Lecture 1: Introduction

Question 1

What type of language should be used when discussing stigmatized topics?

Answer 1

• The language we use has a direct and profound impact on those around us
• The negative impacts of stigma can be reduced by changing the language we use about substance
  use
• Use neutral, medically accurate terminology when describing substance use
• Use “people-first” language, that focuses first on the individual or individuals, not the action (e.g. “people who use drugs”)

Question 2

What is self-stigma?

Answer 2

The tendency to internalize mental health stigma and see oneself in more negative terms as a result of experiencing a psychological problem.

Question 3

What is the primary reason people with depression do not seek help?

Answer 3

According to the Centre for Addiction and Mental Health
in Toronto (CAMH, 2000), the social stigma surrounding
depression is the primary reason why only one third of
the estimated three million people in Canada who suffer
from depression seek help.

Question 4

What is a common misperception about people with psychological disorders?

Answer 4

• It is a common belief that people with psychological disorders are unstable and dangerous.
• Examples such as Vincent Li are incredibly rare and often relate to under-treatment of serious symptoms.

Question 5

How can the negative impacts of stigma be reduced?

Answer 5

• The negative impacts of stigma can be reduced by changing the language we use about mental illness
• Use neutral, medically accurate terminology when describing mental illness
• Use “people-first” language, that focuses first on the individual or individuals, not the action (e.g. “people who use drugs”) or phenomenology (e.g., anorexics)

Question 6

What language should we use instead?

Answer 6

• Instead of “addicts” use people who use drugs
• Instead of “anorexics” use people with an eating disorder
• Instead of “schizophrenics” use people with schizophrenia
• “people living with mental health problems”

Question 7

What is the lifetime prevalence of mental or substance use disorders?

Answer 7

33.1% lifetime, with substance use disorder being the highest at 21.6%

Question 8

What is the lifetime prevalence of mood disorders?

Answer 8

12.6% lifetime, with major depressive episode being the highest at 11.3%

Question 9

What percentage of the population has reported having had an MHC need?

Answer 9

• An estimated 17% of the population aged 15 or older reported having had an MHC need in the past 12 months.
• Two-thirds (67%) of them reported that the needs were met; for another 21%, the needs were partially met; and for 12%, the needs were unmet

Question 10

What are some gender issues with mental illness in Canada?

Answer 10

• Women were 1.5 times more likely than men to meet criteria for a mood or anxiety disorder
• Men were 2.6 times more likely than women to meet criteria for substance dependence.
• Eating attitude problems and agoraphobia were 6 times and 5 times more common among women than men, respectively.

Question 11

What is the reported age of onset in Canada?

Answer 11

• Two-thirds (69%) of young people 15–24 with a mood or anxiety disorder reported that their symptoms started prior to age 15.
• About half (48%) of people 45–64 and one-third (34%) of seniors stated that their disorder began prior to age 25.
• Mood and anxiety disorders also developed during each life stage.

Question 12

Who is more or less likely to have a diagnosable mental disorder in regards to SES?

Answer 12

When compared with people with an annual income of $70,000 or more, people with less than $19,000 per year were 4.3 times more at risk of having a diagnosable mental disorder

Question 13

What is the cost of mental illness in Ontario?

Answer 13

• The burden of mental illness and addictions is 1.5 times greater than the combined burden of all cancers
• The mental health conditions with the highest amount of
  burden were found to be: Depression, Bipolar disorder, Alcohol use disorders, Social phobia, Schizophrenia

Question 14

What is disability-adjusted life years (DALYs)?

Answer 14

• Allows comparison of the burden of disease across many different disease conditions
• DALYs account for lost years of healthy life regardless of whether the years were lost due to premature death or disability (weighted for severity of disability).
• YLL (years of life lost) + YLD (years lived with disability) = DALY (disability adjusted life year is a measure of overall disease burden, expressed as the cumulative number of years lost due to ill-health, disability or early death)

Question 15

What substance use disorder is most attributable to inpatient hospitalizations and deaths in Canada (from 2007-2014)

Answer 15

1) Tobacco

2) Alcohol use

Question 16

Why are mental health disorders important?

