DAN ESPARZA, SENIOR PROGRAM MANAGER HOLLY MCCORMACK (SCOTLAND) STEVE GILBERT, 300 VOICES ENGAGEMENT (UNITED KINGDOM) - MENDOCINO COUNTY

Dan Esparza, Senior Program Manager
         Holly McCormack
              (Scotland)
Steve Gilbert, 300 Voices Engagement
          (United Kingdom)

Objectives

 Provide Examples of State of Stigma Around the World:
   
 Challenges
   
 Successes

 Cultural Considerations for Mental Health Wellness
  Around the World


 What is the “Face” of Mental Health Around The
  World
   
 Personal Perspectives from Center International Fellows

Mental Health Worldwide
Today, about 450 million people ‘experience a mental health condition’.
According to WHO’s Global Burden of Disease 2001,
      
     33% of the years lived with ‘mental health conditions’ are due to
            neuropsychiatric disorders,
      
     a further 2.1% to intentional injuries,
      
     Unipolar depressive disorders alone lead to 12.15% of years lived
            with disability, and rank as the third leading contributor to the
            global burden of diseases,
      
     Four of the six leading causes of years lived with ‘mental health
            conditions’ are due to neuropsychiatric disorders (depression,
            alcohol-use disorders, schizophrenia and bipolar disorder)1
Investing in Mental Health, Department of Mental Health and Substance Dependence, Noncommunicable
Diseases and Mental Health, World Health Organization, Geneva, 2003.

Stigma around the World

Stigma Around The World

 Pakistan: Mental Health Problems are compounded by
  the situation particular to the country due to the unique
  situation with respect to terrorism.
                                                                    • High rate of PTSD 79% for
                                                                      ‘psychological distress and
                                                                      exposure to cues.’ (i.e.
                                                                      Frequent natural calamities
                                                                      such as floods and
                                                                      earthquakes.). 1

      1. Comprehensive Mental Health Action Plan 2013-2020, World Health Organization, October 2013.

On the Horizon
    
 WHO’s Mental Health Action Plan
      2013-2020, endorsed by the World
      Health Assembly in 2013, recognizes the
      essential role of mental health in
      achieving health for all people. The plan
      includes 4 major objectives:
        
   more effective leadership and
            governance for mental health;
        
   the provision of comprehensive,
            integrated mental health and social
            care services in community-based
            settings;
        
   the implementation of strategies for
            promotion and prevention; and
        
   strengthened information systems,
            evidence and research.

On the Horizon

   Uruguay:
    
   Challenge: Suicide ratio of 12.54 per 100.000 persons, goal is to reduce
        mortality related to suicide by 10% for the period 2011-2020.

    
   Plan: Adopted an inter-institutional National Plan for Suicide Prevention
        with a protocol for prevention that also covers the family of the patient:
        
      Group psychosocial interventions, with an emphasis on prevention and
               promotion, targeted essentially to “healthy” populations. Free with no
               waiting list;
        
      Individual, couple, family or group psychotherapy, with a co-payment;
        
      Individual or group psychotherapy, focused on rehabilitation, with a
               smaller co-payment.1
        1Comprehensive   Mental Health Action Plan 2013-2020, World Health Organization, October 2013.

On the Horizon

 Sri Lanka:
  
 Challenge: Between 1950 and 1995 suicide rates in
    Sri Lanka increased eight fold to a peak of 47 per
    100,000 in 1995.
  
 Civil war in Sri Lanka resulting in large numbers of
    refugees is believed to contribute to the suicide rate
    (Berger, 1988),
  
 Plan: National and international policies restricting
    the sale of pesticides that are most toxic to humans
    may have a major impact on suicide prevention in
    the region.4
  
   3Gunnell D, Fernando R, Hewagama M, Priyangika W, Konradsen F, Eddleston M. The impact of pesticide regulations on suicide in Sri
      Lanka. International journal of epidemiology. 2007;36(6):1235-1242. doi:10.1093/ije/dym164.

