Understanding Mental illness, addictions and mental issues
There are many resources with detailed information on mental illness, addictions and mental health issues so this brief is more like a quick way to understand the broad range of this topic, and some ways to understand the range of issues students on your campus will be experiencing. This helps you look for gaps in the supports available, and so you can focus your attention on areas where there are needs but others are not already taking action.
It’s well recognized that physical health and illness encompasses many aspects – heart health, injuries such as broken bones, illnesses or cancers of different organs and systems are only a beginning. The range of mental illness or disorders, addictions and mental issues however are less well recognized.
This brief separates these into four broad sections:
- Mental illnesses and disorders, Suicide
- Mental issues
- So What? How does this influence your strategy?
**This is intended as a brief informational resource, not for professional guidance. If you or someone you know is having persistent or severe challenges or symptoms that are affecting their normal daily activities or relationships with others, then please consult professional help on your campus or in your community.
Mental illnesses and Disorders, Suicide
Mental Illnesses and Disorders are those that are severe and persistent that are associated with distress or disability that goes well beyond general mental responses. They include illnesses or conditions such as bipolar disorders and schizophrenia:
- Bi-polar disorders: Cycles of feeling intensely happy and invincible followed by depression. The lifetime incidence of bi-polar disorder in Canada is 1%.
- Schizophrenia: Seeing, smelling or hearing things that aren’t there or holding firm beliefs that make no sense to anyone else. The lifetime incidence of schizophrenia in Canada is 1%.
Some mental illnesses occur on a spectrum from mild to severe and at the mild end can be part of life’s normal lows. While all mental issues might be considered as having a spectrum, the more common ones are anxiety and depression.
Anxiety: Anxiety can be at a normal level as our response to ambiguity and concern for possible future situations. Mild anxiety may involve symptoms such as dizziness, nervous stomach, shortness of breath, sleep problems, but we can manage our daily living.
If one moves along the spectrum to moderate anxiety, the intensity and frequency of these symptoms increases, and our ability to attend to normal activities decreases. Anxiety Disorders at the severe end of the spectrum might involve panic attacks, phobias, obsessions or post traumatic stress disorder. 12% of Canadians experience an anxiety disorder at some point in their lifetime.
Depression: In addition to the mild-severe spectrum, there are different types of depressive states, which respond to different treatments. For example, depression from seasonal changes, or in bi-polar disorder are not the same as other types of depression and require different treatments.
Depression varies from person to person. No matter how you experience it, depression is different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun. Depression affects the whole body, with symptoms including fatigue, weight changes, aches and pains, and sleep problems.
Common signs and symptoms of depression can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted, the more likely it is that you’re dealing with depression. These can be one or more of:
Feelings of helplessness and hopelessness, Anger or irritability, Self-loathing, Appetite or weight changes, Sleep changes, Loss of energy, Unexplained aches and pains, Reckless behaviour, Concentration problems, Loss of interest in daily activities.
The term ‘mental illnesses’ can relate to a wide variety of conditions or experiences. Traditionally these focus on an individual, though the impacts will be felt more broadly across the person’s family and close network. The standards for what constitute mental disorders in the USA are set out in the Diagnostic and Statistical Manual of Mental Disorders in the USA (The World Health Organization’s ISD is the standard in many international countries). In addition to those identified above, the DSM-V identifies a number of categories of mental disorders:
- Disruptive, Impulse-Control, and Conduct Disorders;
- Dissociative Disorders;
- Feeding and Eating Disorders;
- Neurocognitive Disorders;
- Personality Disorders;
- Sleep-Wake Disorders;
- Somatic Symptoms and Related Disorders;
- Trauma and Stressor-Related Disorders.
Developmental disabilities and autism spectrum disorder, and other Neurodevelopmental Disorders are also included in the DSM-V categories of mental disorders.
Suicide and suicidality are complex topics, and the pain and loss of suicide extends beyond the individual. At least six people are directly affected by each suicide. These people might be family members, lovers, friends, or anyone else who is impacted by the death of a loved one.
Reliable resources on suicide and suicide prevention are available at the CMHA Centre for Suicide Prevention.
Mental Wellness as a companion to mental illness and mental issues. Because wellness does NOT mean no illness or issues, developing your mental wellness capabilities is relevant for students experiencing different mental illnesses or issues as well as those who do not.
For those who have had a diagnosis of a mental illness or mental issue, this has been called a “recovery approach to mental illness or addictions”. The Mental Health Commission of Canada has developed Guidelines for Recovery-oriented Practice, which helps a person to take action to develop their mental wellness capabilities, at the same time or following their treatment process.
Refer to the brief [Understanding Mental Wellness and Life Assets] for more discussion on developing mental wellness capabilities. —link 4.2.3 mw —-
Addictions are illnesses, not failures of will or character. Substance addictions include alcohol, tobacco, prescription and non-prescription drug addictions, food. Process addictions include such processes as work, worrying, sex, buying, Internet use, gambling. Actions more consistent with normal use (e.g. alcohol as substance use), can spiral into addictive behaviour when use becomes continued, or acts become compulsive and interfere with ordinary life responsibilities such as school, work, relationships or health. In other words, the substance or behaviour is detrimental to the person or others. Unfortunately, a person with an addiction may not be aware or is denying that their behaviour is out of control and causing problems for themselves and others.
