Psychiatria
Zapobieganie i profilaktyka
Psychiatria prewencyjna koncentruje się na zapobieganiu zaburzeniom psychicznym poprzez identyfikację czynników ryzyka i ochronnych oraz wdrażanie interwencji opartych na dowodach naukowych, obejmując profilaktykę pierwotną, wtórną i trzeciorzędową. Profilaktyka pierwotna ma na celu zmniejszenie zapadalności na zaburzenia psychiczne poprzez wzmacnianie zdolności radzenia sobie i redukcję stresorów, dzieląc się na profilaktykę uniwersalną (dla całej populacji), selektywną (dla grup podwyższonego ryzyka) oraz wskazującą (dla osób z wczesnymi objawami). Profilaktyka wtórna skupia się na wczesnym rozpoznaniu i leczeniu, aby skrócić czas trwania i nasilenie choroby, natomiast profilaktyka trzeciorzędowa ma na celu rehabilitację i zapobieganie nawrotom u osób z rozpoznanymi zaburzeniami. Kluczowe jest także uwzględnienie krytycznych okresów rozwojowych, zwłaszcza dzieciństwa i młodości, gdzie 50% zaburzeń zaczyna się do 14 roku życia, a 75% do 24 roku życia, co podkreśla znaczenie wczesnej interwencji i profilaktyki w tych grupach wiekowych.
- Wprowadzenie do psychiatrii prewencyjnej
- Poziomy profilaktyki w psychiatrii
- Grupy docelowe i skuteczne strategie prewencyjne
- Podejście wielodyscyplinarne i transdiagnostyczne
- Edukacja i profilaktyka w psychiatrii
- Skuteczność działań profilaktycznych w psychiatrii
- Profilaktyka konkretnych zaburzeń psychicznych
- Zapobieganie depresji i zaburzeniom lękowym
- Profilaktyka samobójstw
- Profilaktyka zaburzeń psychotycznych
- Wyzwania i perspektywy w psychiatrii prewencyjnej
Wprowadzenie do psychiatrii prewencyjnej
Psychiatria prewencyjna to dziedzina psychiatrii skupiająca się na zapobieganiu zaburzeniom psychicznym poprzez identyfikację czynników ryzyka i czynników ochronnych oraz wdrażanie interwencji opartych na dowodach naukowych. Profilaktyka w psychiatrii zyskała w ostatnich latach na znaczeniu, szczególnie w kontekście poprawy zdrowia psychicznego młodych ludzi.1 Koncepcja ta ewoluowała na przestrzeni ostatnich dekad i obejmuje szeroki zakres strategii i celów w ramach prewencji pierwotnej, wtórnej i trzeciowej.2
Światowa Organizacja Zdrowia (WHO) promuje podejście zdrowia publicznego, które kładzie nacisk na profilaktykę pierwotną jako uzupełnienie leczenia i usług zdrowia psychicznego. Podejście to koncentruje się na podstawowych przyczynach dystresu psychicznego, mając na celu promowanie dobrostanu i zapobieganie problemom zdrowia psychicznego, zanim się rozwiną lub pogorszą.3 Badania wykazały, że możemy poprawić ogólny stan zdrowia psychicznego, jeśli będziemy działać zbiorowo na wszystkich poziomach, aby zmniejszyć czynniki ryzyka i promować czynniki ochronne.4
Granice między prewencją a leczeniem
Różnice między profilaktyką, leczeniem i opieką nie zawsze są wyraźne, a ich granice są często nieostre.5 Niedawno zdrowie psychiczne i choroba psychiczna zostały przemodelowane jako kontinuum od zdrowia do choroby, poprzez etapy bycia bezobjawowym w grupie ryzyka, doświadczania dystresu psychicznego, objawów podsyndromalnych, aż po pełnoobjawowe zaburzenia psychiczne. Ta nowa konceptualizacja podkreśliła znaczenie promocji zdrowia psychicznego i interwencji profilaktycznych.6
Warto zauważyć, że interwencje psychologiczne lub psychospołeczne są często stosowane zarówno jako skuteczne metody leczenia dla osób z zdiagnozowanymi zaburzeniami, jak i jako działania profilaktyczne dla grup ryzyka.7 Ta dwojaka rola podkreśla płynną granicę między prewencją a leczeniem w psychiatrii.
Poziomy profilaktyki w psychiatrii
W 1964 roku psychiatra Gerald Caplan opisał poziomy profilaktyki specyficzne dla psychiatrii, które stały się fundamentem współczesnego podejścia do prewencji w zdrowiu psychicznym.8
Profilaktyka pierwotna
Profilaktyka pierwotna ma na celu zmniejszenie zapadalności na zaburzenia psychiczne poprzez identyfikację czynników ryzyka i ochronnych oraz wdrażanie interwencji opartych na dowodach naukowych.9 Skupia się na zapobieganiu wystąpieniu zaburzeń psychicznych poprzez wzmacnianie indywidualnych, rodzinnych i grupowych zdolności radzenia sobie.10
Główne cele profilaktyki pierwotnej obejmują:1112
- Zmniejszenie zapadalności na zaburzenia psychiczne w populacji
- Wspieranie jednostek w zwiększaniu ich zdolności do skutecznego radzenia sobie ze stresem
- Ukierunkowanie na i zmniejszanie szkodliwych czynników (stresorów) w środowisku
Profilaktyka pierwotna została dalej podzielona na trzy kategorie:1314
Profilaktyka uniwersalna – skierowana do ogólnej populacji, która nie wykazuje zwiększonego ryzyka rozwoju zaburzenia psychicznego, na przykład programy szkolne lub kampanie w mediach.15 Uniwersalne podejścia do zdrowia publicznego ukierunkowane na klimat szkolny lub determinanty społeczne (demograficzne, ekonomiczne, sąsiedzkie, środowiskowe, społeczne/kulturowe) zaburzeń psychicznych mają największy potencjał zmniejszenia profilu ryzyka całej populacji.16
Profilaktyka selektywna – koncentruje się na osobach lub grupach, które są bardziej narażone na rozwój zaburzeń psychicznych, ze względu na cechy wrodzone lub doświadczenia życiowe.17 Interwencje te mają na celu zapobieganie manifestacji objawów psychiatrycznych, zmieniając tym samym ścieżkę rozwojową prowadzącą do pełnoobjawowych zaburzeń w stanie przedchorobowym.18
Profilaktyka wskazująca – ukierunkowana na osoby, u których zidentyfikowano wczesne oznaki lub objawy mogące poprzedzać pełne zaburzenie psychiczne.19 Interwencje wskazujące mają na celu identyfikację osób z wysokim ryzykiem klinicznym rozwoju zaburzenia psychicznego, które są funkcjonalnie upośledzone i nie są już bezobjawowe.20
Profilaktyka wtórna
Profilaktyka wtórna koncentruje się na wczesnym rozpoznaniu i leczeniu objawów zaburzeń psychicznych, aby zmniejszyć czas trwania choroby i jej nasilenie.21 Jest realizowana poprzez wczesną identyfikację problemów i szybkie wdrożenie skutecznego leczenia.22
Podobnie jak w innych sektorach opieki zdrowotnej, zdrowie psychiczne przesunęło się w kierunku profilaktyki wtórnej, z wysiłkiem na rzecz wykrywania i leczenia zaburzeń psychicznych jak najwcześniej.23 Strategie wtórnej profilaktyki i usługi wczesnej interwencji mają na celu złagodzenie negatywnych czynników prognostycznych, takich jak długi czas nieleczonej choroby, słaba odpowiedź na leczenie, złe psychospołeczne samopoczucie i funkcjonowanie.24
Kluczowe elementy profilaktyki wtórnej obejmują:25
- Wczesną diagnozę i wyszukiwanie przypadków: Można to osiągnąć poprzez edukację społeczeństwa i liderów społeczności w zakresie rozpoznawania wczesnych objawów chorób psychicznych
- Szybkie i skuteczne interwencje mające na celu przywrócenie funkcjonowania przedchorobowego
- Skierowanie do specjalistycznej opieki w przypadku wykrycia objawów
Profilaktyka trzeciorzędowa
Profilaktyka trzeciorzędowa jest ukierunkowana na osoby z chorobami psychicznymi i pomaga zmniejszyć nasilenie, dyskomfort i niepełnosprawność związaną z ich chorobą.26 Jej głównym celem jest rehabilitacja i zapobieganie nawrotom.27
Główne cele profilaktyki trzeciorzędowej to:28
- Zmniejszenie trwałych deficytów związanych z ciężkimi i przewlekłymi chorobami psychicznymi
- Zapobieganie powikłaniom choroby
- Promowanie rehabilitacji ukierunkowanej na osiągnięcie maksymalnego poziomu funkcjonowania każdej osoby
Rehabilitacja jest procesem umożliwiającym osobie powrót do najwyższego możliwego poziomu funkcjonowania.29 Zwiększanie niezależności jest pierwszym krokiem w procesie rehabilitacji. Podstawowym celem jest poprawa możliwości i kompetencji pacjentów z problemami psychiatrycznymi.30
Skuteczna rehabilitacja powinna obejmować:31
- Maksymalne wykorzystanie pozostałych zdolności
- Aktywny udział pacjenta
- Rozwój umiejętności i środowisko terapeutyczne jako podstawowe interwencje
Grupy docelowe i skuteczne strategie prewencyjne
Dzieci i młodzież
Dzieciństwo i okres dojrzewania to krytyczne etapy życia dla zdrowia psychicznego.32 Około 50% wszystkich zaburzeń psychicznych występujących w ciągu życia zaczyna się do 14 roku życia, a 75% do 24 roku życia.33 Informacje te podkreślają znaczenie wczesnej interwencji i profilaktyki w tych grupach wiekowych.
