Salud Mental

Mental health and psychiatry: Distinctions, links, and ethical/bioethical perspectives

##plugins.themes.bootstrap3.article.main##

Alberto Perales
Renato D. Alarcón
Patrick Wagner-Grau

Abstract

Introduction. Mental health and psychiatry have been terms of intense and complex use for almost a century, and they may have reached a critical level of ambiguous and imprecise synonymy that makes their definition and validation difficult.

Objective. To examine these concepts in depth, establishing precise distinctions, ontological connections, and instrumental scope reinforced by well-defined ideas in ethics and bioethics.

Method. Narrative review of pertinent literature, consultation with diverse scientific, medical, historical, philosophical, and literary sources, with appropriate analysis of ethical and bioethical practices.

Results. A broad, comprehensive definition is elaborated of mental health as a field with sociocultural, political, and demographic implications, and of psychiatry as a medical specialty. In addition to making clear distinctions and describing the specific impact of both fields on diverse populations, various levels of conceptual linkages, sociopolitical action, and ethical content are highlighted, as well as in processes of administration, education, and research.

Discussion and conclusion. There are factors that reinforce or weaken the scope of mental health and psychiatry, including their ethical and bioethical dimensions. Their effectiveness requires a reaffirmation of objectives and the reinforcement of individual and institutional initiatives, as well as the search for authentic connections and a social projection that is objective, comprehensive, and just.
Keywords:
Health, mental health, ethics, bioethics, humanism

References

Adams, J. R., & Quartiroli, A. (2010). Critical consideration of the Diagnostic and Statistical Manual: Importance of the inclusion of cultural and contextual factors. Journal of Humanistic Counseling, Education and Development, 49(1), 84-97. doi: 10.1002/j.2161-1939.2010.tb00089.x

Adis Castro, G. (1991). Problemas de salud mental y contexto psico-social. In R. D. Alarcón, J. Castro, & E. Cipriani (Eds.). Desde nuestra propia entraña. Homenaje al Prof. Javier Mariátegui (pp. 252-273). Lima: Fondo Editorial Cayetano Heredia.

Alarcón, R. D. (2013). Cultural Psychiatry: A general perspective. In R. D. Alarcon (Ed.). Book Series: Advances in Psychosomatic Medicine (pp. 1-14). Karger.

Alarcón, R. D. (2016). Global Mental Health and systems of diagnostic classification: Clinical and Cultural Perspectives. Acta Bioethica, 22(1), 15-25. doi: 10.4067/S1726-569X2016000100003

Alarcón, R. D. (2021a). De la polémica al diálogo: Dicotomías e itinerarios de la Medicina Moderna. In R. D. Alarcón & G. S. Alarcón (Eds.). Universidad Peruana Cayetano Heredia. 60 Años: Al servicio de la Humanidad y la Ciencia (pp. 963-995). Lima, Perú: Fondo Editorial UPCH.

Alarcón, R. D. (2021b). Global Psychiatry: Social determinants and cultural realities. Psychiatric Times, Special Report, 38(12).

Alarcón, R. D., & Frank, J. B. (Eds.). (2012). The Psychotherapy of Hope. The legacy of Persuasion and Healing. The Johns Hopkins University Press.

Alarcón, R. D., Craig, T. J., Fitz, M., & Baldessarini, R. J. (2020). A critical moment in Psychiatry: The need for meaningful psychotherapy training in Psychiatry. Psychiatric Times, Vol. XXXVII. Retrieved from https://www.psychiatrictimes.com/view/critical-moment-psychiatry-need-meaningful-psychotherapy-training-psychiatry

Alarcón, R. D., Westermeyer, J., Foulks, E. F., & Ruiz, P. (1999). Clinical relevance of contemporary Cultural Psychiatry. Journal of Nervous and Mental Disease, 187(8), 465-471. doi: 10.1097/00005053-199908000-00002

Álvaro-González, L. C. (2015). El cerebro social: bases neurobiológicas de interés clínico. Revista de Neurología, 61(10), 458-470.

