hi all:
yes, yes, yes!
this is what i've been sayin!
janet
---------------------------------------------------------------------------
BMJ 2001;322:937 ( 14 April )
Time to abandon the term mental illness
Baker, M.
Menken, M.
When we use the term "mental illness," not "brain illness," do we put our
patients in harm's way?
This is an appropriate time to ask, because it has become apparent in
recent years that disorders of the brain and nervous system are among the
most serious and prevalent health problems globally.
It is harmful to millions of people to declare that some
brain disorders are not physical ailments
By 2020, diseases arising from nervous system disorders will make up 14.7%
of all diseases worldwide (up from 10.5% in 1990), according to the Global
Burden of Disease (GBD) Study recently carried out by the World Health
organization and other institutions:
http://www.hsph.harvard.edu/organizations/bdu/gbdmain.html .
Although nervous system disorders comprise only 1.4% of all deaths, this
study estimated that they account for a remarkable 28% of all years of life
lived with a disability.
Moreover, much of the burden of illness due to road traffic incidents,
violence, war, and falls is a consequence of nervous system dysfunction.
The president of the World Federation of Neurology, James F Toole, has
highlighted brain dysfunction among world leaders as one of the greatest
threats to global peace, and therefore the health of
populations.
In making their estimates, the GBD researchers took into account that
chronic illnesses differ in their impact on people, including the
differential impact resulting from the way friends, co-workers, and society
at large react and respond to each illness.
For example, there is little doubt that people with nervous system
disorders are more likely to be
subjected to discrimination and stigmatisation than people with, say,
disorders of the heart and lung.
Employers try to avoid hiring people with a history of nervous system
disorders, and otherwise compassionate people may avoid contact with such
individuals in social settings.
Health ministries or private insurance companies may deprive some people
with serious brain
disorders of the opportunity to consult with a psychiatrist or neurologist.
Our reflections upon the stigma and prejudice that apply differentially to
people with nervous system disorders have led us to conclude that the
mental health and mental illness labels traditionally and commonly used to
characterise certain brain disorders contribute to these twin sources of
unnecessary suffering.
We propose that these terms be abandoned in favour of "brain health" and
"brain illness."
The concept of mind and mental effort is deeply woven within the western
intellectual tradition as a fundamental concept of philosophy.
Metaphysics is that branch of philosophy that studies the nature of matter
(ontology), of mind (philosophical psychology), and of the ways that matter
and mind interact in sense perception and the acquisition of knowledge
(epistemology).
"That in the soul which is called mind," Aristotle writes,is "that whereby
the soul thinks and judges."
Philosophers, theologians, and children wonder whether mind is a uniquely
human possession, whether other animals have minds, or whether there is a
transcendent intelligence, an absolute mind, in the universe.
However, in proposing that we replace the mental illness label with the
brain label, we are arguing not from a philosophical position but within
the domains of public health and clinical medicine, as an essential step to
promote the improvement of human health.
Last week's World Health Day 2001 commendably highlighted nervous system
disorders.
Although the six disorders underscored in this project were all brain
disorders (depressive disorders, schizophrenia, dementia, alcohol
dependence, epilepsy, and mental retardation), the event was widely known
as World Health Day 2001 on Mental Health.
Advances in neuroscience during the past 50 years have left us not knowing
how or where to draw a line between brain and mental problems, or between
psychiatric and neurological disorders, as is customarily done.
From our angle of vision, there are only brain disorders that psychiatrists
prefer to treat and other brain disorders that neurologists (and
neurosurgeons) prefer to treat.
To be sure, there are many social problems and problems in living that most
healthcare workers would agree do not reflect brain disorders.
We frequently meet people with complex presentations, leaving us uncertain
whether any brain disorder is present.
We should honestly admit this uncertainty, and await the results of further
research without retreating into the ambiguity of the "mental" paradigm.
We suggest that it is unscientific, misleading, and harmful to millions of
people worldwide to declare that some brain disorders are not physical
ailments.
Neurology and psychiatry must end the 20th century schism that has divided
their fields.
There must be closer collaboration in neuroscience research and clinical
practice.
And we must build partnerships with our patients and with societies at large.
Only then will we advance the prevention and treatment of brain and nervous
system disorders.
Mary Baker, president of the European Parkinson's Disease Association,
Matthew Menken, World Federation of Neurology liaison representative,.
BMJ 2001
http://bmj.com/cgi/content/full/322/7291/937
janet paterson, an akinetic rigid subtype, albeit perky, parky
PD: 54/41/37 CD: 54/44/43 TEL: 613 256 8340 EMAIL: [log in to unmask]
"a new voice" home page: http://www.geocities.com/janet313/ .
"new voice news" latest posts: http://groups.yahoo.com/group/nvnNET/ .
----------------------------------------------------------------------
To sign-off Parkinsn send a message to: mailto:[log in to unmask]
In the body of the message put: signoff parkinsn
