Through+The+Looking+Glass

Name: Jack Conkey Student Number: n8320985 Tutor: Emily Mann


 * PRESENT YOUR ARTEFACT**

This cultural artefact is a collection of paintings by popular artist Louis Wain in the late 19th and early 20th centuries. Wain was known for his expressive illustrations of cats, creating a unique cat style, society and culture. During the year 1910 Wain was diagnosed with schizophrenia and was later hospitalised. This collection of 8 paintings titled “Kaleidoscope cats” shows quite clearly the progression of Wain’s mental illness and the increasing distortion of the cats as Wain’ loses his grip on reality. This artefact provides an insight into the mind of someone experiencing one type of mental illness, a psychosis, and allows us to see the transition between clear thought into the bizarre and disorganised thinking characteristic of this disorder. The cat becomes completely obscured; while artistically all the paintings continue to be beautifully crafted.


 * NAME THE PUBLIC HEALTH ISSUE CENTRAL TO YOUR ANALYSIS**

This paper focuses on mental illness in Australia. It explores the epidemiology of mental illness and whether mental health services and mental health outcomes are improving. It examines the demographics of mental illness and identifies those population groups most at risk by describing the differences in the distribution of mental illness by age, sex, geographic location, ethnicity, remoteness and socioeconomic status. This paper will also examine what key theorists (particularly Emile Durkheim) have to say about what contributes to mental illness. Finally this paper will brainstorm ways of preventing the progression of mental illness, mainly focusing on how health care workers identify people with mental illness.

The artefact shows how the onset of schizophrenia can severely impact upon a person’s perception of reality. It is also indicative of the difficulties that mental health workers face when trying to diagnose and treat people with mental illness whose reality is distorted and who may distrust and even fear the people trying to treat them. Without immediately obvious physical symptoms, mental illness may be hidden by people trying to avoid the stigma associated with this group of illnesses and, like the cats, become more obscured than other disorders.


 * LITERATURE REVIEW**

Mental illness is a significant public health issue in Australia. It is the leading cause of health related disability (Begg et al 2008). Mental illness causes more disability than cancer and heart disease in Australia. From an epidemiological perspective mental illnesses can be categorised into two groups. There are low prevalence (or less common) disorders such as schizophrenia although individual cases are usually associated with significant disability. The second group are high prevalence (more common) disorders such as anxiety and depression where individual cases have lower levels of disability (WHO, 2011). Services for people with low prevalence disorders are usually in state run acute mental health services whereas high prevalence disorders are usually treated in primary care.

Currently it is estimated that about 1 in 5 of Australian adults (20%) will experience a mental illness (including alcohol or drug abuse) in a year. This estimate comes from the //National Survey of Mental Health and Wellbeing Summary Document// conducted by the Australian Bureau of Statistics in 2007. The survey found that the most common illnesses were anxiety disorders, followed by affective disorders (such as depression), and followed by substance use disorders. If we breakdown mental illness into the demographics of age, sex, ethnicity, geographic location and socioeconomic status we can see that firstly as the population ages the prevalence of mental illness reduces. However, if you look individually at anxiety disorders, affective and substance abuse disorders, anxiety disorders were highest in the 35-44 and 45-54 age groups, affective disorders were highest in the 35-44 age group, and finally substance abuse disorders were significantly higher in the younger (16-24) age group. If we examine gender differences, in general mental illness was more prevalent in females than males except for cases of substance use disorders where there is a significantly higher prevalence amongst men.

The University of Queensland’s 2003 report on the burden of disease and injury in Aboriginal and Torres Strait Islander people states that mental illness contributes to 13% of the total burden of disease for Indigenous Australians and that the most prevalent mental disorders are anxiety and depression, which makes up 55% of the total mental illness burden in the Indigenous population and is particularly prevalent in women. However alcohol and drug dependence is significantly higher in men. The Queensland Health document titled Health of Queenslanders 2010 shows that the burden of mental illness was 65% higher in Indigenous Australians than non-Indigenous Australians, that it was 3 to 5 times more likely for an Indigenous Australian to be involuntarily admitted to psychiatric care and that Aboriginal and Torres Strait Islander people were twice as likely to be hospitalised for conditions classified as 'mental and behavioural disorders' than other Australians. The same document also highlights a trend in the prevalence of mental illness and geographical location, showing that the more isolated a community is, the higher the prevalence of mental illness. In relation to socio-economic status, we see that the lower an individual’s socio economic status the higher their risk of developing a mental illness.

However, it should be acknowledged that these studies have limitations. For examples the National Survey of Mental Health and Well-Being is a household survey which does not include groups where the prevalence of mental illness can be high, for example people in aged care facilities, people in prison or homeless people. This is a significant problem for mental health analysis because it under-represents the incidence of mental illness in certain populations, in which mental illness is particularly prevalent.