Skuteczne strategie profilaktyczne dla dzieci i młodzieży obejmują:34
- Polityki i przepisy promujące i chroniące zdrowie psychiczne
- Wspieranie opiekunów w zapewnianiu troskliwej opieki
- Wdrażanie programów szkolnych
- Poprawę jakości środowisk społecznych i online
Badania wykazały, że interwencje wczesnego dzieciństwa mogą zapobiegać lub łagodzić skutki zaburzeń psychicznych.35 Badania z całego kraju wielokrotnie dowodzą, że jesteśmy w stanie zapobiegać lub łagodzić skutki chorób psychicznych i umożliwić ludziom prowadzenie satysfakcjonującego, produktywnego życia w społeczności.36
Osoby z grup wysokiego ryzyka
Interwencje selektywne są skierowane do osób lub grup z wyższym ryzykiem rozwoju zaburzeń psychicznych. Obejmują one:37
- Grupy wsparcia dla osób z historią chorób psychicznych w rodzinie
- Programy wczesnej interwencji dla młodzieży wykazującej oznaki psychozy
- Terapię poznawczo-behawioralną dla osób doświadczających łagodnych objawów lęku
Selektywne badania przesiewowe i interwencje psychologiczne/psychoedukacyjne w wrażliwych podgrupach mogą poprawić objawy lęku/depresji, ale ich skuteczność w zmniejszaniu częstości występowania zaburzeń psychotycznych/dwubiegunowych/powszechnych zaburzeń psychicznych nie została udowodniona.38
Istnieją jednak dowody na skuteczność terapii poznawczo-behawioralnej (CBT) u osób z grupy ryzyka. Stosowanie CBT znacząco zmniejszyło liczbę epizodów uogólnionego zaburzenia lękowego i innych objawów lękowych, a także znacząco poprawiło styl wyjaśniający, poczucie beznadziejności i dysfunkcyjne postawy.39 W 2014 roku brytyjski Narodowy Instytut Doskonałości w Opiece Zdrowotnej i Klinicznej (NICE) zalecił profilaktyczną CBT dla osób z ryzykiem psychozy.40
Miejsce pracy i zdrowie publiczne
Profilaktyka psychiatryczna odgrywa ważną rolę w zarządzaniu stresem w miejscu pracy, pomaganiu ludziom w powrocie do pracy po chorobie i zapobieganiu problemom zdrowotnym związanym z pracą, szczególnie wśród najbardziej wrażliwych.41
Z 60% dorosłych będących w sile roboczej i dobrymi dowodami na efektywność kosztową wielu interwencji w miejscu pracy, argumentacja za rozwiązywaniem problemów zdrowia psychicznego i poprawą dobrostanu w miejscu pracy jest mocna.42 Zintegrowane podejście chroniłoby zdrowie psychiczne poprzez zmniejszenie czynników ryzyka związanych z pracą, promowałoby zdrowie psychiczne poprzez rozwijanie pozytywnych aspektów pracy oraz sił i pozytywnych możliwości pracowników, a także zajmowałoby się problemami zdrowia psychicznego wśród pracujących osób, niezależnie od przyczyny.43
Podejście wielodyscyplinarne i transdiagnostyczne
Dowozy sugerują, że nierealistyczne byłoby uznanie promocji i profilaktyki w zdrowiu psychicznym za odpowiedzialność wyłącznie specjalistów zdrowia psychicznego. Potrzebne są zintegrowane i wielodyscyplinarne usługi, aby zwiększyć zakres możliwych interwencji i ograniczyć ryzyko złych długoterminowych wyników, z potencjalnymi korzyściami również w zakresie kosztów systemu opieki zdrowotnej.44
Aby zagwarantować młodzieży zdrowy rozwój psychiczny poprzez promocję, profilaktykę i wczesne interwencje, dowody naukowe wspierają wdrażanie systemów opieki zdrowotnej integrujących opiekę psychiczną, podstawową i społeczną.45
Istnieje pilna potrzeba opracowania lub ulepszenia, tam gdzie istnieją, modeli opieki zdrowia psychicznego dla młodzieży, które mogą wdrażać strategie profilaktyki i wczesnej interwencji.46 Wymaga to przekrojowego zaangażowania sektorowego i działań międzydyscyplinarnych, a także kompleksowych polityk rządowych mających na celu rozwiązanie problemu profilaktyki zaburzeń psychicznych na poziomie populacyjnym.47
Integracja uniwersalnych i ukierunkowanych ram
Korzystając z wiedzy zdobytej podczas przeglądu, opracowujemy plan przyszłych badań i praktyki profilaktycznej psychiatrii u młodych ludzi: integracja uniwersalnych i ukierunkowanych ram; rozwój wielozmiennej, transdiagnostycznej, wielopunktowej wiedzy epidemiologicznej; synergiczne zapobieganie powszechnym i rzadkim zaburzeniom psychicznym; wspólne zapobieganie obciążeniom zdrowia fizycznego i psychicznego; wdrażanie stratyfikowanej/spersonalizowanej prognozy; ustanowienie interwencji profilaktycznych opartych na dowodach; opracowanie ram etycznych, poprawa profilaktyki poprzez edukację/szkolenie; konsolidacja efektywności kosztowej psychiatrii profilaktycznej; oraz zmniejszanie nierówności.48
Te cele można osiągnąć jedynie poprzez pilną reakcję na poziomie indywidualnym, społecznym i globalnym, która promuje energiczną współpracę między sektorami naukowymi, opieki zdrowotnej, społecznymi i rządowymi w celu wdrożenia psychiatrii profilaktycznej, ponieważ stawka jest wysoka dla młodych ludzi z nowymi zaburzeniami psychicznymi lub zagrożonych nimi.49
Znaczenie determinantów społecznych
Wiele czynników wpływa na nasze zdrowie psychiczne, takich jak nasza osobista historia (nasza rodzina, relacje i to, jak widzimy siebie) oraz nasze okoliczności społeczne (w tym nasze mieszkanie, zatrudnienie i edukacja).50 To nie tylko indywidualne zmiany pomogą nam pozostać w dobrym zdrowiu. Jako społeczeństwo musimy zająć się nierównościami i przyjrzeć się społecznym, ekonomicznym, środowiskowym i innym czynnikom wpływającym na zdrowie psychiczne.51
Komponent zdrowia publicznego w profilaktyce samobójstw powinien skupiać się na systematycznym zmniejszaniu nierówności społecznych poprzez ukierunkowanie na modyfikowalne czynniki ryzyka, takie jak bezrobocie, niekorzystna sytuacja edukacyjna, niekorzystna sytuacja społeczno-ekonomiczna, bezdomność, samotność i słabe powiązania społeczne.52
Promocja zdrowia psychicznego i prewencja koncentrują się na zidentyfikowaniu indywidualnych, społecznych i strukturalnych determinantów zdrowia psychicznego, a następnie interweniowaniu w celu zmniejszenia ryzyka, budowania odporności i tworzenia wspierających środowisk dla zdrowia psychicznego.53
Edukacja i profilaktyka w psychiatrii
Edukacja jest kluczowym elementem skutecznej profilaktyki w psychiatrii. Edukowanie populacji w zakresie zdrowia psychicznego obejmuje zestaw działań edukacyjnych, wychowawczych, agitacyjnych i propagandowych mających na celu promowanie zdrowego stylu życia, zapobieganie chorobom, utrzymanie i wzmocnienie zdrowia, zwiększenie zdolności ludzi do pracy oraz przedłużenie ich aktywnego życia.54
Edukacja psychiatryczna i psychoprofilaktyka
Indywidualna psychoedukacja, edukacja psychiatryczna i psychoprofilaktyka towarzyszą całemu procesowi leczenia osób z zaburzeniami psychicznymi.55 Podczas wizyty ambulatoryjnej wszyscy psychiatrzy, bez wyjątku, muszą prowadzić indywidualne rozmowy na temat profilaktyki chorób psychicznych, podczas których ważne jest wyjaśnienie pacjentom, jaka patologia występuje u pacjenta, jakiego rodzaju leczenie jest wymagane, jakie istnieją środki zapobiegawcze dla zaburzeń psychicznych (psychoprofilaktyka, psychohigiena).56
Edukacja zdrowotna w psychiatrii we wszystkich formach przyczynia się do szerszej profilaktyki medycznej w zakresie rozwoju patologii w sferze psychicznej, a także do poprawy już rozwijających się chorób i zapobiegania nawrotom wyleczonych chorób.5758
Praca sanitarno-edukacyjna
Praca sanitarno-edukacyjna w psychiatrii ma na celu podniesienie poziomu wiedzy ludności na temat zaburzeń psychicznych, opanowanie metod ochrony przed stresem, szkodliwym wpływem złych nawyków.59 Psychoedukacja, edukacja psychiatryczna i psychoprofilaktyka prowadzona przez psychiatrę uczą pacjentów zapewniania sobie możliwych i dostępnych rodzajów działań profilaktycznych, zwiększa skuteczność wykorzystania dostępnych zasobów materialnych i poprawia jakość życia.60 Są to rodzaje interwencji psychologicznych mających na celu osiągnięcie pozytywnych zmian w sferach poznawczych, emocjonalnych i behawioralnych osoby chorej.61
Skuteczność działań profilaktycznych w psychiatrii
Istnieją przekonujące dowody z wysokiej jakości badań, że promocja zdrowia psychicznego i interwencje profilaktyki pierwotnej mogą zmniejszyć ryzyko zaburzeń psychicznych, wzmocnić czynniki ochronne dla dobrego zdrowia psychicznego i fizycznego oraz prowadzić do trwałych pozytywnych efektów w zakresie szeregu wyników społecznych i ekonomicznych.62
Dowody skuteczności
Wytyczne Europejskiego Towarzystwa Psychiatrycznego (EPA) z 2011 r. dotyczące profilaktyki zaburzeń psychicznych stwierdzają: „Istnieją znaczące dowody na to, że różnym schorzeniom psychiatrycznym można zapobiec poprzez wdrożenie skutecznych interwencji opartych na dowodach naukowych”.63
Raport brytyjskiego Departamentu Zdrowia z 2011 r. na temat ekonomicznego uzasadnienia promocji zdrowia psychicznego i profilaktyki chorób psychicznych wykazał, że „wiele interwencji wykazuje wyjątkową wartość za pieniądze, niskie koszty i często stają się samofinansujące z czasem, oszczędzając wydatki publiczne”.64
W przypadku zaburzeń depresyjnych, gdy ludzie uczestniczyli w interwencjach, niektóre badania pokazują, że liczba nowych przypadków jest zmniejszona o 22% do 38%.65 Takie interwencje również oszczędzają koszty.66
Efektywność kosztowa
Modele sugerują, że mniej niż 30% obciążenia zaburzeniami psychicznymi może zostać odwrócone, nawet przy optymalnej opiece i dostępie do usług. Wskazuje to na potrzebę zmniejszenia częstości występowania zaburzeń psychicznych, wykorzystując strategie profilaktyczne oparte na dowodach naukowych i działania polityczne.67
Pierwsze lata życia odgrywają kluczową rolę w determinowaniu zdrowia psychicznego i dobrostanu w późniejszym życiu, a istnieją istotne dowody na skuteczność i opłacalność interwencji ukierunkowanych na rodzicielstwo i dzieciństwo.68 Zapobieganie problemom zdrowia psychicznego na wczesnym etapie życia może zapobiec przyszłym kosztom związanym z przestępczością, brakiem edukacji, bezrobociem oraz niezdrowym i ryzykownym zachowaniom.69
Co istotne, istnieją również dobre dowody pokazujące, że wiele strategii, które można wykorzystać do zapobiegania zaburzeniom zdrowia psychicznego, jest opłacalnych, ponieważ są zwykle niedrogie, ale przynoszą znaczne oszczędności krótko- i długoterminowe.70
Profilaktyka konkretnych zaburzeń psychicznych
Zapobieganie depresji i zaburzeniom lękowym
Istnieją dowody potwierdzające skuteczność programów budowania umiejętności psychologicznych, które wykorzystują techniki wywodzące się z terapii psychologicznych, takich jak CBT, terapia interpersonalna, terapia akceptacji i zaangażowania oraz dialektyczna terapia behawioralna, które mogą pomóc zapobiec depresji i lękowi.71
Grup Zadaniowa ds. Usług Profilaktycznych Stanów Zjednoczonych (USPSTF) przeanalizowała 50 metodologicznie rygorystycznych badań i znalazła dobre dowody na to, że interwencje doradcze (wymienione są dwa: Program Mothers and Babies, interwencja poznawczo-behawioralna; Reach Out, Stand Strong, Essentials for new Mothers (ROSE), interwencja terapii interpersonalnej) są skuteczne w zapobieganiu depresji okołoporodowej wśród osób w ciąży i po porodzie.72
Profilaktyka samobójstw
