Epidemiology_ Psychiatry and Mental Health Professionals Essay

According to “World Health Organization” (2012), ” Epidemiology is the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems.” (para.1). There are many approaches for collecting this beneficial data, and there are three basic standard methods. These three methods include routinely collected data, data collected for other purposes, and epidemiologic data (Stanhope & Lancaster, 2012). Routinely collected data is secondary data that is collected routinely from the general population, which may include births, deaths, fertility or infectious disease notifications (Stanhope & Lancaster, 2012). The quality of this data may vary depending on time and region (Stanhope & Lancaster, 2012). Data collected for other purposes are also secondary data, collected within a region or area of interest, and may be used for research and investigative purposes (Stanhope & Lancaster, 2012).

Epidemiologic data is primary data that uses sample populations to answer specific questions of interest or concern, surveys and new cutting edge GIS technology are often used (Stanhope & Lancaster, 2012). Epidemiology uses these methods of data to study health related states and events. There are three factors that must be present in order to create or maintain these health related events. These three factors include an agent to carry and disperse the disease, a host to carry and maintain the disease, and the environment that facilitates the interactions between the host and the agent (Stanhope & Lancaster, 2012). Together these three factors are called the epidemiological triangle, and without these three factors there is no health related state or event to study. When all three of these factors are present, data can then be collected, and an investigation of this data may take place. The two basic types of methods for these investigations are descriptive epidemiology and analytical epidemiology.

These two methods rely on each other. As descriptive epidemiology focuses on the concrete, such as who is affected, where they are affected, and when they are affected; analytical epidemiology focuses on how and why the population is affected. The purpose of this paper is to provide both analytical and descriptive views on the prevalence of obesity in people who suffer from mental health disabilities. Obesity is widely referred to as an epidemic not only in the United States but in other countries as well. As the study of mental health disabilities and its treatments continues to evolve and progress, research shows a significant link between mental health and obesity. According to Gasper and Tsai (2006) “Weight gain is a prominent side effect of atypical antipsychotics” (p. 9).

When medications used to treat mental illness are combined with lifestyle factors and a low-income, it can be very difficult for people with mental illnesses to overcome the battle to maintain optimal physical health, as well as mental health. Although this link has surfaced and brought light to an important issue, there is still very much progress needed to attack this problem and provide a better quality of life for people with mental health disabilities around the world. In 2012 a research article published by The Canadian Journal of Psychiatry, pointed out that in 2007 funding for a mental health commission was launched in Canada, while an epidemic of obesity, affecting one in four adult Canadians failed to receive similar consideration (Sharma, 2012). This statistic was used in this article to illustrate how the two disorders are actually co-epidemics.

A worldwide study published by the International Journal of Obesity further illustrates this correlation by clearly finding a stronger relationship between people with severe obesity and mental disorder (Scott, Bruffaerts, Simon, Alonso, Angermeyer, Girolamo, Demyttenaere, Gasquet, Haro, Karam, Kessler, Levinson, Medina, Oakley, Browne, Ormel, Villa, Uda, and Von Korff, 2008). The actual cause of this link in the general population is not yet fully understood (Scott, 2008). However there are a few factors that shed light upon this correlation. The relationship between atypical antipsychotics and weight gain, contributing to hyperlipidemia, and type-two diabetes is common knowledge amongst most mental health professionals.

According to an article published by the Australian Journal of Primary Health, a well-known three year clinical antipsychotic trial from 2004 also illustrates a 27-36% increase in hypertension, and a 1% increase in cardiac disease in patients that were on atypical antipsychotics for fourteen years prior to the study (Stanley, Laugharne, Jonathan, 2012). The article also sheds light on how people that are taking anti-depressants and mood stabilizers are also experiencing there a higher rate of chronic physical health problems (Stanley, Laugharne, Jonathan, 2012). In addition this article touches on a study using 160,000 patients with a diagnosis of depressive disorder using antidepressants for at least two years that exhibited an 84% increased risk for diabetes. This article not only exemplifies the obvious association between psychiatric medications and weight gain, it also demonstrates how lifestyle further amplifies the risk of obesity, and chronic disease in these patients.

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A survey of 200,000 people in the United States was used to support this association; the population reported that the higher their depression, the higher their likelihood of physical inactivity, obesity, and cigarette smoking (Stanley, Laugharne, Jonathan, 2012). All of these factors in combination with a poor diet suggest the need for lifestyle interventions for these patients. The implementation of these interventions may be tricky as the symptom profile of mental health patients comes in to play. In addition to unhealthy lifestyles, mental illness is also known to impact ones motivation, energy, and appetite (Taylor, Stonehocker, & Steele, 2012).

