NEET Biology Human Health And Disease / मानव स्वास्थ्य और रोग Mental Health and Community Health

Mental Health

There is a general feeling that if you are and not ill you are healthy. A truly healthy person is the one who has a sound body, lives in harmony with others, has the ability to face stresses and strains and holds certain moral and spiritual values. Body and mind are intimately related. Any disturbance in one has its effect on the other. Like the body, mind too can become ill.

It is estimated that 1 percent of the world population suffers from serious mental illness and 10 percent from mild mental disorders. In India, there are 67million people with incapacitating mental disorders.

Characters of Mentally Healthy Person

If potential conflicting instinctive drives. A mentally healthy person has (1) Self-respect. (2) Knowledge of one's capabilities and limits. (3) Independent personality but comfortably placed in hierarchy in work, family and society. (4) Feeling of friendship and trust for others. (5) A purposeful life with reasonable goals to achieve. (6) Potential to perform all the daily chores and not dependent on any other person. (7) No tendency in decision making to get swayed away by emotions, fear, anger, love or guilt. (viii) Ability to meet all the demands of life, solving problems as they arise. A mentally sick.

Mental illness

It is a state of mind in which a person is not able to think, behave and interact with others normally. On set of mental illness is exhibited by (1) Changes in behavior and personality due to abnormality of thoughts, memory, feelings, perception and judgment. (2) Difficulty in adjustment with family members and colleagues. (3) Inability to carry on daily business, with signs of tension, trembling, depression, aggressive behavior, fear, phobia, etc. There is thus social and vocational dyes functioning.

Characters of Mentally Sick Person

(1) Inability to concentrate. (2) Absence of sound sleep. (3) Worrisome behavior. (4) Short temper. (5) Unhappiness. (6) Mood fluctuations from depression to elation. (7) Tendency to get upset by a change in routine. (8) Apprehensive nature. (9) Bitterness. (10) Dislike of others. (11) Considering others to be wrong. (12) Children getting on nerves. (13) Feeling of pains / aches in different body parts without any actual ones.

Types of Mental illness

Mental illness can be grouped under three broad categories – psychosis, neurosis and mental disorders.

(1) Psychosis / Insanity / Madness: It is a serious type of mental illness in which the patient loses touch with reality. Psychosis may be caused by disease of central nervous system. In some cases it is associated with diabetes, hypertension and tuberculosis. The patient in not aware of illness and refuses to take the treatment.

(2) Neurosis: It is less severe form of mental illness where the patient is aware of the problem and tries to seek help. There is abnormal anxiety, fear, sadness, vague aches and pains. Neurosis develops due to stress and anxiety in patient's environment. The patient shows excessive / prolonged reaction to a given stress, e.g., anxiety neurosis, hysteria, obsessional neurosis, reactive depression. All of us have tendency to become neurotic. Rather neurosis is mode of overcoming certain problems like worry, fear, anxiety, feeling of insecurity, etc.

(3) Mental Disorders: The disabilities are caused by physical, physiological and psychological defects like (i) Injury (ii) Infection from worms tuberculosis, measles, leprosy or encephalitis. (iii) Nutritional deficiency during development of infant. (iv) Radiation damage during neural development. (v) Toxicity of lead and mercury. (vi) Degeneration due to ageing. (vii) Tumors or neoplasms. (viii) Poor availability of oxygen glucose / blood supply. (ix) Excessive intake of alcohol. (x) Excessive use of psychotropic drugs.

(i) Epilepsy: It is a mental illness characterized by abnormal electrical discharge in a part of brain often leading to warning cry, fits of convulsions like jerking, stiffness, tongue biting sensory changes, loss of bladder and bowel control, ending in loss of consciousness falling down and sleep. The condition epileptic attack is called seizure. It may recur with biorhythm, photic stimulation, musical composition, tactile stimulation, reading, etc. Proper treatment can cure epilepsy in most of the cases.

(ii) Parkinson’s Disease: (Paralysis Agitans; Parkinson, 1817). It is a sporadic disorder of middle and late life which is characterized by stooped pasture, stiffness and slowness of movements, fixity of facial expression and rhythmic tremor of limbs (most pronounced in hands) which subsides on relaxation or actively willed movement. Relief can be obtained through regular medicine, physiotherapy and surgery.

(iii) Alzheimer’s Disease: A progressive degenerative disease of brain which is caused by senile plaques and neuro - fibrillary tangles resulting in loss of choline acetyltransferase activity. First sings are subtle changes in personality, memory disturbance and trembling of hands. It is followed by progressive increase in dementia over next 5 – 10 years. The disease commonly appears after the age of 40, through it can occur in any age group.

