Public mental Health

1. 2nd Semester –10th January 7th March- Public mental Health

2. Public Mental Health Course Outline: • Public Mental Health • Essential Epidemiology • Essential Health Economics • Public Health Policy • National and district mental healthcare planning • Health Information Systems

3. Public Mental Health • Drugs Management • Prevention and promotion of mental health • Global Mental Health 10 week course Examined alongside research methods in March Written Paper

4. Research Projects • You must be completing this alongside public mental health module • You MUST comply with deadlines, or risk losing percentage of final degree mark –this is a degree programme! • Submission to COMREC by 28th January 2012

5. What is public health? • Winslow (1920): the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals • The organised response by society to protect and promote health, to prevent injury, illness and disability

6. History of public Health • 19th century public health movement – focus on legislation and sanitary reforms • 1848 Public Health Act: powers to remedy unsanitary conditions and require adequate drainage and sanitation of towns • John Snow: Broad Street pump: removal of handle at centre of cholera outbreak Since this time the field gradually developed

7. Public Health Eras • Germ Theory • Targetting of living conditions (nutrition + housing); employment conditions (trade unions)

8. New Public Health • 1970’s: ‘healthy lifestyle’ focus • Lalonde report: health beyond healthcare: environment & lifestyle • Health for All by Year 2000 (WHO), Alma Ata declaration • Selective primary care: disease focus • Ottawa Charter (1986):healthy public policy; supportive environments; strengthening community; advocacy • Healthy City Movement

9. Public Health • Focus on the population rather than at individual level: Maximise health benefit for the most people • Balancing competing interests • Operates at wider societal level – not confined to the health service

10. Definitions of health and mental health ?

11. Health as a measure of outcome of all activities of government and the private sector - importance of health promotion in all sectors - social and economic determinants of health

12. Public Health • Incorporates a range of disciplines: • Epidemiology • Health Economics • Healthcare management and planning • Health promotion and disease prevention • Infectious Disease Surveillance • Social sciences- study of human behaviour and organisation of society

13. Public Health Activities • Monitors health of population • Prevents epidemics • Protects environment, sanitation, housing, working & social conditions • Responds to disasters • Mobilisescommunity action • Ensures equitable, accessible, quality healthcare • Addresses needs of most vulnerable populations

14. Epidemiology • Studies the patterns of disease in the population • Measures of disease occurrence: distribution and patterns; and determinants of ill-health such as risk factors

15. Health Economics • Economic analysis of healthcare • The application of economic theory, models and empirical techniques to the analysis of decision making by individuals, healthcare providers and governments with respect to health and healthcare (Morris et al 2009)

16. Health Economics • Resources are limited; potential uses of resources are endless: how to choose quantity and mix of healthcare, how to produce it, pay for it and how should it be distributed?

17. Public Health Policy • Working to influence public health decision making at local regional, national and international policy levels • Legislative and political interface • Advocacy

18. Health Promotion • Promotion of positive health • Activity to reduce morbidity and premature mortality (medical model) • Behaviour change • Increasing education and knowledge • Empowerment • Social change

19. Healthcare systems • Considering all different components of healthcare system • Information and Planning systems • Human resources • Policy and political context • Coverage of population • Design of healthcare • Financial systems supporting healthcare

20. Key Objectives for course • Human geography of Malawi • Epidemiology • Health economics • Public health policy • Health care systems • Health Information systems • Essential drugs management

21. Understanding of: • Mental health and the MDGs • Mental health and maternal and child health, Mental health and communicable disease (eg malaria, HIV) and non communicable disease • Mental health promotion • Mental health prevention • Mental health education • Importance of International Human Rights legislation • Impact of traditional beliefs and religion upon mental health, and role of traditional healers and religious groups in mental health care.

22. Understanding of.. • Current national mental health policy and strategy • Malawian health service structure and planning processes • Roles and responsibilities at each level in the health service (national, district and health centre) • Role of civil society and user and care groups in mental health care in Malawi

23. Key Skills • Be able to conduct a needs assessment • Be able to conduct a local situation appraisal (context, needs, inputs, processes, outcomes) • Be able to conduct inter-sectoralliaison e.g. with police, prisons, schools and universities, NGOs, community leaders, traditional health practitioners, media etcetc • Understand how to construct an annual operational plan including budgeting • Understand how to develop district and national policies and strategic action plans (e.g a national suicide prevention strategy)