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| MENTAL HEALTH AND MENTAL ILLNESS |
MENTAL HEALTH AND MENTAL ILLNESS
Mental health and mental illness are difficult to define
precisely. People who can carry out their roles in
society and whose behavior is appropriate and adaptive
are viewed as healthy. Conversely those who fail
to fulfill roles and carry out responsibilities or whose
behavior is inappropriate are viewed as ill. The culture
of any society strongly influences its values and
beliefs, and this in turn affects how that society defines
health and illness. What one society may view
as acceptable and appropriate, another society may
see as maladaptive or inappropriate.
The World Health Organization (WHO) defines
health as a state of complete physical, mental, and
social wellness, not merely the absence of disease or
infirmity. This definition emphasizes health as a positive
state of well-being, not just absence of disease.
People in a state of emotional, physical, and social
well-being fulfill life responsibilities, function effectively
in daily life, and are satisfied with their interpersonal
relationships and themselves.
No single, universal definition of mental health
exists. Generally a person’s behavior can provide clues
to his or her mental health. Because each person can
have a different view or interpretation of behavior
(depending on his or her values and beliefs), the determination
of mental health may be difficult. In most
cases, mental health is a state of emotional, psychological,
and social wellness evidenced by satisfying
interpersonal relationships, effective behavior and
coping, positive self-concept, and emotional stability.
Mental health has many components, and a wide
variety of factors influence it (Mohr, 2003):
• Autonomy and independence: The person
can look within for guiding values and rules
by which to live. He or she considers the
opinions and wishes of others but does
not allow them to dictate decisions and
behavior. The person who is autonomous
and independent can work interdependently
or cooperatively with others without losing
his or her autonomy.
• Maximization of one’s potential: The person is
oriented toward growth and self-actualization.
He or she is not content with the status quo
and continually strives to grow as a person.
• Tolerance of life’s uncertainties: The person
can face the challenges of day-to-day living
with hope and a positive outlook despite not
knowing what lies ahead.
• Self-esteem: The person has a realistic awareness
of his or her abilities and limitations.
• Mastery of the environment: The person can
deal with and influence the environment in a
capable, competent, and creative manner.
• Reality orientation: The person can distinguish
the real world from a dream, fact from
fantasy, and act accordingly.
• Stress management: The person can tolerate
life stresses, appropriately handle anxiety or
grief, and experience failure without devastation.
He or she uses support from family
and friends to cope with crises, knowing that
the stress will not last forever.
These factors constantly interact; thus, a person’s
mental health is a dynamic or ever-changing state.
Factors influencing a person’s mental health can
be categorized as individual, interpersonal, and social/
cultural. Individual factors include a person’s
biologic makeup, sense of harmony in life, vitality,
ability to find meaning in life, emotional resilience
or hardiness, spirituality, and positive identity
(Seaward, 1997). Interpersonal factors include effective
communication, ability to help others, intimacy,
and a balance of separateness and connection. Social/
cultural factors include a sense of community, access
to adequate resources, intolerance of violence, and
support of diversity among people. Individual, interpersonal,
and social/cultural factors are discussed in
Chapter 7.
Mental Illness
The American Psychiatric Association (APA, 2000)
defines a mental disorder as “a clinically significant
behavioral or psychological syndrome or pattern that
occurs in an individual and that is associated with
present distress (e.g., a painful symptom) or disability
(i.e., impairment in one or more important areas
of functioning) or with a significantly increased risk
of suffering death, pain, disability, or an important
loss of freedom” (p. xxxi). General criteria to diagnose
mental disorders include dissatisfaction with one’s
characteristics, abilities, and accomplishments; ineffective
or nonsatisfying relationships; dissatisfaction
with one’s place in the world; ineffective coping
with life events; and lack of personal growth. In addition,
the person’s behavior must not be culturally
expected or sanctioned, nor does deviant behavior
necessarily indicate a mental disorder (APA, 2000).
Factors contributing to mental illness also can be
viewed within individual, interpersonal, and social/
cultural categories. Individual factors include biologic
makeup, anxiety, worries and fears, a sense of
disharmony in life, and a loss of meaning in one’s life
(Seaward, 1997). Interpersonal factors include ineffective
communication, excessive dependency or
withdrawal from relationships, and loss of emotional
control. Social and cultural factors include lack of resources,
violence, homelessness, poverty, and discrimination
such as racism, classism, ageism, and sexism.
