scholarly journals Why it’s time to stop saying “mental illness”:  A commentary on the revision of the Irish Mental Health Act

2021 ◽  
Vol 4 ◽  
pp. 28
Author(s):  
Malcolm MacLachlan ◽  
Rebecca Murphy ◽  
Michael Daly ◽  
Philip Hyland

The Irish Mental Health Act (2001) is undergoing revision.  In 2014 an Expert Review Group recommended that the term currently used in the act “mental disorder”, should be replaced with the term “mental illness”.  We argue that the proposed change, while well intentioned, contradicts the internationally adopted terminology of “mental disorder” used by the United Nations, World Health Organisation and European Commission. The term “mental illness” is atavistic, it implies an unsupported cause, it contravenes the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), and it is associated with concerns regarding stigma and reduced self-efficacy.  Furthermore, the term “mental illness” is not used in any internationally accepted diagnostic or classification system in the mental health field. While any term used to describe mental health problems, may be contested, Ireland should not revert to using archaic terminology.  In accordance with international best practice, and perhaps in lieu of a willingness to accept more progressive alternatives, Ireland should continue to use cause-neutral terminology, such as “mental disorder”, in the revised Mental Health Act.

2014 ◽  
Vol 11 (1) ◽  
pp. 1-2 ◽  
Author(s):  
Soumitra Pathare ◽  
Laura Shields ◽  
Jaya Sagade ◽  
Renuka Nardodkar

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) serves as a comprehensive and legally binding framework for the rights of persons with mental illness. The extent to which countries have adapted their mental health legislation to reflect the binding provisions outlined in the CRPD is unclear. This paper reviews the situation across the Commonwealth.


Author(s):  
Vijay Kumar Chattu ◽  
Paula Mahon

Mental health problems affect society as a whole, and not just a small, isolated segment. In developed countries with well-organized healthcare systems, between 44% and 70% of patients with mental disorders do not receive treatment whereas in developing countries the treatment gap being close to 90%. Schizophrenia is a severe mental disorder affecting more than 21 million people worldwide. People with schizophrenia are 2-2.5 times more likely to die early than the general population. The case study highlights about agnosia in a schizophrenic patient in a primary care setting and how to address the management at a broader perspective using the appropriate antipsychotic medication and ensuring the support from a family without violating the human rights of the patient. The World Economic Forum estimated that the cumulative global impact of mental disorders in terms of lost economic output will amount to US$ 16 trillion over the next 20 years, equivalent to more than 1% of the global gross domestic product. Mental health should be a concern for all of us, rather than only for those who suffer from a mental disorder. The mental health action plan 2013-2020, endorsed by the World Health Assembly in 2013, highlights the steps required to provide appropriate services for people with mental disorders including schizophrenia. A key recommendation of the action plan is to shift services from institutions to the community. Mental health must be considered a focus of renewed investment not just in terms of human development and dignity but also in terms of social and economic development.


Author(s):  
Rebecca McKnight ◽  
Jonathan Price ◽  
John Geddes

One in four individuals suffer from a psychiatric disorder at some point in their life, with 15– 20 per cent fitting cri­teria for a mental disorder at any given time. The latter corresponds to around 450 million people worldwide, placing mental disorders as one of the leading causes of global morbidity. Mental health problems represent five of the ten leading causes of disability worldwide. The World Health Organization (WHO) reported in mid 2016 that ‘the global cost of mental illness is £651 billion per year’, stating that the equivalent of 50 million working years was being lost annually due to mental disorders. The financial global impact is clearly vast, but on a smaller scale, the social and psychological impacts of having a mental dis­order on yourself or your family are greater still. It is often difficult for the general public and clin­icians outside psychiatry to think of mental health dis­orders as ‘diseases’ because it is harder to pinpoint a specific pathological cause for them. When confronted with this view, it is helpful to consider that most of medicine was actually founded on this basis. For ex­ample, although medicine has been a profession for the past 2500 years, it was only in the late 1980s that Helicobacter pylori was linked to gastric/ duodenal ul­cers and gastric carcinoma, or more recently still that the BRCA genes were found to be a cause of breast cancer. Still much of clinical medicine treats a patient’s symptoms rather than objective abnormalities. The WHO has given the following definition of mental health:… Mental health is defined 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.… This is a helpful definition, because it clearly defines a mental disorder as a condition that disrupts this state in any way, and sets clear goals of treatment for the clinician. It identifies the fact that a disruption of an individual’s mental health impacts negatively not only upon their enjoyment and ability to cope with life, but also upon that of the wider community.


