The Prevalence of Mental Health - Research Paper Example

Depression in Students: The Causes and Available Support and Remedies through the Law Name: University: Course Title: Instructor: Date: 1.0 Introduction The prevalence of mental health challenges such as depression among students in Australia has become an issue of significant concern to parents, the authorities, as well as the general public (Brain and Mind Research institute, 2009, p.1). According to Bitsika, Sharpley and Melhem (2010, p.52), reiterate that depressive disorders are the fourth largest contributing risk factors to global disease burden. Depression is a psychological health challenge which manifests itself in various forms such as: feelings of despair, hopelessness, loneliness, and worthlessness; unshakable and deep sadness; diminished interest in many activities; as well as suicidal thoughts (National Institute of Mental Health, 2013). These manifestations of depression significantly vary in symptoms, persistence and severity. Studies have indicated that there could be a significant link between students and depression, drug and substance abuse and other forms of psychological health challenges (Liselotte et al., 2006, p.354). The increasing incidences and numbers of depressed students in schools and colleges have renewed and rejuvenated awareness and need for students assistance programs through the law. This research paper seeks to investigate depression in students. This investigation shall focus on the causes and available support and remedies through the law in Australia. 2.0 Depression/Depressive Disorders: An Overview Depression can be regarded as a condition in which an individual feels hopeless, sad, discouraged, disinterested, or even unmotivated in life generally (Chang, Daly and Elliott, 2006, p.433). Feelings of nervousness, anxiousness, loneliness, sadness, or even being scared following difficult situations such as loss of a loved one, loss of job, and divorce/separation among others are normal reactions to stressors of human life (Anxiety and Depression Association of America, 2013). According to the US National Institute of Mental Health (2013), everybody feels blue or rather sad occasionally. However, such feelings are usually temporary and go away within a couple of days. Barbee (1998, p. 15); and Regier and colleagues (1998, p.24) posit that when such feelings persists for more than two weeks and begin jeopardizing daily normal routine such as going to class/school, doing homework/assignments, as well as spending time with friends, then it indicates a depressive episode. Depression is not only a common psychological challenge, but it is also serious. Despite the fact that many people even those with severe form of depression never seek medical attention; all forms of depression can be effectively treated through psychotherapies, medications, as well as other non-medical methods (Kelk, Medlow and Hickie, 2010, p.113). Depressive disorders are associated with higher rates of comorbidity. As such, depressive disorders are more likely to cause more disability in individual when it occurs with another disorder as compared to when it occurs alone. Depression is usually associated with anxiety disorders than any other mental or psychological disorder. Depressive disorders are also associated with health-oriented risk behaviour such as illicit drug abuse, tobacco use, misuse and dependence on alcohol, as well as obesity and eating disorder. Physical illness like fatigue and pain are other conditions associated with depressive disorders. In addition, there is considerable prevalence of depressive disorders among individuals diagnosed with chronic diseases such as cardiovascular diseases, diabetes, cancer, HIV/AIDS as well as various forms of injuries (CPGs for Treatment of Depression, 2004, p.391; National Institute of Mental Health, 2013). The first form of depressive disorder is the major depression also referred to as major depressive disorder characterized by various symptoms which jeopardize the ability of an individual to work, eat, study, sleep, or even enjoy once enjoyable/pleasurable activities (Liselotte et al., 2006, p.354 CPGs for Treatment of Depression, 2004, p.392).The second form of depression is dysthymia also called dysthymic disorder. This form of depression lasts for as long as two years or longer. The third form of depression is minor depression characterized by symptoms lasting for up to two weeks or longer, but fall short of the criteria for a major depression or major depressive disorder. There are three sub-forms of minor depression including: psychotic depression characterized by delusions and hallucinations; postpartum depression is usually experienced by women after giving birth; and seasonal affective disorder (SAD) (Rohan et al., 2004, p.274). The fourth form of depression is the bipolar disorder also referred to as the manic depressive disorder (CPGs for Treatment of Depression, 2004, p.392). Individuals experiencing depression or depressive disorder exhibit different symptoms. The symptoms of the depressive disorder are subject to their severity, duration, frequency, as well as the individual together with his or her given depressive disorder. However, the general symptoms of depression or rather depressive disorders/illnesses include: persistent feelings of sadness, anxiety or “emptiness;” feelings of