American Psychiatric Association [APA]. (2022). Diagnostic and Statistical Manual of Mental Disorders: Text Revision DSM-5-TR (5th Edition). American Psychiatric Association Publishing.

Berry, H. L., Bowen, K., & Kjellstrom, T. (2010). Climate change and mental health: A causal pathways framework. International Journal of Public Health, 55(2), 123-132. doi: 10.1007/s00038-009-0112-0

Brockman, J. (1995). The Third Culture: Beyond the Scientific Revolution. New York, NY: Simon & Schuster.

Burris, S., Hancock, T., Lin, V., & Herzog, A. (2007). Emerging strategies for healthy urban governance. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 84(Suppl 3), i154-i163. doi: 10.1007/s11524-007-9174-6

Chartered Institute for Personnel and Development [CIPD]. (2020). Professional values. Principles-led. Explore the three key principles to making good decisions. Retrieved from http://peopleprofession.cipd.org/profession-map/core-purpose/principles-led

Cherniss, C., & Adler, M. (2000). Promoting Emotional Intelligence in organizations. Alexandria, VA: American Society for Training and Development (ASTD) Publications Department.

Clark, S. (2015). Ethical decision-making: eight perspectives on workplace dilemmas. Research report. London: CIPD Publishing. Retrieved from https://www.cipd.co.uk/knowledge/culture/ethics/workplace-decisions-report#gref

Compton, M. T., & Shim, R. S. (Eds.). (2015). The Social Determinants of Mental Health (1st Edition). American Psychiatric Publishing.

Comte, A. (1985). Curso de Filosofía Positiva. Barcelona: Editorial Orbis.

de la Fuente Muñiz, R. (2021). Medicina y Valores Humanos. Ciudad de México: APM Ediciones y Convenciones en Psiquiatría.

de Soto, H., Ghersi, E., & Ghibellini, M. (1986). El otro sendero. La Revolución Informal. Instituto Libertad y Democracia. Lima, Perú: Editorial El Barranco.

Delgado, H. (1955). Curso de Psiquiatría. Barcelona, España: Editorial Científico-Médica.

Dewey, J. (1915). Democracy and Education. New York, NY: MacMillan Eds.

Dewey, J. (1925). Experience and Nature. Chicago, IL: Open Court Publishing Company.

Di Nicola, V. (2023). Convergent vs. divergent trends in Social and Cultural Psychiatry: A conceptual analysis. [Joint Congress] London, UK: World Association of Social Psychiatry and the Faculty of Rehabilitation and Social Psychiatry of the Royal College of Psychiatrists.

Edwards, R. B. (Ed.). (1982). Psychiatry and Ethics. Insanity, rational autonomy, and mental health care. Buffalo, NY: Prometheus Books.

Ekuma, K. J., & Akobo, L. A. (2015). Human resource management ethics and professionals’ dilemmas: a review and research agenda. Human Resource Management Research, 5(3), 47-57.

Frank, J. D. (1973). Persuasion and Healing. A comparative study of Psychotherapy (2nd Ed.). Baltimore, MD: Johns Hopkins University Press.

Gamow, G. (2007). Biografía de la Física. Madrid, España: Alianza Editorial.

Gobierno de México, Comisión Nacional contra las Adicciones. (2022). ¿Qué es la Salud Mental? - Abril 28. Retrieved from https://www.gob.mx/salud/conadic/acciones-y-programas/que-es-la-salud-mental#:~:text=abril%20de%202022-,Es%20un%20estado%20de%20bienestar%20por%20medio%20del%20cual%20los,y%20contribuir%20a%20sus%20comunidades

Goleman, D. (2005). Emotional Intelligence: Why it can matter more than IQ. New York, NY: Random House.

Gómez Pin, V. (2012). La mirada de Proust: Redención y Palabra. Madrid: Triacastela.

Gracia, D. (1998). Ética y Vida: Estudios de Bioética (Vol. 3). Bioética Clínica. Bogotá, Colombia: El Buho.

Gracia, D. (2004). Como arqueros al blanco. Estudios de Bioética. Madrid: Triacastela.

Gracia, D. (2013). Construyendo valores. Madrid: Triacastela.

