the Health Code to phase out artificial trans fat in all NYC restaurants and other food service establishments. It is in full effect.
The phase out of artificial trans fat in restaurant foods took effect in two stages. First, as of July 1, 2007, NYC food service establishments have been prohibited from using oils, shortening and margarine containing artificial trans fat for frying or as a spread that have 0.5 grams or more of trans fat per serving. As of July 1, 2008, all foods must have less than 0.5 grams of trans fat per serving if they have any artificial trans fat. Packaged foods served in the manufacturer's original, sealed packaging are exempt.

Mental Retardation and Developmental Disabilities Services and Information

In the years since the conditions at the Willowbrook State School on Staten Island were made public, great strides have been made in NYC to improve services and conditions for persons with developmental disabilities and to establish comprehensive, community-based service systems. The mission of the New York City Department of Health and Mental Hygiene (DOHMH), Division of Mental Hygiene (Division or DMH) with regard to mental retardation and developmental disability services, is to provide person-centered planning and the development of individualized, comprehensive, community-integrated services.

Division of Mental Hygiene

The New York City Department of Health and Mental Hygiene, Division of Mental Hygiene (Division or DMH), under the City Charter and in accordance with State Mental Hygiene Law, is responsible for administering, planning, contracting, monitoring, and evaluating early intervention services for children under three years old who have a developmental delay or disability, and community mental health, mental retardation, and chemical dependency services within the City of New York. In addition, DMH plans and collaborates with other City agencies to provide a variety of uniquely targeted programs, including those for individuals who are homeless or who have co-occurring disorders.
DMH is committed to ensuring that all mental health services in New York City meet the highest quality standards for the over 450,000 people in New York City who suffer from one or more mental health disorders. It is the Division’s mission to partner with consumers, families, advocates, and providers to ensure access to high quality services and to improve the lives of New Yorkers with mental health and chemical dependency disorders and those with mental retardation and developmental disabilities.

samedi 4 février 2012

How to Become a Mental Health Counselor

Mental health counselors are licensed professionals who offer a variety of services including diagnosis, therapy, educational programs and development of treatment plans. Diverse working environments are common for counselors and can be found in such places of employment as schools, rehabilitation centers, jails, employment facilities and family services. Use these tips to learn how to become a mental health counselor.
Education and Experience Requirements
Particular education requirements are necessary for a career in mental health therapy. A master’s degree is the most common educational requirement. In order to meet state licensing requirements to become a mental health counselor, a person must complete a master's degree in a program of study related to counseling. This includes a variety of degree programs such as mental health counseling, marriage and family counseling, rehabilitation counseling or community counseling.
In addition to the educational requirements, experience in mental health counseling jobs is required for licensing. Prior to taking the test to become a licensed mental health counselor, professionals must work in a clinical setting providing mental health therapy for two years. A two-year internship is required by most schools and may or may not be a paid position.
The work experience must be completed under the supervision of someone who is licensed or certified in a mental health profession. Following completion of the required work experience or internship, it is necessary to pass the licensing examination required by the state in which the professional resides.
Students who have families or already established careers and are going back to school to gain the education they need to switch gears may want to consider earning their mental health counseling degrees online. Online programs allow students to obtain the education they need without disrupting their lives. Depending on the student’s individual needs, any accredited university or college that offers mental health counseling studies is sufficient. This may include an online university or campus-based college program.
Licensing Requirements
Licensing requirements for mental health counseling are similar to those required for marriage and family therapists as well as clinical social workers. Licensure varies by state and work setting. Continuing education requirements may be necessary in some states in order to achieve the required license. Public schools in nearly every state require licensing and counseling certifications.
Job Outlook and Salary Expectations
According to the reports from the Bureau of Labor Statistics for 2012, mental health counselor occupations are expected to increase at a greater rate than the average job. Projected employment growth is favorable and expected to increase approximately 20%. Substance abuse counselors and mental health counselors who deal with behavioral disorders are among the fastest growing occupations in the industry. Openings for employment are expected to rise over the next decade in jails and treatment program facilities. 

Mental Health Counselor

Counselors are professionals who assist individuals and groups with their personal problems in order to help them become more self-sufficient. Individuals that specialize in mental health counseling concentrate on promoting optimum mental health through various programs and services. They help individuals deal with suicidal impulses, self-esteem issues, addictions and substance abuse, stress management, job and career concerns, marital problems, educational decisions, and issues associated with aging. Beginning with the interview process, mental health counselors make observations that help them determine a treatment plan that will accomplish their client’s goals. They often use personality, aptitude, and psychological tests to determine more precisely the needs of a particular patient. They often work closely with other mental health professionals including psychiatrists, psychologists, and social workers to ensure that all of the patient’s needs are being met. Mental health counselors are also responsible for maintaining records of tests and counseling services, and making sure that all records are kept confidential. They frequently conduct research and report their findings in professional and trade journals. Anyone interested in a career as a mental health counselor should be emotionally stable, sensitive to people’s feelings, and have excellent oral and written communication skills.

Work Environment:
Mental health counselors are employed in a variety of settings including private practice, hospitals, correctional institutions, mental health clinics, schools and universities, drug and alcohol rehabilitation centers, halfway houses, and residential care facilities. They may work long, irregular hours including nights and weekends.

High School Preparation:
Students interested in a career in mental health counseling should take high school courses in biology, geometry, algebra, English, health occupations/medical professions education, sociology, literature, psychology, computer skills, social studies, and speech.

College Requirements:
Individuals interested in mental health counseling must first obtain a bachelor’s degree in counseling, psychology, education, sociology, or social work. Most employment opportunities for mental health counselors require a master’s degree or a doctoral degree. Voluntary certification is available through The National Board of Certified Counselors. An internship, a taped sample of clinical work, or other professional experience, as well as passing a written examination is required to receive this certification.
Students interested in counseling should contact schools for information on admission and course of study.

Facts About Clinical Mental Health Counselors

What is a clinical mental health counselor?

