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Mental Health and Wellbeing > diversity and differences > Flashcards

diversity and differences Flashcards

1
Q

define health

A

“… a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

positive and holistic view
WHO

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2
Q

define mental health

A

“… a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community” (WHO, 2013)

incorporates wellbeing
places mental health within the wider social determinants of health and wellbeing
mental health not in a vacuum

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3
Q

what are the wider determinants of health and wellbeing?

think basic needs

A 
Holistic:
• Physical, emotional, psychological
• Self-actualisation
• Personal goals
• Being productive
• ‘Belonging’
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4
Q

what is wellbeing

A

dynamic state
impacts ability to feel and function
satisfied with life- evaluation

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5
Q

impact of external factors on wellbeing

A

Autonomy, Control, Purpose
• ‘urbanicity’ increases incidence of schizophrenia and bipolar
disorder (Krabbendam & van OZ, 2003; Pederson & Mortenson 2007)
• High Wellbeing i.e. functioning well, positive feelings à
‘Flourishing’ (New Economics Foundation (nef), 2012)

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6
Q

nef model of wellbeing

A 
good feelings day to day and overall
good functioning and satisaction of needs
external conditions
personal resources
= flourishing
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7
Q

nef - wellbeing

‘good feelings day to day and overall’

A

happiness
joy
contenment

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8
Q

nef - wellbeing

‘good functioning and satisfaction of needs’

A

to be autonomous, competent, safe and secure, connected to others

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9
Q

nef - wellbeing

external conditions

A

material conditions
work
productivity
income (levels and stability)

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10
Q

nef - wellbeing

personal resources

A

health
resilience
optimism
self-esteem

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11
Q

what are the two diversity and difference legislative framework

A
  • Human Rights Act (1998)

* Equality Act (2010)

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12
Q

what is public sector equality duty

A

universities, NHS, local government have specific duties
actively promote opportunity
•Eliminate unlawful conduct prohibited by the Act e.g. discrimination, harassment and victimisation

  • Advance equality of opportunity between people
  • Foster good relations between people who share a“protected characteristic” and those who do not
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13
Q

what are the protected characteristics - there are 9

A 
Protected characteristics
• Age 
• Disability
• Gender reassignment 
• Marriage and civil partnership
• Pregnancy and maternity  (including breast feeding) 
• Race 
• Religion and belief (including lack of belief) 
• Sex 
• Sexual orientation
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14
Q

what is the NHS ethos as part of healthcare policy context

A

NHS ethos – 3 Core Principles:
• Universal : to provide same standard of health care throughout the UK
• Comprehensive: cover all health needs
• Free at the point of delivery: available to all citizens equally on the basis of need, not ability to pay.

founded to eradicate inequalities

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15
Q

what are the areas that the policies are aimed at reducing persistent inequalites

A
  • Health (DH, 2003; DH, 2013)
  • Mental Health: Gender (DH, 2002, 2003) Ethnicity (DH, 2005)
  • Social Care (2014)
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16
Q

what is Epidemology?

A

Epidemiology: disease prevalence and incidence

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17
Q

what can you predict from illness patterns and need

A

age is associated with cognitive disorders - ageing population - dementia
obesity- diabeties and cardiovascular disorders
physical health - mental health

18
Q

understanding diversity and difference supports service desing and delivery, give examples

A

Supports service design and delivery
• Strategies to reduce inequalities
• Screening and disease prevention vs illness interventions
• Workforce planning
• Facilitates intersectional vs ‘one-size-fits-all’ approach (Banks & Kohn-Wood, 2002)

19
Q

how much higher is the risk of depression anxiety suicide in LGBT people

A

1.5

20
Q

how much higher is the suicde risk in gay men

A

2-4 times

21
Q

how much higher is the self harm rate in LGBT people

A

2x general population

22
Q

% depression in gay young people who arent bullied

A

35%

23
Q

what contributes to worse mental health in LGBT people

A

• Discrimination

  • social stress
  • concealment
  • stigma
  • internalised homophobia linked withworse mental health
24
Q

when was homosexuality decriminised and not classified as a mental illness

A
  • Homosexuality decriminalised 1967 (1980 Scotland)

* Until 1993 homosexuality classified as mental illnesses (DSM)

25
Q

how much higher is the risk of psychosis and being sectioned in the black population