Gribbin, J. (2003). Historia de la ciencia: 1543-2001. Crítica.

Griffin, J. (1986). Wellbeing: Its meaning, measurement and moral importance. Oxford, UK: Clarendon Press.

Group for the Advancement of Psychiatry [GAP], Committee on Cultural Psychiatry. (2002). Cultural Assessment in Clinical Psychiatry: GAP Report No. 145. American Psychiatric Publishing.

Herman, H. (2001). The need for mental health promotion. Australian & New Zealand Journal of Psychiatry, 35(6), 709-715. doi: 10.1046/j.1440-1614.2001.00947.x

Herman, H., Saxena, S., & Moodie, R. (Eds.). (2005). Promoting Mental Health: Concepts, Emerging Evidence, Practice. A Report of the World Health Organization, Department of Mental Health and Substance Abuse in Collaboration with the Victorian Health Promotion Foundation and the University of Melbourne. World Health Organization.

Kant, I. (1997). Lectures on Ethics. P. Heath, & J. Schneewind (Eds.). Cambridge University Press. doi: 10.1017/CBO9781107049512

Kellar-Guenther, Y. (2016). Workplace wellness programs and accessibility for all. AMA Journal of Ethics, 18(4), 393-398. doi: 10.1001/journalofethics.2016.18.4.nlit1-1604

Kendler, K. S. (2014). The structure of Psychiatric Science. American Journal of Psychiatry, 171(9), 931-938. doi: 10.1176/appi.ajp.2014.13111539

Kirkwood, T. (2020). Health, wellness and their determinants. Hektoen International. Retrieved from https://hekint.org/2020/01/28/health-wellness-and-their-determinants/ Access date 28/05/2020

Kjellstrom, T., & Mercado, S. (2008). Towards action on social determinants for health equity in urban settings. Environment and Urbanization, 20(2), 551-574. doi: 10.1177/0956247808096128

Kleinman, A. (1988). Rethinking psychiatry: From cultural category to personal experience. New York, USA: Free Press.

Koenig, H. G. (2009). Research on Religion, Spirituality, and Mental Health: A Review. Canadian Journal of Psychiatry, 54(5), 283-291.

Kohn, R., Ali, A. A., Puac-Polanco, V., Figueroa, C., López-Soto, V., Morgan, K., ... Vicente, B. (2018). Mental health in the Americas: an overview of the treatment gap. Revista Panamericana de Salud Pública, 42, e165. doi: 10.26633/RPSP.2018.165

Kragh, H. (2007). Generaciones cuánticas: una historia de la Física en el siglo XX. Madrid, España: Akal.

Laín-Entralgo, P. (1984). La espera y la esperanza (2a Edición). Madrid, España: Alianza Editorial.

Lanier, J. (2010). You are not a Gadget: A Manifesto. Knopf.

Laughland, O. (2020). “A perfect storm”: poverty and racism add to COVID-19 toll in US deep south. London, UK: The Guardian. April 12. Retrieved from https://www.theguardian.com/us-news/2020/apr/12/coronavirus-us-deep-south-poverty-race-perfect-storm

Le Mappian, M. (1970). Humanism et psychiatrie. [Humanism and psychiatry]. L’Evolution Psychiatrique, 35(1), 139-157.

Leighton, A. H. (1981). Culture and Psychiatry. Canadian Journal Psychiatry, 26(8), 522-529. doi: 10.1177/070674378102600802

Lewis-Fernández, R., Aggarwal, N. K., Hinton, L., Hinton, D. E., & Kirmayer, L. J. (Eds.). (2016). DSM-5 Handbook on the Cultural Formulation Interview. American Psychiatric Association Publishing.

Lolas, F. (2001). Bioética. El diálogo moral en las Ciencias de la Vida (2a Edición). Editorial Mediterráneo Ltda.

Lolas, F. (2010a). Psychiatry: a specialized profession or a medical specialty? World Psychiatry, 9(1), 34-35. doi: 10.1002/j.2051-5545.2010.tb00263.x

Lolas, F. (2010b). Psychiatry and Human Rights in Latin America: Ethical dilemmas and the future. International Review of Psychiatry, 22(4), 325-329. doi: 10.3109/09540261.2010.500864

Lolas, F., & Rodríguez, E. (2020). Bioética y Humanidades Médicas. Lecturas complementarias. Ciudad Autónoma de Buenos Aires: Hygea Ediciones.

