section 1, foundational concepts

Mental health

• state of well-being where person can cope with stress, work productively, contribute to society

• exists on continuum, not simply "health vs ill”

mental illness

• broad, non-clinical term referring to conditions that significantly affect mood, thinking,/behaviour

• often used in legal, policy, everyday language

mental disorder

• clinical diagnosis based on criteria (e.g., DSM-5)

• used by medical, mental health professionals

terminology

• patient: medical/clinical context

• client: social services, counselling, justice settings

• service user: emphasizes autonomy, rights

mental health statistics

• based on diagnosis, self reports, hospitalizations

• often underreported due to stigma, access barriers, misdiagnosis

• 10.1% of canadians had symptoms of mental/substances disorder in past year (2012)

• 33.1% of canadians (9.1 million) met criteria for at least 1 mental/substance use disorder

key reformers

• dorothea dix: advocated for public systems, reform

  • exposed abuse of ppl with mental illness, advocated for humane, publicly funded asylums instead of prisons, almshouses

asylum movement

• goal: remove ppl from jails, poorhouses

• intended as therapeutic but became overcrowded, custodial

moral treatment

• emphasized routine, kindness, work, social interaction

• declined as patient numbers increased

historical practices

• physical restraints, isolation, lobotomies

• asylum tourism: public paid to view patients for entertainment

deinstitutionalization

• shift from psychiatric hospitals to community-based care

• driven by new medications, cost concerns, rights movements

transinstituionalization

• movement from hospitals to jails, prisons, shelters,/streets

• mental health needs remain unmet

revolving door syndrome

• repeated cycles of hospitalization, release, relapse, re-entry

• caused by lack of stable housing, community support

substance use

• consumption without significant harm/impairment

substance abuse

• harmful use causing social, legal,/health problems

• term increasingly avoided due to stigma

substance dependence

• compulsive use with tolerance, withdrawal

• loss of control over use

clinical vs morals explanations (substances)

• clinical: addiction as medical condition

• moral/social: views addiction as personal failure (largely outdated)