Clinical mental health counseling is a distinct profession with national standards for education, training and clinical practice. Clinical mental health counselors are highly-skilled professionals who provide flexible, consumer-oriented therapy. They combine traditional psychotherapy with a practical, problem-solving approach that creates a dynamic and efficient path for change and problem resolution.
  • According to the report, "Mental Health, United States, 2004" published by the U.S. Department of Health and Human Service's (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA), more than 100,500 mental health counselors are licensed or certified for independent practice in the United States.
  • The majority of national behavioral health managed care companies reimburse clinical mental health counselors for services they provide.
  • The median cost per session for clinical mental health counselors is $63, compared to a median cost of $75 for psychologists, and $60 for clinical social workers and marriage and family therapists, according to a January 2006 study by Psychotherapy Finances.
  • All 50 states, the District of Columbia, and Puerto Rico license or certify mental health counselors for private practice.
  • Clinical mental health counselors adhere to a rigorous code of ethics and professional practice standards.  Purchase a printed copy of either document
Clinical mental health counselors offer a full range of services including:
  • Assessment and diagnosis
  • Psychotherapy
  • Treatment planning and utilization review
  • Brief and solution-focused therapy
  • Alcoholism and substance abuse treatment
  • Psychoeducational and prevention programs
  • Crisis management
In today's managed care environment, clinical mental health counselors are uniquely qualified to meet the challenges of providing high quality care in a cost-effective manner. Clinical mental health counselors practice in a variety of settings, including independent practice, community agencies, managed behavioral health care organizations, integrated delivery systems, hospitals, employee assistance programs, and substance abuse treatment centers.
The American Mental Health Counselors Association (AMHCA) is the professional membership organization that represents the clinical mental health counseling profession. Clinical membership in AMHCA requires a master's degree in counseling or a closely related mental health field and adherence to AMHCA's National Standards for Clinical Practice.
Graduate education and clinical training prepare clinical mental health counselors to provide a full range of services for individuals, couples, families, adolescents and children. The core areas of mental health education programs approved by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) include:
  • Diagnosis and psychopathology
  • Psychotherapy
  • Psychological testing and assessment
  • Professional orientation
  • Research and program evaluation
  • Group counseling
  • Human growth and development
  • Counseling theory
  • Social and cultural foundations
  • Lifestyle and career development
  • Supervised practicum and internship
Licensure requirements for clinical mental health counselors are equivalent to those for clinical social workers and marriage and family therapists, two other disciplines that require a master's degree for independent status.
A licensed clinical mental health counselor has met or exceeded the following professional qualifications:
  • Earned a master's degree in counseling or a closely related mental health discipline;
  • Completed a minimum of two years post-master's clinical work under the supervision of a licensed or certified mental health professional; and
  • Passed a state-developed or national licensure or certification examination.

vendredi 3 février 2012

A Novel Mental Health Treatment Program Dramatically Reduces Suicides

If you've seen the photos of crumbling Detroit buildings that are being circulated lately, you'd probably expect the whole city to be full of miserable, despairing people, a place where a suicide rate of zero is unthinkable. Think again! Detroit is struggling but not nearly as badly as those photos suggest, and this Crain's article on the Henry Ford Health System that serves southeast Michigan suggests that "perfect" depression care is entirely possible even in an area that's going through tough times:
"The bigger issue was this culture change that we eventually implemented which simply did not accept the notion that people would kill themselves, the idea that zero would be our goal," says Ed Coffey, a physician who is vice president at the Henry Ford system and CEO of its behavioral health services division. The division has a staff of about 500 and provides mental health and substance-abuse services through its integrated delivery system of two hospitals and 10 clinics that serves Southeast Michigan and adjacent states. "That to me was the biggest thing and the key lever that allowed us to accomplish the success we had," he said.
...The Perfect Depression Care initiative includes six major tactics: commit to "perfection" (zero suicides) as a goal; develop a clear vision of how each patient's care will change; listen to patients regarding their care redesign; conceptualize, design and test strategies for improving patient partnership, clinical practice, access to care and information systems; implement relevant measures of care quality, assess progress and adjust as needed; and communicate the results.
Within the first four years of the program, the annual rate of patient suicides in the behavioral health services department dropped 75 percent to about 22 per 100,000 -- the average rate between 2002 and 2005 -- from 89 suicides per 100,000 at the baseline in 2000, according to an April 2007 article in the Joint Commission Journal on Quality and Patient Safety. In the past two years, or the last 10 consecutive quarters, the department has not seen one patient suicide.

Playing Around With Depression

A new study out of East Carolina University found that playing casual, non-violent video games - in particular "Bejeweled","Peggle" and "Bookworm" - reduced depression symptoms in study participants.
The study, which was underwritten by PopCap games, found that, of the 59 people who participated in the study, the half that spent an average of 40.7 minutes playing the games had a 57% reduction in their depression symptoms.
The seven subjects who were identified as having moderate to severe depression symptoms prior to study had their symptoms reduced to minimal or mild following the study, while the numbers of those who had milder forms of depression prior to the study dropped from nine to four.
The study found that there was a 65% overall improvement in general mood and anxiety, in addition to a reduction in physical symptoms, such as tension (49.6%), anger (55%), confusion (50%) and fatigue (58%).
In a statement, lead author Dr. Carmen Russoniello said, "The results of this study clearly demonstrate the intrinsic value of certain casual games in terms of significant, positive effects on the moods and anxiety levels of people suffering from any level of depression."
"In my opinion," Russoniello concluded,"the findings support the possibility of using prescribed casual video games for treating depression and anxiety as an adjunct to, or perhaps even as a replacement for, standard therapies including medication."

How Does Exercise Improve Mental Health?

We know that exercise has positive effects on the brain. Researchers at Duke University demonstrated several years ago that exercise has antidepressant properties. Other research has shown that exercise can improve the brain functioning of the elderly and may even protect against dementia. How does exercise improve mental health?
One theory for some of the benefits of exercise include the fact that exercise triggers the production of endorphins. These natural opiates are chemically similar to morphine. They may be produced as natural pain relievers in response to the shock that the body receives during exercise. However, researchers are beginning to question whether endorphins improve mood. Studies are showing that the body's metabolism of endorphins is complex, and there are likely additional mechanisms involved in the mental health effects of exercise.
Some studies have found that exercise boosts activity in the brain's frontal lobes and the hippocampus. We don't really know how or why this occurs. Animal studies have found that exercise increases levels of serotonin, dopamine and norepinephrine. These neurotransmitters have been associated with elevated mood, and it is thought that antidepressant medications also work by boosting these chemicals.
Exercise has also been found to increase levels of "brain-derived neurotrophic factor" (BDNF). This substance is thought to improve mood, and it may play a role in the beneficial effects of exercise. BDNF's primary role seems to be to help brain cells survive longer, so this may also explain some of the beneficial effects of exercise on dementia.
The bottom line is that most of us feel good after exercise. Physical exercise is good for our mental health and for our brains. Someday we will understand it all better -- but we can start exercising today.