Having an addiction or a pattern of heavy use need not be the end of the road. The Mental Health Commission of Canada has developed Guidelines for Recovery-oriented Practice, which helps a person to take action to develop their mental wellness capabilities.
Look for resources on treating addictions as illnesses, and the recovery process. The Family Wellness Initiative, has a wealth of resources on the relationship between brain development and addictions, including information and resources for emerging adults.
Included in the range of possible mental issues are:
- Brain Injury – from trauma or a stroke.
- Violence – physical, emotional or psychological violence can arise from various sources (e.g. family or domestic violence, sexual violence, bullying).
- Trauma – Research into the impacts of trauma have demonstrated the effect of Adverse Childhood Effects and their negative impact on Brain Development. Trauma expresses itself in many ways other than addictions or mental illness – sometimes years later in the form of heart disease and other chronic illnesses or conditions.
- Intergenerational Trauma. As we learn more about the impact of trauma on brain development, we are seeing the intergenerational impacts – trauma in one generation influences children and grandchildren and following generations in different ways. Sometimes the impact is such that the children traumatize others, strengthening the cycle of intergenerational impact.
Stigma or Inclusion
Other Environmental Factors that influence an individual’s mental health, illness or addictions.
Collective issues – concerning characteristics of a place, community or society.
While we usually think of mental illness as a characteristic of an individual, it is possible to apply the concept to a group, community or society. The definition of positive mental health from the Public Health Agency of Canada (following the World Health Organization definition) includes both individual and collective dimensions.
“…the capacity of each and all of us to feel, think, act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity” .
Through this lens, the characteristics of a collective – a family, community or society as well as a place such as a campus, school or workplace can be assessed by the degree to which it assures that violence is not the primary strategy for resolving conflict, social norms that prize inclusion over exclusion and stigma, that ensure equitable access to shelter, education, food and income, as well as the stability and sustainability of the natural and built environments.
A healthy place, such as a community, workplace or campus, as described by the U.S. Department of Health and Human Services is one that:
“continuously creates and improves both its physical and social environments, helping people to support one another in aspects of daily life and to develop to their fullest potential. Healthy places are those designed and built to improve the quality of life for all people who live, work, worship, learn, and play within their borders — where every person is free to make choices amid a variety of healthy, available, accessible, and affordable options.”
Stigma and Marginalization
Being stigmatized or marginalized can impact a person’s sense of belonging, self worth and self-confidence or shame. They also impact the person who is doing the stigmatizing although that may not be recognized. Social norms as well as physical environments and structural factors such as policy all influence the degree to which a person or group is excluded or limited. While your particular initiative might highlight stigma of mental illness, the broad range of marginalization crosses racism, socio-economic challenges, and social norms that privilege strength over weakness.
**These are intended as brief informational resources, not for professional guidance. If you or someone you know is having persistent or severe challenges or symptoms that are affecting their normal daily activities or relationships with others, then please consult professional help on your campus or in your community.
So What? How does this influence your Strategy?
You can frame your strategy around mental illness, addictions and mental issues and focus on the subset of students who are at risk or who have illness, addictions and issues. This is a very common way to frame a strategy. Even if you do not wish to provide the professional services associated with treatment or supporting students at risk, there are many strategies that students have employed to increase accessibility, knowledge or reduce the stigma associated with having a mental illness.
Understanding that various environmental factors, like stigma (a social environmental factor), or physical environment (such as lighting in parking lots to help students be safe or reduce their anxiety, or quiet spaces where students who are more sensitive to noise pollution can spend some time, or gender neutral bathrooms) means you can advocate with different departments on campus than you might think of at first. Looking for the departments responsible for physical plant, or for capital planning for example, and helping them to understand how their work can support students’ mental health can be important to developing an overall mentally healthy campus.
Also, student associations might think of approaching faculty members in different fields, such as sociology, political science and anthropology, or business, to explore how they might help you think of different ways to influence the campus social environment. If you don’t have these faculties on your campus, you might collaborate with another students association who do.
There is lots of information to help you think about what strategies you want to use, and to know what to look for to know you’re making progress, depending on what outcomes you want to achieve with your activities.
Remember that the ACMHI strategy understands this within the frame of a Mentally Healthy Campus. It also helps to understand why systemic factors matter more than individual willpower and behaviour, as well as recognizing normal human experiences and brain development in the context of mental wellness and illness. What is a Mentally Healthy Campus? provides additional background.
Contributions of the social and physical environment are also recognized in the healthy place model.
Another useful resource is the Health Promoting Universities and Colleges. It recognizes a ‘whole system’ approach such as the Mentally Healthy Campus approach, though broadened to include physical dimensions of wellness. The 2015 International Conference produced the Okanagan Charter, setting out a set of interdependent strategies.
The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) describes the important role that environments play in determining whether a person experiences a disability. (Note this is different than the World Health Organization’s International Classification of Diseases, the ICD)
You can use the reference list as a starting point for exploring the topics more broadly if you want further information.
Additional background briefs provide more information:
- It’s usual for humans to… gives a quick overview of stress, grief, fear and other expected human emotions as well as brain development and plasticity through life.