Mental health and Mental disorders (Psychiatric Illness): Training for Community Health Workers 

Introduction to Mental Health and Mental Disorders
Mental Illness are classified in many ways based on the characteristics of the illness, severity, duration and the disability it causes to an individual. Mental disorders can affect women and men differently.
What is Health?
As per the definition of health is "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Thus, for an individual to stay healthy, apart from physical health, mental well-being is equally important. It has been proposed by WHO ‘that there can be no physical health without mental health’.
Mental well-being of an individual implies that an individual is able to:
1. Realize his or her own potentials,
2. Cope with the normal stresses of life,
3. Work productively and fruitfully, and
4. Make a contribution to her or his community.
Few major components influencing the mental health include,
• Resilience: Life poses various short- and long-term challenges. Dealing with them effectively and not getting overwhelmed by them is crucial for mental health. Various life skills such as critical thinking, problem solving and stress tolerance can help us in this.
• Self-esteem: Self-esteem refers to our perception towards ourselves; for example, in our own evaluation how valuable we are to others and how confident we are in our own abilities. Positive self-esteem helps us in realization of our potentials and having a sense of control.
• Emotional well-being: Regulations of emotions in constructive manner and dealing with emotional upheavals so that they do not affect us negatively are important for our emotional well-being.
• Spiritual well-being: It refers to having sense of purpose in life and our connectedness with others. Spirituality does not mean religiosity but religious beliefs can be one of the means for our spiritual well-being. Apart from this, sharing, helping etc. boosts our spiritual well-being.
• Social connectedness: Last but not least, having a wider perspective towards society, respect for others and acceptance of other’s beliefs and values are important for positive mental health.
Bio-psycho-social cause of mental illness
Patients / caregivers/ general public will often ask you the reasons for development of mental illnesses. It is very important to make them understand that in contrary to the popular belief, mental illnesses are not the result of possession by evil spirits, curses, astrological influences, character weakness, laziness, karma or black magic. There are many factors that play a vital role in the onset and course of the mental illnesses.
Most mental illnesses are caused by a combination of factors including: stressful life events, biological factors, individual psychological factors (e.g. poor self-esteem, negative thinking), adverse life experiences during childhood (e.g. abuse, neglect, death of parents or other traumatic experiences), social factors like poverty, migration, access to health and sanitation etc.
Factors affecting mental health
Mental illnesses are often caused by a combination of biological, psychological and social factors. It is important to identify the contributing risk factors at various levels and also the protective factors which can be leveraged upon for patient care.
A brief description is as follows: Most mental health disorders are caused by a combination of factors including,
• Stressful life events
• Biological factors
• Individual psychological factors e.g. poor self-esteem, negative thinking
• Adverse life experiences during childhood e.g. abuse, neglect, death of parents or other traumatic experiences.
Some people may be more vulnerable to mental health disorders than others but may not develop an illness until they are exposed to stressful life events.
- Biological factors can include genetics, brain injury, and chemical imbalance in the brain.
- Stressful life events can contribute to the development of mental health disorders . A lot of stress may also contribute to an imbalance of chemicals in the brain.
- Poverty can place a person at risk of mental health disorders because of the stresses associated with low levels of education, poor housing and low income. Mental health disorders are also more difficult to cope with in conditions of poverty.
- Difficulties in childhood such as sexual or physical violence, emotional neglect, or early death of a parent can sometimes lead to a mental health disorder later in life.
- Unhealthy behaviors such as drug and alcohol abuse can lead to the development of a mental health disorder as well as being the result of a mental health disorder