Presentation on Poster

Although there is agreement on what ‘stigma’ is (a mark of disgrace or discredit that sets a person aside from others), definitions differ in the breadth of experiences they describe. Stigma, by definition, is a mark of disgrace or shame (Anon, 2007). It is the negative effect of a label (Hayward & Bright, 1997). For Corrigan & Penn (1999), stigma is another term for prejudice based on negative stereotyping

Stigma can have a bad impact on clients with long term mental illness and their families that they might feel ashamed, particularly when the illness produces behavior which is out of the ordinary and so obvious for others to see for example, talking to oneself. In view of this, stigma has a fatal effect on all aspects of the clients live as well as their families such they become reluctant to seek help, do not comply with the treatment. In addition it also forms a real barrier to optimal recovery, it causes distress, discrimination in housing, education and employment, economics burdens, increased feelings of hopelessness and low self esteem and confidence that leads to suicidal behavior. Family members may also feel lonely, have less social interactions with others in the community due to being ashamed and total social rejection, distress and violations of humans. In the ends, this leads to social exclusion (Sticley, 2005)

Stigma can be prevent and be reduce by thinking the positive image by:
1. Health promotion – talks workshop, seminars, advertisement, posters, post cards or letters (Herrman, 2001)
2. Laws and Policy of Mental Health Nursing needs to be enforces and improve in order for the clients to have a better access to Mental Health Services (Funk et al, 2004)
3. Involving government and non government organizations – conducting a seminar to convey correct information’s about Mental Health Illness to the public (Sticley, 2005)
4. Changing and improve attitudes of the Health care Professionals – increase the professional self-understanding about mental illness (Sadavoy et al, 2004)
5. Developing a new and appropriate of Mental Health Hospital – provides an excellent opportunity to clients who will use the service provided, valuing them and their carers (Wildgoose et al, 2005)

Seminar at IPA about Cognetive Behaviour Theraphy

What is CBT?
It is a way of talking about:
How you think about yourself, the world and other people
How what you do affects your thoughts and feelings.

CBT can help you to change how you think ("Cognitive") and what you do ("Behaviour)". These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the "here and now" problems and difficulties. Instead of focussing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

It has been found to be helpful in:
Anxiety
Depression
Panic
Agoraphobia and other phobias
Social phobia
Bulimia
Obsessive compulsive disorder
Post traumatic stress disorder
Schizophrenia

How does it work?
CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are:

A Situation - a problem, event or difficult situationFrom this can follow:
Thoughts
Emotions
Physical feelings
Actions

Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. It can also alter what you do about it.

What does CBT involve?

The sessions

CBT can be done individually or with a group of people. It can also be done from a self-help book or computer programme. In England and Wales two computer-based programmes have been approved for use by the NHS. Fear Fighter is for people with phobias or panic attacks, Beating the Blues is forpeople with mild to moderate depression.

If you have individual therapy:
-You will usually meet with a therapist for between 5 and 20, weekly, or fortnightly, sessions. Each session will last between 30 and 60 minutes.

-In the first 2-4 sessions, the therapist will check that you can use this sort of treatment and you will check that you feel comfortable with it.

-The therapist will also ask you questions about your past life and background. Although CBT concentrates on the here and now, at times you may need to talk about the past to understand how it is affecting you now.

-You decide what you want to deal with in the short, medium and long term.

-You and the therapist will usually start by agreeing on what to discuss that day.

The Work
-With the therapist, you break each problem down into its separate parts, as in the example above. To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.

-Together you will look at your thoughts, feelings and behaviours to work out:- if they are unrealistic or unhelpful- how they affect each other, and you.

-The therapist will then help you to work out how to change unhelpful thoughts and behaviours

-It's easy to talk about doing something, much harder to actually do it. So, after you have identified what you can change, your therapist will recommend "homework" - you practise these changes in your everyday life. Depending on the situation, you might start to:

-Question a self-critical or upsetting thought and replace it with a positive (and more realistic) one that you have developed in CBT

-recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.

-At each meeting you discuss how you've got on since the last session. Your therapist can help with suggestions if any of the tasks seem too hard or don't seem to be helping.

-They will not ask you to do things you don't want to do - you decide the pace of the treatment and what you will and won't try. The strength of CBT is that you can continue to practise and develop your skills even after the sessions have finished. This makes it less likely that your symptoms or problems will return.

How effective is CBT?
It is one of the most effective treatments for conditions where anxiety or depression is the main problem
It is the most effective psychological treatment for moderate and severe depression
It is as effective as antidepressants for many types of depression

What other treatments are there and how do they compare?
CBT is used in many conditions, so it isn't possible to list them all in this leaflet. We will look at alternatives to the most common problems - anxiety and depression.

CBT isn't for everyone and another type of talking treatment may work better for you.
CBT is as effective as antidepressants for many forms of depression. It may be slightly more effective than antidepressants in treating anxiety.

