Definition

'Mental' is a word which is seen almost exclusively in negative terms - as a term of abuse in the playground, at work and even in the family.

But we are all 'mental' beings - in the same way as we are all 'physical' beings. And mental health is just as important as physical health.

If we are to grow and to flourish, if we are to contribute individually and collectively to society, we need to accept that we are 'mental' beings with emotional and spiritual needs, as well as physical ones.

What are mental health problems?

Mental health problems range from the worries and grief we all experience as part of everyday life, to the most bleak, suicidal depression or complete loss of touch with every day reality.

On average one in four of us will experience a mental health problem in the course of a year. These problems can cause real and lasting damage, both to the individual and to the community. Fortunately the majority of people who experience mental health problems can get over them or learn to live with them especially if they get help early on.

Unfortunately many people experiencing a mental health problem don't receive the right kind of help and some don't receive any help at all. In fact many people with mental health problems are shunned or discriminated against by their families, friends and the professionals who are supposed to be caring for them.

Mental illness

When someone experiences severe and or enduring mental health problems they are sometimes described as mentally ill. However, there are certain difficulties with this term.

There is no universally agreed cut-off point between normal behaviour and that described as mental illness. What is considered abnormal behaviour or an abnormal reaction to circumstances differs between cultures, social groups within the same culture, and even different social situations.

The label mental illness is highly stigmatising. It encourages people to think of 'the mentally ill' as an entirely separate category from 'people like us', rather than as ordinary people who have, for whatever reason, more severe emotional difficulties to cope with. Popular misconceptions, fuelled by the media, depict mentally ill people as violent and dangerous. These stereotypes are contradicted by ordinary people's experiences of mental health problems affecting themselves, their family members, friends or work colleagues.

Use of the term mental illness may be misleading if it is taken to imply that all mental health problems are solely caused by medical or biological factors. In fact, most mental health problems result from a complex interaction of biological, social and personal factors. For example, some people may be biologically vulnerable to experiencing depression, yet strong social support during difficult times can reduce their risk of becoming severely depressed. Similarly, in people with a higher than average genetic risk of schizophrenia, a particular psychotic experience may be triggered by stressful life events and circumstances.

For many people the existing systems of categorising illnesses do not relate closely enough to their experiences. Some people, including some professionals, prefer not to accept diagnoses which may be misleading or stigmatising, for example 'personality disorder' or 'schizophrenia'.  They find these terms unhelpful and prefer to talk about 'psychotic experiences'.

Types of Mental Health Problems

Despite the controversy surrounding the definitions and usefulness of the term 'mental illness', mental health problems today still remain largely in the province of psychiatry, and hence are usually discussed in medical terms.

Psychiatrists sub-divide the different kinds of mental health problems in several different ways.

Organic versus Functional Disorders

'Organic' disorders result directly from identifiable brain malfunction e.g. delirium may be caused by a knock on the head.

'Functional' means that the disorder is not due to simple structural abnormalities of the brain. Most mental health problems are classed as 'Functional'.

Neurotic versus Psychotic Disorders

'Neurosis' describes various forms of mental health problem that can be regarded as severe forms of normal experiences. Examples of neurotic disorders include anxiety and depression.

'Psychosis' is more severe and involves distortion of a person's perception of reality, often accompanied by delusions and/or hallucinations. Examples of psychotic disorders include manic depression and schizophrenia.

Not all diagnoses of mental ill-health can be classified as either neurosis or psychosis. For example, the diagnosis of 'personality disorder' falls outside these categorisations. In other diagnoses, such as 'post-traumatic stress disorder', there may be an overlap between so-called neurotic and psychotic symptoms. Finally, the term 'severe mental health problems' is sometimes used to refer only to the psychoses. However, people with severe depression or anxiety attacks can be just as disabled by their distress as those with psychotic symptoms.

ICD-10 Classification of Mental and Behavioural Disorders

A complete list of all mental and behavioural disorders is given in The ICD-10 classification of mental and behavioural disorders. This classification system was developed from Chapter V(F) of the Tenth Revision of the International Classification of Diseases (ICD-10)3, published by the World Health Organisation.

Organic mental disorders e.g. Alzheimer's disease, delirium.

Mental and behavioural disorders due to psychoactive substance use e.g., alcohol, street drugs, medications.

Schizophrenia, schizotypal and delusional disorders e.g. paranoid schizophrenia, psychotic disorders.

Mood [affective] disorders e.g. depression, manic depression

Neurotic, stress-related and somatoform disorders e.g. anxiety disorders, obsessive-compulsive disorders.

Behavioural syndromes associated with physiological disturbances and physical factors e.g. eating disorders, non-organic sleep disorders.

Disorders of adult personality and behaviour e.g. paranoid personality disorder, transsexualism.

Mental retardation i.e. learning disabilities

Disorders of psychological development e.g. specific reading disorders such as dyslexia, childhood autism.

Behavioural and emotional disorders with onset usually occurring in childhood and adolescence e.g., attention deficit (hyperactivity) disorder, conduct disorders.

Unspecified mental disorders.

Statistics on Mental Health

How many people in the UK have a mental health problem?

1 in 4 people will experience some kind of mental health problem in the course of a year.

What are the main types of mental health problems?

1 in 6 people will have depression at some point in their life. Depression is most common in people aged 25-44 years.

1 in 10 people are likely to have a 'disabling anxiety disorder' at some stage in their life. For manic depression and schizophrenia this figure is 1 in 100.

Who develops mental health problems?

20 per cent of women and 14 per cent of men in England have some form of mental illness.

18 per cent of women have a 'neurotic disorder' such as anxiety, depression, phobias and panic attacks, compared with 11 per cent of men.

Men are three times more likely than women to have alcohol dependence and twice as likely to be dependent on drugs.

What about mental health problems among children and young people?

15 per cent of pre-school children will have mild mental health problems and 7 per cent will have severe mental health problems.

6 per cent of boys and 16 per cent of girls aged 16-19 are thought to have some form of mental health problem.

What is the prevalence of mental health problems in older people?

15 per cent of people over 65 have depression.

Up to 670,000 people in the UK have some form of dementia. Five per cent of people over 65 and 10 to 20 per cent of people over 80 have dementia.

What about suicide and self-harm?

75 per cent of all suicides are by men.

20 per cent of all deaths by young people are by suicide.

17 per cent of all suicides are by people aged 65 or over.

Approximately 142,000 hospital admissions each year in England and Wales are the result of deliberate self-harm. Approximately 19,000 of these are young people.

Self-harm is more common in women than in men.

What is the relationship between mental health problems and offending?

10-20 per cent of young people involved in criminal activity are thought to have a 'psychiatric disorder'.

In England and Wales an estimated 66 per cent of the remand population had mental health problems compared with 39 per cent of the sentenced population.

What are the costs of mental health problems?

The total cost of mental health problems in England has been estimated at £32 billion. More than a third of this cost (almost £12 billion) is attributed to lost employment and productivity related to schizophrenia, depression, stress and anxiety.

Over 91 million working days are lost to mental ill health every year. Half of the days lost through mental illness are due to anxiety and stress conditions.

Maintaining a balance

One in four of us will have some sort of mental health problem in their life. This means there are millions of people in Britain who are either encountering problems themselves or know someone else who is experiencing them.