To address this, attempts have been made to carry out surveys on the prevalence of mental illness in populations who would not be included in household surveys of adults, such as the National Survey of Mental Health and Well-being. For example the there has been a child and adolescent mental health survey (Sawyer et al, 2000).

There have also been surveys of homeless people and prison populations (Australian Institute of Health and Welfare, 2009). Another limitation of these studies is that generally nationally representative population surveys are used for high prevalence disorders. They are generally not used for low prevalence disorders due to the fact that the numbers generated are too small for meaningful analysis. Therefore, low prevalence mental disorders were not included in the National Survey of Mental Health and Well-Being despite the fact that schizophrenia is a major mental illness. Given the importance of understanding the epidemiology of schizophrenia and other low prevalence disorder, a specific low prevalence mental health survey has been undertaken using a case finding, catchment area methodology (Barry et al, 2002).

Finally, the general population studies are limited in that they don’t pick up mental health issues in small sub-population groups, in particular Aboriginal and Torres Strait Islander people because, again, the sample size is too small, within the general population, to enable meaningful analysis to occur. Specific mental health (emotional and social well-being) questions are included in the National Aboriginal and Torres Strait Islander Health Survey, but the self-reported nature of this survey with its highly subjective responses, reduces its value.

Although metal illness is a significant health problem for Australia, unfortunately many individuals who are suffering do not get picked up by community health workers and so can go untreated. For those who have been identified, many different treatment options and community support programs are available. The odds of recovery are favourable in most cases. Treatment of mental illness since the 1900’s has undergone dramatic changes, where previously people with mental illnesses, and related disabilities, where physically isolated from society, generally due to a lack of understanding by their society or due to the stigma associated with the disability (Australian Human Rights Commission, 2005). However in today’s society due to the establishment of a more generalised appreciation of an individual's worth and rights (regardless of disability), has given rise to a much greater acknowledge and research into the nature of mental illness. This has aided the development of much more effective treatment options such as better medication and psychological treatments (Nathan, 2007). There are medications that can control the more severe symptoms of psychosis and depression allowing patients to be treated out of hospital more often. There are short term psychological treatments, such as cognitive therapy, that can help people with common mental illness such as anxiety and depression. As well as a greater influence on more self-help services allows individuals to access information about disorders and how to get treatment from a community health worker, psychologist or a psychiatrist. However there is still a lot of work that needs to be done, in order to effectively determine many of the causes of mental illness and more importantly establish effective methods of preventing a patient’s condition from deteriorating. The 2007 National Survey of Mental Health and Wellbeing showed that only 35% of people with a mental illness or substance abuse accessed treatment. To improve outcomes for people with mental illness we also need to understand the disorder from a sociological perspective.


 * CULTURAL AND SOCIAL ANALYSIS**

The social theorist Emile Durkheim (1985-1917) is renowned for his theories regarding mental illness. Durkheim was one of the founding professors of sociology in the universities of Bordeaux and Paris, and has written numerous books on society, suicide, authority, religion and mental illness. His work particularly focuses on how these issues govern and explicitly impact on a person’s social experience and lifestyle. Interestingly, although there is a common perception that links mental illness and suicide, Durkheim theorised (Dunne M. 2011) that mental illness has little impact on a person’s suicidal ideation; that in fact a person’s predisposition to developing a mental disorder was based on the governing principles in the society that a person was a part of, and that this was also the greatest factor in person developing suicidal tendencies.

With this in mind it is clear that Durkheim was of the belief that the external mechanisms in a society (as opposed to internal psycho/physiological ones) were more influential on a person’s likelihood of developing a mental disorder. He argued that the social distresses within society are the reason for patients developing a mental illness. These factors, such as social isolation, feelings of lack of control over a person’s life etc., can often lead to mental health problems, particularly depression and anxiety disorders. In other words, social stressors can result in mental health problems and can even lead to a person developing suicidal ideation. This belief challenges the view that mental illness was determined by genetic factors, or that it was a random effect on people that could not be controlled. If Durkheim’s theory is correct, it could mean a way of preventing mental illness and a dramatic shift in the way people with mental illness are treated. Instead of relying on expensive medical treatments and long term psychotherapy, it could mean a greater emphasis on modifying social factors that increase the risk of developing mental illness and the importance of more community support with the integration of patients back into society and the workforce.

It is more likely that people with common anxiety and depression rather than those who have a chronic, severe mental illness, are affected by social distress. However it is important to understand that people with severe chronic illnesses such as schizophrenia (even though this disorder has a strong genetic predisposition will need social support services and social inclusion as well as medical intervention to achieve the best outcomes.


