9. WHO 2001
ทฏษฎีเปลียน
่
International Classification of Functioning
(ICF)
“Every human being can experience some degree of disability.
The ICF ‘mainstreams’ the experience of disability and
recognises it as a universal human experience.”
not as just a 'medical' or 'biological' dysfunction
But social and environmental
http://www.who.int/classifications/icf/en/ 9
11. ICF
International Classification of Functioning, Disability and Health
Health Condition WHO 2001
(disorder and disease)
Bodily
Function & activities participation
Structures
Environmental Individual
(Social) (Personal)
Factors Factors 11
12. Disability
is dynamic & fluctuant
Encourage the patient to remain independent
They might need help partially or fully
12
25. • a cost of about $350 per month per
drinker, alcohol maintenance programs
can reduce policing costs and medical
fees associated to frequent emergency
room visits for illicit booze drinkers.
‘Illicit Drinkers’ seek free alcohol lounge in Vancouver’s Downtown Eastside
25
globaltvbc.com
26. STOP criteria
to recognize attitudes and actions that support the stigma of mental illness.
ask yourself if what you hear:
• Stereotypes, assumes they are all alike
rather than individuals?
• Trivializes or belittles people?
• Offends people by insulting them?
• Patronizes by treating them as if they were
not as good as other people?
26
www.cmhanl.ca/pdf/Stigma.pdf
28. “Patronizing”
by treating them as if
they were not as good as other people?
• อุปถัมภ์, อ้างตัวเป็นผู้มอุปการะคุณ
ี
• “สงเคราะห์”
พยายามเข้าใจ เห็นใจ ดีกว่า สงสาร
28
29. We have already changed the way we refer to
women
people of colour and
people with physical disabilities.
Why stop there?
29
47. Mental illness
Mental disorders
Mental health
yourbasiclefty.blogspot.com
47
48. Mental Health
สุ ข ภาพจิ ต
a state of well-being in which every
individual realizes his or her own
potential, can cope with the normal
stresses of life, can work productively
and fruitfully, and is able to make a
contribution to her or his community.
48
49. Mental illness is common
• 1/5 Canadian adults under age 65
David R Offord et al. (1996)
• 1/4 people in the UK has a mental
health problem at some point
nhs.uk/conditions/Mental-health
• 1/3 Americans has at least one mental
health problem during their lifetime
Serivani JS. (2007)
49
52. Mental illness is NOT
a single, rare disorder.
• Mental illness is not a single disease but a
broad classification for many disorders.
• e.g. Anxiety, depression, schizophrenia,
eating disorders, organic brain disorders,
substance abuse, dementia. etc.
52
53. Mental Disorders [MeSH]
…abnormalities of thought,
feeling, and behavior
producing either distress
or impairment of function.
53
54. functional impairment
• making it more difficult for them to
sustain interpersonal relationships
and carry on their jobs, and
sometimes leading to self-
destructive behavior and even
suicide.
54
http://plato.stanford.edu/entries/mental-illness/
56. • Schizophrenia and
Disorders with Psychotic Features
(Paranoid Disorders, Psychotic Disorders, Schizophrenia)
• Sexual and Gender Disorders
• Sleep Disorders
• Somatoform Disorders
• Substance-Related Disorders
• Mental Disorders Diagnosed in Childhood
56
57. CAMBODIA It's All in the Mind?
Kum Kim, 47, sees a witch doctor for her schizophrenia.
In Cambodia, there is not a single inpatient mental hospital:
the nation of 11 million has only 20 psychiatrists
http://www.time.com/time/photogallery/0,29307,2052507,00.html#ixzz1ln4yKuBT 57
58. Mental Illness?
The most heated controversies about the existence of
particular mental illnesses are often over ones that seem to
involve culturally-specific or moral judgments, such as
homosexuality, pedophilia, antisocial
personality disorder, and premenstrual
dysphoric disorder
58
(Radden, 2009)
59. Mental Illness?
OR
the borderline between normality and pathology
dysthymia
a low level chronic form of depression
59
(Radden, 2009)
61. Myth
• violent and dangerous
• poor
• less intelligent
davidcoethica.wordpress.com
61
62. They cannot just “snap out of it”.
understandingaddictions.com 62
63. Complex causes
• Traumatic experiences
• Genetic vulnerabilities
• Changes in the brain and
nervous system
• Drugs
• Injuries
• Society - Culture
63
64. มุมมองต่อ Mental illness
• reduce social explanations of mental illness to
explanations at “lower” levels
Biological สารเคมีในสมอง
• encourage the co-existence of explanations of
mental illness at a variety of levels
Biological สารเคมีในสมอง + สังคม จิตวิญญาณ
64
69. Google scholar
("mental health" OR
"mental disorder*" OR
"mental illness")
AND
(dental* OR dentist*
OR "oral health” OR mouth)
69
70. • Dental amalgam fillings
• Dental anxiety
• Addiction/susbstance abuse
• Oral health and dental care of
people with mental illness
• Mental health of
dentists & dental students
70
74. Assessment and
Consent for treatment
• Informed consent and the cognitively
impaired geriatric dental patient.
