WHAT IS MENTAL ILLNESS?

1. WHAT IS MENTAL ILLNESS?

2. TWO TOPICS • DEFINITION OF MENTAL ILLNESS • NATURE OF SCHIZOPHRENIA

3. WHY WANT DEFINITION OF MENTAL ILLNESS? • DISTINGUISH FROM NORMAL • INDICATE NEED FOR MENTAL HEALTH TREATMENT • WHAT CONDITIONS SHOULD BE REIMBURSED? • DETERMINE CRIMINAL LIABILITY - PUNISH OR TREAT?

5. DSM-IV DEFINITION (1) • “MENTAL DISORDER IS A CLINICALLY SIGNIFICANT BEHAVIORAL OR PSYCHOLOGICAL PATTERN THAT IS ASSOCIATED WITH PRESENT DISTRESS OR DISABILITY.”

6. DISTRESS OR DISABILITY • MUST HAVE EITHER DISTRESS (MENTAL PAIN) OR DISABILITY (LOSS OF FUNCTIONING) • EITHER MUST REALLY BOTHER PEOPLE - E.G. THINK LEFT STOVE ON • OR HAVE NEGATIVE IMPACT ON THEIR LIVES - E.G. SCHIZOPHRENIA

7. DSM (2) • “IN ADDITION, THIS PATTERN MUST NOT BE MERELY AN EXPECTABLE AND CULTURALLY SANCTIONED RESPONSE TO A PARTICULAR EVENT, FOR EXAMPLE, THE DEATH OF A LOVED ONE.”

8. NOT EXPECTABLE RESPONSE • BEREAVEMENT EXCLUSION • SYMPTOMS ARE NORMAL • ROMANTIC BREAKUPS • SOLDIER ENTERING COMBAT • SYMPTOMS THEMSELVES ARE NOT SUFFICIENT • MUST KNOW CONTEXT

9. DSM (3) • “WHATEVER ITS ORIGINAL CAUSE, IT MUST CURRENTLY BE A BEHAVIORAL, PSYCHOLOGICAL, OR BIOLOGICAL DYSFUNCTION IN THE INDIVIDUAL.”

10. INTERNAL DYSFUNCTION • SOME PSYCHOLOGICAL SYSTEM (MOOD, FEAR, THOUGHT, EMOTION, ETC.) IS NOT FUNCTIONING PROPERLY - SOMETHING IS WRONG • WRONG CONTEXT OR TOO SEVERE OR TOO ENDURING • MANY CAUSES – BIOLOGICAL, PSYCH., SOCIAL – OF M.I.

11. DSM (4) • “NEITHER DEVIANT BEHAVIOR (E.G. POLITICAL, RELIGIOUS, OR SEXUAL) NOR CONFLICTS BETWEEN THE INDIVIDUAL AND SOCIETY ARE MENTAL DISORDERS UNLESS THE DEVIANCE OR CONFLICT IS A SYMPTOM OF A DYSFUNCTION IN THE INDIVIDUAL.”

12. MENTAL DISORDER IS NOT DEVIANCE • DEVIANCE IS VIOLATION OF MORAL STANDARDS OR SOCIAL NORMS - BAD BEHAVIOR • PEOPLE WHO DRINK TOO MUCH, TAKE WRONG KIND OF DRUGS, OR STEAL, CHEAT, AND LIE NEED NOT BE MENTALLY ILL

13. DEVIANCE OR M.I.? • ONLY MENTAL DISORDER WHEN SOME MECHANISM IS UNABLE TO FUNCTION AS IT IS SUPPOSED TO • ALCOHOLIC OR ADDICT WHO CAN’T STOP DRINKING OR TAKING DRUGS • NOT JUST DEFIANCE OF RULES • VERY DIFFICULT TO DISTINGUISH

14. SUMMARY • MENTAL DISORDER IS HARMFUL INTERNAL DYSFUNCTION • CAUSES CAN BE PSYCHOLOGICAL, BIOLOGICAL, OR SOCIAL • DISTINGUISH FROM EXPECTABLE RESPONSES TO STRESSORS AND FROM SOCIAL DEVIANCE

15. TYPES OF MENTAL ILLNESS

16. PSYCHOSES • MOST SEVERE KIND OF M.I. • SCHIZOPHRENIA • BI-POLAR (MANIC DEPRESSION)

17. SCHIZOPHRENIA • PERHAPS MOST IMPORTANT MENTAL ILLNESS • CREATES STEREOTYPE OF MENTAL ILLNESS - CRAZY, NUTS, BIZARRE

19. IMPORTANCE • MOST ADMISSIONS AND RESIDENTS OF PUBLIC MENTAL HOSPITALS • SEVERITY AND CHRONICITY MEAN COSTLY AND DIFFICULT TO TREAT • PUBLIC POLICY - HOMELESSNESS, NOTORIOUS CRIMES • TREMENDOUS FAMILY BURDEN

20. A BEAUTIFUL MIND • JOHN NASH

21. SYMPTOMS • THOUGHT DISORDER • POSITIVE SYMPTOMS • THOUGHT INSERTION AND BROADCAST • LOOSE ASSOCIATION • HALLUCINATIONS - AUDITORY • DELUSIONS - PARANOIA, GRANDIOSITY

22. NEGATIVE SYMPTOMS • FLAT AFFECT • LACK OF PLEASURE - ANHEDONIA • ISOLATION

23. DISABILITIES • POOR SOCIAL, FAMILY, AND WORK RELATIONSHIPS • SIDE EFFECTS OF MEDICATION • VIOLENCE WHEN IN PSYCHOTIC STATE • SOCIAL STIGMA