Zapobieganie samobójstwom jest globalnym priorytetem i zostało uwzględnione w Celach Zrównoważonego Rozwoju.73 Zespół Instytutu Zapobiegania Samobójstwom łączy badaczy, klinicystów, edukatorów, decydentów, ludzi wiary, osoby z marginalizowanych społeczności oraz doradców z doświadczeniem życiowym, aby szybko wdrożyć skalowalne interwencje profilaktyki pierwotnej, wtórnej i trzeciorzędowej w zakresie samobójstw oparte na dowodach naukowych.74
Uniwersalny dostęp do terminowej, skoordynowanej, wysokiej jakości opieki w zakresie zdrowia psychicznego jest kluczowym elementem zapobiegania samobójstwom, szczególnie dla osób z poważnymi chorobami psychicznymi i zaburzeniami używania substancji. Dostęp do całodobowej opieki kryzysowej jest jednym z najważniejszych aspektów świadczenia usług w zakresie zdrowia psychicznego w zapobieganiu samobójstwom.75
Impulsywność samobójstwa stwarza możliwości zmniejszenia ryzyka poprzez ograniczenie dostępu do śmiertelnych środków i umożliwienie czasu na ustąpienie myśli samobójczych.76 Skoordynowana, asertywna opieka następcza odgrywa ważną rolę w zapobieganiu samobójstwom po próbie.77
Profilaktyka zaburzeń psychotycznych
Usługi dla osób z Klinicznym Wysokim Ryzykiem Psychozy (CHR-P) zostały przede wszystkim stworzone w celu wspierania młodych ludzi z osłabionymi objawami (profilaktyka wskazująca).78 Te usługi wdrażają liczne inicjatywy profilaktyki zdrowia publicznego i promocji dobrego zdrowia psychicznego, wykraczające poza wskazaną profilaktykę psychozy.79
Usługi CHR-P mogą wpływać na wyniki akademickie/zawodowe, umiejętności poznawcze i jakość życia oraz promować dobre zdrowie psychiczne.80 Poprzez te działania usługi CHR-P mogą wpływać na wiedzę o zdrowiu psychicznym, postawę wobec zaburzeń psychicznych, umiejętności samozarządzania, rodzinę i znaczące relacje, umiejętności społeczne, wyniki akademickie/zawodowe, umiejętności poznawcze, zdrowie fizyczne i jakość życia oraz promować dobre zdrowie psychiczne.81
Wyzwania i perspektywy w psychiatrii prewencyjnej
Przejście od prewencji do wyprzedzania
Uniwersalna prewencja była przedmiotem badań psychiatrycznych przez ostatnie 4 dekady. Wykorzystując podejście zdrowia publicznego, badania wykazały, że łagodzenie głównych czynników ryzyka, takich jak ubóstwo i stres we wczesnym okresie życia, oraz promowanie czynników ochronnych może poprawić wyniki behawioralne.82
Obecnie może nadszedł czas, aby rozważyć przejście od uniwersalnej profilaktyki świadczonej w szerokiej populacji do podejść wyprzedzających. Interwencje wyprzedzające ukierunkowane są na osoby najbardziej zagrożone chorobami psychicznymi oraz na osoby z objawami poddiagnostycznymi, zapewniając to, co wcześniej było określane jako profilaktyka selektywna i wskazująca.83
Podejście wyprzedzające obiecuje zmniejszenie zachorowalności i śmiertelności poprzez wczesną interwencję, przed rozwinięciem się pełnego zespołu, i ponowne dostosowanie trajektorii rozwoju, aby osoba zidentyfikowana jako zagrożona miała największą szansę na osiągnięcie najlepszego wyniku.84
Wyzwania we wdrażaniu
Podejście do promocji dobrego zdrowia psychicznego jest obecnie fragmentaryczne.85 Istnieje pilna potrzeba zidentyfikowania działań niezbędnych do osiągnięcia ogólnych celów w profilaktyce zdrowia psychicznego.86
Musimy połączyć kropki i opracować systemowe podejście oparte na dowodach, jeśli mamy osiągnąć postęp w tym kierunku.87 Skuteczna profilaktyka powinna być kierowana dostępnymi dowodami, a zaburzenia psychiczne mają wiele determinantów.88 W związku z tym strategia profilaktyczna powinna uwzględniać te wielorakie przyczyny i ich interakcje.89
Najlepsze praktyki interwencyjne zidentyfikowane w przeglądach osiągnęły sukces w różnorodnych krajach i kontekstach. Jednak niewiele z nich zostało rozszerzone na poziom krajowy. Dlatego też dowody na wykonalność ich skutecznego i zrównoważonego wdrażania muszą zostać wzmocnione.90
Ramy etyczne i zmniejszanie nierówności
Ochrona praw człowieka jest główną strategią zapobiegania zaburzeniom psychicznym.91 Psychiatria profilaktyczna może łagodzić negatywne stereotypy dotyczące specjalistów, które podważają zaufanie społeczne do nowoczesnej specjalistycznej wiedzy psychiatrycznej i interwencji opartych na dowodach naukowych.92
Skuteczna profilaktyka może przyczynić się do zmniejszenia stygmatyzacji, dyskryminacji i naruszeń praw człowieka związanych z zaburzeniami psychicznymi.93 Skuteczne programy mogą zmniejszyć ryzyko zaburzeń psychicznych.94 Skuteczne programy i polityki powinny być szeroko dostępne.95
Fundamentalna zmiana jest potrzebna w sposobie postrzegania usług zdrowotnych. Profilaktyka powinna być prowadzona zgodnie z dostępnymi dowodami.96 Potrzebna jest pilna reakcja na poziomie indywidualnym, społecznym i globalnym, aby zmniejszyć częstość występowania i obciążenie zaburzeniami psychicznymi u młodych ludzi.97
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Materiały źródłowe
- #1 Preventive psychiatry: a blueprint for improving the mental health of young peoplehttps://pmc.ncbi.nlm.nih.gov/articles/PMC8129854/
Preventive approaches have latterly gained traction for improving mental health in young people. […] We then review the evidence supporting primary prevention of psychotic, bipolar and common mental disorders and promotion of good mental health as potential transformative strategies to reduce the incidence of these disorders in young people. […] Selective screening and psychological/psychoeducational interventions in vulnerable subgroups may improve anxiety/depressive symptoms, but their efficacy in reducing the incidence of psychotic/bipolar/common mental disorders is unproven. […] Universal public health approaches targeting school climate or social determinants (demographic, economic, neighbourhood, environmental, social/cultural) of mental disorders hold the greatest potential for reducing the risk profile of the population as a whole.
- #2https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
Preventive psychiatry aims at the reduction of mental disorders and behavioural problems by identifying risk and protective factors and applying evidence-based interventions in the framework of primary, secondary and tertiary prevention. […] The concept of prevention in psychiatry has evolved over the last few decades and covers a wide range of strategies and objectives for primary, secondary, and tertiary prevention. […] Promotion of mental health and wellness is a related concept. The distinction between mental health promotion and mental disorder prevention lies in their targeted outcomes. […] However, differences between prevention, treatment, and care are not always clear, and its boundaries are less defined. […] There is an urgent need to identify the action required to accomplish overall goals in mental health prevention.
- #3 About Mental Health | Mental Health | CDChttps://www.cdc.gov/mental-health/about/index.html
CDC promotes a public health approach to prevent mental health conditions before they develop or worsen. […] Public health uses a strategy that places emphasis on primary prevention to complement treatment and mental health services. Public health focuses on the underlying causes of mental distress, aiming to promote well-being and prevent mental health conditions before they develop or worsen. […] However, studies have shown we can improve overall mental health if we work collectively at all levels to reduce risk factors while promoting protective factors. In addition, preventing risk factors and promoting protective factors are especially impactful for mental and physical health during critical developmental stages, such as in childhood and adolescence. […] Some mental health conditions can also be prevented.
- #4 About Mental Health | Mental Health | CDChttps://www.cdc.gov/mental-health/about/index.html
CDC promotes a public health approach to prevent mental health conditions before they develop or worsen. […] Public health uses a strategy that places emphasis on primary prevention to complement treatment and mental health services. Public health focuses on the underlying causes of mental distress, aiming to promote well-being and prevent mental health conditions before they develop or worsen. […] However, studies have shown we can improve overall mental health if we work collectively at all levels to reduce risk factors while promoting protective factors. In addition, preventing risk factors and promoting protective factors are especially impactful for mental and physical health during critical developmental stages, such as in childhood and adolescence. […] Some mental health conditions can also be prevented.
- #5https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
Preventive psychiatry aims at the reduction of mental disorders and behavioural problems by identifying risk and protective factors and applying evidence-based interventions in the framework of primary, secondary and tertiary prevention. […] The concept of prevention in psychiatry has evolved over the last few decades and covers a wide range of strategies and objectives for primary, secondary, and tertiary prevention. […] Promotion of mental health and wellness is a related concept. The distinction between mental health promotion and mental disorder prevention lies in their targeted outcomes. […] However, differences between prevention, treatment, and care are not always clear, and its boundaries are less defined. […] There is an urgent need to identify the action required to accomplish overall goals in mental health prevention.
- #6 Promotion, prevention and treatment interventions for mental health in low- and middle-income countries through a task-shifting approach | Epidemiology and Psychiatric Sciences | Cambridge Corehttps://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/promotion-prevention-and-treatment-interventions-for-mental-health-in-low-and-middleincome-countries-through-a-taskshifting-approach/55951A79185D86284E263328481C134D
Recently, mental health and ill health have been reframed to be seen as a continuum from health to ill health, through the stages of being asymptomatic at risk, to experiencing mental distress, sub-syndromal symptoms and finally mental disorders. This new conceptualisation emphasised the importance of mental health promotion and prevention interventions, aimed at reducing the likelihood of future disorders with the general population or with people who are identified as being at risk of a disorder. […] This concept generated discussion on the distinction between prevention and treatment interventions, especially for those mental health conditions which lie between psychological distress and a formal psychiatric diagnosis. […] This new conceptualisation emphasised the importance of mental health promotion and prevention interventions, aimed at reducing the likelihood of future disorders with the general population or with people who are identified as being at risk of a disorder.
