(Volume 4) - Mental Health Disorders - Vula - University of Cape Town

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Figure 3: Summary of operational processof the Mental Health WorkgroupBrief review of risk & protectivefactors for mental illnessRanking and selection of corerisk/protective factorsLiterature review of evidencefor interventions targetingcore risk factorsBrief review of existinginterventions (public/private) inthe Western cape targeting corerisk/protective factorsGap analysisReview of policy environmentRECOMMENDATIONSConsultation with stakeholders: feasibility,acceptability, sustainabilityTo occur at:Development & HealthSummit May 2007POLICY/PROGRAMME DEVELOPMENT17
Why mental health is necessary: the burden of mental illnessAs illustrated in this report, mental illness has a major impact on individualand population health, educational outcomes, teenage pregnancy, socialcapital, community violence, poverty, and the economy of a country.The state of mental health is also a determinant of multiple socio-economicoutcomes: the mentally ill are more likely to be unemployed, live ininadequate housing and in poor neighbourhoods, and are less likely tocomplete schooling. Furthermore, mental illness, and in particular substanceabuse, is associated with less social capital and greater community violence;in South Africa 58% of homicide deaths and 57% of road-traffic accidentdeaths are associated with alcohol abuse (MRC, 2005). Socio-economicfactors are also significant determinants of mental health, withunemployment, poverty, low social capital and community violence allassociated with increased mental illness. Multi-component mental healthinterventions can therefore improve a broad range of outcomes, as suggestedby this report.Interventions that improve mental health “not only enhance positivemental health, but also contribute to the reduction of risk behaviourssuch as tobacco, alcohol and drug misuse and unsafe sex; the reductionof social and economic problems such as dropout from school, crime,absenteeism from work and intimate partner violence; and the reductionof rates, severity of, and mortality from physical and mental illness”Moodie & Jenkins (2005) The evidence of mental health promotion effectiveness: strategies for action.iv. International Prevalence Journal of of Mental Health Promotion Disorders and Education. in the Supplement. Western 2: 42-46 CapeThe South African Stress and Health Survey (SASH) has recently beencompleted and is a household survey estimating the national prevalence ofmental illness. The results show a 30.3% lifetime prevalence of anypsychiatric disorder (Stein, in press); annual prevalence and disorderprevalence rates are still pending. Aside from this data, there is currently noother source of reliable data on the prevalence of mental disorders in theWestern Cape Province or South Africa (Draper & Corrigall 2006).The mortality data on injuries provides a proxy measure for the extent ofmental-health problems, including substance abuse, in the Western CapeProvince. In considering which component of injury data is the most accuratemarker of mental illness one must recognise that only a small fraction ofthose with mental health problems commit suicide. Homicide and road-trafficaccident rates are better proxy measures of the impact of mental illness onmortality, given that the majority of homicides and road-traffic accidents areassociated with substance abuse, which falls within the spectrum of mentalillness. Certainly it will be an underestimate of the extent of the morbidity dueto mental disorders, but it is far superior to suicide rates as a measure of theimpact of mental health problems on Provincial mortality. As a marker of thecomparative prevalence of mental disorders across the Provinces of SouthAfrica, it is noteworthy that the Western Cape has the highest proportions ofpremature deaths due to homicide, road-traffic accidents and suicides in thecountry, as illustrated in Table 6 below (Bradshaw et al, 2004).18
Page 1 and 2: Western Cape Burden of DiseaseReduc
Page 3 and 4: AcknowledgementsAuthorsDr Joanne Co
Page 5 and 6: illion a year. When the further cos
Page 7 and 8: Table 2: Percentage contribution of
Page 9 and 10: I Multiple Deprivation1. Improve ac
Page 11 and 12: 11.Evaluate and support Non-Governm
Page 13 and 14: interventions. More broadly, the su
Page 15 and 16: Figure 2: An example of how interve
Page 17: The aim of the Mental Health Workgr
Page 21 and 22: Medical Research Council/ UNISA. (2
Page 23 and 24: FindingsWhile the findings of the r
Page 25 and 26: The literature review also identifi
Page 27 and 28: Table 7: Selection criteria with re
Page 29 and 30: Cape Province. Furthermore, such an
Page 31 and 32: On the other hand, the Provincial G
Page 33 and 34: the quality of building materials,
Page 35 and 36: Conclusion‣ The Western Cape can
Page 37 and 38: association and the evidence on the
Page 39 and 40: Figure 7: The relationship between
Page 41 and 42: The Michigan Prevention Research Ce
Page 43 and 44: y 11-34% (Ficano et al, 2006). This
Page 45 and 46: through the stresses associated wit
Page 47 and 48: ‣ an insufficient recognition of
Page 49 and 50: ‣ Community buy-in and participat
Page 51 and 52: understand the relationship between
Page 53 and 54: ‣ Ensure ongoing training and sup
Page 55 and 56: Evans, G.W., Wells, N.M., Moch, A.
