Empowerment of clients with mental health problems

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Empowerment of clients with mental health problems
Elodie- Belgium Siret- Estonia Ingeborg-
Norway Julie- Norway Signem- Turkey
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Content

• Mental illness
• Epidemiology
• Empowerment
• Safety
• Discussion

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Mental health
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Definitions

• Mental health - state of well-being in which
  every individual realises 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 (WHO).

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• Mental disorder or mental illness - psychological
  or behavioral pattern that occurs in an
  individual and is thought to cause distress or
  disability that is not expected as part of normal
  development or culture (Helsedirektoratet).

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Facts

• Most middle and low-income countries devote less
  than 1 of their health expenditure to mental
  health. Consequently mental health policies,
  legislation, community care facilities, and
  treatments for people with mental illness are not
  given the priority they deserve.
• Mental illnesses affect and are affected by
  chronic conditions such as cancer, heart and
  cardiovascular diseases, diabetes and HIV/AIDS.

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Classification

• psychotic disorders
• mood disorders
• anxiety disorders
• dissociative disorders
• eating disorders
• personality disorders
• and many other categories

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Causes of mental disorders

• Often explained in terms of biopsychosocial model
• In many cases
• -gt no single reason accepted
• -gt no consistent cause of mental disorders.
• The recognition and understanding of mental
  disorders has changed over time and across
  cultures.

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• Widespread problems with
• stigma
• discrimination
• People with these disorders are often
• subjected to social isolation,
• increased mortality,
• decrease of the communication skill,
• poor quality of life.
• These disorders are the cause of staggering
  economic and social costs.

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Epidemiology

• Hundreds of millions of people worldwide are
  affected by mental, behavioural, neurological and
  substance use disorders.
• One in four patients visiting a health service
  has at least one mental, neurological or
  behavioural disorder but most of these disorders
  are neither diagnosed nor treated.
• (WHO)

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• WHO data in 2002
• 154 million people globally suffer from
  depression
• 25 million people from schizophrenia
• 91 million people are affected by alcohol use
  disorders
• 15 million by drug use disorders.
• WHO data in 2003
• 450 million people worldwide suffer from mental
  or behavioral disorder.

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Estonian, Norwegian and Belgian data

• 30-50 gets a mental illness during their life,
  20 30 of adults have had such a disease the
  last year.
• Between 15 and 20 of all children and
  youngsters has a mental illness that affects
  their functional level.
• Depression is the most common mental illness.
• (WHO)

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Turkish data (2006)
(Turkish psychiatric association )
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Thoughts over data

• Why does Turkey have a lower number of people
  diagnosed with mental health problems?
• Why women have more mental health problems then
  men?

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Psychiatric systems and empowerment
Focusing on adult clients with mild mental health
problems.
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Empowerment

• is the process of increasing the capacity of
  individuals or groups to make choices and to
  transform those choices into desired actions and
  outcomes.
• Central to this process are actions which both
  build individual and collective assets, and
  improve the efficiency and fairness of the
  organizational and institutional context which
  govern the use of these assets
• (World bank organisation)

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Institutional psychiatric system
disempowerment
People with mental illness
Many years in psychiatric hospitals with a
Father to son relation type.
Explanation of the Father to son relation
One way communication, the patient doesnt have
the knowledge to wonder what is happening to him.
Patient
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Community-based care psychiatric system
EMPOWERING
Community based-care systems
People with mentall ilnesses
Psychosocial rehabilitation
In this system, the patient is now called client
(in many countries) and he is informed of his
problems and his choices related to these This
is an equal to equal relation.
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Lucy goes MAD !!!!!
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Our vision of empowerment for clients with
mental health problems in our everyday work as
care-givers.
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NURSE (AND PHYSIOTHERAPIST)

• Developing coping skills
• Decreasing the stigma perceived
• Increasing the clients social environment
• Working on body awereness
• Promoting physical activity
• Promoting group activity

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Centres Norway

• Psychiatric hospitals with different units, long-
  term, short- term, acute
• After treatment Day- centers, Fountain house (5
  in Norway), sheltered work places, sheltered
  living facilities, following up dialogs at the
  hospital, group therapy.

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Centres Norway

• Fountain House
• Started in New York 50 years ago
• Its 350 different Fountains houses in the world
  (5 in Norway).
• Its a professional self- help program. The
  program is run by people that are in
  rehabilitation themselves after a psychiatric
  illness and people that are hired from the
  government.
• The goal
• The vision
• The main goal is that the members should take
  control of their own life by gaining self-
  respect, a meaningful life and hope for the
  future.
• Transfer work

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Centres Estonia

• There are 29 different homes, hospitals, centres
  for taking care of people with mental health
  problems, what provide also supported working and
  living services
• 7 of them are day-centres

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Mental Health Centre in Tallinn

• Has 3 subcentres in different parts in Tallinn
• Aim is to support people in their independent
  living environment
• Letter of referral from psyciatrist, therapies
• Free for clients

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In Belgium

• Psychiatric care is available in residential care
  (eg. Institutionnal admittance) ,
  semi-residential care (eg. Partiel institutionnal
  admittance or sheltered houses) and ambulatory
  care.
• These initiatives are financed by the federal
  governement and the communities.
• The psychiatric offers are

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Examples of what is on offer in Belgium

• Zigzag (place of social meetings)
• White farm (labour work in a safe environment
  adapted to the clients and their abilities)
• Creahm (Expositions, concerts and plays -and
  everything around plastic arts and drama- showing
  the work of artists who have a mental health
  problem)

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(No Transcript)
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IN TURKEY

• Mental health care is provided by psychiatry
  wards in hospitals and psychiatry hospitals
  located throughout the country
• In some psychiatry wards inpatient and
  outpatient follow- up programs and programs
  including families are conducted

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SERVICES IN TURKEY
OUTPATIENT
INPATIENT
DAYTIME HOSPITAL
FAMILY -PATIENT COPING SKILL AND PROBLEM
SOLVING IMPROVING PROGRAM
PATIENT SOCIAL SKILL IMPROVING PROGRAM
FAMILY -PATIENT PSYCHOEDUCATION PROGRAM
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SAFETY

• Definition- condition of being protected against
  physical, social, spiritual, financial,
  political, emotional, occupational,
  psychological, educational or other types or
  consequences of failure, damage, error,
  accidents, harm or any other event which could be
  considered non-desirable. This can take the form
  of being protected from the event or from
  exposure to something that causes health or
  economical losses.
• (Helsedirektoratet)

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Do you think there might be a link between the
feeling of safety and the capacity of empowerment
of clients ?
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Thank you!