Week 1 Lecture 1 - Diversity and Difference Flashcards
What is “health” defined as by the WHO?
“a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
What does the definition of “health” by the WHO focus on?
- more positive view of health
- more holistic
What does the WHO define “mental health” as?
“… 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”
What can the definition of “mental health” by the WHO be summarised as?
- realising potential, being resilient, coping with life stresses, contributing to the community you feel a part of
What does the definition of “mental health” by the WHO place mental health in terms of?
- the wider determinants of health and wellbeing
The WHO defines mental health in a more holistic sense, what does this include?
- physical, emotional, psychological
- self-actualisation
- personal goals
- being productive
- “belonging”
could also add other factors such as financial
What is wellbeing?
- overarching concept
- dynamic state –> not passive, fluctuates
- informs how people feel, function and evaluate their lives (satisfaction)
Are context and external factors important to wellbeing?
Yes –> means wellbeing is relative to yourself but also to others
- autonomy, control and purpose all come under this
What is high wellbeing i.e., functioning well, positive feelings also known as?
Flourishing
What is the nef model of wellbeing?
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
What are the 3 reasons why diversity and difference matter?
- legislative framework
- healthcare and policy context
- practice context
What is legislative framework in diversity and difference?
- legal context to help protect diversity and aid in equality
What are 2 important legal policies for diversity and difference?
- Human Rights Act (1998)
- Equality Act (2010)
What is the Equality Act (2010)?
- underpins diversity
- brings multiple individual acts together into one united act
What is a key act of the Equality Act?
Public Sector Equality Duty
What is the Public Sector Equality Duty
- 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
What are some examples of protected characterisitcs?
- 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
What is healthcare policy context in diversity and difference?
- 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
What is practice context in diversity and difference?
- Epidemiology –> disease prevalence and incidence
- Prediction of illness patterns and need
- supports service design and delivery
- facilitates intersectional vs “one-size-fits-all” approach
True or false?
Lesbian, Gay, Bisexual & Transgendered (LGBT) people have worse mental health than the general population
True
Higher risk of mental health issues, suicide, self-harm, being bullied, facing discrimination when seeking help relating to mental health
True or false?
Compared with White British people, members of Black, Asian and other minoritized communities have worse mental health
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
Is the link between ethnicity and mental health clear cut?
- no
- inconsistent findings
- between and within group difference found
How much more likely are Black people to be diagnosed with Sz compared to White British?
6 - 9 times greater risk
How much more likely are Black people to be “sectioned” compared to White British?
4 times
What are outcomes for Black people facing mental health difficulties likely to be like?
- report worse care
- have poorer treatment outcomes
- disengage from mainstream mental health services –> leading to high rates of relapse and readmission to hospital
True or false?
Women have worse mental health than men
False
Hospital admissions roughly 50%
Are there some conditions that are more commonly diagnosed in women?
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
Are there some conditions that are more commonly diagnosed in men?
Yes
- majority of suicides committed by men (75%)
In the UK, the difference in life expectancy for men and women with diagnosed mental illness and those without is?
16 years for males
12 years for females
However this gap is widening due to context shifting
What have the majority of excess deaths due to physical conditions been linked to?
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
True or false?
Children of people diagnosed with mental health problems do less well
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
What was Pakistani & ‘British-born Pakistani women’ with higher rates perinatal depression found to be associated with?
- 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
True or false?
Deaf people have worse mental health than hearing people
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
What are some inequalities that people face in access, experience and outcomes when facing MHDs?
- communication: diagnosis, care planning & experience, advocacy
- culturally aware/ sensitive care
- accessible information standard
- focus on spoken and written language –> translation, interpretation
Given some examples of how Deaf people may face inequality when trying to access MH care
- 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
