Connection between mental health, physical well-being stressed

Acting Director General of Medical Services, Dr Hjh Lailawati Hj Jumat delivering her speech during the World Mental Health Day forum 2010. Picture: BT/Zamri Zainal

 "THERE is no (physical) health without mental health," said the Acting Director-General of Medical Services at the Ministry of Health (MoH) yesterday.

Dr Hjh Lailawati also stressed that since the body's physical well-being is interconnected with its mental health, then the latter needs to be given priority.

Speaking at the World Mental Health Day Forum organised by the MoH, Dr Hjh Lailawati, said, mental health needs to be given a high importance at all levels of society the individual, the family and the organisational levels.

This year's theme "Mental Health in Chronic Physical Illness" emphasises the need for patients and health professionals to be aware of the close relationship between mental and physical health.

It is estimated that 10 per cent of Bruneians suffer from some form of mental illness, with less than five per cent of the population developing more serious mental illnesses.

Statistics from Raja Isteri Pengiran Anak Saleha Hospital (Ripas) showed that between 2002 and 2006 the number of diagnosed cases of mental illness had risen by 62 per cent to 6,335 patients. Some of the disorders treated included depression, bipolar disorder and schizophrenia.

In the past five years, approximately 300 children and adolescents have been registered with the Psychiatric Department of the Ministry of Health (MoH) for depression, emotional and behavioural problems.

Dr Hjh Lailawati said that while mental health services have improved in many countries, they are still not getting the support, resources and funding they need.

Almost 100 health professionals from the MoH attended the forum at The Empire Hotel and Country Club, where three senior medical officers from the Department of Psychiatry presented keynote lectures.

Ripas Hospital's Head of Psychiatry, Dr Ramli Hassan said the aim of the forum was to increase awareness and recognition of mental illness by MoH staff, and emphasise the importance of early intervention.

"Unfortunately, in Brunei as in Malaysia, we still see cases who have been severely mentally ill for 8-10 years before being brought for treatment, often when the patient becomes aggressive, violent or unmanageable," said Dr Ramli.

During his lecture, senior medical officer at the Department of Psychiatry, Dr Rifai Farid, said there is still a stigma attached to mental illness, and that many people in Brunei and Malaysia still do not recognise depression and anxiety as legitimate illnesses.

Dr Ramli added that a combination of genetic factors and various types of stresses are the main common causes of mental illnesses in Brunei Darussalam. Individuals with a family history of mental illness also have a 10 per cent higher risk of developing a similar mental illness.

About 70 to 80 per cent of the patients would see improvements in their condition after undergoing drug treatment, said Dr Ramli.

Last year, Ripas Hospital spent more than $1 million on Olanzapine, a medication that has been proven effective for treating schizophrenia and bipolar disorder. This makes the drug the third largest drug expenditure at the hospital.

According to a previous report, the Ministry of Health also provides a Mental Health Allowance for those with chronic mental illnesses who find themselves incapacitated by their respective affliction.The Brunei Times 

Source Taken from:

Quratul-Ain Bandial (2010).Connection between mental health, physical well-being stressed.< http://www.bt.com.bn/news-national/2010/11/29/connection-between-mental-health-physical-well-being-stressed.> Updated 29 November 2010.

Illnesses can be aggravated by depression

 

Department of Psychiatry of RIPAS Hospital, Dr Rifai Farid during the World Mental Health Day forum 2010 held at the Empire Hotel and Country Club, Jerudong, yesterday. Picture: BT/Zamri Zainal 

PATIENTS who have chronic illnesses such as cancer, diabetes and heart disease have a significantly increased chance of dying if also afflicted by depression or anxiety, said the Acting Director-General of Medical Services yesterday.

During the opening of the World Mental Health Day Forum, Dr Lailawati Hj Jumat said that depression worsens physical illnesses and weakens the patient's ability to cope with the disease and its accompanying treatment .

Patients with severe or chronic physical illnesses often have a co-existing mental health problems, she added.

Citing recent medical research, the Acting Director-General stated that patients who survive a heart attack but also suffer from major depression have a 17 per cent chance of dying within six months compared to only three per cent in those who are not depressed.

"In fact, depression has been proven to be such a risk factor for morbidity and mortality in cardiac disease that the American Heart Association has recommended that all cardiac patients be screened for depression," she said during a speech at The Empire Hotel and Country Club.

Studies show that patients with chronic physical illnesses have much higher rates of depression and anxiety than the general population. "In fact, depression is the most common complication of all chronic or serious medical conditions," said Dr Hjh Lailawati.

Between 15 and 20 per cent of cancer patients suffer from depression and this increases their mortality rate by 25 to 39 per cent.

Similarly, anxiety disorders have been associated with a 74 per cent increased risk of cardiovascular events such as heart attack, stroke, heart failure and death.

Anxiety and depression are also common in diabetes patients with one in every four diabetics suffering from depression, according to the World Health Organisation (WHO), which increases their mortality rate by 30 per cent.