A

Black people more likely to:
• Be diagnosed with psychosis (e.g. 6-9 times great risk schizophrenia compared with White British)
-compulsorily admitted to hospital (4 times more likely to be ‘sectioned’ under the Mental Health Act (2007)

26
Q

what do black people report in their experience of mental health

A 
Report worse care experience 
• Have poorer treatment outcomes
• Disengage from mainstream mental health services
- Leading to social exclusion 
- Deterioration in their mental health
- High rates of relapse and readmission to hospital
higher doses of medication
more likely to be held in seclusion
27
Q

what do African/Black Carribean people report in terms of mental health

A

Lower rates of diagnosed common mental disorders (CMD) (e.g. anxiety & depression) than other groups but higher rates severe mental illness (SMI)

28
Q

what do South Asian people report in terms of mental health

don’t have information for east Asia

A

Low rates of suicide and depression in men, high in women.

High rates of alcohol use in Indian men.

29
Q

what do White Irish people report in terms of mental health

A

White Irish: High rates depression, alcohol use, increased risk of suicide – especially
men

30
Q

are there differecnes in men and women experiencing mental health problems

A

no, overall no significant differences in men and woman (50% hospital admission)

31
Q

what effects hospital input data

A

more likely to talk to gp
men seld medicate
willingness of ability to access the diagnosis

32
Q

what conditions are more commonly diagnosed in women

A

• Depression 2:1 (women: men)
• 60% OCD, phobia = women
• PTSD 20.4% for women vs 8.1% for men
• Link between reproductive cycle and MH problems e.g. ‘perinatal depression’ (15% women)
• Others not e.g. 25% suicide = women
Gender-sensitive services – recognise role of trauma

33
Q

In the UK, the difference in life expectancy for men with diagnosed mental illness and those without is:

A

16 - male
12 female
the gap is widening

34
Q

deaths in mentally ill people with cardiovascular disease

A
  • Majority excess deaths due to physical conditions:
  • Cardiovascular disease:
  • 32% male, 46% female patients with schizophrenia
  • ‘Other psychoses’: 33% male, 41% female
  • Neurotic disorders: 38% male, 38% female
35
Q

are people with mental illness at a disadvantage in regards to common physical conditions

A

yes
“Significant advances in reducing death rates due to common physical conditions, but people with mental illness have not benefited to the same extent as the general population” (Lawrence et al, 2013)

36
Q

do children of people diagnosed with mental health problems do less well

A

yes
young carers
greater level of emotional, psychological and behavioural problems
poorer academic achievement -> higher risk of mental illness

37
Q

Children of people diagnosed with mental health problems do less well

A

True Pakistani & ‘British-born Pakistani women’, higher rates perinatal (antenatal & postnatal) depression
• Associated with:
•Poorer physical outcomes in children
-Lower birth weight babies, higher rates of infant mortality, psychological problems

• Poorer psychological outcomes in children
-E.g. problems with the infants’ adaptive behaviour

• Increased risk of chronicity - ilnesses going on to become long term - in women
- Up to 50% cases

38
Q

deaf people and mental health

A

As sociated with:
• 40% Deaf children experience mental health difficulties compared with 25% hearing children
• Prevalence of depression and anxiety 33% compared with 15% rest of the population
• Around 90-95% Deaf children born into hearing households
• Deaf children in families with communication difficulties (e.g. ‘language deprivation’) 4 times more likely to develop psychological difficulties than families with no communication difficulties
• Increased risk of bullying, social isolation, increased risk of suicide
• Reduced educational attainment and health literacy

39
Q

what are the inequalities in access for deaf people

A

Inequalities in access, experience and outcomes
• Intersectionality
• Communication: Diagnosis, Care Planning & Experience, Advocacy
• Culturally aware/sensitive care – often culture=ethnicity/race
• Accessible Information Standard
• Focus on spoken and written language à translation, interpretation
• Deaf people
• Limited number of professional BSL interpreters
• Lip reading: Average Deaf adult can lip-read only 26% to 40% of speech
• Fear being mis-diagnosed and ‘sectioned’

40
Q

what is Parity of esteem

A

describes the need to value mental health equally to physical health

41
Q

what qualities impact access care and outcomes - inequalities

A 
gender
ethnicity
SES
age
disabilities

Mental Health and Wellbeing (11 decks)

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