Answer 16

• They are highly prevalent and disabling
• Result in an enormous amount of human misery, lost health and lost economic output
• Can result in death.
• Especially substance use disorders

Question 17

What is pathology?

Answer 17

the study of disease

Question 18

What is psychopathology?

Answer 18

the study of mental diseases/disorders

Question 19

What is “abnormal behavior”?

Answer 19

• Abnormality is usually determined by the presence of several characteristics at one time such as:
• • Violation of norms
• • Unexpectedness
• • Statistical infrequency
• • Personal suffering
• • Disability or dysfunction

Question 20

What is norm violation?

Answer 20

• Social norms vary over time and across cultures.

- Who gets to define “normal”?

Question 21

What is unexpectedness?

Answer 21

-Unexpectedness refers to a surprising or out of proportion response to environmental stressors

Question 22

What is statistical infrequency?

Answer 22

• Unusualness

- Does not distinguish between desirable and undesirable rarities

Question 23

In the past, what would have been a sign of mental illness?

Answer 23

• In the past, based on our criteria of violation of social norms and statistical rarity, this would have been a sign of a mental illness
• In fact, homosexuality was once considered a mental illness

Question 24

What is personal suffering?

Answer 24

• Behaviour that causes personal suffering or distress (however it is not only about harming the self, because people with mental disorders can also cause harm to others intentionally or unintentionally)

Question 25

What is disability or dysfunction?

Answer 25

• Behaviour that causes impairment in one or more important areas of life (e.g., work, personal relationships, family)

Question 26

How can we combine standards to define abnormal behaviour?

Answer 26

• Facts – statistical rarity & clearly dysfunctional behaviour
• Values – adaptation and adherence to social norms

Question 27

What are the 4 behaviours in which some societies identify as categories of behaviour that indicate mental disorder?

Answer 27

Most societies identify the same categories of behaviour as indicating “mental disorder”

1. Behaviour that is harmful to the self/others without serving the interests of the self
2. Poor reality contact (beliefs/sensory perceptions that most others do not have)
3. Inappropriate emotional reactions (for the person’s situation)
4. Erratic behaviour – behaviour that shifts unpredictably

Question 28

What are some different mental health professions?

Answer 28

• Clinical Psychologist (Ph.D.)
• Counselling Psychologist (M.A.)
• Social Worker (M.S.W.)
• Psychiatrist (M.D.) – can prescribe medication
• In Ontario “Psychologists” are regulated by the College of Psychologists of Ontario

Question 29

Who was Hippocrates?

Answer 29

• Early proponent of somatogenesis (genesis = origin)
• Mental disorders are caused by aberrant functioning in the soma (i.e., physical body) and this disturbs
  thought and action.
• Contrasts with psychogenesis = Mental disorders have their origin in psychological malfunctions.

Question 30

Who was Emil Kraepelin?

Answer 30

Proposed two major groups of severe mental diseases:
1) Dementia praecox (early term for schizophrenia). Thought chemical imbalance as the cause of schizophrenia.
2) Manic-depressive psychosis (now called bipolar disorder). Thought an irregularity in metabolism as the cause of manicdepressive psychosis.
- His scheme became the basis for the present diagnostic
categories

Question 31

What is general paresis?

Answer 31

steady physical and mental deterioration, delusions of grandeur and progressive paralysis from which there was is recovery

Question 32

What progress was being made in the mid 1800s?

Answer 32

• Mid-1800s progress was being made in terms of understanding senile and presenile psychoses and mental
  retardation from a biological perspective
• However, far more was then discovered about the nature
  and origin of syphilis (i.e., germ theory of disease). They thought that perhaps if one disorder that caused psychosis started from a germ (i.e., syphillis) perhaps other mental disorders had a biological component.

Question 33

What is the biopsychosocial perspective?

Answer 33

• A model that incorporates biological (e.g., genetic predisposition), psychological (e.g., emotions) and social (e.g., social support) perspectives in order to understand mental illness
• More holistic and encompassing
• Unique combinations to create the perfect storm for mental illness
• This is a model on the antecedents

Question 34

What is harmful dysfunction?

Answer 34

-Dysfunctions are failures of internal mechanisms to perform naturally selected functions…a disorder attribution requires both a scientific judgment that there exists a failure of designed function and a value judgment that the design failure harms the individual.