Dr Hjh Lailawati added that control and treatment of the symptoms of mental illness is important to avoid the occurrence of metabolic problems and other complications from diabetes.

Because of these alarming statistics, the Acting Director-General emphasised the urgent need for better integration between mental health and physical health care, especially for mental health screening at the primary care level.

It is therefore essential to enhance the capabilities of the primary care system to detect and treat mental illness in the patient, said Dr Hjh Lailawati.

About 60 per cent of the world's deaths can be attributed to four chronic diseases: cardiovascular disease, diabetes, cancer and respiratory ailments. The Ministry of Health organised the half-day forum for doctors, nurses and other healthcare professionals as part of their efforts to promote awareness and acceptance of mental illness in the country.

As part of their outreach programme, the Ministry will hold seminars on mental health for community leaders, village heads, teachers and schools.The Brunei Times

Source Taken from:

The Brunei Times (2010). Illnesses can be aggravated by depression. 
<http://www.bt.com.bn/news-national/2010/11/29/illnesses-can-be-aggravated-depression> Updated: 29 November 2010.

Depression with chronic illness cuts survival rate

Dr Hajah Lailawati (2R) and Head of Psychiatry Services Dr Ramli Hassan (R) and other invited guests listening to one of the presentations.

Like many illnesses, depression kills, too.


When coupled with chronic diseases such as cardiovascular, diabetes, cancer and respiratory illnesses, which have been deemed responsible for 60 per cent of the world's deaths, the depression that follows could actually decrease an individual's chance of survival.


Studies have indicated that women in the general population run a 10-25 per cent risk of being depressed whist men run a five to 10 per cent risk. However, the percentage is even higher for patients living with a chronic physical illness as they have a 25 to 33 per cent risk of developing depression.


The World Health Organization (WHO) has described depression as a common form of mental disorder characterised by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy and poor concentration.


In its severity, depression can also lead to suicide as it substantially impairs an individual's ability to cope with daily life.


Speaking at the opening of the Mental Health Forum on 'Mental Health in Chronic Physical Illness' yesterday on the occasion of Mental Health Day 2010, the Acting Director-General of Medical Services, Dr Hajah Lailawati binti Haji Jumat, also said that depression not only causes distress and suffering to the patient and their families but "also worsens the physical illness, weakens the patient's ability to cope with the illness and its treatment" thus creating a "vicious cycle of worsening physical and emotional symptoms".


Citing a few examples of the consequences of mental health disorders, Dr Hajah Lailawati said that patients who survive a Myocardial infarction, or heart attack, but suffer from major depression, have a 17 per cent risk of dying within six months following the incident when compared to only three per cent in those who are not depressed.


"In fact, depression has been proven to be such a risk factor for morbidity and mortality in cardiac disease that the American Heart Association has recommended that all cardiac patients be screened for depression," she said, addressing a room full of healthcare providers at the Empire Hotel and Country Club.


Anxiety disorders, as well, have been shown to be associated with a 74 per cent increased risk of cardiovascular events such as heart attacks, strokes, heart failure and death in patients living with a form of heart disease.


Furthermore, she also said that depression is also common in patients with cancer, affecting 15 to 25 per cent of patients whilst increasing the mortality rate by 24 to 39 per cent as compared to patients who are not depressed.


Anxiety and depression have also been shown to be common in diabetic patients, she said, with one in every four diabetic suffering from this disorder and increases the mortality risk by 30 per cent whilst also increasing healthcare costs by 50 to 75 per cent.


"Control of these psychological symptoms is important to avoid the occurrence of metabolic problems and other complications of the diabetes," she said.


Therefore, patients, their families and carers are encouraged to be more aware of the importance of mental health and illness in the care of patients with chronic physical illness.


Though effective treatments for these mental health problems are available, she stressed that in order to reduce the distress experienced by patients and their families; to improve the prognosis of their illness and their survival rate; and to reduce the economic and social burden on society, "the time has come for better integration of care of those chronic physical patients both at the specialist and primary care level".


Three speakers from Ripas Hospital were invited to talk at yesterday's forum in which they shared with other healthcare providers topics - Psychosocial Aspects of Physical Illness by Dr Ahmad Rifai Farid, Mental Health and Illness Among Patients with Chronic Physical Illness by Dr Ramli Hassan and Empowering Patients with Chronic Physical Illness and their carers by Dr Abang Bennett Abang Taha.

Written by : Siti Hajar

Source taken from: 

Borneo Bulletin (2010) Depression with chronic illness cuts survival rate. <http://www.borneobulletin.com.bn/mon/nov29h2.htm> Update: November 29 November 2010.

Kisah Pesakit mental

BANDAR SERI BEGAWAN, Ahad - Usaha harus diteruskan untuk meningkatkan kesedaran orang ramai dan bagi memberikan pengiktirafan bahawa penyakit mental harus diberikan rawatan dan dikesan pada peringkat awal lagi supaya rawatan dapat dilaksanakan.