- #7 Promotion, prevention and treatment interventions for mental health in low- and middle-income countries through a task-shifting approach | Epidemiology and Psychiatric Sciences | Cambridge Corehttps://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/promotion-prevention-and-treatment-interventions-for-mental-health-in-low-and-middleincome-countries-through-a-taskshifting-approach/55951A79185D86284E263328481C134D
Indicated prevention includes strategies that are targeted to individuals who are identified (or individually screened) as having detectable signs or symptoms which can foreshadow, precede and may sometimes if left unaddressed lead to a full diagnosable mental disorder based on an individual assessment. […] Treatment interventions are delivered to people who have a diagnosed mental disorder. However, sometimes, these treatment interventions, particularly psychological or psychosocial interventions, are also considered as effective treatments for those population groups that may receive indicated prevention interventions in the category above.
- #8 Preventive psychiatric | PPThttps://www.slideshare.net/slideshow/preventive-psychiatric-237971831/237971831
Preventive psychiatry is the prevention of mental illness through primary, secondary and tertiary prevention. […] In 1964 psychiatrist Gerald Caplan describe levels of prevention specific to psychiatry. He described primary prevention as an efforts directs towards reducing the incidence of mental disorder in a community. Secondary prevention refers to decreasing the duration of disorder while tertiary prevention refers to reducing the level of impairment. […] Primary prevention seeks to prevent the occurrence of mental disorders by strengthening individual, family and group coping abilities. […] Reducing the incidence of mental disorder within the population. […] Assisting individual to increase their ability to cope effectively with stress. Targeting and diminishing harmful forces i.e, stressor within the environment.
- #9https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
Preventive psychiatry aims at the reduction of mental disorders and behavioural problems by identifying risk and protective factors and applying evidence-based interventions in the framework of primary, secondary and tertiary prevention. […] The concept of prevention in psychiatry has evolved over the last few decades and covers a wide range of strategies and objectives for primary, secondary, and tertiary prevention. […] Promotion of mental health and wellness is a related concept. The distinction between mental health promotion and mental disorder prevention lies in their targeted outcomes. […] However, differences between prevention, treatment, and care are not always clear, and its boundaries are less defined. […] There is an urgent need to identify the action required to accomplish overall goals in mental health prevention.
- #10 Preventive psychiatric | PPThttps://www.slideshare.net/slideshow/preventive-psychiatric-237971831/237971831
Preventive psychiatry is the prevention of mental illness through primary, secondary and tertiary prevention. […] In 1964 psychiatrist Gerald Caplan describe levels of prevention specific to psychiatry. He described primary prevention as an efforts directs towards reducing the incidence of mental disorder in a community. Secondary prevention refers to decreasing the duration of disorder while tertiary prevention refers to reducing the level of impairment. […] Primary prevention seeks to prevent the occurrence of mental disorders by strengthening individual, family and group coping abilities. […] Reducing the incidence of mental disorder within the population. […] Assisting individual to increase their ability to cope effectively with stress. Targeting and diminishing harmful forces i.e, stressor within the environment.
- #11 Preventive psychiatric | PPThttps://www.slideshare.net/slideshow/preventive-psychiatric-237971831/237971831
Preventive psychiatry is the prevention of mental illness through primary, secondary and tertiary prevention. […] In 1964 psychiatrist Gerald Caplan describe levels of prevention specific to psychiatry. He described primary prevention as an efforts directs towards reducing the incidence of mental disorder in a community. Secondary prevention refers to decreasing the duration of disorder while tertiary prevention refers to reducing the level of impairment. […] Primary prevention seeks to prevent the occurrence of mental disorders by strengthening individual, family and group coping abilities. […] Reducing the incidence of mental disorder within the population. […] Assisting individual to increase their ability to cope effectively with stress. Targeting and diminishing harmful forces i.e, stressor within the environment.
- #12 Model of prevention in psychiatry | PPThttps://www.slideshare.net/slideshow/model-of-prevention-in-psychiatry/248194794
The main aim of prevention is to keep people healthy or become even healthier and enhancing individual’s ability to achieve psychosocial well being. Prevention focuses on cause or etiology of psychiatric illness to avoid illness. Promotion and prevention are interrelated and overlapped. […] In the 1960s, Psychiatrist Gerald Caplan described levels of prevention specific to psychiatry. He described Primary prevention as an effort directed towards reducing the incidence of mental disorders in a community. Secondary prevention refers to decreasing the duration of disorder while tertiary prevention refers to reducing the level of impairments. […] Primary Prevention Services aimed at reducing the incidence of mental disorders within the population. Primary prevention targets both individuals and the environment. Emphasis is twofold: 1. Assisting individuals to increase their ability to cope effectively with stress. 2. Targeting and diminishing harmful forces (stressors) within the environment.
- #13https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
We need to connect the dots and develop an evidence-based systemic approach if progress is to be realized in this direction. […] Primary prevention aims at reducing the incidence of disease. […] Primary prevention has been further divided into universal, selective, and indicated prevention. […] The protective factors refer to conditions that improve people’s resistance to risk factors and have been defined as those factors that modify, ameliorate, or alter a person’s response to some environmental hazard that predisposes to a maladaptive outcome. […] There are a few general principles for effective prevention programs by addressing the factors that play causal roles, reverse or reduce risk factors, enhance protective factors to increase competency in multiple domains, and have to be age specific, developmentally appropriate, and culturally sensitive.
- #14 Prevention and mental health | Mental Health Foundationhttps://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/prevention-and-mental-health
Many factors influence our mental health, such as our personal history (our family, relationships and how we see ourselves) and our social circumstances (including our housing, employment and education). […] While it isn’t possible to stop all mental ill-health from developing, many mental health problems can be prevented with the right approach. […] Prevention can help all of us, whether we currently have good mental health or not. […] There are three types of prevention: […] Primary prevention: stopping mental health problems before they start […] This focuses on stopping people from developing mental health problems and promoting good mental health for all. […] Secondary prevention: supporting those at higher risk of experiencing mental health problems […] This focuses on supporting people who are more likely to develop mental health problems, either because of characteristics they were born with or experiences they’ve had.
- #15 Prevention of mental disorders – Wikipediahttps://en.wikipedia.org/wiki/Prevention_of_mental_disorders
There has been an historical trend among public health professionals to consider targeted programmes. […] Universal prevention (aimed at a population that has no increased risk for developing a mental disorder, such as school programs or mass media campaigns) need very high numbers of people to show effect. […] In 2020 a US paper identified the need for prevention, and led with focus on preventing traumatic events and adverse childhood experiences. […] A European paper highlighted „addressing both poor parenting and children’s maladaptive personality traits and insufficient life skills.” […] In 2018 the University of Birmingham Mental Health Policy Commission focused on prevention, including the challenges of funding given the shortness of political cycles versus the longer paybacks of prevention.
- #16 Preventive psychiatry: a blueprint for improving the mental health of young peoplehttps://pmc.ncbi.nlm.nih.gov/articles/PMC8129854/
Preventive approaches have latterly gained traction for improving mental health in young people. […] We then review the evidence supporting primary prevention of psychotic, bipolar and common mental disorders and promotion of good mental health as potential transformative strategies to reduce the incidence of these disorders in young people. […] Selective screening and psychological/psychoeducational interventions in vulnerable subgroups may improve anxiety/depressive symptoms, but their efficacy in reducing the incidence of psychotic/bipolar/common mental disorders is unproven. […] Universal public health approaches targeting school climate or social determinants (demographic, economic, neighbourhood, environmental, social/cultural) of mental disorders hold the greatest potential for reducing the risk profile of the population as a whole.
- #17 Prevention and mental health | Mental Health Foundationhttps://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/prevention-and-mental-health
Many factors influence our mental health, such as our personal history (our family, relationships and how we see ourselves) and our social circumstances (including our housing, employment and education). […] While it isn’t possible to stop all mental ill-health from developing, many mental health problems can be prevented with the right approach. […] Prevention can help all of us, whether we currently have good mental health or not. […] There are three types of prevention: […] Primary prevention: stopping mental health problems before they start […] This focuses on stopping people from developing mental health problems and promoting good mental health for all. […] Secondary prevention: supporting those at higher risk of experiencing mental health problems […] This focuses on supporting people who are more likely to develop mental health problems, either because of characteristics they were born with or experiences they’ve had.
- #18 Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? | International Journal of Mental Health Systems | Full Texthttps://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00356-9
Selective interventions aim at preventing the manifestation of psychiatric symptoms, thus altering the developmental pathway to full-threshold disorders in the premorbid state. […] Indicated interventions aim at the identification of those individuals at clinical high risk for the development of a mental disorder who are functionally impaired and no longer asymptomatic. […] Secondary preventive strategies and early intervention services aim at mitigating the occurrence of negative prognostic factors such as long duration of untreated illness, poor treatment response, poor psychosocial well-being and functioning, comorbid substance use, and high burden on patients families, with the final goal of preventing relapse or incomplete recovery. […] Tertiary preventive strategies aim at addressing treatment resistance, poor psychosocial wellbeing and functioning, comorbid substance use, and high burden on patients families, with the final goal of preventing multiple relapses and disease progression.
- #19 Promotion, prevention and treatment interventions for mental health in low- and middle-income countries through a task-shifting approach | Epidemiology and Psychiatric Sciences | Cambridge Corehttps://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/promotion-prevention-and-treatment-interventions-for-mental-health-in-low-and-middleincome-countries-through-a-taskshifting-approach/55951A79185D86284E263328481C134D
Indicated prevention includes strategies that are targeted to individuals who are identified (or individually screened) as having detectable signs or symptoms which can foreshadow, precede and may sometimes if left unaddressed lead to a full diagnosable mental disorder based on an individual assessment. […] Treatment interventions are delivered to people who have a diagnosed mental disorder. However, sometimes, these treatment interventions, particularly psychological or psychosocial interventions, are also considered as effective treatments for those population groups that may receive indicated prevention interventions in the category above.
- #20 Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? | International Journal of Mental Health Systems | Full Texthttps://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00356-9
Selective interventions aim at preventing the manifestation of psychiatric symptoms, thus altering the developmental pathway to full-threshold disorders in the premorbid state. […] Indicated interventions aim at the identification of those individuals at clinical high risk for the development of a mental disorder who are functionally impaired and no longer asymptomatic. […] Secondary preventive strategies and early intervention services aim at mitigating the occurrence of negative prognostic factors such as long duration of untreated illness, poor treatment response, poor psychosocial well-being and functioning, comorbid substance use, and high burden on patients families, with the final goal of preventing relapse or incomplete recovery. […] Tertiary preventive strategies aim at addressing treatment resistance, poor psychosocial wellbeing and functioning, comorbid substance use, and high burden on patients families, with the final goal of preventing multiple relapses and disease progression.