2018 ◽  
Vol 16 (03) ◽  
pp. 68-70
Author(s):  
J. Maphisa Maphisa

The Mental Disorders Act of 1969 is the primary legislation relating to mental health in Botswana. Despite the country not being a signatory to the United Nations Convention on the Rights of Persons with Disabilities, its Act has a self-rated score of four out of five on compliance to human rights covenants. However, it can be argued that the Act does not adequately espouse a human rights- and patient-centred approach to legislation. It is hoped that ongoing efforts to revise the Act will address the limitations discussed in this article.


Author(s):  
Sangeeta Dey ◽  
Graham Mellsop ◽  
Kate Diesfeld ◽  
Vajira Dharmawardene ◽  
Susitha Mendis ◽  
...  

Abstract Background Involuntary admission or treatment for the management of mental illness is a relatively common practice worldwide. Enabling legislation exists in most developed and high-income countries. A few of these countries have attempted to align their legislation with the United Nations Convention on the Rights of Persons with Disabilities. This review examined legislation and associated issues from four diverse South Asian countries (Bangladesh, India, Pakistan and Sri Lanka) that all have a British colonial past and initially adopted the Lunacy Act of 1845. Method A questionnaire based on two previous studies and the World Health Organization checklist for mental health legislation was developed requesting information on the criteria and process for involuntary detention of patients with mental illness for assessment and treatment. The questionnaire was completed by psychiatrists (key informants) from each of the four countries. The questionnaire also sought participants’ comments or concerns regarding the legislation or related issues. Results The results showed that relevant legislation has evolved differently in each of the four countries. Each country has faced challenges when reforming or implementing their mental health laws. Barriers included legal safeguards, human rights protections, funding, resources, absence of a robust wider health system, political support and sub-optimal mental health literacy. Conclusion Clinicians in these countries face dilemmas that are less frequently encountered by their counterparts in relatively more advantaged countries. These dilemmas require attention when implementing and reforming mental health legislation in South Asia.


2000 ◽  
Vol 24 (2) ◽  
pp. 69-70 ◽  
Author(s):  
John P. Tobin

The civilian population of southern Lebanon has endured military conflict, civil war, and two invasions since the foundation of the State of Israel in 1948. Currently part of the south is under Israeli occupation forming a buffer zone between Israel and the hostile forces of the Hizbollah and Amal militias. The Israeli Defence Forces are aided by the South Lebanese Army which is the remnants of a Christian militia. The Hizbollah is supported by Iran and Syria and is the dominant force outside the occupation zone. In the south of Lebanon there is a United Nations mandate force which is attempting to return Lebanese government control over the south, decrease hostilities, protect the civilian population and provide humanitarian aid. This is part of the humanitarian mandate of the United Nations Interim Force in Lebanon (UNIFIL) that I had the opportunity to observe and to treat the mental health problems of the civilian population who were living under long-term artillery bombardment and living with continuous fluctuating conflict. Under such circumstances, rigorous scientific methodology in assessing the mental health of the population is extremely difficult. In order to operate effectively, as well as my own rudimentary Arabic, a translator was required. A translator does more than just translate language they also translate custom, culture and provide a valuable source of local information. Utilising my own observations and those of my valued translator, Basima, I did my best to assess how the civilian population coped with what was difficult circumstances. These assessments are value laden and I suppose are in many ways personal. My position as a military psychiatrist in the United Nations allowed me access to both the occupation zone and unoccupied Lebanon.