Page 57 and 58: Vic Health.(2007).www.health.vic.go
Page 59 and 60: 1999; Stenius & Veysey, 2005) — a
Page 61 and 62: Collaborating Centre for Mental Hea
Page 63 and 64: Conclusion‣ Some types of early i
Page 65 and 66: ‣ Self-awareness training should
Page 67 and 68: ‣ Non-Governmental Organisations
Page 69 and 70:
g) Any disaster plans for the Weste
Page 71 and 72:
National Institute of Mental Health
Page 73 and 74:
The legal regulation of substances
Page 75 and 76:
‣ Media campaigns are shown to be
Page 77 and 78:
3.1. Social-influence model‣ Emph
Page 79 and 80:
Conclusion‣ Reducing the availabi
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‣ Marital and family therapy has
Page 83 and 84:
emphasis on broader environmental f
Page 85 and 86:
Table 10: Governmental intervention
Page 87 and 88:
D. RecommendationsThe recommendatio
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Ferri, M., L. Amato, et al. (2006).
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IV. MENTAL HEALTH SERVICES(return t
Page 93 and 94:
Table 12: Categories of mental-heal
Page 95 and 96:
opportunities and rewards for bully
Page 97 and 98:
‣ Culturally appropriate interven
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Some health services in schools are
Page 101 and 102:
2.1. Core features of workplace-bas
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2.3. Existing interventionsWhile th
Page 105 and 106:
to be representative of the general
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• Trauma units and surgery casual
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Similar models may be generated for
Page 111 and 112:
Table 15:. Estimated needs for ment
Page 113 and 114:
D. Recommendations1. School-based m
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Invest in media campaigns that aim
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Browne, G., Gafni, A., Roberts, J.,
Page 119 and 120:
McLoone, J., Hudson, J. L., & Rapee
Page 121 and 122:
for Economic Sciences, economist Ja
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employment, which is protective aga
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turnover, positive and committed at
Page 127 and 128:
only one quarter of the community-b
Page 129 and 130:
Ou, S. & Reynolds, A.J. (2006). "Ea
Page 131 and 132:
leisure significantly predicts posi
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Conclusion‣ There is evidence tha
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Petticrew, 2003). South (2004) repo
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4. Environmental factorsHealthy nei
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• Include non-competitive sports
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Table 17: Recreational activities t
Page 143 and 144:
ReferencesArgyle, E., & Bolton, G.
Page 145 and 146:
Marine, A., Ruotsalainen, J., Serra
Page 147 and 148:
educing falls among elderly people:
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economic opportunities and assets.
Page 151 and 152:
Table 19: The impact of recommended
Page 153 and 154:
V. Implementationi. Integrating int
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programme is first implemented) wit
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Appendix 1Literature review of the
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Conclusion: There is strong evidenc
Page 161 and 162:
achievements and successes in the s
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• The built environment influence
Page 165 and 166:
Evidence from cross-sectional surve
Page 167 and 168:
and substance abuse disorders among
Page 169 and 170:
isk for physical ill-health, which
Page 171 and 172:
Conclusion: The evidence demonstrat
Page 173 and 174:
has shown that the most poor are un
Page 175 and 176:
1.9. Transport Back to IndexNo arti
Page 177 and 178:
nine provinces ranging from 0.20-0.
Page 179 and 180:
(Bhugra, 2004). Furthermore, the li
Page 181 and 182:
1.12. Spatial segregation Back to I
Page 183 and 184:
conversely, substance abusers were
Page 185 and 186:
Conclusion: The evidence for urban
Page 187 and 188:
Again, the likelihood is that this
Page 189 and 190:
this instance are (Kaliebe & Sondhe
Page 191 and 192:
2.4. Race Back to IndexA review of
Page 193 and 194:
females 3.8 times as likely to have
Page 195 and 196:
teacher burnout (Hastings & Bham, 2
Page 197 and 198:
2.7. Personal experience of abuse o
Page 199 and 200:
A review of literature in the devel
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studies: one (Dalgard & Tambs, 1997
Page 203 and 204:
Section 10. Human dignitySection 12
Page 205 and 206:
punishment, which explains the effe
Page 207 and 208:
health or social harm (a pattern co
Page 209 and 210:
McKee, Karasz, & Weber (2004) descr
Page 211 and 212:
abuse, HIV related stressors and Ai
Page 213 and 214:
methodological problem of recall bi
Page 215 and 216:
• Maternal substance using during
Page 217 and 218:
childhood to adulthood. While these
Page 219 and 220:
American Psychiatric Association (1
Page 221 and 222:
Bursik, R. (1988). Social disorgani
Page 223 and 224:
De Vries, M. W. & Wilkerson, B. (20
Page 225 and 226:
Funk, M., Saraceno, B., Drew, N., L
Page 227 and 228:
Jin, R., Shah, C., & Svoboda, T. (1
Page 229 and 230:
Leatt, A., Rosa, S., & Hall, K. (20
Page 231 and 232:
Mulvihill, D. (2005). The health im
Page 233 and 234:
Patel, V. & Kleinman, A. (2003). Po
Page 235 and 236:
Rosenheck, R., Dausey, D., Frisman,
Page 237 and 238:
Stukas, A., Dew, M., Switzer, G., D
Page 239 and 240:
Whitaker, R., Phillips, S., & Orzol
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(Volume 4) - Mental Health Disorders - Vula - University of Cape Town

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