- #21 Preventive psychiatric | PPThttps://www.slideshare.net/slideshow/preventive-psychiatric-237971831/237971831
Secondary prevention targets people who show early symptoms of mental health disruption but regain premorbid level of functioning through aggressive treatment. […] Early diagnosis and case finding: This can be achieved by educating the public, community leaders in how to recognize early symptoms of mental illness. […] Tertiary prevention targets those with mental illness and helps to reduce the severity, discomfort and disability associated with their illness. […] Reducing the residual defects that are associated with severe and persistent mental illness. […] Preventing complications of the illness. Promoting rehabilitation that is directed towards the achievement of each individuals maximum levels of functioning. […] Rehabilitation is the process of enabling the individual to return to his highest possible level of functioning.
- #22 Model of prevention in psychiatry | PPThttps://www.slideshare.net/slideshow/model-of-prevention-in-psychiatry/248194794
Secondary Prevention Interventions aimed at minimizing early symptoms of psychiatric illness and directed toward reducing the prevalence and duration of the illness. Secondary prevention is accomplished through early identification of problems and prompt initiation of effective treatment. […] Tertiary Prevention Services aimed at reducing the residual defects that are associated with severe and persistent mental illness. Tertiary prevention is accomplished in two ways: 1. Preventing complications of the illness. 2. Promoting rehabilitation that is directed toward achievement of each individual’s maximum level of functioning. […] Rehabilitation is the process of enabling the individual to return to his highest possible level of functioning. Rehabilitation is an attempt to provide the best possible community role which will enable the patient to achieve the maximum range of activity, interest and of which he is capable.
- #23 Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? | International Journal of Mental Health Systems | Full Texthttps://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00356-9
Similar to other health care sectors, mental health has moved towards the secondary prevention, with the effort to detect and treat mental disorders as early as possible. […] However, converging evidence sheds new light on the potential of primary preventive and promotion strategies for mental health of young people. […] This urges redesigning preventive strategies in a youth-focused multidisciplinary and trans-diagnostic framework which might early modify possible psychopathological trajectories. […] Evidence suggests that it would be unrealistic to consider promotion and prevention in mental health responsibility of mental health professionals alone. Integrated and multidisciplinary services are needed to increase the range of possible interventions and limit the risk of poor long-term outcome, with also potential benefits in terms of healthcare system costs.
- #24 Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? | International Journal of Mental Health Systems | Full Texthttps://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00356-9
Selective interventions aim at preventing the manifestation of psychiatric symptoms, thus altering the developmental pathway to full-threshold disorders in the premorbid state. […] Indicated interventions aim at the identification of those individuals at clinical high risk for the development of a mental disorder who are functionally impaired and no longer asymptomatic. […] Secondary preventive strategies and early intervention services aim at mitigating the occurrence of negative prognostic factors such as long duration of untreated illness, poor treatment response, poor psychosocial well-being and functioning, comorbid substance use, and high burden on patients families, with the final goal of preventing relapse or incomplete recovery. […] Tertiary preventive strategies aim at addressing treatment resistance, poor psychosocial wellbeing and functioning, comorbid substance use, and high burden on patients families, with the final goal of preventing multiple relapses and disease progression.
- #25 Preventive psychiatric | PPThttps://www.slideshare.net/slideshow/preventive-psychiatric-237971831/237971831
Secondary prevention targets people who show early symptoms of mental health disruption but regain premorbid level of functioning through aggressive treatment. […] Early diagnosis and case finding: This can be achieved by educating the public, community leaders in how to recognize early symptoms of mental illness. […] Tertiary prevention targets those with mental illness and helps to reduce the severity, discomfort and disability associated with their illness. […] Reducing the residual defects that are associated with severe and persistent mental illness. […] Preventing complications of the illness. Promoting rehabilitation that is directed towards the achievement of each individuals maximum levels of functioning. […] Rehabilitation is the process of enabling the individual to return to his highest possible level of functioning.
- #26 Preventive psychiatric | PPThttps://www.slideshare.net/slideshow/preventive-psychiatric-237971831/237971831
Secondary prevention targets people who show early symptoms of mental health disruption but regain premorbid level of functioning through aggressive treatment. […] Early diagnosis and case finding: This can be achieved by educating the public, community leaders in how to recognize early symptoms of mental illness. […] Tertiary prevention targets those with mental illness and helps to reduce the severity, discomfort and disability associated with their illness. […] Reducing the residual defects that are associated with severe and persistent mental illness. […] Preventing complications of the illness. Promoting rehabilitation that is directed towards the achievement of each individuals maximum levels of functioning. […] Rehabilitation is the process of enabling the individual to return to his highest possible level of functioning.
- #27 Prevention and mental health | Mental Health Foundationhttps://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/prevention-and-mental-health
Tertiary prevention: helping people living with mental health problems to stay well […] This helps people with mental ill-health stay well and have a good quality of life. […] It’s not just individual changes that will help us stay well. As a society, we need to tackle inequalities and look at the social, economic, environmental and other factors affecting mental health. […] Our report on prevention and mental health looks at the societal changes that will make the biggest difference to everyone’s mental health, namely: helping parents nurture their children, protecting children from trauma, educating young people to understand and manage their emotions, supporting people under a lot of stress at work, reducing loneliness for older people, building connections in our communities, caring for people with suicidal thoughts, helping people to recover and look after themselves.
- #28 Preventive psychiatric | PPThttps://www.slideshare.net/slideshow/preventive-psychiatric-237971831/237971831
Secondary prevention targets people who show early symptoms of mental health disruption but regain premorbid level of functioning through aggressive treatment. […] Early diagnosis and case finding: This can be achieved by educating the public, community leaders in how to recognize early symptoms of mental illness. […] Tertiary prevention targets those with mental illness and helps to reduce the severity, discomfort and disability associated with their illness. […] Reducing the residual defects that are associated with severe and persistent mental illness. […] Preventing complications of the illness. Promoting rehabilitation that is directed towards the achievement of each individuals maximum levels of functioning. […] Rehabilitation is the process of enabling the individual to return to his highest possible level of functioning.
- #29 Preventive psychiatric | PPThttps://www.slideshare.net/slideshow/preventive-psychiatric-237971831/237971831
Secondary prevention targets people who show early symptoms of mental health disruption but regain premorbid level of functioning through aggressive treatment. […] Early diagnosis and case finding: This can be achieved by educating the public, community leaders in how to recognize early symptoms of mental illness. […] Tertiary prevention targets those with mental illness and helps to reduce the severity, discomfort and disability associated with their illness. […] Reducing the residual defects that are associated with severe and persistent mental illness. […] Preventing complications of the illness. Promoting rehabilitation that is directed towards the achievement of each individuals maximum levels of functioning. […] Rehabilitation is the process of enabling the individual to return to his highest possible level of functioning.
- #30 Preventive psychiatric | PPThttps://www.slideshare.net/slideshow/preventive-psychiatric-237971831/237971831
Increasing independence would be the first step in rehabilitation process. Primary focus is on improvement of capabilities and competence of clients with psychiatric problems. Maximum use must be made of residual capacities. Patient’s active participation is very essential. Skill development, therapeutic environment are fundamental interventions for a successful rehabilitation process.
- #31 Preventive psychiatric | PPThttps://www.slideshare.net/slideshow/preventive-psychiatric-237971831/237971831
Increasing independence would be the first step in rehabilitation process. Primary focus is on improvement of capabilities and competence of clients with psychiatric problems. Maximum use must be made of residual capacities. Patient’s active participation is very essential. Skill development, therapeutic environment are fundamental interventions for a successful rehabilitation process.
- #32 Mental Health | Mental Health | CDChttps://www.cdc.gov/mental-health/index.html
About Children’s Mental Health Childhood and adolescence are critical stages of life for mental health. […] Protecting the Nation’s Mental Health CDC promotes well-being and prevents mental distress, substance use, overdose, and suicide.
- #33 What is mental health prevention and early intervention? | Steinberg Institutehttps://steinberginstitute.org/what-is-mental-health-prevention-and-early-intervention/
Most mental health challenges begin early on in life. According to the National Alliance on Mental Illness (NAMI), 50% of all lifetime mental illnesses start by age 14, and 75% by age 24. Knowing this, we have an obligation to ensure young people have the support they need to cope with mental health conditions. […] Prevention and early intervention services are services that focus on reducing the risk of serious mental illness or substance abuse. They aim to intervene at early periods in childhood development so that young people are supported through their mental health challenges and learn how to navigate them on their own. This entails looking out for warning signs of mental health and substance use challenges and acting early before conditions worsen. They are often created to meet the needs of specific communities more at risk of certain adverse health outcomes.
- #34https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
Affordable, effective and feasible strategies exist to promote, protect and restore mental health. […] Promotion and prevention interventions work by identifying the individual, social and structural determinants of mental health, and then intervening to reduce risks, build resilience and establish supportive environments for mental health. […] Reshaping the determinants of mental health often requires action beyond the health sector and so promotion and prevention programmes should involve the education, labour, justice, transport, environment, housing, and welfare sectors. […] Suicide prevention is a global priority and included in the Sustainable Development Goals. […] Promoting child and adolescent mental health is another priority and can be achieved by policies and laws that promote and protect mental health, supporting caregivers to provide nurturing care, implementing school-based programmes and improving the quality of community and online environments. […] Promoting and protecting mental health at work is a growing area of interest and can be supported through legislation and regulation, organizational strategies, manager training and interventions for workers.
- #35 Prevention and early intervention in mental health | Mental Health Americahttps://www.mhanational.org/issues/prevention-and-early-intervention-mental-health
„Fortunately, we know how to act early. Studies around the country prove over and over again that we are able to prevent or mitigate the effects of mental illness and allow individuals to live fulfilling, productive lives in the community.” […] „Instead of investing in prevention and early intervention programs and providing access to appropriate services, we have unconscionable rates of suicide, school drop-out, homelessness, and involvement in the juvenile justice system.” […] „The hope is that support for these policy changes and implementation of prevention and intervention programs will reduce the number of families who will reflect on 'if only’ as well as decrease the over reliance on hindsight and reactionary practices that are used now to address mental illness.” […] „If we truly want to address mental illness, we must address all of the factors we know play a role in its development and we must address these factors early.”
- #36 Prevention and early intervention in mental health | Mental Health Americahttps://www.mhanational.org/issues/prevention-and-early-intervention-mental-health
„Fortunately, we know how to act early. Studies around the country prove over and over again that we are able to prevent or mitigate the effects of mental illness and allow individuals to live fulfilling, productive lives in the community.” […] „Instead of investing in prevention and early intervention programs and providing access to appropriate services, we have unconscionable rates of suicide, school drop-out, homelessness, and involvement in the juvenile justice system.” […] „The hope is that support for these policy changes and implementation of prevention and intervention programs will reduce the number of families who will reflect on 'if only’ as well as decrease the over reliance on hindsight and reactionary practices that are used now to address mental illness.” […] „If we truly want to address mental illness, we must address all of the factors we know play a role in its development and we must address these factors early.”
