MENTAL HEALTH AND MENTAL ILLNESS A CASE OF JOHN AND FAMILY

Mental health and mental illness has existed as a continuum. It may be difficult to establish at which point in the continuum a person can be said to be healthy and at what point they can be said to be mentally ill. This paper aims at discussing the concept of mental health and illness. To bring out a concrete discussion of the subject, a case of John, who is Schizophrenic, in a family background that family members are likely to suffer mental illness from different causes is discussed. The paper, therefore, adopts a descriptive and analytic approach to bring out the concept of mental health and illness.

The concept of mental health given by the World Health Organization appears to hold water, in relation to the components that compose mental health. WHO (2014) defines mental a state of mental, physical, as well as social well-being, that is not just the mere absence of an illness. In this case, mental health relates to the well-being of the mind. It composes the activities that are aimed at preventing disorders of the mind, and activities that are aimed at promoting the social well-being of the mental quarters of a human being. In aIDition, it is involved with the rehabilitation and treating of people who have mental illnesses.

The concept of mental health has been said to exist as a continual model that has two extreme ends. One end in the continuum represents mental illness, while the other end in the continuum represents mental illness. In considering mental health, a report by the WHO (2004 considers it as a positive concept that is concerned with the social and emotional well-being of communities and individuals. The components that have been affiliated with this include ability to cope with stresses, a sense of connection to other people, enjoyment of life, and the fulfilment of one’s potential and goals in life (WHO, 2004 p. 16). On the other hand, the term mental illness of mental ill health has been used to refer to the inability to control the cognitive, emotional and social behavior by an individual. It composes of the mental illnesses and the mental health problems that are characteristic of people suffering from the condition. According to the WHO (2004 p. 17), there is a distinction between mental illness or mental disorder, and mental health problems. Mental disorders or mental illness is a disease that affects or interrupts the emotional, social and the cognitive judgment of a person. An individual who may be suffering from a mental disorder cannot be in a position to make a sound decision. A mental disorder is clinically diagnosable. A system has been developed that is usually used to diagnose a mental disorder. Two systems exist with the name of international Classification of Diseases (ICD) plus the Diagnostic and the Statistical Manual for Mental Disorders (DSM) (WHO, 2004 P. 21). Psychotic disorders like schizophrenia are included in mental disorders. A mental health problem to its part, may not qualify to be called a mental disorder, since it may not have the criteria of classifying it according to the systems devised to classify mental illness. However, it also encompasses the deviation in the emotional, cognitive and the social well-being of an individual. According to WHO (2004) life stresses are the leading causes of mental health problems. An example is despair and sadness. Most of the times, a mental problem is an early stage of a mental disorder.

In connection with the continuum of mental health and mental illness, a human being can exist in between the following point in the continuum. One can be having optimal mental well-being and health, or minimal mental well-being and health. On the other hand, a person may be having maximal mental ill health, or minimal mental ill health (Tudor 1996).

In relation to the definition of mental health and the case presented of John and family, there are features of John and some members of his family that point to mental illness and problems. To start with, the father of john, according to the case, behaves as it he has a mental problem. The case presents that the mother of John separated from her husband having suffered physical beating for a long time. Tudor (1996) asserts that physical beating is a symptom of a mental disorder or problem. The evidence presented about a prolonged physical beating is an indication that the father of John was suffering from a mental problem. Secondly, as outlined out by the WHO (2004) in the definition of mental illness, the father of John made it difficult for the family members, more so his mother, to enjoy life. This shows that he also was not able to control his emotions, or his cognitive behavior. This is a pointer to his mental problem. The kind of life lived by the elder sister of John, Janet, and their mother is an indication of a mental problem. The two spend their life quarreling; they are not able to control their stresses in life. The sister continually blames her mother for breaking with their father, yet she was a witness of the mistreatment that their mother received from their father. In the new home, she has become the new tormenter to her mother. This is an indication of a mental disturbance. From this schizophrenia case, it is very evident that Jane is not enjoying life. According to the World Health Organization (2004), inability to enjoy life and to control stresses in life, amounts to a mental disorder, or mental problem.

The case of John is an extreme case. He displays the symptoms of schizophrenia. The condition is known to be severe form of mental disorder. According to the Centers for Disease Control and Prevention (CDC) (2013), about seven people in every a thousand people, in the population are affected by population. The age group that is between the ages of fifteen years and thirty five years is the most affected. However, in this age group, the prevalence is not as much as in adults. It exists in three people out of ten thousand people. Throughout the world, schizophrenia is known as affecting as many as twenty four million people (WHO 2013). Although the condition is treatable, it is advised to treat the condition in the early stages. Research shows that treatment is more effective in the early stages of life (CDC 2013). One of the areas of care that has been neglected by the society is the area of mental health care. Statistics from the WHO (2013) show that more than half of the populations of people that suffer from schizophrenia are never cared for as they are supposed. The developing countries are the most hit with more that ninety percent of schizophrenic cases being found in them. On the part of care, it becomes difficult; because a long time span is needed to get a person recover. Therefore, even though the community can be involved in the care of people with schizophrenia, many people that provide the care in the community have not been trained. This leads to poor outcomes. The cost implications of treating schizophrenia are challenging to governments. Because of this, the World Health Organization reports that majority of the victims are not in a position to afford treatment. Failure to start treatment leads to disease chronicity.

