Mental health
Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. Mental health plays a crucial role in an individual's daily life when managing stress, engaging with others, and contributing to life overall. According to the World Health Organization, it is a "state of well-being in which the individual realizes their abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can contribute to their community". It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health includes subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one's intellectual and emotional potential, among others.
Mental health also includes emotional, psychological, and social well-being, and it affects how people manage stress and make everyday decisions.
From the perspectives of positive psychology or holism, mental health is thus not merely the absence of mental illness. Rather, it is a broader state of well-being that includes an individual's ability to enjoy life and to create a balance between life activities and efforts to achieve psychological resilience. Cultural differences, personal philosophy, subjective assessments, and competing professional theories all affect how one defines "mental health".
Mental disorders
Mental health, as defined by the Public Health Agency of Canada, is an individual's capacity to feel, think, and act in ways to achieve a better quality of life while respecting personal, social, and cultural boundaries. Impairment of any of these is a risk factor for mental disorders, or mental illnesses, which is a component of mental health. In 2019, about 970 million people worldwide suffered from a mental disorder, with anxiety and depression being the most common. The number of people suffering from mental disorders has risen significantly over the years. Mental disorders are defined as health conditions that affect and alter cognitive functioning, emotional responses, and behavior associated with distress and/or impaired functioning. The ICD-11 is the global standard used to diagnose, treat, research, and report various mental disorders. In the United States, the DSM-5 is used as the classification system of mental disorders.Mental health is associated with a number of lifestyle factors such as diet, exercise, stress, drug abuse, social connections, and interactions. Psychiatrists, psychologists, licensed professional clinical counselors, social workers, nurse practitioners, and family physicians can help manage mental illness with treatments such as therapy, counseling, medication, and Trauma-informed care.
Mental health in the digital age
Digital technology has an increasing impact on mental health. Research suggests that constant online connection can increase stress, while digital tools may also expand access to mental-health support for people who cannot easily receive in-person care.Research also shows that digital media use can affect adolescents’ emotional well-being, social development, and mental health outcomes.
Cyberbullying and online harassment can worsen mental-health symptoms in children and adolescents. Studies show links between online bullying, depression, and anxiety.
History
Early history
In the mid-19th century, William Sweetser was the first to coin the term mental hygiene, which can be seen as the precursor to contemporary approaches to work on promoting positive mental health. Isaac Ray, the fourth president of the American Psychiatric Association and one of its founders, further defined mental hygiene as "the art of preserving the mind against all incidents and influences calculated to deteriorate its qualities, impair its energies, or derange its movements.In American history, mentally ill patients were thought to be religiously punished. This response persisted through the 1700s, along with the inhumane confinement and stigmatization of such individuals. Dorothea Dix was an important figure in the development of the "mental hygiene" movement. Dix was a school teacher who endeavored to help people with mental disorders and to expose the sub-standard conditions into which they were put. This became known as the "mental hygiene movement. Before this movement, it was not uncommon that people affected by mental illness would be considerably neglected, often left alone in deplorable conditions without sufficient clothing. From 1840 to 1880, she won the support of the federal government to set up over 30 state psychiatric hospitals; however, they were understaffed, under-resourced, and were accused of violating human rights.
Emil Kraepelin in 1896 developed the taxonomy of mental disorders, which has dominated the field for nearly 80 years. Later, the proposed disease model of abnormality was subjected to analysis and considered normality to be relative to the physical, geographical, and cultural aspects of the defining group.
At the beginning of the 20th century, Clifford Beers founded "Mental Health America – National Committee for Mental Hygiene", after publication of his accounts as a patient in several lunatic asylums, A Mind That Found Itself, in 1908 and opened the first outpatient mental health clinic in the United States.
The mental hygiene movement, similar to the social hygiene movement, had at times been associated with advocating eugenics and the sterilization of those considered too mentally deficient to be assisted into productive work and contented family life. In the post-WWII years, references to mental hygiene were gradually replaced by the term 'mental health' due to its positive aspect that evolves from the treatment of illness to preventive and promotive areas of healthcare.
Institutionalization and deinstitutionalization
When US government-run hospitals were accused of violating human rights, advocates pushed for deinstitutionalization: the replacement of federal mental hospitals with community mental health services. The closure of state-provisioned psychiatric hospitals was enforced by the Community Mental Health Centers Act in 1963, which laid out terms under which only patients who posed an imminent danger to others or themselves could be admitted into state facilities. This was seen as an improvement from previous conditions. However, there remains a debate on the conditions of these community resources.It has been proven that this transition was beneficial for many patients: there was an increase in overall satisfaction, a better quality of life, and more friendships between patients, all at an affordable cost. This proved to be true only in the circumstance that treatment facilities had enough funding for staff and equipment, as well as proper management. However, this idea is a polarizing issue. Critics of deinstitutionalization argue that poor living conditions prevailed, patients were lonely, and they did not acquire proper medical care in these treatment homes. Additionally, patients who were moved from state psychiatric care to nursing and residential homes had deficits in crucial aspects of their treatment. Some cases result in the shift of care from health workers to patients' families, where they do not have the proper funding or medical expertise to give proper care. On the other hand, patients who are treated in community mental health centers lack sufficient cancer testing, vaccinations, or regular medical check-ups.
Other critics of state deinstitutionalization argue that this was simply a transition to "transinstitutionalization, or the idea that prisons and state-provisioned hospitals are interdependent. In other words, patients become inmates. This draws on the Penrose Hypothesis of 1939, which theorized that there was an inverse relationship between prisons' population size and the number of psychiatric hospital beds. This means that populations that require psychiatric mental care will transition between institutions, which in this case includes state psychiatric hospitals and criminal justice systems. Thus, a decrease in available psychiatric hospital beds occurred at the same time as an increase in inmates. Although some are skeptical that this is due to other external factors, others will attribute this conclusion to a lack of empathy for the mentally ill. There is no argument for the social stigmatization of those with mental illnesses; they have been widely marginalized and discriminated against in society. In this source, researchers analyze how most compensation prisoners are unemployed, homeless, and have an extraordinarily high degree of mental illnesses and substance use disorders. Compensation prisoners then lose prospective job opportunities, face social marginalization, and lack access to resocialization programs, which ultimately facilitate reoffending. The research sheds light on how the mentally ill—and in this case, the poor—are further punished for certain circumstances that are beyond their control, and that this is a vicious cycle that repeats itself. Thus, prisons embody another state-provisioned mental hospital.
Families of patients, advocates, and mental health professionals still call for an increase in more well-structured community facilities and treatment programs with a higher quality of long-term inpatient resources and care. With this more structured environment, the United States will continue with more access to mental health care and an increase in the overall treatment of the mentally ill.
However, there is still a lack of studies on mental health conditions to raise awareness, knowledge development, and attitudes toward seeking medical treatment for MHCs in Bangladesh. People in rural areas often seek treatment from the traditional healers, and MHCs are sometimes considered a spiritual matter.