How Stress Affects Your Health and Happiness

You’ve probably heard that stress can impact your health. But do you know to what extent? Because stress can weaken your immune system, it can make you more susceptible not only to major diseases such as heart disease, but can increase your risk of catching the common cold and flu. And illness can detract from your overall happiness in a significant way. The following resources can help you to better understand how stress affects your health, and find ways to stay healthier.

Your Horse's Mental Health and Happiness

Much has been written about natural horse keeping, but there really is no such thing anymore. Horses under truly natural conditions run wild and free, without fences to stop their migrations. They live in herds and spend their lives foraging for food, fleeing from danger, and raising young. Unfortunately, the price for this lifestyle is a shortened lifespan, as the wild horse succumbs to disease, injury, and predators much sooner than her captive counterparts.

Your horse will be happier and mentally healthier if you can keep him under as natural conditions as possible. This means keeping him on pasture with ample grazing when weather permits. Unfortunately, many people keep their horses confined to stalls most of the day, either for convenience or because of limited land resources. This circumstance is quite unnatural for horses, and the ensuing boredom and pent-up energy can lead to all sorts of behavioral problems. To simulate more natural conditions, give your horse as much turnout time as possible so he can graze and stretch his legs.
Provide Companionship Horses are herd animals and are happiest when living with other equine companions. If you can afford to own only one horse, keeping him at a boarding facility offers the advantage of other horses for him to socialize with. If boarding isn't an option for you, then consider owning more than one horse, if at all possible. If you can't afford to buy two horses, perhaps you can adopt a homeless horse from a rescue shelter. If you have enough land, consider keeping someone else's horse on your property so that both animals have a companion and you have a riding buddy.

Author of Hormones Health and Happiness

Information about the controversial Dr. Steven Hotze, author of the book Hormones Health and Happiness, and founder of the Hotze Health and Wellness Center. 
In this article, Drs. Richard and Karilee Shames weigh in with their thoughts on the AACE, CBS, Dr. Steven Hotze controversy, and the overall implications for the thyroid community. 
 
All out war is being waged between Dr. Steven Hotze, author of "Hormones, Health and Happiness," and the American Association of Clinical Endocrinologists (AACE). The controversy centers on an appearance Dr. Hotze made on the CBS Early Show on September 19, 2005, to discuss his book. Hotze made a head-on assault against conventional endocrinology -- along with its main source of funding, Synthroid, and the AACE has fired back. Explore the controversy with patient advocate Mary Shomon.

Physical, Emotional and Lifestyle Effects of Stress

Stress can affect you in many ways. People often notice the emotional effects of stress, but aren't always aware of all of the ways stress can have a physical impact. Learn more about the effects of stress, and how to safeguard your health and happiness.
 When you experience stress, there's a cascade of physical changes that occur to prepare you to deal with it. Here's what happens in your body--and what can happen when your stress response is triggered too often.

Mental Illness - Mental Disorders

Information about different mental disorders. Diagnosis is not always exact, and some of these disorders overlap. Most of the content is in the "More Categories" folders in the right-hand column.
Living with a mental health condition means not only taking efforts to manage it, but coping with the ways in which it can affect your life and those in it. If you're faced with a mental health concern, or if you are the loved one of someone who is, there are things you can do to help make way for a better life.
 

Mental health and development

The new WHO report on mental health and development is a call to action to all development stakeholders - governments, civil society, multilateral agencies, bilateral agencies, global partnerships, private foundations, academic and research institutions - to focus their attention on mental health.
The report presents compelling evidence that persons with mental and psychosocial disabilities are a vulnerable group but continue to be marginalized in terms of development aid and government attention. It makes the case for reaching out to this group through the design and implementation of appropriate policies and programmes and through the inclusion of mental health interventions into broader poverty reduction and development strategies. The report also describes a number of key interventions which can provide a starting point for these efforts. By investing in persons with mental and psychosocial disabilities, development outcomes can be improved.

How Does Exercise Improve Mental Health?

We know that exercise has positive effects on the brain. Researchers at Duke University demonstrated several years ago that exercise has antidepressant properties. Other research has shown that exercise can improve the brain functioning of the elderly and may even protect against dementia. How does exercise improve mental health?
One theory for some of the benefits of exercise include the fact that exercise triggers the production of endorphins. These natural opiates are chemically similar to morphine. They may be produced as natural pain relievers in response to the shock that the body receives during exercise. However, researchers are beginning to question whether endorphins improve mood. Studies are showing that the body's metabolism of endorphins is complex, and there are likely additional mechanisms involved in the mental health effects of exercise.
Some studies have found that exercise boosts activity in the brain's frontal lobes and the hippocampus. We don't really know how or why this occurs. Animal studies have found that exercise increases levels of serotonin, dopamine and norepinephrine. These neurotransmitters have been associated with elevated mood, and it is thought that antidepressant medications also work by boosting these chemicals.
Exercise has also been found to increase levels of "brain-derived neurotrophic factor" (BDNF). This substance is thought to improve mood, and it may play a role in the beneficial effects of exercise. BDNF's primary role seems to be to help brain cells survive longer, so this may also explain some of the beneficial effects of exercise on dementia.
The bottom line is that most of us feel good after exercise. Physical exercise is good for our mental health and for our brains. Someday we will understand it all better -- but we can start exercising today.

Mental Health and the Holidays

As Christmas and New Year's draw closer, many of us are bracing for changes to our routines that could shake anyone's mental health. Travel and jetlag, a break from the rigid schedule of work or school, meals at unusual times, and the distractions of family can all contribute to forgetting to take medication. Many therapists and other mental health providers are out of reach while they enjoy their own celebrations (and hard-earned rest). Holiday stress may worsen mental health conditions, and while holiday joy is a wonderful thing, January can be a real let-down.

