Matthew, O.

kashan university of medical sciences

Nurs Midwifery Stud. 2017 March; 6(1):e41515.
Published online 2016 October 22.
doi: 10.5812/nmsjournal.41515.
Letter
Challenges Facing Mental Health in the 21st Century: A Summary of
Scientific Evidences
Ojone Matthew1,*
1Nursing Science Department, Ebonyi State University Abakaliki, Ebonyi State, Nigeria
*Corresponding author: Ojone Matthew, Nursing Science Department, Ebonyi State University Abakaliki, Ebonyi State, Nigeria. Tel: +234-8036113783, E-mail:
ojone.matthew@yahoo.com
Received 2016 August 14; Accepted 2016 September 07.
Keywords: Challenges, Facing, Mental Health
Dear Editor,
Industrialization and modern lifestyle have had an ad-
verse effect on mental health, so that many people fre-
quently experience mental disorders (1). Globally, a system-
atic review and meta-analysis reported 21.4% prevalence of
sexual violence among female refugees and approximately
one in five refugees or displaced women in complex hu-
manitarian settings have experienced sexual violence (2).
As a global health issue, mental health concerns both the
rich and the poor, regardless of country of origin or gender.
Family and society at large, mental fitness, physical sound-
ness and social alertness are all vital elements of life, which
are closely interwoven, and interdependent (3).
Problems related to beliefs and behaviors are now on
the higher cargo of international health issues. About
12% of the global population is affected by mental ill-
nesses, which contribute to the worldwide burden on
socio-economic life of the people (4). There is a popular no-
tion that every individual harbors abnormality. As true as
this may sound, there is a great degree in the midst of in-
dividual’s rank of deviation since mental illnesses show a
discrepancy in severity and type. Mental health is simply
defined as the state of psychological and emotional well-
being of an individual; it may not necessarily be absence
of mental disorder. Also, mental health can be defined as a
state of stability, in which an individual recognizes his/her
personality and can be able to adjust to the daily pressures
of life and be able to meaningfully affect the society. Un-
fortunately, these criteria have been an unrealistic aim of
every man as they are barely possible to accomplish. To
achieve the mentioned functions, a mentally healthy indi-
vidual must have some qualities such as courage, integrity,
inspiration, tolerance and tenacity (ability to concentrate
on a given job without allowing interruptions or delay to
interject it). Shortness in any of them signifies an interfer-
ence with ones’ mental functioning.
The global epidemiology of mental illness is grow-
ing more than other diseases (5). Five in every 10 princi-
pal causes of frailty worldwide are mental disorders; e.g.,
major depression, schizophrenia, bipolar disorders, alco-
hol use and obsessive compulsive disorders, regardless
of country of origin, socio-economic status, and level of
knowledge. Moreover, there is a great probability that soon
issues related to mental illness become a major challenge
in the health care settings. Currently, in Nigeria, less than
5% of the budget allocated to the health sector is allotted
to psychiatric asylum.
1. Mental Health Challenges: The Scientific Evidence So
Far
1.1. Sexual Disorder
Sexual disorder is a type of mental illness associated
with the exhibition of hypo/hyper-active behavior during
a sexual cycle. The hyperactive form is characterized by un-
controllable and over reaction of an individual during a
sexual cycle, or a frequent urge to initiate sexual action to
self or to another, irrespective of gender. Most often, these
abnormal behaviors are associated with parental upbring-
ing and early exposure to sexual activities such as watching
pornographic films and substance abuse, both of which
could predispose an individual to the act of rape. Undoubt-
edly, substance abuse, due to its euphoric effect, bridges
the gap between moral and immoral conduct among the
abusers. This outcome could lead to premature sexual
experience among boys and even young girls. Rape (bi-
astophilia) is an act of having sexual intercourse with an
unconsented live being. Constitutionally, no one under the
age of eighteen is qualified to give consent for a sexual act,
but this varies from country to country. Nonetheless, even
in this modern world reports of sexual harassment, espe-
cially among young girls, are no longer surprising due to
its global incidence and prevalence. The surprising part
is ‘incest’ (sexual relations between those classed as being
Copyright © 2016, Kashan University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial
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Matthew O
too closely related to marry each other, such as father and
daughter, brother and sister, house cleaner and father of
the house), in which the executors and the sufferers usu-
ally deny it. This mysterious behavior is gaining ground
day by day, mainly due to an increase in paraphilic disor-
ders such as voyeurism in males and exhibitionism in fe-
males. Some people are now behaving like animals as they
engage in sexual acts in public. Unfortunately, it seems
that some people are not morally concerned about their
sexual actions. Can madness go beyond this?
1.2. Substance Abuse
Substance abuse is increasing among the general pop-
ulation, and the time of introduction usually occurs dur-
ing adolescence. The most common abused substances
include but not limited to alcohol and alcohol beverages,
cigarette, cannabis and cocaine. The recommended daily
intake of alcohol varies from country to country, depend-
ing on the drink. In Nigeria, for instance, a can of beer con-