 * ANALYSIS OF THE ARTEFACT AND YOUR OWN LEARNING REFLECTIONS**

As an educated person who has grown up in a family that promoted healthy learning, providing me with access to quality schooling and education, I was surprised to find that when confronted by Louis Wain’s //‘Kaleidoscope cats’// I responded with sadness and some fear. Along with my recent studies as a paramedic student where I have come across lower acuity patients and patients suffering from mental illness, who have not been as fortunate as myself. I have come to recognise the value of education and mental well-being. To see a representation of the deterioration of reality and thought as clearly and as well defined as “//Kaleidoscope cats//” it makes me very sad to see someone as talented and distinguished as Louis Wain lose their grip on reality. At the same time it frightens me to think that this could happen to me (although I am low risk), and because I value my mental health and well-being, nothing would scare me more than having my mind and mental capacity progressively deteriorate.

This artefact has without a doubt altered my perspective of mental illness. From my paramedic studies we are taught to treat patients presenting primarily with physical ailments, and as a result of this I have to overlook the importance of identifying someone presenting with mental illness. This artefact has helped to build my awareness of the importance of being calm and comforting, of showing support, respect and empathy for people with a mental illness, particularly those experiencing psychotic episodes, because they are probably confused, disorientated and frightened.




 * REFERENCE LIST**


 * Australian Bureau of Statistics, (2007). The Nation Survey of Mental Health and Wellbeing Summary of Results. ABS, Canberra, Australia


 * Australian Human Rights Commission. (2005).HREOC Submission to Senate Inquiry on Mental Health. Retrieved from []


 * Australian Institute of Health and Welfare. (2009). the health of Australian Prisoners 2009. Retrieved from []


 * Barry Frost, Vaughan Carr, Sean Halpin (2002). Employment and Psychosis, //Low Prevalence Disorder Component of the National Study of Mental Health and Wellbeing Bulletin 3//. Retrieved from []


 * Dunne M. (August, 2011). //Emile Durkheim: social integration and suicide//. Paper Presented at QUT blackboard. Retrieved from []


 * Geoff. (2008). Wain’s Kaleidoscope Cats. retrieved from []


 * M G Sawyer,B W Graetz, L Whaites, F Arney, P Baghurst, and R Kosky. (2000). Initial results from the child an adolescent component of the national study of mental health and well-being, //Australian and New Zealand Journal of Psychiatry,// 34 (1):59-60 retrieved from []


 * Nathan, P. E., & Gorman, J. M. (Eds.). (2007). A guide to treatments that work (3rd ed.). n.p. New York: Oxford


 * Queensland Government, (2010). The Health of Queenslanders 2010: Third Report of the Chief Health Officer Queensland. Queensland Health, Queensland, Australia. Brisbane (QLD)
 * Stephen J Begg, Theo Vos, Bridget Barker, Lucy Stanley and Alan D Lopez. (2008). Burden of disease and injury in Australia in the new millennium: measuring health loss from diseases, injuries and risk factors. //Medical Journal of Australi,//188 (1): 36-40. Retrieved from []


 * The University of Queensland. (2003). The Burden of disease and injury in Aboriginal and Torres Strait Islander People. retrieved from []


 * World Health Organisation. (2011) The world Health Report: Prevalence Disorders. retrieved from []


 * DISCUSSION**

FINDING THEMSELVES AND THE TRUTH: THE CONTROVERSY SURROUNDING DISSOCIATIVE IDENTITY DISORDER Ali, Firstly I have to say that I found your artefact very interesting and comforting, its mind blowing to think that one person could develop so many different alter ego’s all through the power of the mind.

Secondly, I found your views about the film and other media sources to be “stigmatising” DID, very intriguing and I have to agree, because after all it is a very serious condition for a number of people. It’s shameful that the media has misrepresented DID simply for the purpose of entertaining an audience. Also, I found it astonishing to think that there hasn’t been more research done to treat and better understand patients who have DID when 1% of the world population suffers from it.

Finally, as a fellow health care worker like yourself I can see how this artefact would have influenced you and I definitely agree that we need to show a greater understanding and a greater respect for patients suffering from DID so that we are able to effectively treat them.

Well Done!

Jack Conkey

MENTAL WHO Hey Sarah,

Just wanted to say a few things,

Firstly I loved your artefact; I totally agree that mental illness is a big issue for all Australian’s. I loved that the artefact outlined that the “contents may vary in colour” vividly illustrating that mental illness is not just specific to one group. Also, being a paramedic student like yourself, I can see the need to show respect and to treat people that suffer from mental illness with a greater degree of care because as your artefact stipulates they can be “fragile”.

Also, since I covered a similar topic in my wiki I also came across similar issues when looking at the statistics related to mental illness and trying to determine which group in society was indeed at the most risk of mental illness. I found it interesting to that you highlighted the stigma placed on people struggling with mental illness from society and that this then can lead to consequences in the delivery of and access to appropriate health care. I strongly agree, if people stigmatise this significant health issue nothing is going to get better for people with mental illness, and as you clearly outlined (due to the governments many failings when it comes to determining the prevalence of this health issue) more and more people will slip under the radar and go untreated.

Congratulations on a wonderful piece of work

Cheers

Jack Conkey