A Novel Mental Health Treatment Program Dramatically Reduces Suicides

If you've seen the photos of crumbling Detroit buildings that are being circulated lately, you'd probably expect the whole city to be full of miserable, despairing people, a place where a suicide rate of zero is unthinkable. Think again! Detroit is struggling but not nearly as badly as those photos suggest, and this Crain's article on the Henry Ford Health System that serves southeast Michigan suggests that "perfect" depression care is entirely possible even in an area that's going through tough times:
"The bigger issue was this culture change that we eventually implemented which simply did not accept the notion that people would kill themselves, the idea that zero would be our goal," says Ed Coffey, a physician who is vice president at the Henry Ford system and CEO of its behavioral health services division. The division has a staff of about 500 and provides mental health and substance-abuse services through its integrated delivery system of two hospitals and 10 clinics that serves Southeast Michigan and adjacent states. "That to me was the biggest thing and the key lever that allowed us to accomplish the success we had," he said.
...The Perfect Depression Care initiative includes six major tactics: commit to "perfection" (zero suicides) as a goal; develop a clear vision of how each patient's care will change; listen to patients regarding their care redesign; conceptualize, design and test strategies for improving patient partnership, clinical practice, access to care and information systems; implement relevant measures of care quality, assess progress and adjust as needed; and communicate the results.
Within the first four years of the program, the annual rate of patient suicides in the behavioral health services department dropped 75 percent to about 22 per 100,000 -- the average rate between 2002 and 2005 -- from 89 suicides per 100,000 at the baseline in 2000, according to an April 2007 article in the Joint Commission Journal on Quality and Patient Safety. In the past two years, or the last 10 consecutive quarters, the department has not seen one patient suicide.

Launch of Mental Health Atlas 2011

The WHO Mental Health Atlas 2011 represents the latest estimate of global mental health resources available to prevent and treat mental disorders and help protect the human rights of people living with these conditions. It presents data from 184 WHO Member States, covering 98% of the world’s population. Facts and figures presented in Atlas indicate that resources for mental health remain inadequate. The distribution of resources across regions and income groups is substantially uneven and in many countries resources are extremely scarce. Results from Atlas reinforce the urgent need to scale up resources and care for mental health within countries.The WHO Mental Health Atlas 2011 represents the latest estimate of global mental health resources available to prevent and treat mental disorders and help protect the human rights of people living with these conditions. It presents data from 184 WHO Member States, covering 98% of the world’s population. Facts and figures presented in Atlas indicate that resources for mental health remain inadequate. The distribution of resources across regions and income groups is substantially uneven and in many countries resources are extremely scarce. Results from Atlas reinforce the urgent need to scale up resources and care for mental health within countries.

Perinatal Mental Health

The Perinatal Mental Health Consultation Service (PMHCS) is a tertiary service provided by Mental Health ACT. It is a consultation and liaison service specialising in the assessment, diagnosis and treatment of women experiencing significant mental health issues in the preconception, antenatal and postnatal periods. The service provides a one and a half day a week clinic staffed by a Psychiatrist, Registrar, Psychologists and a Registered Nurse. Please be aware that this tertiary service does not provide clinical management or “supportive counselling”
PMHCS does not offer clinical management or provide crisis assessments. If you have a client who requires these services, please contact the Mental Health Crisis Assessment Treatment Team on 1800 629 354.

Information on the Mental Health Act

Mental Health Act 1983

The Mental Health Act 1983 primarily deals with the detention in hospital of people with mental disorders, as well as other compulsory measures including guardianship and supervised community treatment. It sets out the criteria that must be met before compulsory measures can be taken, along with protections and safeguards for patients.


Mental Health Act 2007

The Mental Health Act 2007 received Royal Assent on 19 July 2007. It made a number of amendments to the Mental Health Act 1983. It also extended the rights of victims by amending the Domestic Violence, Crime and Victims Act 2004 and amended the Mental Capacity Act (MCA) 2005 to introduce new deprivation of liberty safeguards.

Mental health problems

Specialist mental health services for older people have grown rapidly and successfully over the past two decades, aiming to offer services that are comprehensive, accessible, responsive, individualised, multidisciplinary, accountable, and systematic. As with all mental health problems, the burden falls on primary care (where minor morbidity often goes undetected) and specialist services tend to be reserved for those conditions and patients where diagnosis and management is problematic. The total cost of caring for people with dementia in the United Kingdom is estimated at £6bn ($9bn) a year1—a figure whose impact is diluted by the fact that it combines both health and social services. We outline the current evidence of benefit in four areas: services currently available; interventions that have been shown to be effective; rating scales that should be recommended to clinicians for detecting common mental health problems; and the needs of carers.

Trends in the use of the Mental Health Act

Sharon Wall, research worker,a Matthew Hotopf, senior lecturer in psychological medicine,a Simon Wessely, professor of liaison and epidemiological psychiatry,a and Rachel Churchill, lecturer in psychiatric epidemiologyb
aDepartment of Psychological Medicine, Guy’s, King’s College, and St Thomas’s School of Medicine and the Institute of Psychiatry, London SE5 8AZ, bSection of Epidemiology and General Practice, Institute of Psychiatry, London SE5 8AF
Contributed by
  Contributors: MH, RC, and S Wessely developed the original protocol and obtained funding. S Wall obtained and analysed the data, and wrote the article. MH, RC, and S Wesselysupervised this work and made comments on earlier drafts. MH is guarantor for the paper.
Correspondence to: Dr Hotopf m.hotopf@iop.bpmf.ac.uk
Accepted January 19, 1999.

CAPACITY AND ‘BEST INTERESTS

An Expert Committee set up by the Government in 1998 to advise on reform of the MHA endorsed two fundamental principles: non-discrimination against those with a mental illness, so they are treated like those with other illnesses, and respect for patients' autonomy (Department of Health, 1999). This led to a reconsideration of the grounds of involuntary treatment in general and to the conclusion that this must be connected with a patient's lack of capacity to make treatment decisions. ‘Capacity’, put at its simplest, refers to the patient's ability to understand the nature and purpose of the recommended treatment, including the consequences of having or not having it, and to reason using this information (Law Commission, 1995; Grisso & Appelbaum, 1998).

By any standards, the Committee complied with the Government's demand for a ‘ root and branch’ reassessment of the MHA: it recommended radical and far-reaching revisions — far too radical, it now appears. Table 1 summarises the key recommendations and, for comparison, the Government's proposals in the Green Paper (Secretary of State for Health, 1999). As Table 1 shows, the Green Paper finds capacity unattractive; the overarching principle is to reduce the risk of harm — to the patient and especially to others. However, where this principle comes from and why it should be primary is unexplained.

Reform of the Mental Health Act

The Mental Health Act 1959 followed a groundbreaking Royal Commission and marked a transition from legalistic forms to paternalism. Mental health professionals were given wide latitude to act in the health interests of people with mental disorders. The Mental Health Act 1983 (MHA) curtailed some of these powers and strengthened patients' rights against paternalistic intrusion. The 1990s has seen yet another shift; ‘community care’ has frightened many into a preoccupation with ‘public safety’ and seeking means of exerting more control over patients, especially to ensure their compliance with treatment in the community (Department of Health, 1998, 1999). Such swings of policy remind us that the prescription of involuntary treatment is primarily a social matter and only weakly related to the epidemiology or clinical features of mental disorder.

