Mental Conditions in Adult Women: Epidemiology and Impact

Thinking about the impact of illness has evolved over the past 50 years to encompass both the physiology of disease and the personal experience of illness. The signs and symptoms evident in bodily structures and functions (impairment) have become disentangled from the personal impact and understanding of them (disability), and their social consequences (handicap; Susser and Watson 1961; World Health Organization (WHO) 1980). More recently, political and social movements have begun to pose the idea that outcomes of care should move beyond well-being and personal satisfaction to include the many aspects of actual participation. In their view, it is essential that public health and social policy and practice support disabled individuals to achieve and sustain practical opportunities or “capabilities” in multiple and valued areas of their lives. In the public mental health arena, the President’s New Freedom Commission envisions recovery as the process by which people are able to “live, work, learn and participate fully in their communities” (Hogan 2003, p. 1467). This vision takes the idea of disease beyond its clinical dimensions (WHO 2001), making it essential that public mental health practitioners, policy makers, and advocates understand the extent and distribution of both disability and disorder in order to develop policies and practices that contribute to people’s activity and ability to participate in society throughout their lives.