pessimism or hopelessness; feelings of helplessness; worthlessness or guilt; restlessness and irritability; loss of interest in hobbies or other activities once enjoyable/pleasurable such as sex; decreased energy and fatigue; loss of concentration; indecisiveness; difficulty in remembering details; excessive sleep, insomnia, or early morning wakefulness; loss of appetite, or overeating; suicidal attempts or suicidal thoughts; as well as pains or aches, cramps, indigestion, and headaches which wont go away even after medication among many others (Kelk, Medlow and Hickie, 2010, p.113; World Health Organization, 2000, p.413; Liselotte et al., 2006, p.354 and 355). National Institute of Mental Health (2013) notes that depression if left untreated during childhood and adolescent usually persists, recurs, and is most likely to continue into adulthood. 3.0 The Causes of Depression among Students in Australia The etiology of mental health challenges such as depression is significantly complex and multi-factorial in nature. As such, effective understanding of both risk as well as protective factors of depression requires a biopsychosocial model which takes into consideration the interaction as well as the relationship between many varied factors. Clinical researches have shown that biochemical changes which take place in the brain give rise to the main symptoms of depression in individuals, while psychosocial factors are the precipitants of these changes. In addition to the biochemical changes and the psychosocial factors which give rise and precipitate depressive symptoms in individuals, genetic factors act as risk factors which increase the vulnerability of individuals to depression. However, the specific genes which are involved have remained largely unknown. Determining the paramount risk or protective factors in depression among students is difficult due to the fact that depression seems to be a factor of many and varied factors. These factors range from biological factors at the level of individual, social structural factors, to environmental factors (National Institute of Mental Health, 2013). According to Bitsika, Sharpley and Melhem (2010, p.52), adjusting to the university or college way of life is a key identifiable and a more common cause of depression among young adults in Australia. University or college way of life is associated with pressures and challenges arising from need for finances; academic pressures; deprivation of sleep; as well as social and sexual issues. Various studies have shown that the demands or rather the pressures of college or university way of life are a significant risk factor for depression among students. According to the results of a study conducted by Law (2007, p.239), the pressures resulting from college or university study fatigued students more as compared to another nine occupational groups among them the teachers, medical practitioners, practitioners in the law/legal profession, as well as the police among others. Fatigue is a significant symptom of depression among students in colleges and universities in Australia and elsewhere around the world. Despite the fact that fatigue occurs in a small proportion of young adults in Australia, its contribution to the implication of depression among young adults in colleges and universities in Australia cannot be overlooked. Researches indicate that depression and associated psychological challenges such as anxiety among students in colleges and universities in Australia have significant adverse implications on their academic performance and thus lead to difficulties in learning. In addition, joining college or the university for the first time could be overwhelming for most first year students which could lead to mental health challenges such as depression and adverse influence their interpersonal and social relationships as well as academic performance. Organization for Economic Co-operation and Development (2001) postulate that with approximately 18 percent of young adults in Australia attending universities, it is the pressures from university life which contribute to the development of depression and related psychological disorders among the 15 to 29 years age group. Other studies have also shown that students in colleges and universities in Australia experience higher levels of depressive disorders as compared to the general community partly due to pressures and demands resulting from university studies. Studies in the US indicated that even students with no prior history of depressive disorders had experienced up to 45 per cent and 16 per cent minor depression and major depression respectively in the first three years of college or university study (Bitsika, Sharpley and Melhem, 2010, p.52). Adverse or negative environmental implications which could significantly increase the vulnerability of students to depression include recent experiences or events of failure or loss in life such as bereavement, separation from family, trauma, and family illness; minimal/decreasing performance or failure in school; social isolation; poor peer relationships; social disadvantage or socio-economic factors such as homelessness, unemployment and poverty; discord in family such as break-up of relationships, family conflict, and poor parenting; parental mental illness; child abuse through neglect, sexual and physical abuse; as well as caring for a family