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What is mental health?
A scale to measure mental health
Mental health hygiene

What Mental Health is

According to the World health Organization (WHO), mental health has been defined variously by scholars from different cultures1. From a cross-cultural perspective, it is nearly impossible to define mental health comprehensively. Generally, however, the concept of mental health is multi-dimensional, involving

subjective well-being
perceived self-efficacy
autonomy
competence
intergenerational dependence
self-actualization of one’s intellectual and emotional potential¹

Characteristics of mental health

The study of the characteristics that make up mental health has been called “positive psychology”. Here are some of the ideas that have been put forward as characteristics of mental health:

The ability to enjoy life: essential to good mental health.
Resilience: The ability to bounce back from adversity has been referred to as “resilience”.
Balance: between time spent socially and time spent alone; between work and play, between sleep and wakefulness, rest and exercise, and between time spent indoors and time spent outdoors and so on.
Flexibility: of opinions, of expectations, emotions
Self–actualization: ability to recognize our gifts and make our dreams come true.
The ability to form healthy relationships with others.
Good self–esteem
Healthy sexuality.²

A Scale to measure mental health

A practical scale which is useful in understanding what mental health is the one designed by the American Psychiatric Association (APA) and is called Global Assessment of Functioning (GAF).3 It considers psychological, social, and occupational functioning on a hypothetical continuum of mental health-illness, in a scale of 100 to 0, 100 being the ideal mental health status and 1 being the worst mental health status.

91 to 100%

Anyone with GAF score of between 91 to 100% has superior functioning in a wide range of activities.
life’s problems never seem to get out of hand.
He is sought out by others because of his or her many positive qualities.
He has no emotional problems like sadness, anxiety, excessive happiness, perplexity; no abnormal thoughts like like delusions, obsession, incoherence and so on; no cognition symptomes like problems of attention, concentration, memory, judgment, panning,calculation and so on; no perception probelms like hallucination of any sensory modality; and no behaviourioural probelms like aggression, restlessness, poor sleep.

In other words, a person with the score of 91 -100 doesn’t have any of these symptoms whatsoever: doesn’t have problems with sleep for whatever reason, is never sad in face of adversity, never anxious when preparing for exams or job interview, in total control of situations and circumstances. If you do not think your self rating gives you this GAF score, there is room for improvement.

81 to 90%

Absent or minimal symptoms (e.g. mild anxiety before an exam).
Good functioning in all areas.
Interested and involved in a wide range of activities.
Socially effective.
Generally satisfied with life.
No more than everyday problems or concerns (e.g., has occasional arguments with family members, but NO difficulty concentrating after family argumen.
No sad mood over loss of a loved one to cause even slight impairment in social, occupational, or school functioning (e.g., temporarily falling behind in schoolwork).

71 to 80%

If symptoms are present, they are transient and expected reactions to psychosocial stressors (e.g., difficulty concentrating after family argument, sad mood over loss of a loved one).
no more than slight impairment in social, occupational, or school functioning (e.g., temporarily falling behind in schoolwork).

61 to 70%

Some mild symptoms (e.g., depressed mood, anxious mood, mild poor sleep, crawling sensation over the body, peperish sensation on the body, tension headache)
OR some difficulty in social,occupational, or school functioning (e.g., occasional truancy, or theft within the household)
But generally functioning pretty well
Has some meaningful interpersonal relationships.

So far all the ranges we have considered have to do with people considered to be mentally healthy. But as you can see, some are more mentally health than others. It is important to note that someone who scores 71 to 80 today can score 61 to 70 tomorrow. We fluctuate along the continuum depending on the stressors at hand, our constitutional make ups, and prevailing environmental factors.

The next sets of scores are for those said to have poor mental health or, in other words, mental disorders. According to scientific research findings, one in four families is likely to have at least one member with a mental disorder; about one in ten of people all over the world has mental disorder at any point in time; and more than 25% of all people are expected to be at some points during their lives1.