Narcissism puts men's health at risk

Do you really love yourself? If you're a man, you could be risking your health, according to a new study.

The study found narcissism - particularly in men - is tied to unhealthy stress on the body.

Narcissism is characterized as having an inflated self-esteem, little empathy, and a sense of entitlement.

The study, published Jan. 23 in the journal PLoS ONE, analyzed 106 volunteer students from American university - 79 females, 27 males, with were on average 20 years old. The volunteers were given a 40-item questionnaire called the Narcissistic Personality Inventory, which assesses five different components of narcissism: two unhealthy (exploitativeness and entitlement) and three healthy (leadership/authority, superiority/arrogance, and self-absorption/self-admiration). Researchers also measured participants' baseline levels of cortisol, a hormone that's responsible for the body's response to stress. High cortisol levels are generally correlated with high psychological stress.

Combining the data, the researchers found that males who had higher measures of the unhealthy components of narcissism also had higher levels of cortisol. The unhealthy components of narcissism were more than twice as likely to predict high cortisol in males than in females. No link was found between healthy narcissism and cortisol in either gender.

Why might narcissistic men be more stressed? "Even though narcissists have grandiose self-perceptions, they also have fragile views of themselves, and often resort to defensive strategies like aggression when their sense of superiority is threatened," study author David Reinhard, a graduate student in the department of psychology at the University of Virginia in Charlottesville, said in a written statement. According to Reinhard, these aggressive coping strategies are tied to high blood pressure would lead to "chronically elevated levels of stress."

"People with narcissism may be type-A, very driven, perfectionistic and seek high-stress situations, and the cortisol levels may be measuring that," Dr. Mark Russ, director of psychiatric services at Zucker Hillside Hospital in Glen Oaks, N.Y. who was not involved in the study, told USA Today. "There may be an overlap."

Why did narcissism affect men and not women? The study authors speculate that societal definitions of masculinity (with traits like arrogance or dominance) might play a role. "Threats to male gender roles and masculinity are constant, and provide a source of stress that make these roles difficult to maintain," the authors wrote.

Despite their differing stress levels, men and women are equally narcissistic, the study found. It also notes that narcissism is on the rise in the U.S., which may have potential "longterm public health consequences.

Narcissism puts men's health at risk

Do you really love yourself? If you're a man, you could be risking your health, according to a new study.

The study found narcissism - particularly in men - is tied to unhealthy stress on the body.

Narcissism is characterized as having an inflated self-esteem, little empathy, and a sense of entitlement.

The study, published Jan. 23 in the journal PLoS ONE, analyzed 106 volunteer students from American university - 79 females, 27 males, with were on average 20 years old. The volunteers were given a 40-item questionnaire called the Narcissistic Personality Inventory, which assesses five different components of narcissism: two unhealthy (exploitativeness and entitlement) and three healthy (leadership/authority, superiority/arrogance, and self-absorption/self-admiration). Researchers also measured participants' baseline levels of cortisol, a hormone that's responsible for the body's response to stress. High cortisol levels are generally correlated with high psychological stress.

Combining the data, the researchers found that males who had higher measures of the unhealthy components of narcissism also had higher levels of cortisol. The unhealthy components of narcissism were more than twice as likely to predict high cortisol in males than in females. No link was found between healthy narcissism and cortisol in either gender.

Why might narcissistic men be more stressed? "Even though narcissists have grandiose self-perceptions, they also have fragile views of themselves, and often resort to defensive strategies like aggression when their sense of superiority is threatened," study author David Reinhard, a graduate student in the department of psychology at the University of Virginia in Charlottesville, said in a written statement. According to Reinhard, these aggressive coping strategies are tied to high blood pressure would lead to "chronically elevated levels of stress."

"People with narcissism may be type-A, very driven, perfectionistic and seek high-stress situations, and the cortisol levels may be measuring that," Dr. Mark Russ, director of psychiatric services at Zucker Hillside Hospital in Glen Oaks, N.Y. who was not involved in the study, told USA Today. "There may be an overlap."

Why did narcissism affect men and not women? The study authors speculate that societal definitions of masculinity (with traits like arrogance or dominance) might play a role. "Threats to male gender roles and masculinity are constant, and provide a source of stress that make these roles difficult to maintain," the authors wrote.

Despite their differing stress levels, men and women are equally narcissistic, the study found. It also notes that narcissism is on the rise in the U.S., which may have potential "longterm public health consequences."

Mental illness affects 38 percent of Europeans, study shows

mental illness more common in Europe than in other parts of the world? Reliable statistics aren't readily available, but mental health experts expressed surprise over new research showing that 38 percent of the European population, or 165 million people, have a mental or neurological disorder.
"Although the figure seems shockingly high, this is the most rigorous study done in Europe," said Graham Thornicroft, a professor of community psychiatry at the Institute of Psychiatry at King's College London, who was not linked to the study. "The real tragedy is that so few people with mental health problems receive treatment."
Experts estimate that only one-third of people affected by the disorders get help.
Researchers arrived at the eye-popping figure after reviewing data from previous studies involving more than 500 million people in 27 European countries, plus Switzerland, Iceland, and Norway. They considered more than 90 mental and neurological problems, including attention-deficit hyperactivity disorder and other problems that are more common in children as well as those typically found in the elderly, such as dementia.
The rates of mental and neurological disorders didn't appear to be rising, compared to a similar study in 2005. The most common problems include anxiety disorders, insomnia, depression, alcohol and drug dependence and dementia.
Using such a broad definition of mental health and neurological disorders might artificially inflate the problem, some experts who were not connected to the study said. "Not all of these people require psychiatric interventions," said Matt Muijen, a mental health expert with World Health Organization's European office in Copenhagen. "The 38 percent is indicative of stress in society, not necessarily psychiatric disorders."
Because researchers in other areas use varying definitions of what constitutes mental illness, it's hard to compare European rates to those elsewhere, he said. The NIH estimates that about 26 percent of American adults have some type of mental disorder.
Other experts said the numbers of people with mental health problems appeared higher than what is commonly believed because most patients don't report their illness and because this study includes disorders in children and the elderly.
Study author Hans-Ulrich Wittchen said many patients still face discrimination and limited services when seeking treatment, adding, "Mental health disorders are Europe's largest health care challenge in the 21st century."