2015 ◽  
Vol 14 (4) ◽  
pp. 205-210
Author(s):  
Peter John Huxley

Purpose – The purpose of this paper is to report on the development and results of the Mental Health Inclusion Index. Design/methodology/approach – Data gathering and interviews with key policy makers in 30 countries in Europe (the EU28 plus Switzerland and Norway). Data gathered enabled the production of an 18 indicator benchmarking index ranking the 30 countries based on their commitment to integrating people with mental illness. Findings – The main findings were: mental illness exacts a substantial human and economic toll on Europe, and there is a substantial treatment gap, especially for people with common mental health problems. Germany’s generous social provision and strong healthcare system put it number one in the Mental Health Integration Index. The UK and Scandinavian states come next. The lowest-scoring countries in the index are from Europe’s south-east, where there is a long history of neglect of mental illness and poorly developed community services. One needs to understand that the leading countries are not the only ones providing examples of best practice in integrating those with mental illness. Employment is the field of greatest concern for people with mental illness, but employment is also the area with the most inconsistent policies across Europe. A distinction can be made between countries whose policies are aspirational and those where implantation is support by substantial and most importantly sustained, resource investment. Europe as a whole is only in the early stages of the journey from institution- to community-based care. Lack of data makes greater understanding of this field difficult, and improvement can only be demonstrated by repeated surveys of this kind, based on more substantial, comprehensive and coherent information. Research limitations/implications – Usual caveats about the use of surveys. Missing data due to non-response and poverty of mental health inclusion data in many European countries. Practical implications – The author reflects on the findings and considers areas for future action. The main implications are: better services result from substantial, but most importantly, sustained investment; and that employment is most important to people with mental health problems, but is one of the most inconsistent policy areas across Europe. Social implications – Supports the need for consistent investment in community mental health services and more consistent employment policies in Europe. Originality/value – This survey is the first of its kind in Europe, and was conducted by the Economist Intelligence Unit in London, and sponsored by Janssen.


Criminologie ◽  
2005 ◽  
Vol 28 (2) ◽  
pp. 61-83 ◽  
Author(s):  
Danielle Laberge ◽  
Daphné Morin ◽  
Marie Robert

This article discusses how pre-trial detention has become an important instrument in the treatment of the accused whose mental state has been questioned during the judicial process. This study is part of a major research trend centered on the hypothesis of criminalization of the mental illness. This hypothesis has been defined as a shift of groups of the population from the mental health system to the criminal justice system. First, the authors examine how the Criminal Code's dispositions and those regarding mental disorder, which have been revised in February 1992, can be associated with the Court's decisions regarding the release of the accused during the legal process. Then, the authors continue to look into the question concerning the articulation of dual decisional logic (judicial and psychiatric) by studying approximately 1 000 cases heard before the Criminal and Penal Chamber of the Québec Court in Montréal in 1992-1993, in which the mental illness issue was raised. This analysis will try to demonstrate a link between pre-trial detention and mental health problems. It will also show that, despite the adoption of the principle of presumption against custody during assessment orders regarding mental disorder, the Court practices are changing slowly and the new dispositions are rarely used.


Author(s):  
Derek Bolton

The question "What is mental illness?" raises many issues in many contexts, personal, social, legal, and scientific. This chapter reviews mental health problems as they appear to the person with the problems, and to family and friends-before the person attends the clinic and is given a diagnosis-a time in which whether there really is a problem, as opposed to life's normal troubles and variations, is undecided, as also the nature of the problem, if such it be, and the related matter what kind of expert advice should be sought. Once at the clinic, a diagnosis may be given-using criteria well-worked-out in the diagnostic manuals. The chapter discusses the conceptualizations of mental disorder in the diagnostic manuals, their rationale, and what can and cannot be reasonably expected of them. There are more position statements than definitions, and while they signal many dilemmas, they do not resolve them. Attempts to do so in the surrounding literature on the concept of mental illness are reviewed in the chapter, with conclusions favoring the features emphasized in the diagnostic manuals: distress and impairment. Finally the chapter considers how far the science may help draw boundaries around mental illness.


Sign in / Sign up

Export Citation Format

Share Document