Schizophrenia: It is a type of mental illness or psychotic disorder which is characterized by progressive deterioration of personality, shallowness of emotional life, auditory hallucinations, delusions, illogical thinking, sense of being influenced by others and feeling of being controlled by outside forces. Schizophrenia can be caused by excessive dopamine production, alterations in neuropeptides, increased ventricular brain rations and decreased frontal lobe activity. Recovery is possible with regular use of chlorpromazine along with psychosocial therapy.

Causes of Mental illness: Mental illness is caused by a variety of factors acting singly or together. These cause are:

(1) Changes in Brain: See mental disabilities.

(2) Home Atmosphere: Fight, quarrel, cruelty and lack of warmth affection and accommodation in the family often lead to mental illness.

(3) Hereditary Factors: Tendency to develop mental illness is influenced healthy heredity. Chances of a schizophrenic child are 40 times higher from a schizophrenic couple than the normal one.

(4) Childhood Experiences: A balance of guidance, encouragement, affection, love discipline and companionship is a must for healthy mental development of a child. Lack of any of them and repeated unpleasant experiences lead to mental illness.

(5) Socio - Economic / Special Factors: A number of Socio – economic factors lead to mental illness. They include disparities, hunger, poverty injustice, lack of opportunities, cruelty, insecurity etc.

Treatment of Mental illness

Social Therapy: Mental health is governed to a large extent by adjustment of an individual in the community and the attitude of an individual towards the community. Sympathy shown by family members and community is extremely useful to an individual to overcome misery and adjust to stresses and strains. Curing a mental patient requires a lot of recreational opportunities, companionship, compassion and understanding by family members and society.

Psychotherapy: It is treatment involving psychological techniques like psychoanalysis, discussion, explanation, reassurance, etc. Psychoanalysis (founded by Freud) is method of reviving past and forgotten emotional experiences of a person so as to find out the reason for mental illusion and helping the patient to readjust attitude to causal experiences. Group psychotherapy is also resorted where a group of mental patients are allowed to speak out their problems before a psychiatrist. Suggestions made by the different patients help individual to understand one’s problems and their remedies.

(1) Drugs / Psychochemotherapy: A number of drugs are available to treat different types of mental illness, e.g., sedatives for promoting sleep, tranquillisers for reducing anxiety (e.g., valium or diazepam, larpose or lovazepam, sorapax or oxozepam, librium or chlorodazepoxide), antidepressants (e.g., trimpramine trazodone), antipsychotic (e.g., largactil or chlorpromazine, melleril or thioridazone, thiothixene, loxapine, clozapine, supiride) and anti7epileptic (e.g., epilex, carabadac, carbatol, epitol).

(2) Shock Treatment/ECT (Electroconvulsive Therapy) The treatment is useful in curing acute depression, acute mania, stupor (confessional state) and some types of schizophrenia. The treatment given by expert psychiatrists involves placing of electrodes on the head of the patient and providing an electric stock for a fraction of second by passing a current of definite voltage. It produces convulsion.

Prevention of Mental illness

(1) Companionship where worries and unpleasant experiences can be discussed.           

(2) Occasional review of one's ideas in the light of experiences and vies points of others.

(3) Awareness of assets and liability.

(4) Time for the family and children.

(5) Proper relaxation and sleep.

(6) Routine physical exercise.

(7) Avoiding undue mental strain.

(8) Healthy pastime.

(9) Proper estimate of one's potentiality.

(10) Creating small achievable goals.

Community Health

The individual is a part of community. Community health depends on active participation of its members you have just read how a person can be helped by the community to stay away from addictions. The mental health of an individual also depends to a large extent on the way he adjusts himself to the community and the way the community helps him adjust to stresses ad strains. The community plays a major role in the prevention and control of infectious diseases also.

Health centres

For community development and community health, the country has been divided (1st April, 1958) into 5000 blocks. On June 30, 1996, the rural areas of the country has 2424 Community Health Centres (each catering a population of 80,000 -120,000 having 45 doctors, 30 bed hospital with laboratory and X-ray facility), 21854 Primary Health Centres (each catering a population 20000 - 30000, having a medical officer, one multipurpose female worker, one health educator, and supporting staff) and 132730 sub centres (one for 3000 - 5000 population, having one male and one female multipurpose workers). These health centres are operating under state governments.