- #37 Levels of Prevention in Mental Health: Primary, Secondary, and Tertiary Interventionshttps://www.therapytrainings.com/pages/blog/levels-of-prevention-in-mental-health-primary-secondary-and-tertiary-interventions?srsltid=AfmBOopcZzV2vYtje6Zdi1QCEtCLjCXC-gykEW2u806OL8NLlIc6mxtc
Primary prevention focuses on preventing the onset of mental health issues in the general population. These interventions target individuals who are not yet experiencing mental health problems and aim to promote overall well-being and resilience. […] Primary prevention strategies include school-based mental health education programs, workplace stress management workshops, community awareness campaigns about mental health, and parenting skills training to promote healthy child development. […] Secondary prevention targets individuals who are showing early signs of mental health issues or are at high risk due to various factors. The goal is to identify problems early and intervene quickly to prevent them from becoming more severe. […] Secondary prevention strategies include screening programs for depression in primary care settings, support groups for individuals with a family history of mental illness, early intervention programs for adolescents showing signs of psychosis, and cognitive-behavioral therapy for individuals experiencing mild anxiety symptoms.
- #38 Preventive psychiatry: a blueprint for improving the mental health of young peoplehttps://pmc.ncbi.nlm.nih.gov/articles/PMC8129854/
Preventive approaches have latterly gained traction for improving mental health in young people. […] We then review the evidence supporting primary prevention of psychotic, bipolar and common mental disorders and promotion of good mental health as potential transformative strategies to reduce the incidence of these disorders in young people. […] Selective screening and psychological/psychoeducational interventions in vulnerable subgroups may improve anxiety/depressive symptoms, but their efficacy in reducing the incidence of psychotic/bipolar/common mental disorders is unproven. […] Universal public health approaches targeting school climate or social determinants (demographic, economic, neighbourhood, environmental, social/cultural) of mental disorders hold the greatest potential for reducing the risk profile of the population as a whole.
- #39 Prevention of mental disorders – Wikipediahttps://en.wikipedia.org/wiki/Prevention_of_mental_disorders
Use of cognitive behavioral therapy (CBT) with people at risk has significantly reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and also given significant improvements in explanatory style, hopelessness, and dysfunctional attitudes. […] In 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT for people at risk of psychosis. […] For depressive disorders, when people participated in interventions, some studies show the number of new cases is reduced by 22% to 38%. […] Such interventions also save costs. […] Depression prevention continues to be called for. […] In those at high risk there is tentative evidence that psychosis incidence may be reduced with the use of CBT or other types of therapy. […] In 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT for people at risk of psychosis.
- #40 Prevention of mental disorders – Wikipediahttps://en.wikipedia.org/wiki/Prevention_of_mental_disorders
Use of cognitive behavioral therapy (CBT) with people at risk has significantly reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and also given significant improvements in explanatory style, hopelessness, and dysfunctional attitudes. […] In 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT for people at risk of psychosis. […] For depressive disorders, when people participated in interventions, some studies show the number of new cases is reduced by 22% to 38%. […] Such interventions also save costs. […] Depression prevention continues to be called for. […] In those at high risk there is tentative evidence that psychosis incidence may be reduced with the use of CBT or other types of therapy. […] In 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT for people at risk of psychosis.
- #41https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
Preventive psychiatry has a role in managing work stress, returning people to work as soon as possible following illness, and preventing work-related health problems, especially among the most vulnerable. […] Thus, preventive psychiatry, located within a public mental health framework, provides an opportunity to recognize more explicitly important preventive elements of the existing psychiatric practice. […] Prevention of violence and hostility between adults and young people has been long recognized as a core task of preventive psychiatry. […] Hence, a fundamental shift is needed in the way we view health services. Prevention should be guided by available evidence, and mental disorders have multiple determinants. […] Accordingly, preventive strategy should address these multiple causes and their interactions. […] Effective programs can reduce risk of mental disorders.
- #42 Prevention of mental disorders: evidence, challenges and opportunities | BMC Medicine | Full Texthttps://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-75
Similarly, with 60% of adults in the workforce, and good evidence for the cost-effectiveness of many workplace-based interventions, the argument for addressing mental health problems and improving wellbeing in the workplace is a strong one. […] Such an integrated approach would protect mental health by reducing work-related risk factors, promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities, and address mental health problems among working people regardless of cause. […] This highlights the imperative for intersectoral engagement and cross-disciplinary action, as well as comprehensive governmental policies to address the prevention of mental disorders at a population-level. […] In order to continue to progress the prevention and mental health promotion agenda, there is a need for governments, other policy makers and business leaders to fully recognize the impact of poverty and social disadvantage, environmental determinants of health and educational and workplace policies on the mental health of the population.
- #43 Prevention of mental disorders: evidence, challenges and opportunities | BMC Medicine | Full Texthttps://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-75
Similarly, with 60% of adults in the workforce, and good evidence for the cost-effectiveness of many workplace-based interventions, the argument for addressing mental health problems and improving wellbeing in the workplace is a strong one. […] Such an integrated approach would protect mental health by reducing work-related risk factors, promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities, and address mental health problems among working people regardless of cause. […] This highlights the imperative for intersectoral engagement and cross-disciplinary action, as well as comprehensive governmental policies to address the prevention of mental disorders at a population-level. […] In order to continue to progress the prevention and mental health promotion agenda, there is a need for governments, other policy makers and business leaders to fully recognize the impact of poverty and social disadvantage, environmental determinants of health and educational and workplace policies on the mental health of the population.
- #44 Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? | International Journal of Mental Health Systems | Full Texthttps://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00356-9
Similar to other health care sectors, mental health has moved towards the secondary prevention, with the effort to detect and treat mental disorders as early as possible. […] However, converging evidence sheds new light on the potential of primary preventive and promotion strategies for mental health of young people. […] This urges redesigning preventive strategies in a youth-focused multidisciplinary and trans-diagnostic framework which might early modify possible psychopathological trajectories. […] Evidence suggests that it would be unrealistic to consider promotion and prevention in mental health responsibility of mental health professionals alone. Integrated and multidisciplinary services are needed to increase the range of possible interventions and limit the risk of poor long-term outcome, with also potential benefits in terms of healthcare system costs.
- #45 Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? | International Journal of Mental Health Systems | Full Texthttps://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00356-9
In order to guarantee youth a healthy mental development through promotion, prevention, and early interventions, research evidence supports the implementation of healthcare systems integrating mental, primary, and social care. […] Mental health promotion focuses on enhancing the strengths, capacity and resources of individuals and communities to enable them to increase control over their mental health and its determinants. Prevention, on the other hand, aims to reduce the incidence, prevalence and severity of targeted mental health conditions. […] Primary prevention strategies may be universal, selective, or indicated, depending on whether they target the general population, a sub-group of the population, or specific individuals, respectively. […] Mental health universal prevention aims at promoting normal neurodevelopment.
- #46 Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? | International Journal of Mental Health Systems | Full Texthttps://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00356-9
Prevention and early intervention are recognized key elements for minimizing the impact of any potentially serious health condition. […] Theoretical considerations about the opportunity to intervene in this specific age window in terms of mental health follow a number of evidence-based considerations. […] In order to meet the need for early intervention into childhood and young adulthood mental health difficulties, it is imperative to parallel redesign prevention and early intervention services for young populations, by promoting multidisciplinary collaborations between different specialized professionals in an enhanced and integrated service of extended primary care. […] Based on evidence summarized above, there is a pressing need to develop, or improve where present, youth mental healthcare models which can implement prevention and early intervention strategies.
- #47 Prevention of mental disorders: evidence, challenges and opportunities | BMC Medicine | Full Texthttps://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-75
Similarly, with 60% of adults in the workforce, and good evidence for the cost-effectiveness of many workplace-based interventions, the argument for addressing mental health problems and improving wellbeing in the workplace is a strong one. […] Such an integrated approach would protect mental health by reducing work-related risk factors, promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities, and address mental health problems among working people regardless of cause. […] This highlights the imperative for intersectoral engagement and cross-disciplinary action, as well as comprehensive governmental policies to address the prevention of mental disorders at a population-level. […] In order to continue to progress the prevention and mental health promotion agenda, there is a need for governments, other policy makers and business leaders to fully recognize the impact of poverty and social disadvantage, environmental determinants of health and educational and workplace policies on the mental health of the population.
- #48 Preventive psychiatry: a blueprint for improving the mental health of young peoplehttps://pmc.ncbi.nlm.nih.gov/articles/PMC8129854/
The approach to promotion of good mental health is currently fragmented. […] We leverage the knowledge gained from the review to develop a blueprint for future research and practice of preventive psychiatry in young people: integrating universal and targeted frameworks; advancing multivariable, transdiagnostic, multiendpoint epidemiological knowledge; synergically preventing common and infrequent mental disorders; preventing physical and mental health burden together; implementing stratified/personalized prognosis; establishing evidencebased preventive interventions; developing an ethical framework, improving prevention through education/training; consolidating the costeffectiveness of preventive psychiatry; and decreasing inequalities. […] An urgent individual, societal, and global level response is needed to reduce the incidence and burden of mental disorders in young people.
- #49 Preventive psychiatry: a blueprint for improving the mental health of young people – PubMedhttps://pubmed.ncbi.nlm.nih.gov/34002494/
We leverage the knowledge gained from the review to develop a blueprint for future research and practice of preventive psychiatry in young people: integrating universal and targeted frameworks; advancing multivariable, transdiagnostic, multi-endpoint epidemiological knowledge; synergically preventing common and infrequent mental disorders; preventing physical and mental health burden together; implementing stratified/personalized prognosis; establishing evidence-based preventive interventions; developing an ethical framework, improving prevention through education/training; consolidating the cost-effectiveness of preventive psychiatry; and decreasing inequalities. […] These goals can only be achieved through an urgent individual, societal, and global level response, which promotes a vigorous collaboration across scientific, health care, societal and governmental sectors for implementing preventive psychiatry, as much is at stake for young people with or at risk for emerging mental disorders.
- #50 Prevention and mental health | Mental Health Foundationhttps://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/prevention-and-mental-health
Many factors influence our mental health, such as our personal history (our family, relationships and how we see ourselves) and our social circumstances (including our housing, employment and education). […] While it isn’t possible to stop all mental ill-health from developing, many mental health problems can be prevented with the right approach. […] Prevention can help all of us, whether we currently have good mental health or not. […] There are three types of prevention: […] Primary prevention: stopping mental health problems before they start […] This focuses on stopping people from developing mental health problems and promoting good mental health for all. […] Secondary prevention: supporting those at higher risk of experiencing mental health problems […] This focuses on supporting people who are more likely to develop mental health problems, either because of characteristics they were born with or experiences they’ve had.
- #51 Prevention and mental health | Mental Health Foundationhttps://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/prevention-and-mental-health
Tertiary prevention: helping people living with mental health problems to stay well […] This helps people with mental ill-health stay well and have a good quality of life. […] It’s not just individual changes that will help us stay well. As a society, we need to tackle inequalities and look at the social, economic, environmental and other factors affecting mental health. […] Our report on prevention and mental health looks at the societal changes that will make the biggest difference to everyone’s mental health, namely: helping parents nurture their children, protecting children from trauma, educating young people to understand and manage their emotions, supporting people under a lot of stress at work, reducing loneliness for older people, building connections in our communities, caring for people with suicidal thoughts, helping people to recover and look after themselves.