Cultural Considerations for Mental Health
        Wellness Around the World


 Culture, Ethnicity and Race are part of what makes up
  our ideas, values and who we are, as people.

 Our ideas are often formulated by our cultural
  background and how we understanding the world.

 Individuals with mental health conditions:
   
 May view what they are experiences through a “cultural
     lens.”
   
 Utilize “idioms of distress” to describe what is happening
     to them.

Cultural Considerations

 As service providers, understanding the “idioms of
  distress” can provide insight to an individuals mental
  health condition.


 Important to also understand the person’s own
  “individual” beliefs and her/his take on those “idioms of
  distress.”

Idioms of Distress

1Cross Cultural
           Mental Health: Attitudes, Approaches, Accessibility, Approaches, British Columbia’s Mental Health Journal: Visions, No.9,,
Canadian Mental Health Association. Winter 2000.

Idioms of Distress

1. Cross Cultural Mental Health: Attitudes, Approaches, Accessibility, Approaches, British Columbia’s Mental Health Journal: Visions,
No.9,, Canadian Mental Health Association. Winter 2000.

Other World Views?

Mental Health and
    Wellness
 in New Zealand
   Sialei Anamani

FOR ME, WELLNESS IS:


   Reconciling and finding meaning in my personal
    distress; cause, effect and recovery.

   Knowing who I am, being ok with every facet of being
    me – labels don’t mean much any more.

   Having opportunities to use my experience for the good
    of myself and others.

   Looking forward to the future and remaining hopeful.

   Enjoying my life.

How Sialei does it:


   Relationships – keep good ones and trust a few to tell me
    straight.


   Know my strengths and limits – learning to say NO
    more!


   Get good sleep


   Watch my stress


   And I know I should exercise more…

Te Whare Tapa Wha

Aotearoa – Our Strengths
• Embrace a cultural approach in mental health services
  and treatment

• Specialist Maori and Pacific Services funded by
  Government

• Cohesion with mainstream models

• Holistic health models; Te Whare Tapa Wha, Fono fale
  used in mainstream services as a basis to wellness plans

• Inclusion of a spiritual understanding of mental distress
  (voice hearers etc.)

• Oldest National Anti stigma and discrimination
  programme – Like Minds, Like Mine.

• Some great people - world renowned International peer,
  academic and ‘activist’ leaders.

• Some great peer-led services.

Aotearoa –
        CHALLENGES

Disconnect between ‘best practice’
 and actual practice.

Bio-medical view of mental
 distress still the only view taught
 through tertiary institutions. Peer
 leaders working as lecturers in
 university’s struggling to have their
 work supported.

Continue to invest millions of
 dollars into institutions - $53.6m
 into new acute unit in Auckland.

Sialei’s Projects


Employment Equality Project – Like Minds, Like
 Mine. http://www.likeminds.org.nz/


Live for Tomorrow – Like Minds, Like Mine.


PeerZone – O’Hagan McCook Weir Consulting
 Ltd. Peer led workshop on mental health.

Mental Health and Wellness
   Around The World

    SCOTLAND

Holly McCormack
•   Stay in Paisley – that’s 7 miles from
    Glasgow. Home of the Paisley
    Pattern, St Mirren FC and David
    Tennant (Dr Who).
•   29 years old
•   Freelance mental health
    journalist/blogger
•   Editor of Mental Matters available
    http://www.mentalmatters.co.uk
    re-launching soon
•   Winner of 2013 Mind Media award
    for Student Journalist
•   Diagnosis of Borderline Personality
    Disorder

What is mental health?

       Some people call mental health ‘emotional health’ or ‘well-being’ and it’s just as important as
        good physical health.


       Being mentally healthy doesn’t just mean that you don’t have a mental health problem. Equally –
        being mentally ill doesn’t mean you have bad mental health. It is a continuum.
        If you’re in good mental health, you can:

        •          Make the most of your potential
        •          Cope with life
        •          Play a full part in your family, workplace, community and among friends

       Mental health is everyone’s business. We all have times when we feel down or stressed or
        frightened. Most of the time those feelings pass. But sometimes they develop into a more serious
        problem and that could happen to any one of us.


