Dr. Rajesh G. Konnur

Professor, Department of Psychiatric Nursing, Kurji Holy Family College of Nursing, Patna, Bihar, India.

&

Ms. Soumya Kuriakose

Senior Nursing Tutor, Department of Psychiatric Nursing, Kurji Holy Family College of Nursing, Patna, Bihar, India.

CONCEPT AND PHILOSOPHY:

In order to think in depth, about the necessity of mental health promotion strategies along with physical health interventions, among world population, one more Mental Health Day has come. This day aims at global mental health education, awareness and advocacy against social stigma existing about mental diseases and mobilizing efforts in support of mental health. Every year, 10^th of October; the World Mental Health Day, World Health Organization (WHO) celebrates with different themes. And this year, mental health of young people is at the central point of discussion with a theme “Young people and mental health in a changing world”. Researches and mental health focused activities begun to run from the end of 19^th century onwards, proving that medical world has recognized the significance of general awareness about the prevention of mental diseases and mental health promotion. Following this, governing bodies and health agencies worldwide have started to take steps in regard to this view. All over, physical and mental health has to get equal importance, since there is no health without mental health. A healthy body with a healthy mind together contributes to build a healthy human. Today’s young people are the builders of tomorrow’s nation.  They are described as the greatest wealth and strength of any nation. The younger generation, strengthened mentally and physically health wise, can take critical decisions and can bring significant changes in the society. During such a fruitful time period of life, youth must be given special attention and protected from all kinds of mental disturbances.

DEFINITION OF “MENTAL HEALTH”:

“Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”

World Health Organization (WHO)

INTERRELATIONSHIP BETWEEN MENTAL AND PHYSICAL HEALTH:

A healthy mind is the foundation of good health. The overall health of a person depends on his level of well being. Equal importance has to be given to physical health and mental health because of the inseparable relationship between them. There are scientific evidences linking health outcomes with mental and physical fitness. Physical activity increases the flow of oxygen to the brain. It also increases the amount of endorphins, the “feel-good” chemicals in our brain which controls a number of physiological functions. Another example can be that of an optimistic (optimism is a characteristic feature of good mental health) person who is affected with a serious malignant disorder. If he shows a positive attitude towards his sickness, he can bring necessary adjustments towards his sickness. Such an attitude is very crucial in bringing better treatment outcomes. Sometimes, a person’s inability to make adjustments with increasing demands and simultaneously occurring changes in life, can lead to severe mental diseases like chronic depression and schizophrenia. Also, other acute and chronic medical conditions such as heart attack, high blood pressure, diabetes and digestive health have been linked to mental health.  It is evident that a person with a mental illness will experience disorder in his overall physical functions because mental illness affects thoughts, state of mind, attitude and occupation negatively. Hence, it became clear that physical health and mental health are interrelated and directly proportional.

COMMON MENTAL HEALTH ISSUES OF YOUTH:

Youth is the transitional phase of growth from childhood to adulthood and is a peculiar time frame with multiple features. This stage is the only stage with a possibility of maximum productivity. During this stage, the young people need good attention and appropriate guidance. Parents and society together has to bring up their children as value rich persons. The following are the major problems the youth may face:

• Problems Related to Role Changes :

Since youth is the immediate stage after childhood and a preparatory phase to adulthood, the young person may undergo to a variety of problems. One of such alteration is the thought of dependency. In order to fulfill the career requirements, the young ones may have to migrate from their home, to their destinations. That is, the home in which they lived (as almost fully dependent) into a new world where they become completely independent. That is, a sudden change from the level of dependency to a high level of independence.

Developmental psychologist, Erick Erickson describes this phase as the phase in which the young one will re- examine his identity and try to find out exactly “what he is”. During this period, they explore possibilities and begin to form their own identity based upon the outcome of their explorations. Failure to establish a sense of identity within society (“I don’t know what I want to be when I grow up”) can lead to role confusion. Role confusion involves the individual not being sure about themselves or their place in society.

• Stress Related to Academic Career Development:

The Academic Career Development Stress is an individualized phenomenon, unique to each student and setting. It is a subjective feeling, which is hard to avoid by students. The sources of academic stress may be life events or chronic strains related to academic programs and workloads. Such stress may elicit fear, tension and other psychosomatic problems and may be associated with a variety of serious negative outcomes in the young students, including suicidal ideation, smoking and drinking. Stress may arise due to the academic demands, adjustments to be done to a new course, medium of instructions, institutional situations or when developing appropriate communication with classmates and teachers etc. In extreme situations, students may seek professional help to cope with the debilitating effects. This type of stress is recognized as the harmful physical and emotional responses that occur when the requirements of the academic activities do not match the capabilities, resources and needs of the students. Academic Career Development Stressors are considered as the student perceived stressors which generally emerge from demands of academic and curriculum environments and resourcefulness (ability, stress, etc.) of the students concerned.

