Causes of Mental Health Disorders

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Causes of Mental Health Disorders

Mental health disorders are a significant public health concern that causes suffering, functional impairment, increased suicide risk and additional healthcare costs. While they can be diagnosed and treated effectively, many go untreated or under-treated. Treatment options range from psychotherapeutic or behavioral interventions to medication; some individuals manage their health and functioning within their communities while others require the services of a qualified psychiatric professional for support and prevention.

The rate of depression in primary care is relatively low, and most patients who experience a major depressive episode receive appropriate treatment. Nonetheless, depression should always be taken seriously; thus, the American Medical Association supports research into the course and outcomes for patients with depression in primary medical settings, including developing clinical and system approaches designed to enhance patient outcomes.

Factors such as stigma, patient somatization and denial, time constraints, physician knowledge and skill deficits, limitations in third-party coverage for specialists and drugs like psychotherapeutic care remain major obstacles to getting accurate diagnoses of mental illnesses in primary care settings. While programs are being undertaken to combat these obstacles, undertreatment remains a serious issue.

Depression can cause stigma both at work and home, with families often reluctant to discuss symptoms with others. People affected by depression are often influenced by negative media portrayals of the condition and may feel embarrassed to talk with physicians even if they believe their problems are significant. On the other hand, some may believe the disorder will go away on its own or that it is understandable within context of daily living.

Other common barriers include lack of physician understanding about diagnosing psychiatric disorders and an unwillingness to acknowledge its significance in patients’ lives. Some physicians may not be conversant with DSM-IV criteria or be unaware that transient sadness, bereavement, and clinical illness differ. They could also be unwilling to make a diagnosis out of fear for themselves or their families should they make one.

Additionally, many physicians who are not trained in psychiatry often don’t comprehend the clinical significance of presenting symptoms or their connection to an underlying etiology. Sometimes they mistakenly interpret physical illness symptoms (e.g., pain) as indicative of psychiatric disorder when they are actually not.

Another set of obstacles involves the DSM-IV diagnostic criteria for major depression. These were developed largely in psychiatric settings and have been criticised as not accurately reflecting the condition in primary care settings – particularly among those who meet some but not all criteria and those with mixed depressive-anxiety symptoms that fall below full diagnostic thresholds.

There is an increasing awareness of the need to develop performance standards for diagnosing and treating depression in primary care settings. Improving provider knowledge and skill, increasing access to providers, implementing performance standards, and integrating behavior therapy into health care settings are key objectives. These initiatives will be most successful when they draw upon scientifically sound clinical research evidence as well as well-designed incentives and rewards designed to promote improved patient health outcomes.

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