tains 33 cl, which projects a standard drink of 17.16 g per
day. However, more than half of the alcohol consumers,
particularly teenagers, drink more than four cans (68.64
g). A documented proof (6), has reported that the elicited
drug abuse and heavy drinking among persons aged 12 or
older was 9.4% in 2013. Psychiatric complications that usu-
ally follow substance or alcohol abuse are immediate (con-
fusion, memory loss, unproductive argument, family con-
flict and absenteeism from work) and long-term (imbal-
ance in neurotransmitters leading to psychosis and neuro-
sis).
1.3. Fostering Care and Poor Parent-Child Relationship
Nowadays, the quest for high education and white-
collar work due to economic recession and civilization
have created domestic role conflicts among women; con-
sequently, it has increased child fostering leading to hard
labor. A significant ill-treatment association exists in early
child detachment from biological parents (such as sex-
ual abuse, physical abuse and rejection or discrimination),
which predisposes children to psychological issues, affect-
ing their general wellbeing. Children exhibit five traits:
Preciousness, helplessness, imperfection, codependence,
and immaturity, and it is the parents’ responsibility to
shape their children’s personality in the right way (7). Any
alteration in these striking qualities can be classified as
venomous on a child. Emotional abuse is more common
among children in foster care, which exposes them to men-
tal problems such as depression and low self-esteem (8).
Low self-esteem is more prevalent among adolescents liv-
ing with a guardian compared to those living with bio-
logical parents. Adolescents living with a caregiver other
than biological parent(s) are more likely to express injuri-
ous parental style such as controlling. Furthermore, ado-
lescents raised by controlling parents- harsh but not warm-
are likely to develop noticeable lower self-possession, self-
competence, and complex emotional distress of all kinds.
Parental relationship is the major cause of adolescent
depression (9). Because a reduction in parents-child inter-
personal relationship can leads to manifestation of symp-
toms of low self-esteem and depression.
Unfriendly relationship between close rela-
tives/caregiver and children has absolute consequences
on adolescent’s emotional behavior, and its overall reason
is the over- reproductivity among lower class families
that cannot provide sufficient care for their children. This
can only be prevented through health education and
reinforcement of family planning programs that focus on
this target group.
2. Factors Challenging Mental Health Services
Despite the extensive development of health care sys-
tems across the globe, mental health still lacks the neces-
sary growing curve. There is a popular saying: “preven-
tion is better than cure”. Prevention is not only better, but
also cheaper than cure. Preventive services, such as health
education through audio-visual aids, are always rendered
by healthcare professionals, largely by the nurses. Unfor-
tunately, nursing shortage, especially in mental health,
has been a worldwide problem that does not seem to be
solved anytime soon, and this imposes a great burden on
the patients, especially those with mental illness, as inci-
dence and prevalence of chronic behavioral problems are
increasing year by year. In addition, the followings have
been identified as contributing factors to this setback:
• Inadequate research coverage on incidence and
prevalence of mental health;
• Poor policy and implementation on the side of the po-
litical leaders;
• Lack of proper upbringing of children on the side of
parents;
• Lack of political policies;
• Prejudice associated with misconceptions on the
cause and treatment of mental health by different reli-
gions;
• Inadequate human resources (man power) to care for
the asylum;
• Financial constrains/economic reces-
sion/unemployment;
• Inadequate sensitization campaign by the health
care agencies.
2 Nurs Midwifery Stud. 2017; 6(1):e41515.
Matthew O
3. Implication to Nursing Care
The most important and beneficial part of medicine is
disease prevention. The prerequisite to this is providing
health education on the cause and preventive measures for
chronic and hard to cure disorders through public enlight-
enment campaign by the nurses.
The review of these challenges will serve as a road map
for the nurses and other healthcare practitioners in policy
formulation, practice, and healthy decision- making in var-
ious settings.
4. Conclusion
Mental health problems have become a great chal-
lenge worldwide. The prevailing factors to this unpleas-
ant dispute have been anchored on the increase in sub-
stance use among adolescents and adult population, lack
of proper upbringing of children, and poor distribution of
information on the health implications of these factors.
4.1. Recommendation
The health professionals should provide appropriate
health education on the causes and consequences of in-
ability to control sexual urge, abuse of substance and im-
proper nurturing of children at home in high prevalence
areas. Moreover, government agencies should effectively
monitor the production and sale of commonly used sub-
stances.
Acknowledgments
None declared.
Footnotes
Authors’ Contribution: None declared.
Financial Disclosure: None declared.
Funding/Support: None declared.
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Nurs Midwifery Stud. 2017; 6(1):e41515. 3


Challenges Facing Mental Health in the 21st Century: A Summary of Scientific Evidences

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Challenges Facing Mental Health in the 21st Century: A Summary of Scientific Evidences

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