member, relative or friend with mental or physical disorder. Additionally, Forero and colleagues (1999, p.344) cite bullying as a major cause of poor health such as depression among schoolchildren. The biological and psychological risk factors to depression among students in colleges and universities include: family history of depressive disorder or parental mental disorder; being female adolescent; drug and substance abuse; conduct disorder; pr-existing anxiety disorder; neuroticism personality trait and temperament; adverse though patterns such as learned helplessness and pessimism; as well as avoidant kind of coping style. Foreign students taking their studies in Australia are also not behind. Such students experience depression as a result of various factors. With regard to culture, foreign students in Australia have to adjust to a different social and educational environment with new culture, people, behaviour, beliefs, language, perception, values as well as traditions. Culture besides being an integral component of each and every society, is complex to learn and this might cause a unique form of depression for foreign students in Australia. Language plays a significant role in social and interpersonal interaction as well as closeness with others. Inability to achieve this in a foreign country could be a significant cause of depression for foreign students in Australia. Varying weather patterns can also be another significant cause of depression among foreign students in Australia. This is because the western world has four varying weathers including summer, spring, winter and autumn. Finally, loneliness among foreign students in Australia is a leading cause of depression among foreign students in Australia. This is as a result of being away from home too long, dietary restrictions as well as unfamiliar environments which some students may find difficulties in adjusting to (Oluwafunmilola, 2012, p.4 to 6). 4.0 Legislative Framework; and Available Support and Remedies through the Law There are a number of legislative frameworks as well as cases which best describe the link between Australian legal system and mental illnesses such as depression. The Australian law seeks to be impartial in all matters regarding mental disorder, liability for actions and the requirements of the law. However, the law also holds such individuals liable for their actions despite mental illness for instance, negligence which causes injury to innocent third parties. In addition, the Australian criminal law stipulates that an individual is not criminally, responsible for is or her actions or omission done absent capacity due to mental disorders, illness or disability. According to the Law of Torts in Australia with reference to negligence – duty of care, it is regarded that “children are not and are not expected to be as responsible as adults. Adults who are suddenly attacked by illness or bees can be forgiven because and to the extent that they have no chance to exercise responsible control over their actions. On this basis the insane should be excused too, unless we see insanity as some sort of wages of sin.” Taking Carrier v Bonham [2001] QCA 234 (22 June 2001) case as an example, the Supreme Court of Queensland – Court of Appeal reiterated that the implications of mental disorders such as depression among others must be considered differently in civil courts as they are considered in criminal courts (Supreme Court of Queensland - Court of Appeal, 2001). In the Carrier v Bonham [2001] QCA 234 (22 June 2001) case, the appellant who was diagnosed with chronic schizophrenia, jumped in front of a moving bust with the intention of harming himself without considering the implications of his actions on others. Despite, his metal illness the court indicated that the accused was liable for his negligent action to the respondent. This was because despite suffering from a chronic mental disorder, Bonham’s actions caused serious injury and loss to Carrier leading to serious depression (Supreme Court of Queensland - Court of Appeal, 2001). In the Barber v Somerset County Council [2004] HL case, Barber, 52 years old, was employed as a school teacher heading the mathematics department. Due to work overload and long working hours, he was depressed and suffered mental breakdown at his work station. The complainant had sought intervention from various senior management of the school who only unsympathetically brushed him off. While the school owed Barber duty of care, the law on the other hand required the school to take substantial actions against Barber’s problems and see what could be done ease the problems. Had the school followed the law barber would not have been depressed and suffered mental breakdown (Sixth Form Law, 2008). In Australia, the care and treatment of individuals experiencing mental health challenges or illnesses is governed by the Mental Health Act (1996). This law piece of legislation stipulates that individuals experiencing mental disorders have a right to the best medical care and treatment with the least possible infringement and interference with their rights in terms of freedom and dignity. Care and treatment must emphasize the protection of not only the patient experiencing mental illnesses, but also the general public. The Mental Health Act (1996) also stipulates that care and treatment must ensure minimized adverse implication of mental