Main points:

• encourage a more holistic approach to health
• replace the term 'Mental Health', with 'Psychological Health' in all departmental signage and correspondence
• expand on the treatment options available and the kinds of treatment providers used for doctor prescriptions and in public health clinics

A holistic approach to health involves treating the whole person rather than just a collection of parts. A holistic approach recognizes that:

• treatment can be carried out at any level from cell function (treatment of viruses, cancer, etc) to the level of the person (treatment of behaviour, posture, thought patterns etc).
• It also recognizes that many forms of treatment are valid, and are determined largely by the culture or personality of the client.

Development of a more holistic approach probably starts with GPs, who have first contact with clients, and have the responsibility of providing general health services. GPs are in the position to offer considerable choice as to different measures that can be taken to alleviate symptoms of poor health. At present GP practices are largely focused at the level of cell function, with drugs being the predominant form of treatment. A holistic approach would involve broadening the scope and quality ofbehavioural treatments available through prescriptions, currently called ‘green prescriptions’. This includes self-development programmes in exercise, diet, fitness and personal psychology. It would also include greater recognition of the validity of many non-western methods of treatment.

In the quest for scientific solutions to human health problems, the influence of behaviour has been largely ignored, but behaviour itself is a prime causal factor in any health problem. Western mortality has not fallen simply because of better hospitals and advances in medical science. No doubt that has contributed. We owe our low mortality rate as much to engineers, sanitation systems, cleaning products, household appliances and our everyday activity, in which through our behaviour and better understanding of ourselves, we optimize our health and improve our longevity. As part of that ‘better understanding’ is an increased awareness of behaviours that have the potential to undermine our health.

Many health problems are caused or exacerbated by certain behaviours such as smoking, excessive drinking, poor diet, poor posture, lack of exercise etc, all of which have greater effect as we get older. The effects of these behaviours are currently being publicly identified, thereby laying the foundation for improved service in health education in this area and a reduction in the occurence of preventable health conditions. Dealing with the behavioural influences of many health problems would lead to a reduction in hospital waiting lists and those people on waiting lists could be encouraged to focus on making positive change to their behaviour patterns to reduce their immediate discomfort and diminish their urgent surgical need.

With the increasing amount of processing that can be put into food and health products it is important to maintain high quality information on packaging about contents. The huge variation in dietary tolerances in society makes it important for people to be able to make choices about what they are eating for the sake of their health. It is also important to remove any unnecessarily high quantities of toxins in food in general, such as spray residues, and certain additives and substitutes, so that the overall background ingestion of toxins is not too high. There needs to be a balance between what manufacturers think they need to put into products and what health professionals think is healthy.

Psychological health services are in need of a revamp. Over the past 50 years several things have happened:

• The development of psychoactive medication in the 1960’s has enabled sufferers to be deinstitutionalized, and to live in the community alongside other people.
• Psychological illnesses have been increasingly categorized according to the ‘medical model’, whereby an increasing number of supposedly stable conditions have been identified (using an American based categorization system: DSM-IV).
• An increasing percentage of the population is now considered to be at risk of succumbing to any of these psychological conditions.
• The public is being encouraged to be more accepting of psychological illness and how it affects people.
• There is a worldwide shortage of psychiatrists and innovative people willing to work in the psychological health system.
• The use of pharmaceutical solutions to behavioural problems has increased dramatically. Of greatest concern here should be the increasing use of psychoactive drugs such as Ritalin on children.

The 'medical model' involves identifying pscyhological disorders as 'diseases' with corresponding 'causes' and 'treatments'. Unlike virul diseases, psychological illnesses have no scientific basis, but are categories that are decided upon by a committee of experts in the US as a result of behavioural characteristics gathered through observation. The medical model is useful especially when it is applied to chronic sufferers, where the stability of the symptoms is most prominent, and where sufferers are the least functional and in most need of ongoing care. In those cases the DSM categorization system gives specialists something to work with. However, there has been a tendency for the creation of a plethora of pseudo illnesses with which to categorise minor complaints. The usefulness of these sub-categories is questionable.