Environment and health

The environment is a major determinant of health, estimated to account for almost 20% of all deaths in the WHO European Region. In 1989, concerned about the growing evidence of the impact of hazardous environments on human health, WHO/Europe initiated the first ever environment and health process, towards a broad primary prevention public health approach, and to facilitate intersectoral policy-making.
Collaboration between different sectors is crucial to protect human health from the risks of a hazardous or contaminated environment. Through its European Centre on Environment and Health, WHO/Europe brings many players together with Member States to tackle central environment and health issues.

Maternal and newborn health

While in most cases having a baby is a positive experience, pregnancy and childbirth can cause suffering, ill health or even death. Every year, women and newborn babies die from complications related to childbirth.
The interventions and approaches that help save the lives of mothers and babies are well documented. They can work even where resources are poor. Using this evidence, WHO/Europe provides guidance, training and technical support to governments and their partner agencies to ensure that the health system provides women and their newborn babies with the skilled care they need. The main goal is to help countries achieve Millennium Development Goals 4 and 5: to reduce newborn mortality and maternal mortality significantly by 2015.

Sexual and reproductive health

Sexual and reproductive health is very personal, so people may have trouble finding or asking for accurate information about it. This may also help explain why these issues are still not addressed openly, and services are inadequate, fragmented and unfriendly in some countries in the European Region. Complications of pregnancy and childbirth, unsafe abortions, reproductive tract infections, sexual violence and women dying from avoidable cancer are just a few of the problems in this area. WHO/Europe assists countries to evaluate their situations and to choose the optimal way to improve them.

Definition
People are sexual beings all their lives. The purposes of sexual health care should be the enhancement of life and personal relationships, and not merely counselling and care related to procreation or sexually transmitted infections. Reproductive health implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to have children and the freedom to decide if, when and how often to do so.

Men and women should have access to the safe, effective, affordable and acceptable methods of fertility regulation of their choice, and to appropriate health care services that will enable women to go safely through pregnancy and childbirth, and provide couples with the best chance of having healthy infants.

Problems
Women are over four times as likely to die in childbirth in the newly independent states of the former USSR as in the European Union. In some countries unsafe abortion causes over 20% of all registered maternal deaths, and eastern Europe has the highest abortion rate in the world. Many people still lack information on, for example, sexuality, family planning, pregnancy and childbirth, sexually transmitted infections, infertility, cervical cancer prevention, menopause.

In response, national and regional health policies and programmes increasingly give explicit attention to sexual and reproductive health.

Physical activity

Regular exercise such as walking, cycling, or dancing not only makes you feel good, it has significant benefits for health. It reduces the risk of cardiovascular disease, diabetes and some cancers, helps control weight, and contributes to mental well-being. Taking part in physical activity also increases opportunities for making friends and feeling part of the community.
Active living benefits health at any age, but it is especially important to the healthy development of children and young people, and can make a substantial difference to the well-being of older people. On the contrary, physical inactivity is one of the leading risk factors for health and is estimated to attribute to one million deaths per year in the WHO European Region.
WHO/Europe works towards physical activity promotion in health policy and in other relevant sectors in Europe through the European network for the promotion of health-enhancing physical activity (HEPA Europe) which it hosts.
Increasing physical activity across sectors
There are many ways to increase physical activity, whether it be at school or at work or in the transport choices you have, or the place you live in. WHO calls on all sectors, including health, transport, housing and education to engage with this issue and collaborate in effective policies and interventions.

Child and adolescent health

Most children and adolescents in the WHO European Region enjoy a high standard of health and well-being. The Region includes the countries with the lowest infant and child mortality rates in the world. However it also includes some whose rates are 10 times higher. Every year, 200 000 children in the European Region die before the age of five, 40% of them in the first month of life.
WHO/Europe supports countries as they try to reach the Millennium Development Goals (MDGs) particularly MDGs 3–5, whose aim is to reduce child mortality and improve maternal health by 2015.
Much of the morbidity and mortality among children and young people is preventable. Low-cost measures that have been shown to work – whether they target road traffic accidents or poverty – could prevent two thirds of deaths. Children are particularly vulnerable to environmental pollution, and poor environments aggravate socioeconomic disparities in cities. Children and adolescents need clean air, safe housing, nutritious food, clean water and a healthy way of life; they need friendly services that they can reach and can reach them.
There are warning signs of the return of diseases previously under control, such as diphtheria and tuberculosis; the increase of noncommunicable diseases such as asthma and allergies; and new morbidity from substance abuse, injuries and mental disorders. Further, adverse effects on children’s health result from increasing socioeconomic inequalities across the Region, the consequences of armed conflict and child labour and sexual exploitation.
WHO/Europe’s approach is not to rely on piecemeal measures, but to strengthen health systems and focus on measurable results, designing and implementing policies based on evidence.

WHO/Europe will pursue four priorities for mental healt

  1. high-quality information, as it is often lacking;
  2. service users’ and carers’ empowerment so that the services can respond to direct needs and experiences;
  3. development of services, particularly community-based practice in middle- and low-income countries, where services have traditionally been provided in large mental institutions; and
  4. improving the state of social care homes in Europe, focusing on the conditions for children with intellectual disabilities, who too often live in unacceptable circumstances, and the development of family support and community services.
Mental ill health accounts for almost 20% of the burden of disease in the WHO European Region and mental health problems affect one in four people at some time in life. Nine of the ten countries with the highest rates of suicide in the world are in the European Region.
Much is now known about what works in mental health promotion, prevention, care and treatment. The challenge is now to implement this knowledge.
Services and practice do not always reflect the knowledge of what works in mental health care and treatment. Many countries have limited community-based mental health services and little specialist help for young or elderly people.
Many people in large mental institutions are subject to neglect and abuse of human rights, reflected in high mortality rates. Stigma and prejudice are widespread and affect every aspect of mental health, including whether people seek and receive help.

Mental Health Compass

 La base de données «Mental Health Compass» est un outil de partage des informations sur la santé mentale dans l'UE et les actions menées dans ce domaine.
Cette base de données contient des informations sur les cinq domaines prioritaires du pacte européen pour la santé mentale et le bien-être. Elle se développera au travers des conférences organisées dans le cadre du pacte.

