INTRODUCTION TO STRESS MANAGEMENT - OR MENTAL HEALTH

                       MENTAL HEALTH FOR ALL
                                  or more accurately
       THE STRESS MANAGEMENT BLOG FOR ALL
       ( understanding stress illnesses and managing them)

by AFPA

Asian Federation of Psychiatric Associations

 

 

 

                                      
          Author with a Psychiatrist at new Stress Management Ward in Labasa , Venua Levu Fiji 2011
                     (the first open psychiatric general hospital inpatient ward in Fiji for over 120 years)

This is a blog meant to de-mystify mental health, mental illnesses and stress and stress management for those who are in search of understanding of mental problems that affect a significant portion of people.

Mental illnesses affect 15 % or so of the population and as many as 30% of persons who see out patient general medical consultations and yet most are not recognised for the emotional stress that troubles them. Due to faulty training of health care personnel that considers anything 'mental ' as being mad or psychotic most of them end up looking out for psychoses when they are and do not recognise symptoms of mental stress that are not psychoses.

Mental stresses that are not psychotic include Prolonged Anxiety or Worry and    Depression or prolonged sad feelings that result from stresses that the person is unable to overcome.

             
                  A locked district hospital mental cell in the 1970s and prison cells
                                          used as psychiatric  a mental ward

However under the mistaken belief that all mentally ill are dangerous and unpredictable all mentally ill were locked up in cells and treated in inhumane ways for centuries. The fear even led to staff of some mental wards locking themselves from their patients

                           A locked and barred nursing station in another hospital 

In the past when no real treatments in the form of reliable and effective medicines were available locking the insane and even labelling all under emotional stress as insane was the norm. The locked cell of iron bars and chains were it then seemed safe  methods of "care".  Safety and security of staff and others was of utmost importance. Treating the patient's primary illness seemed less important. In some countries the mentally ill in WWII were actually slowly starved to death  and after the war the staff set up memorials to honour the dead patients .

 

 

                  

                     A hunger ward of  WWII                Memorial to those who died

But in 1954 some 60 years ago  two French doctors at the St Anne's hospital discovered the drug chlorpromazine which was by far the first truly medical treatment for controlling psychosis. It has been followed by numerous medicines for the treatment of Anxiety disorders, Depressive Disorders, Mood disorders, Substance abuse disorders and Psychoses of many types  as well as serious child and adolescent disorders  along with newly discovered psychological and social interventions that can help so many millions all over the world.

 

The Laboratory in St Anne's Hospital where in 1954 Chlopromazine was discovered.

 

 

With All these new treatments available since the 1960s world wide even in developing countries there would be no need for the cells and locked grilles. Out patient clinics, Day Patient units  and short stay Stress Management wards can manage almost all of the patients with stress problems and illnesses but ignorance poor priorities and lack of services continue to lead to abuse of the mentally ill into the 21st century.

 

                              

                           a 2010 picture of a patient shackled to her bed for lack of

                                a monthly injection of antipsychotics costing US $2

 

 

What is needed however is a simpler training of health care staff and wider availability of trained staff and better stress management out patient clinics , stress management day centres and short stay stress management wards. There are many parts of Asia and the Pacific that lack basic psychiatric or stress management facilities and still use cells and police stations to care for the mentally ill.

 

 

 

 

                 THE PACIFIC STRESS MANAGEMENT CHALLENGES

 

                                

                                          Navua Sress Management Clinic Fiji

 

 

 

                                    

Primary Care Psychiatry training  for Rarotonga Nurses and Doctors where there is no psychiatrist.

 

                                       

                       Te Kainga O Pa Taunga Stress Management Day centre Cook Island

 

 

 

 

 

 

 

         THE MONGOLIAN EXPERIENCE IN MENTAL HEALTH REFORM

                              AND GER PSYCHOSOCIAL REHABILITATION

 

 



       

         Mongolian Psychosocial rehabilitation Gers

in Ulaan Baatar

 



 At the same time there is a need to de-institutionalise the old mental hospital practices by offering the long stay mental patients an opportunity to be rehabilitated in less restrictive atmosphere of community care. In Mongolia where the mental hospital was the main method of treatment an attempt was made by housing patients in Mongolian community type tented portable  houses or Gers. These traditional houses afforded the patients more freedom, opportunities for craft work, house keeping chores in winter and farm work in summer. The picture above shows  the author at a ger community outside the mental hospital in Ulaan Baatar that he introduced as a rehabilitation project in 1999 with funding from the WHO . There are several such Ger rehabilitation projects in Mongolia including  Hovd, Dornogobi and Ulaan Baatar.

 

 

                               

 

Discussions were held on ways of improving psychosocial rehabilitation and de institutionalisation Ulaan Baatar. The Asian Federation of Psychiatric Associations also negotiated a visit by Prof P Shastri to help train psychiatrists in child and adolescent psychiatry . This resulted in the Start of a school psychiatric service in UB.

This was followed by a workshop on Primary Care Psychiatry

(picture below)

 

 

 

 

Not all psychiatric treatments need to be in government hospitals as this poster of the NITTE RURAL PSYCHIATRIC CENTRE, SOUTH KARNATAKAINDIA 

started by volunteers and NGO shows

                   Dr Naveen , Mrs Naveen and  Volunteers from an NGO help in disseminating mental health information through a telephone counseling service in
                                                Mangalore, Karnataka, India

                       Training Nursing students  in Community psychiatry care


                                
                               

 

Dr and Mrs Naveen Chandra with Generous support from  The Nitte University

headed by its vice chancellor Prof Vinay Hegde and colleagues opened the Nitte Rural Psychiatry Day Centre and Clinic in 2013. For patients who had no psychiatric care and were often chained for lack of basic medicines, this was the fulfilment of the hard work and dedication of an expatriate son of Nitte.

 

 

 AND IN P R China..........

                  



                                     Training Doctors and Nurses in Changsha, PR China

                

   Training psychiatrists in An Ding Hospital in Chifeng Inner Mongolia, PR China

 MORE TO FOLLOW........
contact devamp37@gmail.com
for more information on Stress Management, and how to change the face of mental illnesses by Stress Management





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