A number of other health organizations are also providing basic health services like Central Government Health services (C.G.H.S.) dispensaries, Employees State Insurance (E.S.I.) hospitals, Indian Council of Medical Research (I.C.M.R.) Programmes, National Institute of communicable Diseases (N.I.C.D.) and a number of other national programmes, thrust areas like National Malaria Eradication Programme (N.M.E.P. started 1953 as part of 1st five year plan), National Filaria Control programme (N.F.C.P.), National Leprosy Control programme (N.L.C.P.), National Cholera Control (N.S.E.P. already achieved), national programmes for control of blindness/trachoma, cancer, AIDS, V.D., tuberculosis, etc.

W.H.O. (World Health Organization) also provides assistance and expertise for certain programmes.

Role of Health Centres

(1) Medical care (i) Giving first aid to all emergencies. (ii) Providing curative medical services to both outdoor and indoor patients. (iii) Refering patients requiring specialised treatment to proper hospitals.

(2) Prevention and control of Communicable Diseases. (i) Mass vaccination against various communicable disease like whooping cough, diphtheria, tetanus polio, tuberculosis, cholera, typhoid, etc. (ii) Coordinating with state and national agencies for programmes of malaria eradication, filaria, tuberculosis eradication, cholera control, leprosy control, V.D. control, trachoma control, AIDS control, etc. (iii) Taking special gatherings, exhibitions etc. (iii) Taking special precautionary measures during fairs, religious and political gatherings, exhibitions etc. (iv) Notification of the spread of epidemic diseases and measures to prevent the same, (v) Killing of mosquitoes, flies rats, strays dogs, etc. (vi) Filling or covering of mosquito breeding places (vii) Inoculation of larger water bodies with larvicidal fishes, plants bacteria and cynaobacteria. (viii) Isolation of patients with highly infectious diseases. (ix) Supervision of eating places, food and milk trades for preventing spread of communicable disease.

(3) Data Collection Vital Statistics: Community health workers collect and cross data about (i) Spread of infectious diseases. (ii) Prevalence of deficiency disorders. (iii) Progress of national, regional health schemes. (iv) Public resistance, hesitation or apathy to new programmes. (v) Sanitation. (vi) Pollution (vii) Sate drinking water and safe edibles.

(4) Maternity and Child Health (M.C.H.): (i) Training of dais / midwives. (ii) Guiding expectant mothers about problems related to pregnancy. (iii) Routine examination of pregnant woman. (iv) Antenatal care. (v) Inoculation against tetanus. (vi) Providing facility for child birth. (vii) Post-natal care. (viii) Milk feeding programme. (ix) Prophylaxis against anemia and vitamin deficiency. (x) Immunisation of infants against common diseases. Child survival and Sate Motherhood (CSSM) programme has been introduced since 1992. The incidence of vaccine preventable diseases has declined since then.

(5) Nutrition Education: Information is provided by health official as to the requirement of various nutrients in persons of various ages, deficiency diseases, balanced diet, availability of nutrients in common foods importance of green and yellow vegetables.

(6) Sanitation: (i) Providing safe clean, germ free drinking water. (ii) Proper disposal of waste through proper latrines, compost pits, soak pit, kitchen gardens, smokeless challah. (iii) Prevention of water pollution. (iv) Prevention of air pollution. (v) Hygienic and healthy working conditions. (vi) Hygienic and healthy housing (vii) Capture of rabid animals. (viii) Prevention of insect breeding and other vector control. (ix) Uncontaminated food.

(7) Community Health Education: Community health education is related to knowledge about transmission, prevention and mechanism of control of communicable disease, development of important no communicable diseases, personal hygiene and addictions. It is carried out through (i) Personal contact. (ii) Pamphlets and other printed materials. (iii) Slides, charts, pictures, cinema, radio, T.V. and other audio – visual aids.

(8) School Health Services: They provide for (i) Medical checkup of the child at the time of admission and regular checkup later on at intervals. (ii) Treatment and follow up action for any disorder. (iii) Immunisation (iv) Regular screening by class teacher. (v) Guidance in personal hygiene (vi) Health education. (vii) School sanitation. (viii) School facilities including safe drinking water, prevention of infection from common glasses, proper sitting lighting and ventilation, etc. (ix) Midday meals in certain areas.

(9) Family Planning / Family Welfare: Keeping the number of children per couple to 2 is to goal of family planning so that the size of Indian population becomes stable. Health centres give free (i) Family planning advice (ii) Family planning services.

National Immunisation Programme

With the success of small pox eradication programme, an impetus has been given to eradication of six preventable disease through universal immunisation programme. The six diphtheria, pertussis (whooping cough), polio, tetanus, tuberculosis and measles. The programme was launched by W.H.O. In May, 1974 and is expected to reach every child by 2000 A.D. In India, It was launched in 1985 with reaching every child in 1992. India has fixed the year 2000 A.D. As year of health for all.