Today is World Mental Health Day

Change attitudes towards the mentally ill:

Miran PERERA

An imbalance in psychological-social or spiritual dimensions causes mental illhealth.

October 10th is the day where everyone should make a determined effort to think further and change attitude towards mental ill health.

It is time for all of us to focus on two important problems which have been holding Sri Lanka in their grip for quite some time. They are the wide spread abuse of hard drugs and increasing mental illnesses, and emotional instability. There is a close link between the grave malaises because increasing emotional turmoil among vulnerable groups exposes them to the risk of hard drug abuse.

This is particularly true to some sections of our youth although mental illnesses are no respecter of age or generation. Brain scientists are on a roll. Concern about rising level of mental distress have resulted in unprecedented level of funding in the US and Europe.

A range of new technologies from genetics to brain imaging are offering extraordinary insights into the molecular and cellular processes underlying how we see, how we remember and why we become emotional. Brain imaging has become quite familiar.

Scanners known by their initials CAT, PET, MRI began as clinical tools enabling surgeons to identify potential tumours, the damage following a stroke or the diagnostic signs of incipient dementia.

The youth are not wilful perpetrators of crime with mental illness. Neither do they become addicts out of choice. They are only victims of a wider social crisis that our society is going through for which we are also responsible.

A wider social crisis forms the backdrop to these problems currently ravaging Lankan Society - hard drug abuse and rising mental illhealth. There is no sure way out of mental illhealth. Mental health cannot be pursued in the same way as physical health. The body is a machine. On bio medical premise one energy produces some other energy.

Mental health is the by-product of efforts to fulfil fundamental human needs which are two fold. They are avoidance of suffering and the pursuit of happiness. To achieve these two objectives conditions such as food, clothing, shelter, protection to continue life, socio-biological needs and freedom to live our own way are necessary.

Life without freedom is not worth living. There has been a radical shift in the approach to the care of persons with mental disorders. In the past they were treated in closed institutions as in-patients removed from their relatives and their community.

Today on the other hand the approach is to provide care for them in the community itself, instead of sending them in to closed institutions like our own Angoda and Mulleriyawa.

In many countries though not perhaps in Sri Lanka there has been a big decrease in the number of patients in closed institutions and the growth of a wide variety of community based mental healthcare programmes.

Major companies are starting to image the brains of potential customers to study how they respond to new designs or brands. They are beginning to speak of neuromarketing and neuroeconomics such trends may be relatively innocuous but the increasing state interest in what the images might reveal is less so.

Specifically, what if brain imaging could predict future behaviour or indicate guilt or innocence of a crime? Should there be a change of attitude towards such mentally ill? There are claims for example that it could reveal potential psychopathy that the brains of men convicted of brutal murders show significantly abnormal patterns.

In the current legislative climate where there have been attempts to introduce pre emptive detention for psychopaths who have not yet been convicted of any crime such claims need to be addressed critically. They are and will be resisted by the judiciary but recent developments suggests that this may be a frail defence against an increasingly authoritarian state. Many social tendencies gravitate vulnerable persons from all age groups towards mental illhealth. In a selfish world even most adults tend to feel neglected. This is particularly true of the ageing segment of the population. Such a sense of alienation could lead to mental illhealth.

At present there is the aspect of mounting illhealth, decreasing social consolidation and cooperation which breeds emotional instability. There observations need to alert all sections to the grave crisis affecting Lankan society. There is more than meets the eye here. Mental health and Mental disorder or Mental illness are two different phenomena but interlinked.

When we speak of health according to the definition of the World Health Organisation physical, psychological, social and spiritual well-being are denoted as health. So we see that 3/4 the of this component involves mental health.

An imbalance in psychological-social or spiritual dimensions causes mental illhealth. On the other hand a mental disorder or a mental illness is an abnormal behaviour which is not in keeping with accepted norms varying from individual to individual. Their causes my be genetic or hereditary, environmental, traumatic either physical or psychological or addiction to drugs.

Poor mental health to a large extent is a contributory factor towards mental illness. Dealing with the consequences of mental disorder there is physical harm to self and others, ruination of life career, negative social attitudes and stigma so attached becomes evident once a person is labelled as a mental patient. It is important to recognise the fact that in traditional times our villagers always had a large incidence of mental illhealth. How did traditional society in Sri Lanka address this reality and treat the affected persons?

The traditional procedure of treatment was when someone behaved abnormally the family would get the help of an astrologer, an ayurvedic physician, a light reader or some such practitioner or a combination of several practitioners to determine what has caused the abnormal behaviour. If it is found that it is the result of some negative inter action of certain planets moving along the axis of time the practitioner may advise one of several actions.

Counselling is one remedial measure against mental illness. Most importantly there are very effective medicine manufactured through latest and complicated research which could be given to patients suffering from mental illness. Counselling by definition means the act or process of assisting and guiding people by a trained person on a professional basis to resolve personal, social or psychological problems or difficulties.

The most important cause of mental illness is said to be family tension. It has been recognised that persons whose condition of mental health has been weakened by family tension especially in childhood are more likely than others to suffer mental illhealth on account of tension in the work place or in the other institutions in which they interact with others. Often those who have had an unhappy childhood are predisposed to mental ill health arising from tension in the relationships they have in their schools, universities, kin groups, neighbourhood and workplaces.

Mental illhealth is a widespread problem. If not addressed and resolved it reflects itself in all types of social disorder. Effective practical decisions and their implementation is in order to create awareness among all segments of people about Mental health on the one side and community based mental healthcare on the other. Overall mental illness badly needs a change of attitude from all factions of society.

Their causes my be genetic or hereditary, environmental, traumatic either physical or psychological or addiction to drugs.