The Canadian Journal of psychiatry emphasizes three basic methods, psychological counseling for weight management, psychotherapies for managing obesity, and pharmacology for obesity management (Taylor, Stonehocker, & Steele, 2012). Psychological counseling consists of cognitive-behavioral therapy, which is a widely supported therapy that focuses on guiding the individual towards self-help (Taylor, Stonehocker, & Steele, 2012). Psychological counseling includes mindfulness therapy, interpersonal therapy, and motivational interviewing; these are all client centered approaches that use a combination of patient awareness, recognition, education, mindfulness, and motivation to assist the patient in overcoming an unhealthy lifestyle (Taylor, Stonehocker, & Steele, 2012).

Pharmacological treatment is used with caution due an associated risk with cardiovascular complications, potential for interaction with psychiatric medications, and addiction. Bariatric surgery is known to be an effective treatment for obese patients (Taylor, Stonehocker, & Steele, 2012). Taylor, Stonehocker, and Steele (2012) use a study from 2009 to reveal that people seeking this procedure are often overrepresented by patients with mental illness, and most morbidly obese patients who have a controlled diagnosis are candidates for this surgery.

It appears that these significant interventions should be available to all mental health patients. In combinations with the tools needed to actually make these changes, mentally ill patients may increase their chance to lead a healthy lifestyle both mentally and physically. It was with this thought that a nurse-led intervention to meet this need was put into place. An overview of this method was published in the International Journal of Mental Health Nursing; its efficacy is still being studied, but the work appears to be promising. Passport 4 Life incorporates the six stages of change into a twelve week program, to develop the skills and knowledge needed for a healthy lifestyle (Park, Usher, & Foster, 2011). The weekly sessions led by a nurse include thirty minutes of discussion and thirty minutes of activity (Park, Usher, & Foster, 2011).

Patients are provided with diet and exercise booklets, pedometers, and participate in easy, low-cost exercise activity such as walking in the park, or sports (Park, Usher, & Foster, 2011). The sessions use menu planning, goal setting, and motivational interviewing as tools to teach clients how to track progress and maintain a healthy lifestyle (Park, Usher, & Foster, 2011). Good health, long life, and longevity, are important aspects desired by cultures and sub-cultures all over the world. People afflicted with mental illness are not exempt from possessing this human desire. Unfortunately for them regardless of this desire they may not be equipped with the knowledge base, motivation, or resources needed to maintain the lifestyle associated with these worldwide aspirations.

Mental health providers possess the ability to make significant changes in quality of life for people that cannot make these changes on their own. Utilizing significant research information, survey results, randomized studies, and interventions allows mental health professionals to implement changes in a person’s life with the confidence that the potential impact is based on scientific evidence. In addition, building off of previous work of self or others allows a chance to progress in the advancement in the knowledge of diseases that affect the human body, pinpoint the exact cause of the disease or combination of causes, and treatments that can eradicate or hinder diseases and their progression. A famous quote by Mahatma Gandhi encourages people to “Be the change you wish to see in the world.” With the proper resources and accurate information that change can be greater, and its impact more valuable.

References

Gasper, J., & Tsai, C. (2006, October). Guidelines for Atypical Antipsychotic Use in Adults in Adults. City and County of San Francisco, Department of Public Health, 1-18. Park, T., Usher, K., & Foster, K. (2011, December). Description of a healthy lifestyle intervention for people with serious mental illness taking second-generation antipsychotics. International Journal of Mental Health Nursing , 20(6), 428-437. Scott, K., Bruffaerts, R., Simon, GE., Alonso, J., Angermeyer, M., Girolamo, G., Demyttenaere, K., Gasquet, I., Haro, JM., Karam, E., Kessler., RC, Levinson, D., Medina ME., Oakley, MA., Browne, Ormel, J., Villa, JP, Uda, HP., and Von Korff, M., (2008, January). Obesity and mental disorders in the general population: results from the world mental health surveys. International Journal Of Obesity , 32(1), 192-200. Sharma, A. (2012, January). Obesity and mental health–a complicated and complex relation. Canadian Journal Of Psychiatry, 57(1), 3-4.

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Stanhope, M., & Lancaster, J. (2012). Public Health Nursing (8th ed.). Maryland Heights, Missouri: Mosby.

Stanley, S, Laugharne, H., Jonathan D. E., (2012, September). Obesity, cardiovascular disease and type 2 diabetes in people with a mental illness: a need for primary health care. Australian Journal of Primary Health, 18(3), 258-264. Taylor, V. H., Stonehocker, B., & Steele, M. (2012, January). An Overview of Treatments for Obesity in a Population With Mental Illness. Canadian Journal of Psychiatry, 57(1), 13-20. World Health Organization. (2012). Retrieved from http://www.who.int/topics/epidemiology/en/

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