López-Ibor Aliño, J. J. (2002). Prólogo a la Edición Española. In CIE 10. Décima Revisión de la Clasificación Internacional de Enfermedades. Trastornos Mentales y del Comportamiento, Descripciones clínicas y pautas para el diagnóstico (pp. 11-14). Meditor.

López-Ibor, J. J. (1954). Estilos de vivir y modos de enfermar. Madrid, España: Editorial Ateneo.

Mari, J. J. (2021). Psychiatry in Latin America: Advances and Trends. WPA Virtual 20th World Congress of Psychiatry, March 10-13. Vienna, Austria.

Mariátegui, J. (1987). Reflexión sobre el saber académico, el psiquiatra y la psiquiatría. Lima, Perú: Editorial Minerva.

Martínez-Pintor, F., & Martínez Gamo, A. (2022). Antropología Médica. Medicina basada en la Antropología. Madrid: Marbán Editorial.

Mitchell, L. (2009). ‘Sick in the head’. Why America won’t get the health-care system it needs. Harper’s Magazine, February, 33-44.

Montori, V. (2020). La rebelión de los pacientes: Contra una atención médica industrializada, (Manuel Iris, Trad.). Barcelona: Antoni Bosch Eds.

Okasha, A., Arboleda-Flórez, J., & Sartorius, N. (Eds.). (2000). Ethics, Culture and Psychiatry. International perspectives (1st Edition). Washington DC: American Psychiatric Press.

Organización Mundial de la Salud [OMS]. (2009). Fomento de la Salud Mental. Conjunto de Guías sobre Servicios y Políticas de Salud Mental. Ginebra, Switzerland: OMS. https://www.mhinnovation.net/sites/default/files/downloads/resource/%28WHO%2C%202003%29.%20WHO%20Advocacy%20for%20Mental%20Health_Spanish.pdf

Organización Panamericana de la Salud/Organización Mundial de la Salud [OPS/OMS]. (2004). Promoción de la Salud Mental: Conceptos, Evidencia Emergente, Práctica. Informe Compendiado. Ginebra, Switzerland: OMS.

Ortiz, P. (1997). La formación de la personalidad. Algunos aspectos de interés pedagógico. Lima: Editorial Distribuidora DIMASO.

Ortiz, P. (2019). Neurociencia Clínica. Una explicación de los trastornos, defectos, y deterioros neuropsíquicos de la personalidad. Lima: Fondo Editorial. Universidad Nacional Mayor de San Marcos.

Pan American Health Organization [PAHO]. (1995). Salud Mental en el mundo: Problemas y prioridades en poblaciones de bajos ingresos. Resumen Ejecutivo. OPS.

Pan American Health Organization [PAHO]. (2013). Strategic Plan of Pan American Health Organization 2014-2019, 52nd. Directing Council of PAHO, 65th, Session of the Regional Committee of WHO for the Americas.

Pan American Health Organization [PAHO]. (2018). The Burden of Mental Disorders in the Region of the Americas, 2018. Retrieved from https://iris.paho.org/handle/10665.2/49578

Perales, A. (1993). Salud Mental en el Perú: Variables Socioeconómicas, Políticas y Culturales. Anales de Salud Mental, (1-2), 83-107. Retrieved from http://repebis.upch.edu.pe/articulos/ansm/v9n1_2/a9.pdf

Perales, A. (2013). Salud Mental y Desarrollo Nacional. Revista Médica Herediana, 5(1). Retrieved from https://revistas.upch.edu.pe/index.php/RMH/article/view/433

Perales, A. (2016). Ethics, Psychiatry and Mental Health. Acta Bioethica, 22(1), 27-36.

