(Vienna, 08 October 2020) The Covid-19 pandemic, which, amongst other things, has led to increasing levels of stress, aggression and existential angst, has further raised awareness of mental health issues. On World Mental Health Day this coming Saturday (which has been celebrated since 1992), general practitioner Wolfgang Spiegel from the Medical University of Vienna's Center for Public Health stresses the importance of public education about mental processes and potential psychological stress factors.
This mental health education (mental health literacy) also includes being aware of one's own physical and emotional resilience and being able to deal with mental health issues in one’s immediate social circle.
Training in mental health literacy helps us to better protect ourselves and those close to us and "ranges from self-care and the ability to accurately and critically rank information about mental health through to knowing when it is sensible and appropriate to contact mental health institutions. Medical help should be sought promptly for typical problems such as anxiety, listlessness, loneliness and depression. In this instance, the general practitioner or family doctor is a low-threshold point of contact who can diagnose and treat common and typical problems and, if necessary, can refer patients on for specialist psychiatric diagnosis and/or treatment," explains Spiegel, who has written an article on this subject in the World Federation for Mental Health (WFMH) publication to mark World Mental Health Day 2020 and has already supervised several projects on the subject at MedUni Vienna.
Experts believe that Austria has made good progress in terms of public understanding and access to information. However, investment in societal health awareness is still urgently required. Corresponding programmes to raise awareness about mental health within the population should be developed and evaluated by experts based on scientifically founded knowledge.
"However, as well as this essential education of patients, the healthcare system must also invest in the corresponding development of specialist skills among treating doctors. By providing specific funding for advanced medical training, healthcare policy in the area of "common and typical mental health issues" could do even more to ensure that important skills are also established in primary care, e.g. among all statutory health insurance doctors.
Taking mental health issues seriously and looking at them holistically
There has long been a stigma attached to mental health issues and/or illness, although this has improved over the last 25 years. Says Spiegel: "Nowadays, patients are much more willing to consult their doctor about mental health problems. However, general practitioners are well aware that people often present with ostensible physical symptoms when they are under psychological stress."
As well as affective disorders (anxiety and depression), patients often turn up in general practices with non-specific symptoms in varying combinations such as insomnia, palpitations, sweating, mood swings and other functional disorders which, after organic causes such as hormone imbalance have been excluded and in the absence of any psychiatric disorder, are classified as 'medically unexplained symptoms' or as 'Bodily Stress Disorder'. "It is important to explain to the patient that there are also variable, non-organic problems that do not meet the criteria for classification as a psychiatric disorders or an organic disease but can still be regarded as 'real' from a medical point of view, even if, in many cases, no diagnosis or treatment is available," says Spiegel.
The scientific discipline of general medicine has defined six "core competencies", one of these being the "person-centred approach" and another "holistic modelling", a term referring to application of the "biopsychosocial model". "Behind these terms are complex theoretical constructs, with which scientific general medicine seeks to impart medical action theory to students and doctors receiving further training, which also takes account of people’s emotions and must still be designated as the a healing art," says Spiegel.
World Mental Health Day on 10 October
World Mental Health Day takes place every year on 10 October. The action day, initiated by the World Federation for Mental Health, aims to educate people about mental health and to prevent people from being stigmatised for having mental health issues. These aims are translationally supported in many areas at MedUni Vienna and already feed into the curriculum, are scientifically investigated, and validated by research results.