The complex interaction between some environmental and genetic factors has been known to cause schizophrenia (CDC 2013). In terms of genetic, people with a very close relative, referred to as a first degree relative who has been a known case of schizophrenia, have chances of developing the disease to a degree of ten percent. However, about sixty percent of schizophrenics do not have a close relative who suffered the disease. On other terms, it is not very common that a schizophrenic must get a sibling who is schizophrenic. In the case of john, the behavior of the father appears to be mentally abnormal. This is because of the physical beatings that his father inflicted on their mother. With this information, it is probable that his father was suffering from schizophrenia, which he passed on to John. The vulnerability of schizophrenia as predisposed by genetics is boosted by the environment. This has been proven through research with twin studies (CDC 2013). A major factor of the environment that has been associated with the development of schizophrenia is stress. This is especially when a person is carrying a pregnancy. Another environmental factor that contributes greatly to the development of schizophrenia is losing a parent or both parents at a young age. This very well coincides and identifies with the case of John. John is now nineteen years old. The case explains that he separated with the father 12 years ago when they left their father to go and live with their mother. The disturbance that John got from leaving their father at a very young age might be the contributor to his suffering from schizophrenia. Also, it is evident that before the separation, John’s family was not living a happy life due to the physical beating his mother was receiving from their father. This counts another point that can lead to John becoming schizophrenic.

The symptoms and signs of schizophrenia fall along some categories. The first category of the symptoms is referred to as delusions. This refers to holding of an idea that is not true while one has the evidence of the truth. Most of the people that suffer from schizophrenia experience these set of symptoms (CDC 2013). John too experienced these symptoms from the case under discussion. Delusions are very evident in the life of John. He believes that the other members of his family are interfering with his earth lines. In other terms, he is behaving as if his mother and the sisters are out to harm his life. From the case, John does not like going out even when their mother is at the home to prepare some meal. This is a sign of a delusion of persecution. The people with schizophrenia also tend to hold a belief about something being directed to them. John believes that fate has something special to offer to him, and as such, he prepares himself to receive the fate’s gift by distancing himself from other people. Through this, John is displaying delusion of reference. He also believed that he has power to control fate, displaying some delusion of grandeur. He had a great belief that though controlled his thoughts; he even told his mother though he did not say everything. This shows the action of delusion of grandeur in his life.

The next category of symptoms for schizophrenics is hallucinations. The victims experiences sounds as if they are real, even though in the reality there are no sounds. John had his environment controlled; he even played loud music that controlled his thinking. It is clear from this case study that he had fate communicating to him, and he informed his mother about the happening (WHO 2013). Disorganized speech with fragmented thinking is another category of the symptoms of schizophrenia. Concentrating, as well as, maintaining a train of thinking is a big problem to people who are affected by schizophrenia. Looking again at the case of John, he had problems spending time with the member of the family. When John was narrating to his mother about fate, he even did not complete the query his mother had.

The next category of symptoms for a schizophrenic is disorganized behavior (CDC 2013). The behavior of an individual affected by this condition appears bizarre and the person seems to have no purpose in their lives. Looking at the life of John, it is alarming that at nineteen, John could not find meaning in his life. All he could do is buy cards and spend all his valuable time in the house playing cards and listening to music. People of the age of John are supposed to be working. However, because of the disease process, John is not bothering about his future life. The last category ofthe symptoms and signs of schizophrenia comes in the form of negative behavior. Emotional expression lacks in these patients. From the behavior described about John, it is very evident that he has a flat voice even when talking to his mother. He does not show any emotions.

Schizophrenia has several effects to the patient. Relationship problems are common to people suffering from the disease (WHO 2013). This is evident from John and family. He has a strained relationship with all the other members of the family. He had a close relationship but this too has deteriorated. Jane, his elder sister has a strained relationship with their mother. Due to heredity, she might also be suffering from schizophrenia, but in the early stages. The normal daily activities are usually disrupted in a person with schizophrenia. The life of John is miserable. He only spends time in the house listening to loud music and playing cards. Drug abuse is also an effect of the disease (CDC 2013). From the case in the presentation, John has started abusing drugs at a very high rate. He is reported of taking cannabis. This is a danger to treatment because it may interfere with medications. The risk of suicide also increases in people suffering from schizophrenia. John is at risk of this since he has distanced himself from all the other members of the family. His sister Jane seems to be following the same trend. She has fallen out with the mother and she is living a life characterized with a lot of stress. This may predispose her to suicidal thoughts.