Social Inclusion and Mental Health

Mental Health Europe has a history and plays an important role in raising awareness and in combating stigma, discrimination and social exclusion associated with mental illness. Mainstreaming mental health in the social policy field has become one of MHE's principal activities and a major area of concern for people with mental health problems. 
EU policy developments in the field of Social Inclusion

In 2000, EU leaders established the Social Inclusion Process  to make a decisive impact on eradicating poverty by 2010. Through this process, the European Union coordinates and encourages Member State actions to combat poverty and social exclusion, and to reform their social protection systems on the basis of policy exchanges and mutual learning.

To read more about EU developments, click here
MHE key activities in this field

MHE's Work Plan for the years 2011-2013 - supported by the PROGRESS Community Programme for Employment and Social Solidarity - has the overall goal to "develop and strengthen MHE's capacities and that of its member organisations, including people with mental health problems, who are at risk of poverty and social exclusion, to inform and influence employment and social policy and processes at the local, national, regional and European level with a view to better reflecting the needs of people with  mental health problems."

To read more about MHE activities in the field of social inclusion

Conceptual framework

Mental Health

According to the World Health Organization (WHO), there is no 'official' definition of mental health. Cultural differences and competing professional theories all affect how 'mental health' is defined. In general, however, most experts agree that mental health and mental illness are not the same thing. In other words, the absence of a recognised mental disorder

Mental Health Promotion

Mental health promotion and disorder prevention activities in Europe are developing a capacity for innovation through work in the community with the message that there is no health without mental health. It appears that this message is reaching more and more policy makers - witness the European Commission launch of the European Pact for Mental Health and Well-being on 13 June 2008 and the new policy initiatives on mental health promotion and prevention in an increasing number of EU member states. 

Mental Health Europe

There is no Health without Mental Health! 

Mental health is an essential part of any citizen's health and well being. As such, it is an essential component of communities. Good mental health is a basic human right. Factors that adversely affect mental health represent a major and growing threat to economic, social and public health in the world.

Welcome to Mental Health Europe.

This site provides you with:

    * Up-to-date information with key challenges in mental health.
    * Information on Mental Health Europe's mission and activities.
    * Access to a network of organisations concerned by the state of mental health in Europe.
       

MHE organized its capacity-building seminar for MHE and ENUSP members on May 20, 2011 in Brussels. Presentations and general information, including the agenda of the seminar

Mental Health Overview

Just as physical health is important, so is good mental health. Still, millions of Americans suffer with various types of mental illness and mental health problems, such as social anxiety, obsessive compulsive disorder, addiction to drugs and alcohol, and personality disorders. Mental illness and psychological disorders have good treatment options with medications, psychotherapy, or other treatments.

Attitudes to mental health

Mental health is about how we think, feel and behave. One in four people in the UK has a mental health problem at some point, which can affect their daily life, relationships or physical health.
Mental health problems can affect anyone. Without support and treatment, mental health problems can have a serious effect on the individual and those around them.
Every year in the UK, more than 250,000 people are admitted to psychiatric hospitals and over 4,000 people commit suicide.

Mental health disorders

Mental health disorders take many different forms and affect people in different ways. Schizophrenia, depression and personality disorders are all types of mental health problem.
Diseases such as dementia generally develop in old age, whereas eating disorders are more common in young people.
There is no single cause of mental health problems and the reasons they develop are complex.

What is Good Mental Health?

Good mental health is not simply the absence of diagnosable mental health problems, although good mental health is likely to help protect against development of many such problems.
Good mental health is characterised by a person’s ability to fulfil a number of key functions and activities, including:

Mental health

As many as one in four of us will have some sort of mental health problem in our lives, yet it’s still a taboo subject. It’s important to make sure you keep your emotional and mental health in check and recognise if there’s a problem.

Autism Spectrum Disorders

Autism, Asperger's Syndrome, and similar developmental disorders are still poorly understood. Research is finding treatments that help parents and children manage these disorders, and we know more about what happens when these children grow up.

Symptoms and Diagnosis of Mental Health Concerns

Diagnosing a mental health condition can only be done by a qualified health professional. But there are some symptoms that may raise awareness that there's a concern brewing. Knowing more about the symptoms of various mental health conditions, and how they are diagnosed, can help you better understand if you or a loved one is in need of help.

Life With a Mental Health Concern

Living with a mental health condition means not only taking efforts to manage it, but coping with the ways in which it can affect your life and those in it. If you're faced with a mental health concern, or if you are the loved one of someone who is, there are things you can do to help make way for a better life.

Mental Illness - Mental Disorders

Information about different mental disorders. Diagnosis is not always exact, and some of these disorders overlap. Most of the content is in the "More Categories" folders in the right-hand column.

About Mental Health

Mental Health affects us all. How we think and feel about ourselves and our lives impacts on our behaviour and how we cope in tough times.

It affects our ability to make the most of the opportunities that come our way and play a full part amongst our family, workplace, community and friends. It’s also closely linked with our physical health.

Whether we call it well-being, emotional welfare or mental health, it’s key to living a fulfilling life.

What are Mental Health Problems?

Mental health problems range from the worries we all experience as part of everyday life to serious long-term conditions. The majority of people who experience mental health problems can get over them or learn to live with them, especially if they get help early on.

Mental health problems are usually defined and classified to enable professionals to refer people for appropriate care and treatment. But some diagnoses are controversial and there is much concern in the mental health field that people are too often treated according to or described by their label. This can have a profound effect on their quality of life. Nevertheless, diagnoses remain the most usual way of dividing and classifying symptoms into groups.

Most mental health symptoms have traditionally been divided into groups called either ‘neurotic’ or ‘psychotic’ symptoms. ‘Neurotic’ covers those symptoms which can be regarded as severe forms of ‘normal’ emotional experiences such as depression, anxiety or panic. Conditions formerly referred to as ‘neuroses’ are now more frequently called ‘common mental health problems.’

Less common are ‘psychotic’ symptoms, which interfere with a person’s perception of reality, and may include hallucinations such as seeing, hearing, smelling or feeling things that no one else can.

Mental health problems affect the way you think, feel and behave. They are problems that can be diagnosed by a doctor, not personal weaknesses.

Mental health problems are very common. About a quarter of the population experience some kind of mental health problem in any one year.

Anxiety and depression are the most common problems, with around 1 in 10 people affected at any one time. Anxiety and depression can be severe and long-lasting and have a big impact on people’s ability to get on with life.

Between one and two in every 100 people experience a severe mental illness, such as bi-polar disorder or schizophrenia, and have periods when they lose touch with reality. People affected may hear voices, see things no one else sees, hold unusual or irrational beliefs, feel unrealistically powerful, or read particular meanings into everyday events.