Perales, A. (2020). Ética, salud mental y COVID-19. Acta Médica Peruana, 37(4), 532-535. doi: 10.35663/amp.2020.374.1043

Perales, A. (2023). Ética, Salud Mental y Desarrollo Nacional. In A. Iza, & J. Saavedra (Eds.). Diálogos de Ética y Desarrollo Humano (pp. 15-32). Academia Nacional de Medicina. Lima.

President’s Council on Bioethics. (2003). Beyond Therapy: Biotechnology and the pursuit of Happiness. Washington, DC: Regan Books.

Primm, A. B., Vasquez, M. J., Mays, R. A., Sammons-Posey, D., McKnight-Eily, L. R., Presley-Cantrell, L. R., & Perry, G. S. (2010). The role of public health in addressing racial and ethnic disparities in mental health and mental illness. Preventing Chronic Disease, 7(1), A20. Retrieved from http://www.cdc.gov/pcd/issues/2010/jan/09_0125.htm

Procuraduría Pública Especializada en Delitos de Corrupción [PPEDC]. (2018). La corrupción en los gobiernos regionales y locales. Informe Temático. Lima: Ministerio de Justicia y Derechos Humanos.

Ramón y Cajal, S. (1999). Cuentos de vacaciones. Espasa-Calpé.

Ramón y Cajal, S. (2006). Recuerdos de mi vida. Editorial Crítica.

Rodríguez-Yunta, E. (2016). Determinantes sociales de la salud mental. Rol de la religiosidad. Persona y Bioética, 20(2), 192-204. doi: 10.5294/pebi.2016.20.2.6

Romeo Casabona, C. M. (Ed.). (1997). Código de Leyes sobre Genética. Universidad de Deusto/Fundación BBV.

Sartorius, N. (2000). Ethic and the societies of the World. In A. Okasha, J. Arboleda-Flórez, & N. Sartorius (Eds.). Ethics, Culture and Psychiatry. International perspectives (1st Edition, pp. 3-14). Washington, DC: American Psychiatric Press.

Satcher, D., & Druss, B. G. (2010). Bridging mental health and public health. Preventing Chronic Disease, 7(1), A03. Retrieved from http:// www.cdc.gov/pcd/issues/2010/jan/09_0133.htm

Sen, A. (2000). Desarrollo y Libertad. Buenos Aires: Editorial Planeta.

Shorter, E. A. (1997). A History of Psychiatry. From the Era of the Asylum to the Age of Prozac. New York: John Wiley and Sons.

Silva, M., Loureiro, A., & Cardoso, G. (2016). Social determinants of mental health: a review of the evidence. European Journal of Psychiatry [online] 30(4), 259-292.

Teilhard de Chardin, P. (1959). El medio divino. Ensayo de vida interior. Madrid: Taurus.

Teilhard de Chardin, P. (1963). La aparición del hombre. Madrid: Taurus.

Thompson, K. S., & Tasman, A. (2022). This is the water. The Social Determinants of Mental Health and the Future of Psychiatry. Psychiatric Times, 39(1), 1.

Vovelle, M. (1985). Ideologías y mentalidades. Barcelona: Editorial Ariel.

Wallace-Wells, D. (2019). The uninhabitable Earth. Life after Warming. Penguin Random House.

Weber, M. (1967). El político y el científico (Trad Cast.). Madrid: Alianza Editorial.

Weisstub, D. N., & Arboleda-Flórez, J. (2000). An international perspective on Mental Health Law Reform. In A. Okasha, J. Arboleda-Flórez, & N. Sartorius (Eds.). Ethics, Culture and Psychiatry. International perspectives (1st Edition, pp. 189-209). Washington DC: American Psychiatric Press.

Williamson, B. (2016). Digital education governance: An introduction. European Educational Research Journal, 15(1), 3-13. doi: 10.1177/1474904115616630

World Health Organization [WHO]. (1948). Preamble to the Constitution. In Official Records of the World Health Organization, No. 2. International Health Conference. Signed on July 22, 1946, New York, NY.

World Health Organization [WHO]. (2012). Comprehensive Mental Health Action Plan 2013-2020. WHO.

World Health Organization [WHO]. (2022). International Classification of Diseases [ICD-11] (11th Edition). Ginebra, Switzerland: WHO.