illnesses on family members of the individual experiencing mental disorder (Mental Illness Fellowship of Australia, n.d, p.1). Some of the key components of the Mental Health Act (1996) include the following. The first component is voluntary patients which mean patients who voluntarily agree to hospitalization. The second component is informed consent. This is where a patient gives permission to be placed under a given treatment based on information on the procedure, risks, and consequences of not consenting, as well as available alternatives. The third component defines the involuntary patients. They are patients who are admitted or detained in mental institutions against their will or subject to Community Treatment Order (CTO). The fourth component of the Mental Health Act (1996) is the Community Treatment Orders (CTOs). This enables involuntary patients to stay or live in the community while under treatment. Fifth is confidentiality. This stipulates that information concerning a patient must not be given to unauthorized people without the consent of the patient (Mental Illness Fellowship of Australia, n.d, p.1). All Australian citizens including children, adolescents or adults experiencing mental disorders have the right to protection, privacy, dignity, as well as appropriate care and treatment. This care and treatment must occur in the most facilitating setting. The Commonwealth of Australia (2000, p.15) recognizes the fact that individuals with mental disorders be they children, adolescents or adults; be they in school, college/university, working or otherwise exhibit special needs with regard to the law. Such individuals facing criminal justice system have the right to appropriate assessment, care and treatment, as well as rehabilitation conforming to their mental health needs. The criminal justice system must not discriminate against such persons based on their mental health condition. Instead such judgements must be based on the ability of such an individual to understand, comprehend and accept the responsibility of their actions (The Commonwealth of Australia, 2000, p.15). The first step in the depression diagnosis and treatment of depression is for the affected student to visit a doctor or mental health specialist or professional for physical examination, interviews, lab tests or psychological evaluation. There are various ways of treating depression. However, the most common support and remedies include medication and psychotherapy. Other remedies include electroconvulsion therapy (ECT) and brain stimulation therapies. Medication is basically via antidepressants commonly referred to as such as selective serotonin reuptake inhibitors (SSRIs). They include: citalopram (Celexa), Fluoxetine (Prozac), escitalopram (Lexapro), paroxetine (Paxil), and sertraline (Zoloft). Others include older antidepressants such as Tricyclics are Monoamine Oxidase Inhibitors (MAOIs) (National Institute of Mental Health, 2013; Chang, Daly and Elliott, 2006, p.439). Psychotherapy or “talk therapy” on the other hand exists in two main types: interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT). Electroconvulsion therapy (ECT) is usually used where both medication and psychotherapy have failed. Brain stimulation therapies are not commonly used. However, researches indicate that they have demonstrated significant promise in treating severe depression. Commonly known brain stimulation therapies include repetitive transcranial magnetic stimulation (RTMS) and vagus nerve stimulation (VNS) (National Institute of Mental Health, 2013). In addition, participating in leisure activities reduces depression by creating an environment/atmosphere which draws students from their university study life; providing enjoyable activities which minimize alienation, isolation and loneliness which all can contribute to depression (McKay, 2012, p.4 and 5; State of California Resources Agency, 2005, p.19). 5.0 Conclusion This research paper has critically investigated depression in students. This investigation focused on the causes and available support and remedies through the law the case of Australia. The prevalence of mental disorders among student in Australia and elsewhere around the globe continue to be an issue of significant concern. It is due to this increasing prevalence and concern that there is need for support and remedies through the law. Various studies have indicated that depressive disorders as a form of mental disorder are the fourth largest contributing risk factors to global disease burden. Depression is a psychological health challenge which manifests itself in various forms depending on symptoms, persistence and severity. In Australia, the care and treatment of individuals experiencing mental health challenges or illnesses is governed by the Mental Health Act (1996). This legal framework for mental disorders support and remedies is supported by the Commonwealth of Australia mental health statements of rights and responsibilities. There are various support and remedies available for students experiencing mental disorders such depression. Some of these include: medication, psychotherapy, electro convulsion therapy (ECT) and brain stimulation therapies. At individual/personal level, participating in leisure and recreation activities can significantly minimize depression among students. 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