       Everyone is different. You may bounce back from a setback while someone else may feel weighed
        down by it for a long time.


       Your mental health doesn’t always stay the same. It can change as circumstances change and as
        you move through different stages of your life.

Source: MHF 2015

Mental health and
               wellness

   Good mental health is not simply the absence of diagnosable
    mental health problems, although good mental health is likely to
    help protect against development of many such problems.


   Good mental health can be characterised by a person’s ability to
    fulfil a number of key functions and activities, including:

•   The ability to learn

•   The ability to feel, express and manage a range of positive &
    negative emotions

•   The ability to form and maintain good relationships with others

•   The ability to cope with and manage change and uncertainty

   Source: MHF 2015

Good mental health – how
     does it look?
•   Maintaining a good diet and exercise
•   Sleep hygiene
•   Talking through any problems you have
•   Routine
•   Turning off blue light few hours before attempting sleep
•   Managing tasks effectively (time management)
•   Getting outside at least once a day
•   Communication with others

The mental health/wellbeing
     continuum model

Strengths in Scotland
•   National Health Service providing
    access to CAMHS, CMHT, GP,
    OOH CPN and IHTT services
•   Free prescriptions
•   Body of third sector
    organisations: SAMH, (RAMH,
    GAMH), Vox, Mental Health
    Foundation, Choose Life
•   Breathing Space, Samaritans, First
    Crisis
•   National anti-stigma campaign –
    See Me
•   NUJ Scotland Journalism Guide

Challenges faced
•   Waiting times to see a GP
•   Access to therapies (CBT, DBT, MBT)
•   Stigma and discrimination
•   Funding
•   Lack of in-patient beds
•   Weather (hard to go out and exercise
    when it’s always raining)
•   Scottish diet – not the healthiest
•   West of Scotland mentality– don’t like
    talking about feelings, leads to people
    suppressing
•   Poverty
                                              Typical Scottish Weather

Activities: Increase mental
              wellness
               Personal                                 Scotland wide

•   Exercise regularly                    •   Scottish Mental Health Film and Arts
                                              Festival
•   Good diet as remember – healthy
    body healthy mind                     •   Healthy Body: Healthy Mind (NUS)
•   Reduce blue light on mobile, pc, tv   •   Keep Active Campaign (SAMH)
    before bed to maintain good sleep
    hygiene                               •   GP led eat well programmes
•   Talk regularly about my feelings      •   Employability services help you into
    whether a professional or                 work
    friend/family
                                          •   Free tuition fees –maybe do a college
•   Keep to a routine even if not             or university course to keep routine
    working
                                          •   Mindfulness
•   Set and maintain small goals
                                          •   Culture Club

Scotland’s moving in the
    right direction…

Steven Gilbert

Steve Gilbert
•   Born and educated in Birmingham, England, UK
•   31 years old
•   Self-employed Healthy-Active Lifestyle Coach
•   Diagnosis of Bipolar Disorder
•   Lived Experience Consultant with 300 Voices project
•   Time to Change Champion
•   Member of the Service User Representative Forum for the
    Royal College of Psychiatry

What does mental health
       look like to me?
•   We all have it
•   We are not the diagnosis
•   Something real
•   Treatable
•   Recovery

Mental Wellness
•   Mindfulness
•   Yoga
•   Peer-support
•   Relaxation
•   Socialising & Support
•   Acceptance
•   Self-compassion
•   Good nutrition

Challenges Faced
• Poor understanding of MH
  problems
• Medication rather than therapy
• Stigma and Discrimination

Strengths
• Free health care
• Mental Health Crisis Care
  Concordat
• Street Triage Teams
• Introduction of access standards and
  waiting time standards

Strengths

www.time-to-change.org.uk

Thank you

Contact Information

 Dan Esparza: daniel@mentalhealthsf.org


 Sialei Anamani: sialei05@gmail.com


 Holly McCormack: holly@mentalmatters.co.uk


 Steve Gilbert: sj.gilbert@me.com