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PSYCHIATRY

Note: consult the glossary for explanation of terms.

Psychiatrically disturbed persons (the mentally ill) are disproportionately represented amongst the homeless and handicapped for many reasons, including:

• Lack of financial resources for quality accommodation.
• Lack of discernment in selecting appropriate accommodation.
• Incapacity (due to apathy, mental and physical inertia, loss of insight) to care for or maintain the accommodation provided.
• Frequent changes of accommodation (often due to an itinerant lifestyle bound up with chronic restlessness and a yearning for unattainable personal fulfilment).
• Exploitation by unscrupulous landlords or proprietors/managers.

In mental illness there is impairment of normal mental functioning. A spectrum of disorders is seen, ranging from milder forms of anxiety disorders to the major psychoses. Features of more than one disorder may be present at the one time. For example, a schizophrenic person may have depressive symptoms, and a depressed person may be anxious.

The main groups of psychiatric disorders are:

• Anxiety disorders. Where anxiety is inappropriate to the situation or manifests as an abnormal behaviour.
• Mood disorders. In clinical depression the person becomes persistently and excessively lowered in mood. In mania, the mood is abnormally elevated. Behaviour is similarly affected.
• The psychotic disorders. Psychosis is characterised by marked loss of contact with reality, and manifests as disorder of mood, thought processes, and/or behaviour. Severe schizophrenia may appear in a psychotic form. Psychosis can have many causes and can be either acute (short term) or chronic (long term).
• Confusion. This is characterised by acute loss of awareness of place, time and people, including possibly one's own identity. Severity fluctuates from hour to hour.
• Dementia. The permanent loss of all higher mental functions such as personality, memory and judgment. Chronic brain damage and Alzheimer's disease are synonymous.
• Personality disorders. These are disorders with persistently abnormal behaviour and which do not fit into any of the above categories. Although not mentally ill, sufferers often come under the care of psychiatrists.

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