The medical model of psychological illness was developed in the 19th century by physicians who were professionals trained in medical health. Sigmund Freud was such a doctor. During the 20th century much progress was made in the new branch of science called psychology, which focused on human behaviour. However despite all the advances made, psychological health services remain controlled by psychiatrists, who train as doctors first and do add-on training in psychology. The current bias in psychological health treatment exists because the psychiatrist’s area of expertise and professional license supports the concept of the medical model of psychological illness. The complex nature of humans and their behaviour means that any dysfunction is likely to have a great number of interrelated causes. Psychologists, who are the ones who spend copious amounts of time face to face with clients, are increasingly finding that it is more useful to treat behaviour holistically, and not try to identify specific syndromes. Their viewpoint is often at odds with that held by psychiatrists.

The term ‘Mental Health Service’ should be replaced by the term ‘Psychological Health Service’.

Use of the term ‘mental illness’ should be restricted to cases exhibiting clear signs of organic brain dysfunction such as dementia, chronic schizophrenia, chronic bipolar disorder, chronic autism and epilepsy.

Control of the Psychological Health Service should be primarily in the hands of psychologists, with psychiatrists on hand to administer pharmaceuticals where required.

Intermediate terms such as ‘Emotional Unfitness’, 'psychological disorder', or 'behavioural disorder' (depending on how the disorder manifests itself) should be used to describe minor and acute forms of disorder which are considered temporary, of medium intensity or curable and in which permanent brain dysfunction has not occurred.

Intermediate Terms

These are categories which professionals can use to apply to the vast number of people who exhibit minor psychological health symptoms and who are not likely to become chronic cases. These people are in the transition area between ‘well’ and suffering from ‘mental illness’. As an example: Emotional unfitness

Emotional Unfitness would describe many sufferers of mood disorders such as depression, anxiety disorders and phobias, as well as substance abuse and eating problems. Anything described as emotional unfitness would have to be deemed to be led chiefly by the emotional responses of the person rather than cognitive ones and to respond well to treatment that is applied to the body rather than to the mind.

The benefit of the Emotional Unfitness definition is that the term puts the onus of responsibility on the sufferer and implies that they have the ability to become fit again. Whenever we consider someone to be physically unfit, it is automatically known what to do to become fit again.  With better understanding of the action required, the same should be possible for emotional unfitness.

Being a holistic term it opens up the doors to multiple treatment methods rather than the limited combination of counseling and pharmaceutical medication currently used. This would involve human development programmes in relaxation, self-esteem, emotional fitness. It would enable practitioners from a wide variety of fields to become involved in this area of health and alleviate some of the problems currently being experienced with lack of professional staff.

The old term ‘mental illness’ does not fit sufferers of emotional disorders, because for them it is largely the emotional system that is awry not the mental system. Rather than having their mental functions treated, emotionally unfit people need their emotions treated.

By providing a transitional definition midway between 'well' and 'mentally ill', the term Emotionally Unfit would be applicable to a greater number of people, enabling potential mental illness sufferers to be defined earlier and have their problems treated sooner rather than later. Potential sufferers are more likely to volunteer themselves for treatment under the label ‘Emotionally Unfit’ than they would under the previous label of ‘mentally ill’. They would find their way more easily into treatment and then back out again to eventual recovery.

Concepts like Emotional Fitness present a proactive approach to emotional disorders, rather than the ‘mental illness’ model which tends to be reactive, and consist of bottom-of-the-cliff attitudes and treatments.

Unconditional Positive Regard

Treatment of people with psychological problems requires a professional attitude which maximizes their chances of recovery. An exemplary approach in this respect is that pioneered by the humanistic psychologist Carl Rogers and embodied in the concept of Unconditional Positive Regard. Most psychological problems are transitory, sufferers have the potential to recover, and that recovery often happens regardless of treatment. Once balance is restored, emotionally unfit people have the potential to make contributions to society far beyond what might be evident in their immediate behaviour. This possibility should always be nurtured. In fact, because of the adversity they have faced during their experiences, many emotionally unfit people have the ability to out perform their peers in many areas of endeavour.

Human Development Programmes

The most important accompaniment to the treatment of emotional unfitness are human development programmes. Human development programmes are facilitated workshops for one or more people designed to enhance personal development by focusing on the person's development rather than the results. These programmes focus on improving general abilities or characteristics such as relaxation, self-esteem, confidence, self-expression, assertiveness, stress management, concentration, emotional fitness, focus, etc. They require active participation and the acquisition of skills and discipline and include many personal development programmes, yoga, relaxation, tai chi and many others. Doctors should be able to prescribe approved programmes subsidized by the government like medication and counseling are now.