Severe mental disorder - impact and burden on community mental health

Abstract

Introduction. Severe Mental Disorder (SMD) refers to a diagnosis of psychotic disorder, bipolar disorder, or either major depression with psychotic symptoms or treatment-resistant depression. Also includes anxiety disorders, eating disorders and personality disorders, if the degree of functional impairment is severe. These deficiencies often lead to an inability to maintain a lucrative activity, poor social support, repeated psychiatric hospitalizations, homelessness, incarceration and coexisting substance use disorders. Community mental health (CMH) care focuses on providing services within the community, close to people's homes, organized promptly and used in case of need. It offers a series of medical, social services in the form of integrated care, in order to optimize the possibilities to recover the person with SMD. Aim of the study: Is to identify the social functionality and the needs of people suffering from SMDs, as well as to elaborate recommendations based on the detected needs. Aim of study. SMD is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The impact of mental illnesses is particularly concentrated among those who experience disability due to SMD. It represents a high burden of disease in the Republic of Moldova. Its incidence and prevalence, as well as the disability caused by depressive disorders, is continuously increasing. Methods and materials. Review of the literature on SMDs and health care. Analyzing methods for studying social functionality of people suffering from SMD. The use of multifunctional questionnaires to elucidate the psycho-social peculiarities of patients with SMDs. Research subject: 20 beneficiaries of the Community Mental Health Center of the Buiucani sector with SMDs. Inclusion criteria: People with SMDs with a disease duration of at least 5 years. People aged 18-65 years old. Results. Due to the early onset of the disease, all beneficiaries face difficulties in their ordinary life. They fail to integrate socially and educationally (difficulty in reading/writing/speaking). Family integration is being very challenging for them, no stable partner for a long-term relationship, no children. The satisfaction of material and individual needs in people affected by SMDs is low. They have difficulties with housing, mostly no adequate nutrition and financial difficulties due to a limited income. Physical disabilities of varying degrees, difficulty in performing personal care, in doing household chores. Most suffer from psychotic symptoms (hallucinations and/or delusions), are affected by cognitive problems, face psychological exhaustion, depressed mood, insomnia. The presence of non-suicidal self-injury is attested, also they believe that they can be dangerous to those around them. Conclusion. SMD is a current public health problem with a high incidence and prevalence. It leads to a high rate of disability which eventually leads to the disintegration of people within the society. It is a social, family and personal burden, which leads to financial, psychological and moral damage. People do not have friends and social networks, are rejected by their families, society and so they feel abandoned. There is still a long way to go to rehabilitate people with SMD and integrate them into the community.