- #52 Suicide prevention – the role of psychiatry | RANZCPhttps://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/suicide-prevention-the-role-of-psychiatry
The public health component of suicide prevention should focus on systematically reducing societal inequities by targeting modifiable risk factors such as unemployment, educational disadvantage, socio-economic disadvantage, homelessness, loneliness and poor social-connectedness. […] The impulsivity of suicide provides opportunities to reduce the risk by restricting access to lethal means and enabling time for suicidal thoughts to subside. […] Primary prevention efforts need to begin early to reduce exposure to adverse childhood experiences, identify early mental illness, and provide direct interventions and support to vulnerable children and families.
- #53https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
Affordable, effective and feasible strategies exist to promote, protect and restore mental health. […] Promotion and prevention interventions work by identifying the individual, social and structural determinants of mental health, and then intervening to reduce risks, build resilience and establish supportive environments for mental health. […] Reshaping the determinants of mental health often requires action beyond the health sector and so promotion and prevention programmes should involve the education, labour, justice, transport, environment, housing, and welfare sectors. […] Suicide prevention is a global priority and included in the Sustainable Development Goals. […] Promoting child and adolescent mental health is another priority and can be achieved by policies and laws that promote and protect mental health, supporting caregivers to provide nurturing care, implementing school-based programmes and improving the quality of community and online environments. […] Promoting and protecting mental health at work is a growing area of interest and can be supported through legislation and regulation, organizational strategies, manager training and interventions for workers.
- #54 The use of methods of psychiatric education in the prevention of mental pathology by a psychiatrist outpatient consultationhttps://www.neuroscigroup.us/articles/APT-5-129.php
Educating the population in the field of mental health includes a set of educational, upbringing, agitation and propaganda activities aimed at promoting a healthy lifestyle, preventing diseases, maintaining and strengthening health, increasing the ability of people to work, and prolonging their active life. […] Determine the role and place of psychoprophylaxis of psychiatric education and in the structure of the work of a psychiatrist of an outpatient consultation appointment. […] Individual psychoeducation, psychiatric education and psychoprophylaxis accompany the entire treatment process of persons with mental disorders. […] Health education in psychiatry in all forms contributes to a wider medical prevention of the development of pathology in the mental sphere, as well as to the improvement of already developing diseases and the prevention of relapse of cured diseases.
- #55 The use of methods of psychiatric education in the prevention of mental pathology by a psychiatrist outpatient consultationhttps://www.neuroscigroup.us/articles/APT-5-129.php
Educating the population in the field of mental health includes a set of educational, upbringing, agitation and propaganda activities aimed at promoting a healthy lifestyle, preventing diseases, maintaining and strengthening health, increasing the ability of people to work, and prolonging their active life. […] Determine the role and place of psychoprophylaxis of psychiatric education and in the structure of the work of a psychiatrist of an outpatient consultation appointment. […] Individual psychoeducation, psychiatric education and psychoprophylaxis accompany the entire treatment process of persons with mental disorders. […] Health education in psychiatry in all forms contributes to a wider medical prevention of the development of pathology in the mental sphere, as well as to the improvement of already developing diseases and the prevention of relapse of cured diseases.
- #56 The use of methods of psychiatric education in the prevention of mental pathology by a psychiatrist outpatient consultationhttps://www.neuroscigroup.us/articles/APT-5-129.php
Sanitary educational work in psychiatry is aimed at increasing the level of knowledge of the population about mental disorders, mastering methods of protection from stress, the harmful effects of bad habits. Individual psychiatric education accompanies the entire treatment process. […] During an outpatient appointment, all psychiatrists, without exception, need to conduct individual conversations on the prevention of mental illness, during which it is important to explain to patients what pathology the patient has, what kind of treatment is required, what preventive measures for mental disorders exist (psychoprophylaxis, psychohygiene). […] Psychoeducation, psychiatric education and psychoprophylaxis, conducted by a psychiatrist, teach patients to provide themselves with possible and affordable types of preventive actions, increases the effectiveness of using the available material resources and improves the quality of life. They are types of psychological intervention aimed at achieving positive changes in the cognitive, emotional and behavioral spheres of the sick person. […] Education in psychiatry in all forms contributes to wider medical prevention of the development of mental pathology, as well as the improvement of already developing diseases and the prevention of relapse of cured diseases.
- #57 The use of methods of psychiatric education in the prevention of mental pathology by a psychiatrist outpatient consultationhttps://www.neuroscigroup.us/articles/APT-5-129.php
Educating the population in the field of mental health includes a set of educational, upbringing, agitation and propaganda activities aimed at promoting a healthy lifestyle, preventing diseases, maintaining and strengthening health, increasing the ability of people to work, and prolonging their active life. […] Determine the role and place of psychoprophylaxis of psychiatric education and in the structure of the work of a psychiatrist of an outpatient consultation appointment. […] Individual psychoeducation, psychiatric education and psychoprophylaxis accompany the entire treatment process of persons with mental disorders. […] Health education in psychiatry in all forms contributes to a wider medical prevention of the development of pathology in the mental sphere, as well as to the improvement of already developing diseases and the prevention of relapse of cured diseases.
- #58 The use of methods of psychiatric education in the prevention of mental pathology by a psychiatrist outpatient consultationhttps://www.neuroscigroup.us/articles/APT-5-129.php
Sanitary educational work in psychiatry is aimed at increasing the level of knowledge of the population about mental disorders, mastering methods of protection from stress, the harmful effects of bad habits. Individual psychiatric education accompanies the entire treatment process. […] During an outpatient appointment, all psychiatrists, without exception, need to conduct individual conversations on the prevention of mental illness, during which it is important to explain to patients what pathology the patient has, what kind of treatment is required, what preventive measures for mental disorders exist (psychoprophylaxis, psychohygiene). […] Psychoeducation, psychiatric education and psychoprophylaxis, conducted by a psychiatrist, teach patients to provide themselves with possible and affordable types of preventive actions, increases the effectiveness of using the available material resources and improves the quality of life. They are types of psychological intervention aimed at achieving positive changes in the cognitive, emotional and behavioral spheres of the sick person. […] Education in psychiatry in all forms contributes to wider medical prevention of the development of mental pathology, as well as the improvement of already developing diseases and the prevention of relapse of cured diseases.
- #59 The use of methods of psychiatric education in the prevention of mental pathology by a psychiatrist outpatient consultationhttps://www.neuroscigroup.us/articles/APT-5-129.php
Sanitary educational work in psychiatry is aimed at increasing the level of knowledge of the population about mental disorders, mastering methods of protection from stress, the harmful effects of bad habits. Individual psychiatric education accompanies the entire treatment process. […] During an outpatient appointment, all psychiatrists, without exception, need to conduct individual conversations on the prevention of mental illness, during which it is important to explain to patients what pathology the patient has, what kind of treatment is required, what preventive measures for mental disorders exist (psychoprophylaxis, psychohygiene). […] Psychoeducation, psychiatric education and psychoprophylaxis, conducted by a psychiatrist, teach patients to provide themselves with possible and affordable types of preventive actions, increases the effectiveness of using the available material resources and improves the quality of life. They are types of psychological intervention aimed at achieving positive changes in the cognitive, emotional and behavioral spheres of the sick person. […] Education in psychiatry in all forms contributes to wider medical prevention of the development of mental pathology, as well as the improvement of already developing diseases and the prevention of relapse of cured diseases.
- #60 The use of methods of psychiatric education in the prevention of mental pathology by a psychiatrist outpatient consultationhttps://www.neuroscigroup.us/articles/APT-5-129.php
Sanitary educational work in psychiatry is aimed at increasing the level of knowledge of the population about mental disorders, mastering methods of protection from stress, the harmful effects of bad habits. Individual psychiatric education accompanies the entire treatment process. […] During an outpatient appointment, all psychiatrists, without exception, need to conduct individual conversations on the prevention of mental illness, during which it is important to explain to patients what pathology the patient has, what kind of treatment is required, what preventive measures for mental disorders exist (psychoprophylaxis, psychohygiene). […] Psychoeducation, psychiatric education and psychoprophylaxis, conducted by a psychiatrist, teach patients to provide themselves with possible and affordable types of preventive actions, increases the effectiveness of using the available material resources and improves the quality of life. They are types of psychological intervention aimed at achieving positive changes in the cognitive, emotional and behavioral spheres of the sick person. […] Education in psychiatry in all forms contributes to wider medical prevention of the development of mental pathology, as well as the improvement of already developing diseases and the prevention of relapse of cured diseases.
- #61 The use of methods of psychiatric education in the prevention of mental pathology by a psychiatrist outpatient consultationhttps://www.neuroscigroup.us/articles/APT-5-129.php
Sanitary educational work in psychiatry is aimed at increasing the level of knowledge of the population about mental disorders, mastering methods of protection from stress, the harmful effects of bad habits. Individual psychiatric education accompanies the entire treatment process. […] During an outpatient appointment, all psychiatrists, without exception, need to conduct individual conversations on the prevention of mental illness, during which it is important to explain to patients what pathology the patient has, what kind of treatment is required, what preventive measures for mental disorders exist (psychoprophylaxis, psychohygiene). […] Psychoeducation, psychiatric education and psychoprophylaxis, conducted by a psychiatrist, teach patients to provide themselves with possible and affordable types of preventive actions, increases the effectiveness of using the available material resources and improves the quality of life. They are types of psychological intervention aimed at achieving positive changes in the cognitive, emotional and behavioral spheres of the sick person. […] Education in psychiatry in all forms contributes to wider medical prevention of the development of mental pathology, as well as the improvement of already developing diseases and the prevention of relapse of cured diseases.
- #62 WHO EMRO | Promotion of mental health and prevention of mental disorders: priorities for implementation | Volume 21, issue 7 | EMHJ volume 21, 2015https://www.emro.who.int/emhj-volume-21-2015/volume-21-issue-7/promotion-of-mental-health-and-prevention-of-mental-disorders-priorities-for-implementation.html
There is compelling evidence from high-quality studies that mental health promotion and primary prevention interventions can reduce the risk of mental disorders, enhance protective factors for good mental and physical health, and lead to lasting positive effects on a range of social and economic outcomes. […] The WHO regional strategy on mental health and substance abuse in the Eastern Mediterranean Region (EMR) incorporates a clear focus on the implementation of evidence-based mental health promotion and prevention as one of its six strategic components. […] Mental health promotion and prevention strategies have been introduced in many countries globally as the most sustainable method of reducing the increasing burden of mental disorders and improving overall health and well-being. […] This paper provides a briefing for policy- and decision-makers in the EMR on the evidence for mental health promotion and primary prevention interventions, identifying priority areas for action based on their effectiveness and feasibility of implementation.
