Week 1 Lecture 1 - Diversity and Difference

Question 1

What is “health” defined as by the WHO?

Answer 1

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

Question 2

What does the definition of “health” by the WHO focus on?

Answer 2

• more positive view of health
• more holistic

Question 3

What does the WHO define “mental health” as?

Answer 3

“… 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”

Question 4

What can the definition of “mental health” by the WHO be summarised as?

Answer 4

• realising potential, being resilient, coping with life stresses, contributing to the community you feel a part of

Question 5

What does the definition of “mental health” by the WHO place mental health in terms of?

Answer 5

• the wider determinants of health and wellbeing

Question 6

The WHO defines mental health in a more holistic sense, what does this include?

Answer 6

• physical, emotional, psychological
• self-actualisation
• personal goals
• being productive
• “belonging”

could also add other factors such as financial

Question 7

What is wellbeing?

Answer 7

• overarching concept
• dynamic state –> not passive, fluctuates
• informs how people feel, function and evaluate their lives (satisfaction)

Question 8

Are context and external factors important to wellbeing?

Answer 8

Yes –> means wellbeing is relative to yourself but also to others
- autonomy, control and purpose all come under this

Question 9

What is high wellbeing i.e., functioning well, positive feelings also known as?

Answer 9

Flourishing

Question 10

What is the nef model of wellbeing?

Answer 10

Flourishing occurs when we have good feelings about:
- ourselves
- the way we live
- feel that our needs are being met (hierarchy of needs)
- our external conditions e.g., work and productivity

Question 11

What are the 3 reasons why diversity and difference matter?

Answer 11

• legislative framework
• healthcare and policy context
• practice context

Question 12

What is legislative framework in diversity and difference?

Answer 12

• legal context to help protect diversity and aid in equality

Question 13

What are 2 important legal policies for diversity and difference?

Answer 13

• Human Rights Act (1998)
• Equality Act (2010)

Question 14

What is the Equality Act (2010)?

Answer 14

• underpins diversity
• brings multiple individual acts together into one united act

Question 15

What is a key act of the Equality Act?

Answer 15

Public Sector Equality Duty

Question 16

What is the Public Sector Equality Duty

Answer 16

• Eliminate unlawful conduct prohibited by the Act e.g., discrimination, harassment and victimisation
• Advance equality of opportunity between people –> not just passive
• Foster good relations between people who share a “protected characteristic” and those who do not

Question 17

What are some examples of protected characterisitcs?

Answer 17

• age
• disability
• gender reassignment
• marriage and civil partnership
• pregnancy and maternity inc. breastfeeding (also in many cases covering paternity also)
• race
• religion and belief
• sex
• sexual orientation

Question 18

What is healthcare policy context in diversity and difference?

Answer 18

• NHS ethos to provide universal, comprehensive and free healthcare to all citizens equally on the basis of need not ability to pay
• range of policies aimed at reducing persistent inequalities in Health, Mental Health (gender and ethnicity) and social care

Question 19

What is practice context in diversity and difference?

Answer 19

• Epidemiology –> disease prevalence and incidence
• Prediction of illness patterns and need
• supports service design and delivery
• facilitates intersectional vs “one-size-fits-all” approach

Question 20

True or false?
Lesbian, Gay, Bisexual & Transgendered (LGBT) people have worse mental health than the general population

Answer 20

True
Higher risk of mental health issues, suicide, self-harm, being bullied, facing discrimination when seeking help relating to mental health

Question 21

True or false?
Compared with White British people, members of Black, Asian and other minoritized communities have worse mental health

Answer 21

True in some categories –> mainly black people
Data often missing for other peoples, or data misinterpreted e.g., in US people referring to Asian communities are often only referring to east Asian communities and are not considering how Southern Asian communities may differ

Question 22

Is the link between ethnicity and mental health clear cut?

Answer 22

• no
• inconsistent findings
• between and within group difference found

Question 23

How much more likely are Black people to be diagnosed with Sz compared to White British?

Answer 23

6 - 9 times greater risk

Question 24

How much more likely are Black people to be “sectioned” compared to White British?

Answer 24

4 times

Question 25

What are outcomes for Black people facing mental health difficulties likely to be like?

Answer 25

- report worse care - have poorer treatment outcomes - disengage from mainstream mental health services --> leading to high rates of relapse and readmission to hospital

Question 26

True or false? Women have worse mental health than men

Answer 26

False Hospital admissions roughly 50%

Question 27

Are there some conditions that are more commonly diagnosed in women?

Answer 27

Yes - depression 2:1 - OCD 60% - PTSD 20.4% for women vs 8.1% for men May be due to men feeling that they cannot discuss their feelings

Question 28

Are there some conditions that are more commonly diagnosed in men?

Answer 28

Yes - majority of suicides committed by men (75%)

Question 29

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

Answer 29

16 years for males 12 years for females However this gap is widening due to context shifting

Question 30

What have the majority of excess deaths due to physical conditions been linked to?

Answer 30

Existing mental health illnesses e.g., for those with cardiovascular disease that died: - 32% male, 46% female patients with Sz - 33% male, 41% female patients with "other psychoses" - 38% male, 37% female patients with neurotic disorders

Question 31

True or false? Children of people diagnosed with mental health problems do less well

Answer 31

True - 66% of people with severe mental illness have at least 1 child under 18 - 175,000 "young carers" - some children of parents with SMI experience greater levels of emotional, psychological and behavioural problems compared to peers in the population

Question 32

What was Pakistani & ‘British-born Pakistani women’ with higher rates perinatal depression found to be associated with?

Answer 32

- poorer physical outcomes in children e.g., lower birth weights - poorer psychological outcomes in children e.g., problems with infants' adaptive behaviour - increased risk of chronicity

Question 33

True or false? Deaf people have worse mental health than hearing people

Answer 33

True - 40% of Deaf children experience MHD vs 25% of hearing children - 33% prevalence of anxiety and depression vs 15% rest of pop. - 90-95% of Deaf children born into hearing households --> communication difficulties lead to child being 4x more likely to develop psychological difficulties - increased risk of bullying, social isolation, suicide - reduced educational attainment and health literacy

Question 34

What are some inequalities that people face in access, experience and outcomes when facing MHDs?

Answer 34

- communication: diagnosis, care planning & experience, advocacy - culturally aware/ sensitive care - accessible information standard - focus on spoken and written language --> translation, interpretation

Question 35

Given some examples of how Deaf people may face inequality when trying to access MH care

Answer 35

- limited number of professional BSL interpreters - Lip reading: on average only 26% - 40% of speech understood - fear of being mis-diagnosed and "sectioned" --> therefore reluctant to access MH services