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Abstract
Key featuresDiscussion of the terminological confusion that exists in relation to issues associated with mental health. The scale of individual suffering from mental health problems and illness among young people. The worldwide phenomenon of the stigmatization of mental illness, originating during childhood.
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Defining mental health andmental illnessSharon Leighton and Nisha DograKey features • Discussion of the terminological confusion that exists in relation to issuesassociated with mental health.• The scale of individual suffering from mental health problems and illnessamong young people.• The worldwide phenomenon of the stigmatization of mental illness,originating during childhood.• Evidence regarding interventions to reduce stigma.IntroductionIn this chapter we explore the concepts of mental health and mental illness from differentperspectives, including those relating to children, and of children. This is important as thosewho work in mental health, or are familiar with the field, often make the assumption that theterms used are readily understood by others. The scale of the problem and access to services isoutlined. We then discuss stigma generally, explore the reasons for it and possible sequelae, andthen consider how this relates to children. Finally, interventions to reduce stigma are brieflypresented. As mentioned in the Introduction, where possible we have referred specifically to theliterature relating to children but where this is limited we have drawn from the wider literatureto highlight key issues.The chapter begins with an exercise which provides a practical context for the theoreticalcontent and should be borne in mind as you read, and answered once you have finished thechapter.Box 1.1ExerciseGeneral questions• What words or images do you associate with the following terms:• Mental health• Mental health problems• Mental illness• Mental disorder• What sorts of problems do people experience that could be described as mentalhealth problems or mental illness?• How would you be able to tell if someone was experiencing mental health prob-lems or mental illness?1
Case scenarios and associated questionsPlease read each senario and then consider the following questions in relation to it:• What do you think might be happening with the young person?• Do you think the young person has a mental health problem or illness? If so, onwhat grounds would you justify that decision?• Do they need help?• If so, who and/or what might be helpful?• How might this be helpful?Case scenario 1Jack, aged 9, lives with his mother and younger brother. His father unexpectedly left thefamily a year ago. Jack started a new school six months ago and is having difficultysettling in. He complains of tummy ache each school morning and is increasinglyreluctant to attend.Case scenario 2Emily, aged 14, lives with her parents, who are both busy professionals. She works hard,achieves A-grades and plans to be a lawyer. Recently she has been teased by herfriends about her weight and has decided to go on a strict diet. She is pleased with theresults so far and plans to continue eating little, making herself sick after meals andexercising a lot.Case scenario 3Joshua, aged 15, lives with his dad and stepmother. He has little contact with his mum oryounger brother and sister. Recently he has been cautioned by the police for joy-ridingin stolen cars with his mates. He prefers to spend time smoking dope with older boysrather than going to school.Defining mental health and mental illnessClarity is essential when using the terms ‘mental health’ and ‘mental illness’. In all phases of arecent small-scale research project, conceptual confusion was identified in the literature reviewand among participants (Leighton 2008). Ironically, referring to mental illness in terms ofmental health originated in the 1960s in an attempt to reduce stigma (Rowling et al. 2002).There is no widely agreed consensus on the meaning of these terms and their use. Mental healthand mental illness can be perceived as two separate, yet related, issues.Ryff and Singer (1998) suggest that health is not a medical concept associated with absenceof illness, but rather a philosophical one that requires an explanation of a good life – being onewhere an individual has a sense of purpose, is engaged in quality relationships with others, andpossesses self-respect and mastery. This is synonymous with the World Health Organization(WHO) (2000, 2005b) definition of positive mental health.However, such a definition is incomplete as individuals do not exist in isolation, but areinfluenced by, and influence, their social and physical environments. Furthermore, people willhave their own individual interpretations of what a good life is. Rowling et al. (2002: 13) definemental health as the8 Nursing in child and adolescent mental health
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