• Strong Unhealthy Peer Influences :

Studies show that peers have a direct influence on building up of youth behavior.  A person in the age of youth ever tends to keep bondage with people of same age. This type of influence would become either negative or positive. And if it is a negative influence, it would result into a destructive progression. If it influences positively, it would bring constructive developments in the youth. The relationship with parents did not demonstrate the expected mediation effect, with the exception of the following elements: relation between type of friends and risk behavior; and communication with parent and lesser involvement in violence behaviors and increased well-being. The negative influence of the peer group is more connected to the involvement in risk behaviors, whilst the positive influence is more connected with protective behaviors.

• Emotional Disturbances :

Emotional immaturity and instability is often seen in youth. Emotional immaturity is the inability to handle situations without unnecessarily escalating them.  An inability to make interpersonal relationship and bondage with parents and family members, failure in building relationship with teachers and friends etc. are the commonest manifestations of emotional disturbances during youth. A strong desire to know about sex and reproduction, to get an opportunity to practice it and to incline to abusing addictive substances are also very common among this age group. Moreover, a self-withdrawal, hyperactivity, excessive anxiety etc. are also notable features of this category. Even though majority of these problems are transient, must be taken seriously and should be handled carefully.

• Over dependence on Internet and Social Media (Social Media Addiction):

Over dependence on internet/ social media will put serious impact on mental health. Social media is addictive precisely, because it gives us something, which the real world lacks: it gives us immediacy, direction and value as an individual. There are many young people who cannot control themselves and are addicted to social media. Addiction to social media has many serious effects, including poor study habits, living away from reality and bad health. Young people who are addicted to social media can live far away from reality. Because of using a cell phone all day, they will not have time for outdoor activities such as playing sports or camping. Instead of going out to meet friends or talk to their parents, these people love chatting with friends on social media. They will just stay at home and update their news on social media. They post status or photos to share with their friends on social media. Gradually, they will only live in a virtual world.

• Lack of Positive Parenting:

While comparing olden living styles and modern system of living it can be seen that family structure and living patterns have changed a lot. People’s attitude and perception about family relationship is also undergoing modifications. Uncontrolled dependence on modern urbanities often brings familial imbalance and mental disturbance. Lack of proper attention and care, impaired communication, unable to get proper guidance in each life stages etc. bring huge behavioral alterations among children and youth. Today’s parents become unable to find out and fulfill their children’s psychological needs. This will influence each stage of the life of those young ones and can throw them into serious mental health issues.

STRATEGIES TO WIDEN THE HORIZONS OF MENTAL HEALTH PROMOTION:

The predominant strategies for Youth Mental Health Promotion include:

• Social Connectedness:

Social connectedness was defined as a “crucial” element for mental health promotion among youth. The sense of belonging begins in the family, but it grows the peer group, community, and culture. In their search for identity, purpose and direction, youth need to feel connected to someone or some-thing in order to thrive. Given that social isolation is a determinant of health, promoting connections and a sense of belonging whether in the school system, the community, family or peer group is essential to combating loneliness and creating opportunities to build psychological resiliency. Youth need people, inside and outside of their family, who care about them; who can be non-judgmental listeners; who they can turn to for well-informed guidance and advice; who they can call on for help in solving problems; who encourage them and promote high expectations; and who set developmentally appropriate limits, rules and monitoring.

Youth has to be motivated to constructively engage in social institutions like religious communities and recreational facilities; that are safe, stable and equitable. Such social institutions provide support for youths’ intellectual, social, emotional, moral and physical development and provide opportunities to participate in organized activities like academic enrichment, sports, social clubs, support groups, volunteering and the labor force.

• Positive Parenting:

The influence of parents on young one’s life is significant on all ages of their life. Nevertheless, the role of parents in this age is an overall evaluation on youth’s decisions and living style. Parents should correct them appropriately and comment on children’s each individualized decision with a critical mind. It is identified that the family unit is the first and the most critical environment to promote healthy youth development. Parents or primary caregivers are in the position of not only acting as the support system, but also as their teacher in their lives. However, it was acknowledged that many parents lack the resources and/or skills to support child development in an optimal way. They are often contending with stress and the social determinants of health, which may impact on their ability to optimize the environment for children to flourish. This should be a strong emphasis, that working with families to build supportive environments and positive parenting approaches will assist youth in reaching their potential and developing resiliency. As such, the family environment and the role of the parent is an upstream approach for mental health promotion.