• Children with intellectual disabilities and
pain perception: a review and
suggestions for future assessment
protocols.
74
75. Treatment & Management
• Psychological treatment of fearful and
phobic special needs patients.
• Eating disorders part II: clinical
strategies for dental treatment.
• Providing dental care for the patient
with autism.
75
76. Substance abuse
• Significance of cannabis use to dental
practice.
• Delivering alcohol screening and alcohol brief
interventions within general dental practice:
rationale and overview of the evidence.
• Implications of drug dependence on dental
patient management.
76
83. Other difficulties
• hearing and visual impairment.
• difficulty focusing and sustaining their attention
• poor auditory memory.
• very lengthy processing and response time
• difficulty understanding grammatical concepts such as negatives (e.g.
not, don’t, isn’t, won’t etc.) and
time concepts (e.g. tomorrow, in a week, in ten minutes etc.).
• Limited expressive vocabulary or word finding difficulties.
• Weak and/or uncoordinated oral musculature.
83
92. Reference เพิ่มเติม
• เอกสารประกอบการสอนสำาหรับนักศึกษาแพทย์ จาก ภาค
วิชาจิตเวชศาสตร์โรงพยาบาลรามาธิบดี
http://www.ramamental.com/medicalstudentpage/generalpsyc/
• Community support systems for persons
with long-term mental illness: A conceptual framework
BA Stroul - Psychosocial Rehabilitation Journal, 1989 - psycnet.apa.org
92
96. personhood
They doubt that I am a real person.
A failure to learn your language is a deficit?
A failure to learn my language is so natural?
silentmiaow
http://www.youtube.com/watch?v=JnylM1hI2jc
96
98. • What to say:
I can’t really understand what you are
feeling, but I can offer my compassion.
• What NOT to say:
Believe me, I know how you feel
98
99. James W. Little et al
Dental Management of the Medically Compromised Patient
A summary หน้ า DM-56 ถึ ง DM-60
Anxiety
Eating disorders
Anxiolytic Drugs
Depression and Bipolar
Antidepressant drugs
Antimanic drugs
Antipsychotic Drugs
Somatoform disorder-Factitious disorder
Substance abuse (+ alcohol ด้วย)
99
101. "Let someone else do it," vs. "Let us all do it!"
"Let us all do it!"
Professor H. Barry Waldman
Stonybrook,NY
101
102. C o m p r e h e n s iv e
n u o u s ly -a c c e s s ib le
a m ily -c e n t e r e d
C o o r d in a t e
o m p a s s io n a t e
lt u r a lly -e f f e c t iv e
102
124. Practical Oral Care for People With Developmental Disabilities
series of publications
124
http://www.nidcr.nih.gov/OralHealth/Topics/DevelopmentalDisabilities/
127. the Academy of Dentistry for Persons
with Disabilities (ADPD)
Formerly known as
Special Care Dentistry Association
http://www.scdonline.org
http://aadmd.org
127
132. 73 Specialists in UK
in NHS or private general practice
arranged a study day
132
Dentists with a Special Interest (DwSI) in Special Care Dentistry
140. ขอบคุ ณ ค่ ะ
“Put an end to the old logo.”
http://www.bushprisby.com/disabled_logo/index.html 140
Notes de l'éditeur
เด็กสมาธิสั้นและซนผิดปกติ (Attention Deficit & Hyperactive Disorders) เด็กที่มีความบกพร่องด้านการเรียน
ลาว เขมร พม่า
Anthropological work in non-Western cultures suggests that there are many cases of behavior that Western psychiatry would classify as symptomatic of mental disorder, which are not seen within their own cultures as signs of mental illness (Warner, 2004, p. 173). One may even raise the question whether all other cultures even have a concept of mental illness that corresponds even approximately to the Western concept
Dystonia : involuntary, and usually painful, spasms and muscle contractions that can induce abnormal movements and postures. Appliance therapy for chronic drooling