Perkara yang mendukacitakan adalah, terdapat kes-kes di Brunei sama seperti di Malaysia di mana terdapat pesakit yang menghidapi dan merana akibat penyakit mental secara berterusan selama antara 8 hingga 10 tahun sebelum mereka di bawa untuk mendapatkan rawatan.


Sebahagian besar daripada pesakit yang dibawa untuk mendapatkan rawatan itu telah menjadi agresif atau sukar untuk di kawal lagi, jelas Ketua Bahagian Perkhidmatan Psikiatri, Dr Ramli Hassan ketika berucap di Forum Hari Kesihatan Mental Sedunia 2010 yang berlangsung di Jerudong, hari ini.


Hadir selaku tetamu kehormat di majlis berkenaan ialah Pemangku Ketua Pengarah Perkhidmatan Perubatan, Kementerian Kesihatan, Dr Hajah Lailawati Haji Jumat. Lebih dari 50 pakar Psikiatri dan pegawai-pegawai serta kakitangan Kementerian Kesihatan turut hadir di forum berkenaan.


Dr Ramli menambah menerusi kegiatan yang diadakan sebagai sebahagian dari Hari Kesihatan Mental Sedunia 2010 diharap akan dapat mempromosikan lagi kepada orang ramai mengenai masalah berkenaan.


Beliau berharap dengan adanya peningkatan kesedaran orang ramai mengenai pentingnya kesihatan mental di kalangan orang dewasa, belia dan kanak-kanak, lebih banyak usaha aktif dapat dikendalikan di semua peringkat bagi memastikan tahap kesihatan mental dapat dipelihara.


Dr Ramli yakin peningkatan kesedaran orang ramai mengenai kesihatan mental akan dapat membantu mereka untuk mengenal pasti masalah penyakit mental dan yang paling penting, mendapatkan rawatan di peringkat awal kehadiran penyakit berkenaan.


Sementara itu, Dr Hajah Lailawati dalam ucapan beliau berkata sering kali masalah kesihatan fizikal dan masalah kesihatan mental wujud bersama dan terdapat kejadian di mana pesakit yang mempunyai penyakit fizikal kronik juga menghidap masalah kesihatan mental serta pada masa yang sama, terdapat pesakit yang mempunyai masalah mental atau masalah penyalahgunaan bahan menghidap masalah kesihatan fizikal yang tidak dikesan atau terus tidak dikenal pasti.


Sehubungan itu, amat penting supaya perlu wujud integrasi yang lebih baik di antara kesihatan mental dan kesihatan fizikal, khususnya bagi mengesan kesihatan mental di peringkat penjagaan asas dan supaya perlu ada peningkatan dari segi keupayaan sistem penjagaan asas untuk mengesan dan merawat penyakit mental di dalam pesakit yang menghidap sakit fizikal.


Perkara itu harus ditekankan kerana kesihatan mental adalah sama penting dengan kesihatan fizikal di mana tidak ada kesihatan tanpa kesihatan mental, tambah beliau lagi.


Beliau mendedahkan perangkaan dari Pertubuhan Kesihatan Sedunia (WHO) menyatakan bahawa empat jenis penyakit kronik iaitu penyakit kardiovaskular, diabetes, kanser dan penyakit respiratori adalah bertanggungjawab bagi 60 peratus dari kematian yang dicatat di seluruh dunia.


Hajah Lailawati juga mendedahkan bahawa kajian menunjukkan bahawa hubungan di antara penyakit fizikal kronik dan penyakit mental meningkat dengan tinggi yang menjelaskan bahawa mereka yang mempunyai penyakit fizikal kronik juga menghidap masalah kemurungan.


Kajian itu menunjukkan bahawa masalah kemurungan menyerang kira-kira 10 hingga 25 peratus wanita dan 5 hingga 10 peratus lelaki tetapi angka itu meningkat kepada 25 hingga 33 peratus dalam pesakit yang menghidap penyakit fizikal kronik.


Beliau menyeru berdasarkan kepada angka-angka berkenaan, supaya pesakit, keluarga mereka dan penjaga pesakit itu, peka dan sedar pentingnya kesihatan mental dalam penjagaan pesakit yang menghidap penyakit fizikal kronik.


Forum itu mengetengahkan sesi ceramah oleh tiga orang penceramah terdiri dari pegawai-pegawai perubatan Jabatan Psikiatri, Hospital Raja Isteri Pengiran Anak Saleha, Dr Ahmad Rifai Farid, Dr Ramli Hassan dan Dr Abang Bennet Abang Taha yang membincangkan mengenai tema, Kesihatan Mental Bagi Pesakit yang Menghidap Penyakit Fizikal Kronik."

Berita ini di tulis oleh:

Sim. Y.H. (2010). Media Pertama Online. 20 November 2010.

http://www.mediapermata.com.bn/isnin/nov29t1.htm

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