• Stigma Reduction:

The presence of stigma in the larger social context is viewed as a barrier to mental health promotion. Given that mental illness is deeply rooted in our culture as a negative or fear-based condition, the existence of negative attitudes and ignorance to mental illness is pervasive in society. Openly, it is required to discuss the importance of mental health promotion work by focusing on reducing stigmatic attitudes and raising awareness about mental health as part of holistic health. Demystifying mental illness will not only promote a shift in societal attitudes, but will inevitably assist those who are struggling with mental health issues to seek help effectively.

• Mental Health Literacy:

Mental health literacy was identified as a key area of focus for mental health promotion work. Currently, there is inconsistency at an inter sectional level regarding what language is used to define mental health and mental wellness. This lack of shared knowledge is a call for action to enhance mental health literacy across the various sectors. Not only would mental health literacy improve a client’s access to mental health services, but would also shift the focus to understanding positive mental health and its place in mental health promotion. Therefore, the need for a shared language and consistent definition of mental health is apparent and is an important upstream approach. Raising awareness and understanding of mental health and wellness has the ability to reduce stigma and enhance accessibility to services for those who require support.

• Periodic Counseling of Youth:

Youth is called the age or period of turbulence, where every individual goes through certain changes in their mental as well as physical structure. Adolescent counseling is aimed at young people to help them make sense of their feelings, behaviors and thoughts and entails the use of unique techniques. Any parent can attest to the fact that the adolescence stage of any child can be extremely difficult and confusing. Hence, it is very important for parents to handle their adolescent children in the best ways. Thus, these psychological counseling sessions are organized for them and they turn out to be effective, most of the time. Adolescence is the most complicated phase of one’s life. These adolescent counseling sessions focus not only on the patient but also on the patient’s family. 

• Promotion of Stress Reduction Strategies and Popularizing Relaxation Techniques:

Today’s youth face more stress than ever before. From academic stress including classes, homework, papers, grades and growing competition to family stress including management of parent expectations, conflicts, sibling rivalry and changes in structure, youth feel stress in numerous aspects of their life. Because youth are not equipped with effective relaxation techniques, they sometimes rely on unhealthy responses like illegal drugs and alcohol. Lot of youth is not equipped with the stress management tools to effectively handle the large amounts of stress they face daily. If stress is not managed effectively, it can lead to negative self-talk, anxiety, depression, sleep disorders, aggression, physical illness and illegal drug and alcohol consumption. Awareness about relaxation techniques will certainly bring better mental health outcomes from youth.

• Skill Training Programs / Youth Development Programs:

Young people need support and guidance in facing the many challenges of today as well as emerging ones. At the same time, youth should be encouraged and actively engaged in addressing societal problems. Youth development programs aim at overall development of youth. Such programs focus on spiritual and ethical developments. It is also expected to enable them to take vital decisions. They have to be encouraged to actively get involved in these programs and helps them to form acceptable behaviors in society.

• Awareness About Benefits and Harmful Sides of Social Media:

The social media addiction means a change in behavior manifested as spending increased amount of time online to produce some pleasurable effects, taking away attention from other tasks, experiencing unpleasant feelings from reducing or stopping interaction with social media etc. There is no recognized treatment for social media addiction. Although we are starting to become aware of the problem, there is no classification of social media addiction as a mental disorder in the same way as substance misuse. Youth have to be explained the health impacts of overtime social media usage. They have to be taught to engage in quality work. They have to be made to understand the value of time. They have to be motivated to come out of the world of fantasy and be in the world of realities. 

SUMMARY:

Youths are the backbone of social fabric. Development of youth as a person must be comprehensive and humane. An optimal growth helps in overall development. A positive outlook and spirit of healthy living are the main determinants of good mental health. Promotion of mentally healthy living styles contributes for growth of society.

REFERENCES:

1. http://miosuperhealth.com/why-your-mental-and-physical-health-are-equally-important/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4777050/
3. http://www.who.int/
4. https://www.mentalhealth.org.uk/a-to-z/c/children-and-young-people
5. https://www.mindmatters.edu.au/docs/default-source/learning-module-documents/