Welcome back. We're now continuing our discussion of mental health. I want to orient us a little bit or go back in time and talk a little bit more about the public health model. Now, typically when we talk about public health and what it is that we do, we do things a little bit differently from the medical model. So if we think about illness and disease on a spectrum, we've got wellness and the green area and illness of the red. We think about medicine or the medical model of treatment as typically intervening here, where we're getting the first signs of disease development either through our screening programs or whatnot and we then start to try to treat or prevent via secondary prevention a little bit later on in the disease process. But the public health model frequently seeks to intervene here where we're optimizing state of wellness and we're doing things like initiating public health campaigns via things like education or prevention strategies, where we're trying to empower the public, is the best way to maintain a state of wellness? So as a result, we have all kinds of public health campaigns about hand washing and hygiene and nutrition and really trying to educate and have people not do things that will cause it to them and say, please don't smoke, please do wash your hands, please don't spit, that spreads disease. Again, we're talking about educating and trying to optimize that state of wellness. Okay? Right. Now we think about this with respect to mental health. We don't really have any vaccines and we don't have many public service announcements saying, hey, here's what you can do to optimize your mental health. In fact, we don't really get much information at all about not only treatment but prevention, which is, as we just discussed, a little bit concerning to me, very concerning, especially when we consider that mental illnesses are likely the most prevalent both for [inaudible] and in terms of lifetime experiences and this is a chronic disease. So now here we are. We've gotten very prevalent. Not a whole lot of education around it. We're not really sure if we get any information about how to prevent or how to optimize a state of wellness. So what is public health have to do with mental-health? How can we possibly translate these? This is the question that's left asking. Okay. Maybe we can get some clues when we think about what we know about what causes mental illness. As we talked about before we don't really know perfectly, we don't have the perfect recipe for what causes mental illness, but we do know about certain risk factors and in terms of risk factors, a lot of these tend to be behavioral factors that could give us some clues about where to intervene. So what might these environmental factors have any ideas about stuff that. I think of where some types of mental illness, there's such isolation you can think of. So maybe poor social support, not having those around you. Okay. It's a great idea I'm told. Yeah. Agreed. Okay. Any other? Traumatic experience. Excellent. Okay. Yeah. Very absolutely. So I've tried to put some of these ideas into a models. Let's just say we've got Jane. Happy Jane. There she is. We put Jane in this situation where potentially some stressors or things going on. So we've got sleep deprivation, maybe working a little bit too hard, got some stress, maybe some financial strain is also known to be an etiologic risk factor for the development of mental illness. Chronic stress, be it occupation, social, academic, poor nutrition, also a known risk factor for the development of mental disorders, alcohol and other substance abuse. Any other risk factor? Social isolation, not engaging in pleasurable activities or getting access to enjoyment in life. Then there are also certain kinds of styles of thinking, things like pessimistic attitudes or certain kinds of styles of self-talk that we know are in the etiologic process. So in other words, we've got says look fed of familiar of socialized. Let us say it looks all too familiar a little bit. Maybe you can grad school. Yeah. Yeah. So these are the things that we actually know are almost normative among students. Sometimes this thoughts you're talking about is that something that you see an individual for his or her life or is that something that can develop over time and then subsequently confer risk for types of mental illness? In terms of optimism and pessimism? Yeah. Types of things, it's like a combination of both. Yeah. Okay. The thing about the thought patterns and this is something that I'll actually elaborate more a little bit when I talk about the treatments is that these kinds of thought patterns are in fact modifiable. So a lot of the treatments that we know to be the most effective are those that can actually intervene at the level of these thoughts and teach people have more adaptive, healthier mode and style of basically conversing with themselves. You can think about thoughts as being a conversation one is having with themselves. I'm always like stealing the punchline on that, but I'm going to describe those in greater detail but the answer is both. But the treatments work very well by teaching people healthier thought patterns. Very interesting. Yeah.