51 to 60%

Moderate symptoms (e.g., emotionally cold and circumstantial speech, occasional panic-anxiety attacks)
OR moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-workers).
Someone with a score in this range needs help, but himself may not know, or may not know what kind of help he needs due to ignorance. And people around him might think he is only proving difficult to relate or work with. No he needs help.

41 to 50%

Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting)
OR any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job).

People with score of 41 to 50% and 51 to 60% are said to have minor mental illness or non–psychotic mental illness

What of people with GAF score of below 41? These are people categorized as having major mental disorders, otherwise called psychotic disorders. These are the people you call mad because you don’t know what else to call them.

For the purpose of knowing who needs help, it is expedient to note that there are more than 400 types of mental disorders according to the WHO’s 10th edition of International Classification of Disease (ICD)4 and that less than ten of this are psychotic. For example poor sleep for at least three nights a week for at least two weeks in the absence of physical problem is a recognized mental disorder, needing therapy.

It is also expedient to note that the measure of mental health and mental illness is a continuum and that any body can slide down or up at anytime. So if you happen to know someone down the scale, it for you to offer all the help you can rather that mock, despise or run away from him.

31 to 41%

Some impairment in reality testing (delusion and hallucination) or communication (e.g., speech is at times illogical, obscure, or irrelevant)
OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood. (e.g., depressed man avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school).

21 to 30%

Behavior is considerably influenced by delusions or hallucinations
OR serious impairment in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation)
OR inability to function in almost all areas (e.g.,stays in bed all day; no job, home, or friends).

11 to 20%

Some danger of hurting self or others (e.g., suicide attempts without clear expectation of death; frequently violent; manic excitement)
OR occasionally fails to maintain minimal personal hygiene (e.g., smears feces)
OR gross impairment in communication (e.g., largely incoherent or mute).

1 to 10%

Persistent danger of severely hurting self or others (e.g., recurrent violence)
OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death.

0%

Inadequate information.

Can you place yourself at any point in this continuum between 0 and 100%? The lower you score yourself, the more the need to improve your mental health. As you can see from the scale, just as health is not the same thing as absence of disease, mental health is broader than a lack of mental disorders1.

Mental Health Hygiene

Mental health hygiene is the science of promoting mental health and preventing mental illness through the application of psychiatry and psychology5. Good “hygiene“ is anything that helps you to have a healthy life6. Here are some tips.

ACRONYM: A SQUARE, B SQUARE, C SQUARE, D SQUARE, R, S SQUARE

Acquire adequate information on the nature and requirements of good mental health: books, internet, professional within reach
Adaptive Coping skills/ Social skills acquisition
Body Exercise
Belt: car seat belt to limit injury from road traffick accidents; psychological belt to guard against both physical and psychological bruises
Concerted efforts: clubs for promoting mental health; self-help groups
Cry out for help: know when to seek professional help and do it on time.
Drug free life: alcohol, cigarette, Indian hemp, cocaine, heroin, valium, amphetamine pentacozine, brenyln with codeine, pethidine
Diet: adequate and safe
Relaxation Techniques: progressive muscle relaxation, isometric muscle relaxation etc
Stigmatize not the mentally ill: Do unto others what you’ll like them to do to you.
Serenity prayer: “God grant me the fortitude to bear what I can not change, the courage to change what I can, and the wisdom to know the difference”

References

WHO (2001) The World health report : 2001 : Mental health : new understanding, new hope.
What is mental health? http://mentalhealth.about.com/cs/
stressmanagement
/a/whatismental.htm (Accessed: 15/09/07)
APA 1994. Diagnostic and statistical Manual of Mental Disorders 4th edition. APA washinton, DC
WHO. (1992) The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Description and Diagnostic guidelines. Oxford University Press. Oxford 5. www.encyclopedia.com/doc/1E1- metalhy.html
www.google.co.za/search?hl=en &q=sleep%2Bhygiene&
btnG=Google+Search&meta=Sleep hygeien