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This report will focus on the case studies of Marcus Jones, who suffers from anorexia
nervosa, and Michael Phillips, who suffers from clinical depression. The aim of this
report is to help gain an understanding on different views on the nature of mental health
and mental wellbeing. The report will also examine how the main forms of mental ill
health are classified, whilst focusing on the case studies on these two individuals.
P1. Explain Factors That Influence Mental Wellbeing and Mental Health
There is no general definition of mental well-being since it means different things to
different people. According to WHO (World Health Organisation), mental wellness may
be defined as "the concept of happiness or contentment," "the absence of sickness," or
"the absence of negative variables in an individual's life". 1 Mental well-being also
involves an individual's social, cognitive, emotional, behavioural, and psychological
reactions in certain circumstances. Furthermore, due to its complexity and lack of
uniform definition, the World Health Organisation states that mental wellness "should be
seen as a range and as working within a spectrum, rather than a condition that is either
present or absent", as mental well-being can vary as it is a fluid term.
Mental health is described as a state of well-being that all people have that is impacted
by many variables in their lives. Individuals with excellent mental health are supposed to
be able to "cope with the regular demands of life, work successfully and constructively,
and participate in society”.2 Similarly to mental wellness, mental health may be viewed
as a spectrum owing to differing attitudes in society as well as health and social care
environments. Someone's mental health may change at different stages in their life
owing to physical changes in health as well as the individual's perspective of the
definition of mental health.
Stress may have a detrimental influence on an individual's mental health, as can mental
disorders, which have varied symptoms for each person and can impact different
individuals' life quite differently. Mental diseases can vary in severity and symptoms,
and each individual's experience with one may be unique. Because there are so many
various forms of mental illnesses, each with the potential to affect someone differently, it
is frequently difficult to detect whether a person is suffering with a mental illness, which
can cause problems in social networks as well as in health and social care.
Throughout history, society's perception of individuals with mental illnesses has shifted
dramatically due to a variety of factors such as reforms, financing, and care provision. In
the early 1900s, mentally ill people were housed in asylums to keep them away from
society. Individuals were frequently sent to asylums involuntarily because their families
1 (Slade, 2010)
2 (2014)
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pushed them to stay and undergo treatment and therapy for their mental health. Despite
the fact that the grounds for admissions were frequently minor, such as being socially
inept, admissions sometimes persisted for extended periods of time because of the
person being unable to manage in the community without help, and often worsening
throughout their stay. Therapy was restricted within asylums, contributing to the length
of hospitalizations because there was little assistance for patients to rehabilitate;
instead, they were frequently left alone and eventually relapsed. Prior to 1948,
psychiatric institutions used straitjackets, padded cells, and restraints; treatments were
equally brutal, including electroshock therapy, insulin-induced comas, and frontal
lobotomies, which were frequently used to treat the symptoms of those with mental
disorders. When the National Health Service was established in 1948, it accepted
responsibility for over 100 asylums in the United Kingdom, and all mental health
treatment was subsidised by the government. In 1950, the Ministry of Health Review
recognised "insulin shock treatment and therapeutic convulsion treatment" 3 as the most
widely used treatments inside hospitals; however, it also indicated that outpatient care
was almost nonexistent, resulting in people being restricted to hospitals almost
indefinitely.
The Mental Health Act, enacted shortly after the foundation of the NHS, allowed
patients to be held in hospital involuntarily, which meant that even if a patient desired to
leave, the law specified that they might be kept locked up until considered safe. Despite
the fact that the NHS and the 1959 Mental Health Act were intended to lower the
number of people in mental hospitals and enable more community treatment, the
reverse occurred. By the mid-1950s, there were approximately "150,000" people held
inside, and also the number was predicted to expand further owing to a lack of
competent community care.
In 1961, Enoch Powell, the minister of health delivered a speech emphasising the same
goals as the establishment of the NHS and the Mental Health Act: a shift toward
outpatient treatment rather than inpatient care for those suffering from mental illnesses.
He introduced the answer as twofold: "on the one side, trying to move the treatment
and prevention illness to the wards and wings of general hospitals; on the other,
working to build new services in the community supported by an expanding social work
profession,"4 which made a fundamental shift to mental health services across England,
a transition made easier by medicines being utilised as a more widely accessible
treatment of mental illness. Despite the fact that Powell's ideas were promising,
progress was gradual, and only a handful mental health facilities had shut by 1970.
However, beginning in the 1980s, societal transformation became visible, with a "60%
drop in mental institution beds from 1987 to 2010". Powell, like many others, advocated
3 (Singh & Kar, 2017)
4 (Thomson, 2016)
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for community-based care for people with mental illnesses, but NHS budget cuts
resulted in underwhelming outpatient care. Due to a shortage of outpatient treatment,
there were several high-profile instances involving community care individuals, in which
other agencies, such as the police, were frequently called in to help and keep
communities safe. The media and different campaigns such as the ‘time to change’
campaign have helped in influencing the shift in the public's perspective on mental
health and wellbeing.
Mental capacity is described as "the entirety of a person's cognitive and emotional
resources"5 and it comprises cognitive ability, emotional intelligence and learning
efficiency. Mental capacity may change over time and is sometimes conceived of in
terms of a trajectory that grows in the early years, plateaus in the middle years, and
begins to diminish as a person becomes older. Numerous factors can affect a person's
mental capacity over their entire life as they start to have different experiences due to
their age; for example, a thirty-year-mental old's trajectory will be influenced by a job,
but a three-year-mental old's capacity will not be influenced by a job because they do
not have one.
The government has come up with interventions to help prevent individuals suffering
with issues to do with their mental health and wellbeing. Primary interventions are
implemented to keep issues with mental health from forming in the first place. Primary
intervention initiatives are aimed at the entire population or at risk populations to
encourage strategies to care for a person's mental wellbeing health. Primary
interventions for issues with mental health are comparable to alcoholism prevention in
that they try to prevent the occurrence from becoming an issue.
Secondary interventions are used to aid in the early diagnosis and prevention of mental
wellbeing and health disorders. The initiative's major goal is to promote awareness of
mental health disorders so that people are conscious of the warning signs and
symptoms and may spot them in themselves and other people early. These projects
attempt to assist individuals in identifying issues and seeking prompt assistance before
they become harmful. Secondary interventions can include charity posters that
emphasise the signs of mental illness to increase awareness. A supplementary
intervention may be something like the posters created by the company 'Beat', an eating
disorder organisation. The poster depicts the symptoms and signs of eating disorders in
5order to inform people who don't have the disease of what signals to watch for and
thus how to recognise the features and seek early care. The poster will aid in the
prevention of eating disorders because more individuals will be aware of the warning
signals and, as a result, will be able to seek assistance before it develops into an eating
5 (Digital, 2019)
