public health- social determinants and mental health

public health- social determinants and mental health Part I. Short answer (3-4 sentences) ANSWER2. 1)    Describe 3 of the 6 basic social patterns of mental distress in the US population that we discussed in class. -see attached social predictors of mental health power point 2)    Describe 2 main epidemiologic patterns Kessler found in the NCS-R study of US mental health. Google: -    Kessler et al., “Prevalence, Severity, and Comorbidity of 12 month DSM-IV disorders in the National Comorbidity Replication Survey” Arch Gen Psychiatry. 2005, 62(6): 617–627. Part II.  Readings Analysis (4-5 sentences each) ANSWER TWO. •    Explain the main point of the article and its specific relevance to social determinants.  Incorporate at least one concept (e.g. specific consequences, data, methods, policy solutions, implications for professional sectors, decision-making authority/governing bodies, etc.). a)    Insel & Fenton, “Psychiatric Epidemiology: It’s not just about counting anymore” Arch Gen Psychiatry. 2005, 62(6): 590–592. b)    Kessler et al., “Prevalence, Severity, and Comorbidity of 12 month DSM-IV disorders in the National Comorbidity Replication Survey” Arch Gen Psychiatry. 2005, 62(6): 617–627. c)    NYT, “The Americanization of Mental Illness” by Ethan Watters (1/10/2010) d)    Shim et al., “The social determinants of mental health: An overview and call to action” Psychiatric Annals. 2014, 44(1):17-26. IV. Small Essay (5-7 sentences) ANSWER BOTH. (30 points each, 60 points for the section) 1)    Describe the Social Ecological Model (SEM) and explain how 2 of the following articles can be applied to the SEM to explain social determinants of mental health.Show evidence of having read and understood the specific article! •    Koplan and Chard, “Adverse early life experiences as a social determinant of mental health” Psychiatric Annals. 2014, 44(1):39-45. •    Manseau, “Economic inequality and poverty as social determinants of mental health” Psychiatric Annals. 2014, 44(1):32-38. •    Compton, “Food insecurity as a social determinant of mental health” Psychiatric Annals. 2014, 44(1): 46-51. •    Langheim, “Poor access to health care as a social determinant of mental health” Psychiatric Annals. 2014, 44(1):52-57. 2) What would a public health approach to reducing disparities look like? Integrate the below article in your answer. •    Todman and Diaz, “A public health approach to narrowing health disparities” Psychiatric Annals. 2014, 44(1): 27-31. III. Main Essay (100 points) General Guidelines: Your essayshould draw on social determinant theories and readings where appropriate.Answers should be well written, legible, coherent, and specific (rather than opinion or conjecture).  Be sure to answer each part of the question.(25 pts each) First read Horwitz article (“Transforming Normality into Pathology: The DSM and the Outcomes of Stressful Social Arrangements”) Below is the vignette with your old friend Jim depicting Social Anxiety Disorder(SAD). With reference to this case, answer the following questions: (1)    Is Jim’s behavior disordered or nondisordered?  Make a case for both etiologies (origins) of his problems and conclude which one you think is the best explanation. For each, explain: a.    What is the cause of his problem? b.    What is the best type of treatment? c.    What is your evidence for each etiology? (2)    What do we mean by “disordered” and “nondisordered” behavior? (3)    According to the Horwitz article (“Transforming Normality into Pathology: The DSM and the Outcomes of Stressful Social Arrangements”), how does the DSM conflate disordered and nondisordered behavior? (4)    What are the implications of a checklist approach in the DSM for large-scale epidemiologic studies of mental illness, such as the Kessler study using the NCS-R? SAD Hypothetical Case Study Jim was a nice looking man in his mid-30s. He could trace his shyness to boyhood and his social anxiety to his teenage years. He had married a girl he knew well from high school and has almost no other dating history. He and his wife, Lesley, had three children, two girls and a boy. At our first meeting, Jim was very shy and averted his eyes from me, but he did shake hands, respond, and smile a genuine smile. A few minutes into our session, Jim was noticeably more relaxed. “I’ve suffered with this anxiety for as long as I can remember,” he said. “Even in high school, I was backward and didn’t know what to say. After I got married, my wife started taking over all of the daily, family responsibilities and I was more than glad to let her.” If there was an appointment to be made, Lesley made it. If there was a parent0teacher conference to go to, Lesley went to it. If Jim had something coming up, Lesley would make all of the social arrangements. Even when the family ordered delivery food, it was Lesley who made the call. Jim was simply too afraid and shy. Indeed, because of his wife, Jim was able to avoid almost all social responsibility – except at his job. It was his job and its responsibilities that brought Jim into treatment. Years earlier, Jim had worked as a small, locally-owned store, where he know the owner and felt a part of the family. The business was slow and manageable and he never found himself on display in front of lines of people. Several years previously, however, the owner had sold his business to a national record chain, and Jim found himself a lower mid-range manager in a national corporation, a position he did not enjoy. “When I have to call people up to tell them that their order is in, or handle a customer service issue, “ he said, “I know my voice is going to be weak and break, and I will be unable to get my words out. I’ll stumble around and choke up…then I’ll blurt out the rest of my message so fast I’m afraid they won’t understand me. Sometimes I have to repeat myself and that is excruciatingly embarrassing…” Jim felt great humiliation and embarrassment about this afterwards: he couldn’t even make a telephone call to a stranger without getting extremely anxious and giving himself away. Then he would beat himself up. What was wrong with him? Why was he so timid and scared? No one else seemed to be like he was. He felt he must be crazy. After a day full of this pressure, anxiety and negative thinking, Jim would leave work feeling fatigued, overwhelmed, and defeated. He had no friends of his own, except for the couples his wife knew from her work. At times when he felt he simply had to go to social events, Jim was very ill-at-ease, never knew what to say, and felt the silences that occurred in conversation were his fault for being so awkward. He knew that he made everyone else feel uncomfortable. Of course, the worst part of all was the anticipatory anxiety Jim felt ahead of time – when he knew he had to perform, do something in public, or even make phone calls from work. The more time he had to worry and stew about these situations, the more anxious, fearful, and uncomfortable he felt.