People suffering from schizophrenia experience a lot of challenges in life, either because of the way they are perceived by other people or because of the effect of the disease. They live a life of stigma all through. Schizophrenia Research Institute (2013) reports that; neglect is a common feature of people suffering from schizophrenia. Looking at the case of John, even his mother didn’t seem to understand that he was sick. He was a neglected case. He used to spend his valuable time playing cards and listening to loud music in the house. Concealment and demonization are other features of difficulties experienced by people suffering from schizophrenia (Schizophrenia Research Institute 2013). Attention that is needed by the patients of schizophrenia is not accorded to them. Due to the effect of strained relationships, most of these patients spend time in isolation, and in most circumstances they have no one to console them.

Family members who have the patient suffering from stigma also undergo a lot of stigma in their lives (Schizophrenia Research Institute 2013). Some of the time they fear public disgrace and hide the patient at home, though their stigma and stress is not hiIDen from the eye of the public. This action has a further effect of demeaning efforts to caring for people suffering from schizophrenia. This is because through hiding, the public attention that is required to be given to individuals suffering from the disease is not accorded. Relatives, work associates and family friends sometimes became a source of inflicting stigma to the affected family. The perception that people has about mental illness in general is a source of stigma for both the victim and the family. For example, many people believe that mental sickness does not recover completely, and they cannot trust the victims to serve in a public office even if they are healed. Due to this stigma, a barrier exists for patients of schizophrenia in seeking support, and this means they spend their lives in loneliness and isolation. This is usually accompanied by discrimination in housing, hopelessness and discrimination in education and employment (Schizophrenia Research Institute 2013).

The Mental Health Foundation (n.d) outlines four areas which are sources of stigma to patients of a mental health condition like schizophrenia. There are family members, friends, relatives and the employers. According to the foundation, ninety percent of the people suffering from mental disorders agree that they experience negative effects through discrimination. The stereotypes thatpeople have formed about people suffering from schizophrenia are among the leading factors for their stigma.

In the treatment of schizophrenia, the medical model and the social model are considered. The medical model has been criticized by many because of its failure of scientific proof in the existence of disease. Many view the medical model as existing only on the mind of psychiatrists but not related to the patients. They consider treating the patient using this model as a way of punishing the patient. This is because lab tests are not one to confirm that the patient has an underlying disease. The social model of schizophrenia on the other hand, is best in understanding the social behavior of the patient (David et al. 1997). This is because the social model considers the patient as a holistic being. In this consideration, the social behavior and effects on the patient are considered in the plan of care.

The treatment for schizophrenia is holistic and looks to a patient as a whole being who exists in a family, which lives in a community. Therefore, in the treatment for schizophrenia, many aspect of the treatment are followed. These include psychotherapy; medications, family and community support (Grohol 2013). Medications are the method of choice for treatment of schizophrenia. Due to the complexity of the disease, combinations of drugs are used. These include anti-psychotics, anti-depressants, and anti-anxieties. In order to ensure that the treatment by medications is effective, it is supported by psychotherapy (Grohol 2013). The activities that are done in psychotherapy are aimed at supporting the patient. These include modelling, reassurance, and education, giving advice, guiding on weekly activities, and helping the patient to set goals. Since the patient is part of the family, the family should be guided on how to support the client (WHO 2013). The support by the family members will be very crucial in helping the patient to set goals, take medications, and adhere to routines. The family members should be patient with the client, and as well communicate calmly to them. In aIDition, it appears asthe duty of the family to support the patient emotionally. Apart from these measures, a patient can be helped to support themselves through self-help groups. However, it is very vital to take caution, to ensure that the group is a beneficial one for them.

In the case of John, a treatment plan should be initiated immediately. John should be taken to a psychiatrist, and a support system put in place for him. Her family too should be guided on how to support him by first ensuring they strengthen the strained relationship with him. Apart from the medications, a good intervention for John will be psychotherapy, and family support.

In conclusion, this paper has discussed the concept of mental sickness and, as well, mental health in relation to the case of schizophrenia. The paper has explained mental health, and mental illness. The paper has also looked at schizophrenia in terms of information available, causes, course of the disease, signs and symptoms, effects of the disease, and treatment. In discussing this mental disorder, the paper has used the case of John, a 19 year old who is suffering from the disease.

REFERENCES

Centers for Disease Control and Prevention (CDC). 2013. CDC mental health information. Retrieved online from http://www.cdc.gov/mentalhealth/mental-health-inf.htm

David, L.P., Corrigan, P.W., Bentall, P.R., Newman, L., & Racenstein, J.M. 1997. ‘Social cognition in schizophrenia’. Psychological Bulletin, Vol 121, no. 1 pp: 114-132.

Grohol, J.M. 2013. Schizophrenia: treatment. Retrieved online from http://psychcentral.com/disorders/sx31t.htm

Mental Health Foundation. n. d. Stigma and discrimination. Retrieved online from http://www.mentalhealth.org.uk/

Schizophrenia Research Institute. 2013. The stigma of schizophrenia. Darlinghurst, Australia: Schizophrenia Research Institute 2013.

World Health Organization (WHO). 2004. Promoting mental health: summary report. Geneva, WHO.

World Health Organizations. WHO. 2014. Health topics: mental health. Retrieved online from the WHO website at http://www.who.int/topics/mental_health/en/

Tudor, K. 1996. Mental health promotion: paradigms and practice. London: Routledge.

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