Although certain symptoms are common in specific mental health problems, no two people behave in exactly the same way when they are unwell.

Many people who live with a mental health problem or are developing one try to keep their feelings hidden because they are afraid of other people’s reactions. And many people feel troubled without having a diagnosed, or diagnosable, mental health problem - although that doesn’t mean they aren’t struggling to cope with daily life.

10 Ways to Look After Your Mental Health

Anyone can make simple changes that have a huge impact on their mental health and wellbeing. We've come up with ten practical ways to take care of yourself and get the most from life.

Mental health is about the way you think and feel and your ability to deal with ups and downs. Making simple changes to how you live doesn't need to cost a fortune or take up loads of time. Anyone can follow our advice.


Talk About Your Feelings
Talk About Your Feelings
Talking about your feelings can help you stay in good mental health and deal with times when you feel troubled. Talking about your feelings isn’t a sign of weakness. It’s part of taking charge of your wellbeing and doing what you can to stay healthy.
Eat Well
Eat Well
There are strong links between what we eat and how we feel – for example, caffeine and sugar can have an immediate effect.  But food can also have a long-lasting effect on your mental health.
Keep in Touch
Keep in Touch
Friends and family can make you feel included and cared for. They can offer different views from whatever’s going on inside your own head. They can help keep you active, keep you grounded and help you solve practical problems.
Take a Break
Take a Break
A change of scene or a change of pace is good for your mental health. It could be a five-minute pause from cleaning your kitchen, a half-hour lunch break at work or a weekend exploring somewhere new. A few minutes can be enough to de-stress you.
Accept Who You Are
Accept Who You Are
Some of us make people laugh, some are good at maths, others cook fantastic meals. Some of us share our lifestyle with the people who live close to us, others live very differently. We’re all different.
Keep Active
Keep Active
Experts believe exercise releases chemicals in your brain that make you feel good. Regular exercise can boost your self-esteem and help you concentrate, sleep, look and feel better. Exercise also keeps the brain and your other vital organs healthy.
Drink Sensibly
Drink Sensibly
We often drink alcohol to change our mood. Some people drink to deal with fear or loneliness, but the effect is only temporary.
Ask for Help
Ask for Help
None of us are superhuman. We all sometimes get tired or overwhelmed by how we feel or when things go wrong. If things are getting too much for you and you feel you can’t cope, ask for help.
Do Something You're Good At
Do Something You're Good At
What do you love doing? What activities can you lose yourself in? What did you love doing in the past? Enjoying yourself helps beat stress. Doing an activity you enjoy probably means you’re good at it and achieving something boosts your self-esteem.
Care for Others
Care for Others
Caring for others is often an important part of keeping up relationships with people close to you. It can even bring you closer together.

Mental Health Issues

This study examines mental health issues among women of different sexual orientations. An anonymous survey was administered at 33 health care sites across the United States; the sample (N = 1304) included lesbians (n = 524), bisexual (n = 143) and heterosexual women (n = 637). Not only did sexual orientation influence the probability of experiencing emotional stress, but also whether a bisexual woman or lesbian had disclosed her sexual orientation (was “out”) impacted the likelihood of having or having had mental health problems. Bisexual women and lesbians experienced more emotional stress as teenagers than did heterosexual women. Bisexual women were more than twice as likely to have had an eating disorder compared to lesbians. If a bisexual woman reported being out she was twice as likely to have had an eating disorder compared to a heterosexual woman. Lesbians who were not out and bisexual women who were out were 2-2.5 times more likely to experience suicidal ideation in the past 12 months. Lesbians and bisexual women who were not out were more likely to have had a suicide attempt compared to heterosexual women. Lesbians used psychotherapy for depression more commonly than did heterosexual or bisexual women. This is one of the few studies that compares lesbians, bisexual and heterosexual women. The implications of these findings are discussed.

Services for older people

A recent report by the Audit Commission surveyed 850 carers and 1005 general practitioners by visiting 12 areas of the United Kingdom and conducting face to face interviews.2 The results showed that the range of services in health authorities was patchy and varied between the different authorities; in addition, coordinated care between health and social services was lacking. Individual components of old age psychiatry services have been evaluated and described in the literature. Memory clinics, for example, improve significantly the quality of life in carers of people with dementia because of the treatment and advice they offer.3,4 In dementia, there has been a particular emphasis on earlier and more open diagnosis to enable individuals to make choices and decisions about their future care at an earlier stage and to offer possible opportunities for treatment.5 Considerable interest has also been shown about improving care for people with established dementia—for example, using the person centred approach advocated by Kitwood.6 Effective liaison services at the interface between old age psychiatry and old age medicine lead to workable models, with some early indications of good efficacy.7

Mental health problems

Specialist mental health services for older people have grown rapidly and successfully over the past two decades, aiming to offer services that are comprehensive, accessible, responsive, individualised, multidisciplinary, accountable, and systematic. As with all mental health problems, the burden falls on primary care (where minor morbidity often goes undetected) and specialist services tend to be reserved for those conditions and patients where diagnosis and management is problematic. The total cost of caring for people with dementia in the United Kingdom is estimated at £6bn ($9bn) a year1—a figure whose impact is diluted by the fact that it combines both health and social services. We outline the current evidence of benefit in four areas: services currently available; interventions that have been shown to be effective; rating scales that should be recommended to clinicians for detecting common mental health problems; and the needs of carers.
Summary points
  • Recent reports have highlighted the needs of older people with mental health problems
  • Mental health problems are underrecognised and undertreated in primary care
  • The use of guidelines and standardised screening instruments may improve this
  • Caring for a person with dementia is stressful, and carers' needs are being increasingly recognised
  • Carer interventions in people with dementia have been shown to be effective in randomised controlled trials
  • Depression, the commonest mental health disorder in later life, is eminently treatable, but psychological therapies are underused

Removal of categories of mental disorder

(1)Section 1(2) of the 1983 Act (key definitions) is amended as set out in subsections (2) and (3).

(2)For the definitions of “mental disorder” and “mentally disordered” substitute—

““mental disorder” means any disorder or disability of the mind; and

“mentally disordered” shall be construed accordingly;”.

(3)The following definitions are omitted—

(a)those of “severe mental impairment” and “severely mentally impaired”,

(b)those of “mental impairment” and “mentally impaired”, and

(c)that of “psychopathic disorder”.

(4)Schedule 1 (which contains further amendments to the 1983 Act and amendments to other Acts) has effect.