For severe depression, CBT should be used with antidepressant medication. When you are very low you may find it hard to change the way you think until antidepressants have started to make you feel better.
Tranquillisers should not be used as a long term treatment for anxiety. CBT is a better option.

Problems with CBT:
If you are feeling low and are having difficulty concentrating, it can be hard, at first, to get the hang of CBT - or, indeed, any psychotherapy

This may make you feel disappointed or overwhelmed. A good therapist will pace your sessions so you can cope with the work you are trying to do
It can sometimes be difficult to talk about feelings of depression, anxiety, shame or anger

How long will the treatment last?
A course may be from 6 weeks to 6 months. It will depend on the type of problem and how it is working for you. The availability of CBT varies between different areas and there may be a waiting list for treatment.

What if the symptoms come back?
There is always a risk that the anxiety or depression will return.If they do, your CBT skills should make it easier for you to control them. So, it is important to keep practising your CBT skills, even after you are feeling better.There is some research that suggests CBT may be better than antidepressants at preventing depression coming back. If necessary, you can have a "refresher" course.

So what impact would CBT have on my life?
Depression and anxiety are unpleasant. They can seriously affect your ability to work and enjoy life. CBT can help you to control the symptoms. It is unlikely to have a negative effect on your life, apart from the time you need to give up to do it.

Fairwell party for Sir Derek Hayes

visited to Narcotics Control Bureau

In 1988 the Narcotics Control Bureau (NCB) was established as a Government department under the Prime Minister's Office. It was aimed specifically at taking over the responsibilities of enforcing relevant drug laws in Brunei Darussalam, as well as activities in preventive drug education, which had until then been overseen by the Ministry of Education.

Mission: To support and promote awareness on the national policy on the abuse of drugs and intoxicating substances. To create a community free from the problems of misuse of drugs.

Function: Being the lead agency in enforcing the relevant laws pertaining to the eradication of abuse of drugs and intoxicating substances; to provide support services in demand reduction through Preventive Drug Education and Aftercare Services and serve as the main agency in coordinating all matters pertaining to the eradication of the abuse of drugs and intoxicating substances.

Current Illicit Drugs Situation

The extent of the drug problem in Brunei Darussalam is reflected only by indicator data, as there are no available national estimates of the number of drug abusers in the country. 64 clients were treated for substance abuse in 2003, while 94 drug seizures and 701 arrests for drug law violations were reported. By 2004, the number of illicit drug seizures had increased to 113, whereas the number of arrests had gone down significantly to 266. In 1990, the primary abuse problems were related to over-the-counter drugs. However, according to recent data, nearly 95% of recent seizures and arrests made relates to methamphetamine.

Based upon 2003 and 2004 law enforcement data, methamphetamine is the dominant illicit drug being abused and seized in Brunei Darussalam, and at present crystal form methamphetamine is reportedly the only type of methamphetamine available in the country. In 2005, the ranking of illicit drugs most often abused, cannabis comes second to methamphetamine followed by nimetazepam and ketamine.


Methamphetamine and cannabis are predominantly administered by smoking, while nimetazepam and ketamine are consumed orally. There have been reports of limited occurrences of methamphetamine injection among some abusers. There are no estimates of the Injecting Drug User (IDU) population or the percent of IDUs estimated to be infected with HIV.

Legislation for Illicit Drugs Control

The main legislation for narcotics control in Brunei Darussalam is the Misuse of Drugs Act (MDA) Chapter 27, which on several occasions has been amended and revised. This legal instrument covers all illicit drug offenses and provides sentencing guidelines. The law specifies the amount and type of drugs that fall under its provisions and includes death as punishment for the trafficking of illegal narcotics. Section 15 of the MDA states that individuals caught in possession of certain amounts of illegal substances are presumed to be trafficking.
The Drug Trafficking Recovery Act of 1996 also provides legislation to recover profits of narcotics trafficking, while the Criminal Conduct Order of 2000 provides law enforcement with greater leeway to recover proceeds of illegal conduct and assist in the implementation of overseas forfeitures.

National Efforts and Activities

The Narcotics Control Bureau (NCB) enforces the drug laws. In addition, NCB is responsible for the Preventive Drug Education activities and the Preventive Drug Education and Aftercare Services. The promotion of public awareness policies to create a community free from drug abuse problems are a central objective of national initiatives.

The Preventive Drug Education Program, along with the Anti Drug Forum, has increased communication between local community leaders and government agencies. Also, the educational community has increased their anti-drug curriculum for greater impact on youth. Additionally, the media has been used across the country to promote drug abuse prevention.

International Cooperation

Brunei Darussalam acceded to the UN 1961 Single Convention on Narcotic Drugs, the UN 1961 Protocol Amending the Single Convention on Narcotic Drugs, and the UN 1971 Convention on Psychotropic Substances in 1987. In 1993, the UN 1988 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances was ratified. Brunei Darussalam is an active ACCORD partner country. NCB also participates in relevant bilateral and regional drug control forums.