Escolar Documentos
Profissional Documentos
Cultura Documentos
Mental Health
Cesa Septiana Pratiwi| Prodi S2 Kebidanan| Universitas Aisyiyah
Yogyakarta
17/11/2017
Prologue
Biomedical model: the disease is an organics condition and dispels non-organic factors associated with
emotional behaviour and symptoms (Haslam, 1798, Kraeppelin in Diedfendorf, 1912)
Social model/ social construction/ sociocultural-: Mental illness has to some extent an uneasy relationship
with sociology. Environment, social, and cultural maladjustment including low socioeconomic, poor social
support and stressful live events play as important roles in influencing the development of mental disorder
(Anthony, 2001) --- Cognitive Behavioural Paradigm (Wundt, 1879; Pavlov, 1928; Skinner, 1953)
Psychosocial model: draws on psychodynamic theory derived from the work of Sigmund Freud. It is believed
that abnormal behaviour is caused by the presence of unconscious mental conflict rooted during early
childhood period followed by inability of the ego to cope with stress and resulting in defence mechanisms
(Freud, 1955)
Biopsychosocial model: Answer for new medical model in the concept of health and illness. Integrated
biomedical, sociocultural and psychosocial in a scientific way still considering their interconnections and
interdependence (Engel, 1977)
Risk factors
During pregnancy: After childbirth:
Illnesses during pregnancy,
Adolescent pregnancy
Difficulties with husbands behaviour antenatal hospital admission,
Being unmarried or separated (physical violence; verbal abuse; alcohol use; operative birth
being illiterate and unemployed; providing
Unwanted pregnancy little assistance; rejecting the pregnancy) Large number of children
Infant unsettled, sick, not thriving
Marital relationship: unsupportive; Inability to confide in partner Problematic relationship with in-law
polygamous
family (mother-in-law and sister-in-
Previous stillbirth or repeated miscarriage Poverty (low income; lack of personal
income generating activity; inadequate
law)
Nulliparity housing) Birth of a girl child in cultures over-
Poverty and lack of financial resources
valuing boy child
Overcrowding and lack of privacy Lack of sustained, dedicated,
Lack of practical support practical care after birth for the
Unintended pregnancy
Pregnancy as a result of rape culturally prescribed period
Adolescent pregnancy Past psychiatric history
Spouse/domestic violence
Other stressful life events
Difficult relationship with in-laws Unmarried
Neonates of mothers with high anxiety levels during pregnancy have decreased motor maturity and vagal
tone when compared to those of non-anxious mothers.
cry more
change more frequently from one behavioural state to another; they are perceived by their mothers as having a
more difficult temperament
they also have more gastro-intestinal problems and delayed growth
Maternal mental health is inextricably linked with both physical and psychological development of children.
Addressing the mental health needs of the mother is likely to benefit these important outcomes. However,
maternal mental health has been ignored in both child nutrition and development programmes and it may be
the missing link in maternal and child health programmes.
Resources
https://www.nice.org.uk/guidance/cg192/evidence/full-guideline-pdf-193396861
http://apps.who.int/iris/bitstream/10665/152936/1/WHO_MSD_MER_15.1_eng.pdf?ua=1&ua
=1
http://www.who.int/bulletin/volumes/90/2/11-091850/en/
http://www.who.int/mental_health/prevention/suicide/lit_review_postpartum_depression.pdf
?ua=1