Mental Health: Wellbeing and Happiness Series with MoNya-Mental
By Psychotherapist Mertha Mo Nyamande
As we have been exploring what mental health is; its various types, categories and characteristics, it is only logical that we follow through with what the solutions or treatments to these illnesses and disorders would be.
In summary, mental health refers to the gap that exists between one’s held beliefs and their reality; the bigger the gap, the more likely they are to struggle.
These beliefs are what informs the thinking behind the emotions and behaviours that create whatever reality. So, whatever interventions, they seek to make sense of why that gap exists, the moral injury caused by whatever trauma and or losses, and what can be done to remedy the disparity.
While we may look at these as treatments or interventions, most are a life’s journey in themselves to undo or relearn. We must also acknowledge and validate the pains that the individuals go through as a result, be it physical or mental pains.
Therefore, a combination of medical and psychological interventions has proven most effective.
The biological perspective is highly supported by the medical model that the psychiatrists and mental health nurses who are medically trained use to assess and prescribe psychoactive medications to try to calm the brain activity identified by scans or symptoms diagnosed as per diagnostic manuals.
Psychoactive Medications are the main medical intervention that believe in the genetics and hormonal imbalances in the brain that base chemical compounds seek to balance.
They are mainly synthesised to help numb the pain with sedation/stimulation to enable capacity for talking therapy that is required, as we find how highly addictive most of them are, and liable to abuse without careful monitoring.
The concepts of serotonin and dopamine have been very popularly supported to explain mental difficulties, although the antipsychiatry movements refute them as there has never been any tests or investigations done to verify whether the medications alter the brain chemical levels claimed.
The human genome has also argued the existence of mental disorders as genetics or heredity, positing that most illnesses are learnt behaviours than anything that can be physically examined, like any disease.
Mental Health has therefore remained controversial and misunderstood, marred with conspiracies and stigma that, often interventions seek to maintain the illness or disorder than get to the route cause of the issues.
There is therefore a biopsychosocial perspective and the Stress vulnerability model that also help to explain the disorders and treatment of these. The psychological models seem to provide more effective explanations based on the psychodynamics within families and communities by trying to understand the history of an individual and how that is impacted by their communities, and vice versa.
Lastly the sociological explanations are not far removed from the psychological in how they outline the socialisations that play a large role on the development of most disorders.
When structuring treatment or interventions to manage or remedy mental disorders, a stepped care model can be adopted, though not very clearly outlined in most treatment pathways.
This model seeks to help provide appropriate levels of support needed as it may be inappropriate to engage in extensive biopsychosocial intervention for someone going through reactive episode difficulties, whereby watchful waiting and social support may be more appropriate.
Stepped care interventions outlined below may help understand the structure of interventions although other schools of thought recommend a psychological assessment as a baseline assessment before all the other interventions.
Step 1 interventions
Step 1 interventions are self-help materials that individuals, families or communities can access and use to help manage their difficulties. These can be in the form of public health information aired in various media to inform wider audiences.
They can also be other printed media given by gatekeeping physicians or other practitioners following general health assessments, for it is not always that an individual is admitted to a hospital or to structured therapies on first assessments.
Step 2 Interventions
Step 2 interventions are low level interventions, usually delivered by low intensity practitioners: counsellors and nurses.
These (PWP) Psychological Wellbeing Practitioners would have studies basic Cognitive Behavioural Therapy (CBT) principles to guide service users in behavioural activation plans that seek to activate new habits and motivations to change or break the vicious cycle that one may have been stuck in.
These are usually limited to 3-6 sessions, failing which, an enhanced intervention is recommended.
Step 3 Interventions
These recognise that the problem is more ingrained than lower levels can satisfy.
Step 3 interventions are higher intensity in nature, often involving counselling psychology with more structured protocols like Eye Movement Desensitisation Resonance (EMDR) a model used for the treatment of Traumas, in particular PTSD, and Psychoanalysis, particularly involving various psychotherapies that are more challenging and prescriptive than the step 2 interventions can offer.
There are newer modalities like the Motion-assisted, Multi-modular Memory Desensitization and Reconsolidation (3MDR) that involves mobility to stimulate associated muscle memory.
Step 4 Interventions
Step 4 interventions are for those that present with more complex and multifaceted difficulties, often carrying a higher level of risk to self and/or others.
These are often tailored for individuals in contained clinical environments like prisons or secure hospitals where formal detentions are effected.
They often recognise that without the safety and support, the individuals are unlikely to engage/comply in the treatment without the obligation of the detention.
These also utilise a stronger multidisciplinary and multi-agency component to their interventions.
Mental Disorders/Illnesses are all treatable, although the duration can depend on the environments in which they have developed, which we often ignore with detrimental effects on whatever intervention.
There are many other alternative therapies, but the bio-psycho-social perspectives are the most common.
Psychotherapist Mertha Mo Nyamande @ www.i-wellbeing.weebly.com. Insightwellbeing.firstname.lastname@example.org
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