- #63 Prevention of mental disorders – Wikipediahttps://en.wikipedia.org/wiki/Prevention_of_mental_disorders
Prevention of mental disorders are measures that try to decrease the chances of a mental disorder occurring. A 2004 WHO report stated that „prevention of these disorders is obviously one of the most effective ways to reduce the disease burden.” […] The 2011 European Psychiatric Association (EPA) guidance on prevention of mental disorders states „There is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions.” […] A 2011 UK Department of Health report on the economic case for mental health promotion and mental illness prevention found that „many interventions are outstandingly good value for money, low in cost and often become self-financing over time, saving public expenditure.” […] In 2016, the National Institute of Mental Health re-affirmed prevention as a research priority area.
- #64 Prevention of mental disorders – Wikipediahttps://en.wikipedia.org/wiki/Prevention_of_mental_disorders
Prevention of mental disorders are measures that try to decrease the chances of a mental disorder occurring. A 2004 WHO report stated that „prevention of these disorders is obviously one of the most effective ways to reduce the disease burden.” […] The 2011 European Psychiatric Association (EPA) guidance on prevention of mental disorders states „There is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions.” […] A 2011 UK Department of Health report on the economic case for mental health promotion and mental illness prevention found that „many interventions are outstandingly good value for money, low in cost and often become self-financing over time, saving public expenditure.” […] In 2016, the National Institute of Mental Health re-affirmed prevention as a research priority area.
- #65 Prevention of mental disorders – Wikipediahttps://en.wikipedia.org/wiki/Prevention_of_mental_disorders
Use of cognitive behavioral therapy (CBT) with people at risk has significantly reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and also given significant improvements in explanatory style, hopelessness, and dysfunctional attitudes. […] In 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT for people at risk of psychosis. […] For depressive disorders, when people participated in interventions, some studies show the number of new cases is reduced by 22% to 38%. […] Such interventions also save costs. […] Depression prevention continues to be called for. […] In those at high risk there is tentative evidence that psychosis incidence may be reduced with the use of CBT or other types of therapy. […] In 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT for people at risk of psychosis.
- #66 Prevention of mental disorders – Wikipediahttps://en.wikipedia.org/wiki/Prevention_of_mental_disorders
Use of cognitive behavioral therapy (CBT) with people at risk has significantly reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and also given significant improvements in explanatory style, hopelessness, and dysfunctional attitudes. […] In 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT for people at risk of psychosis. […] For depressive disorders, when people participated in interventions, some studies show the number of new cases is reduced by 22% to 38%. […] Such interventions also save costs. […] Depression prevention continues to be called for. […] In those at high risk there is tentative evidence that psychosis incidence may be reduced with the use of CBT or other types of therapy. […] In 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT for people at risk of psychosis.
- #67 Prevention of mental disorders: evidence, challenges and opportunities | BMC Medicine | Full Texthttps://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-75
Modelling studies suggest that less than 30% of the burden of mental disorders can be averted, even with optimal care and access to services. This points to the need to reduce the incidence of mental disorders, utilising evidence-based prevention strategies and policy action. […] The case for the cost-effectiveness of preventing mental disorders needs to be strongly argued and new cross-disciplinary, intersectoral initiatives and policies developed for the prevention of mental disorders across the lifespan. […] The first few years of life play a critical role in determining mental health and wellbeing in later life and there is substantial evidence for the effectiveness and cost-effectiveness of interventions targeting parenting and childhood. […] Preventing mental health problems early in life can avert prospective costs associated with crime, lack of education, unemployment and unhealthy and risky behaviours.
- #68 Prevention of mental disorders: evidence, challenges and opportunities | BMC Medicine | Full Texthttps://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-75
Modelling studies suggest that less than 30% of the burden of mental disorders can be averted, even with optimal care and access to services. This points to the need to reduce the incidence of mental disorders, utilising evidence-based prevention strategies and policy action. […] The case for the cost-effectiveness of preventing mental disorders needs to be strongly argued and new cross-disciplinary, intersectoral initiatives and policies developed for the prevention of mental disorders across the lifespan. […] The first few years of life play a critical role in determining mental health and wellbeing in later life and there is substantial evidence for the effectiveness and cost-effectiveness of interventions targeting parenting and childhood. […] Preventing mental health problems early in life can avert prospective costs associated with crime, lack of education, unemployment and unhealthy and risky behaviours.
- #69 Prevention of mental disorders: evidence, challenges and opportunities | BMC Medicine | Full Texthttps://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-75
Modelling studies suggest that less than 30% of the burden of mental disorders can be averted, even with optimal care and access to services. This points to the need to reduce the incidence of mental disorders, utilising evidence-based prevention strategies and policy action. […] The case for the cost-effectiveness of preventing mental disorders needs to be strongly argued and new cross-disciplinary, intersectoral initiatives and policies developed for the prevention of mental disorders across the lifespan. […] The first few years of life play a critical role in determining mental health and wellbeing in later life and there is substantial evidence for the effectiveness and cost-effectiveness of interventions targeting parenting and childhood. […] Preventing mental health problems early in life can avert prospective costs associated with crime, lack of education, unemployment and unhealthy and risky behaviours.
- #70https://psychology.org.au/for-members/publications/inpsych/2022/vol-44-spring-2022/better-than-cure-why-we-should-focus-on-prevention
At a societal level there is some evidence that certain strategies may be effective in the prevention of risk factors such as racism, discrimination and family violence and these are then likely to contribute to reductions in mental ill-health. […] Importantly, there is also good evidence to show that many of the strategies that can be used to prevent mental health conditions are cost-effective, since they are usually inexpensive but produce considerable short- and long-term savings. […] We now need a preventive mental health system to help people stay well. […] Mental health conditions are not inevitable, and we have the knowledge and the programs to prevent many common conditions from occurring right now.
- #71https://psychology.org.au/for-members/publications/inpsych/2022/vol-44-spring-2022/better-than-cure-why-we-should-focus-on-prevention
The suggestion isnt that we can prevent everyone from experiencing a mental health condition much like we cant prevent every case of skin cancer or heart disease but we know enough to prevent many more people from experiencing behavioural disorders, anxiety conditions and depression. […] There is also considerable evidence that psychological skills-building programs that utilise techniques derived from psychology treatments such as CBT, interpersonal therapy, acceptance and commitment therapy and dialectical behaviour therapy, can also help to avert depression and anxiety. […] There is also good evidence that parenting and family strategies that focus on secure attachment, parenting style, communication skills, boundary-setting and conflict resolution are effective in the prevention of internalising disorders and externalising disorders.
- #72 Prevention of Perinatal Mental Health Disorders SIG | The International Marce Society for Perinatal Mental Healthhttps://marcesociety.com/prevention-pmh-disorders-sig/
Welcome to our SIG! We began our SIG in July 2021 and have had a wonderful and welcoming response! […] In October 2021, we had six meetings with a wide international audience on a variety of topics, including effective programs for prevention of perinatal mental disorders (universal and high risk populations); family-based preventive interventions of perinatal mental disorders; implementation/integration of prevention programs in primary health care services; prevention of perinatal mental disorders in developing countries; prevention programs using new technologies; and policy advocacy/implications for prevention of perinatal mental disorders. […] The United States Preventive Services Task Force (USPSTF) reviewed 50 methodologically rigorous studies and found good evidence that counseling interventions (two are cited: the Mothers and Babies Program, a cognitive behavioral intervention; the Reach Out, Stand Strong, Essentials for new Mothers (ROSE), interpersonal psychotherapy intervention) are effective in preventing perinatal depression among pregnant and postpartum individuals.
- #73https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
Affordable, effective and feasible strategies exist to promote, protect and restore mental health. […] Promotion and prevention interventions work by identifying the individual, social and structural determinants of mental health, and then intervening to reduce risks, build resilience and establish supportive environments for mental health. […] Reshaping the determinants of mental health often requires action beyond the health sector and so promotion and prevention programmes should involve the education, labour, justice, transport, environment, housing, and welfare sectors. […] Suicide prevention is a global priority and included in the Sustainable Development Goals. […] Promoting child and adolescent mental health is another priority and can be achieved by policies and laws that promote and protect mental health, supporting caregivers to provide nurturing care, implementing school-based programmes and improving the quality of community and online environments. […] Promoting and protecting mental health at work is a growing area of interest and can be supported through legislation and regulation, organizational strategies, manager training and interventions for workers.
- #74 Suicide Prevention Institute | Department of Psychiatryhttps://www.med.unc.edu/psych/research/psychiatry-department-research-programs/unc-suicide-prevention-institute/
The SPI team unites researchers, clinicians, educators, policymakers, people of faith, those in marginalized communities, and lived experience advisors to rapidly deploy scalable evidence-informed primary, secondary, and tertiary prevention interventions for suicide. […] We will identify, adapt, or develop the most effective interventions to prevent and treat individuals with suicidality. […] We will ensure that every citizen of the State of North Carolina will have access to and be aware of resources to address suicide. […] Our ultimate goal is to rapidly and rigorously apply findings from science to refine and personalize detection and prevention of suicide. […] Thorough and ongoing community consultation will ensure that all citizens of North Carolina benefit equally from our work.
- #75 Suicide prevention – the role of psychiatry | RANZCPhttps://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/suicide-prevention-the-role-of-psychiatry
The RANZCP is committed to supporting people in suicidal distress and working with governments and communities to prevent suicides. […] The aim of this position statement is to outline the complex factors that contribute to suicide, the role of psychiatrists in preventing suicide, and the best ways to support individuals, families/whnau and communities to cope with suicidal behaviours and prevent suicides. […] Suicide prevention requires a comprehensive approach that spans systems, organisations, communities, cultures and environments, combining treatment, support and intervention, and bridges gaps between fragmented services. […] Universal access to timely, coordinated, high quality mental health care is a critical component of suicide prevention, particularly for people with serious mental illness and substance use disorders. Access to 24-hour crisis care is one of the most important aspects of mental health service provision in the prevention of suicide.
- #76 Suicide prevention – the role of psychiatry | RANZCPhttps://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/suicide-prevention-the-role-of-psychiatry
The public health component of suicide prevention should focus on systematically reducing societal inequities by targeting modifiable risk factors such as unemployment, educational disadvantage, socio-economic disadvantage, homelessness, loneliness and poor social-connectedness. […] The impulsivity of suicide provides opportunities to reduce the risk by restricting access to lethal means and enabling time for suicidal thoughts to subside. […] Primary prevention efforts need to begin early to reduce exposure to adverse childhood experiences, identify early mental illness, and provide direct interventions and support to vulnerable children and families.
- #77 Suicide prevention – the role of psychiatry | RANZCPhttps://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/suicide-prevention-the-role-of-psychiatry
The RANZCP is committed to embedding suicide prevention approaches in the psychiatry training curriculum to ensure that psychiatrists provide the most appropriate and effective, evidence-based treatment and practice to support people in distress. […] Coordinated, assertive, aftercare plays an important role in preventing suicide following an attempt. […] Postvention support for families, friends and communities impacted by suicide is also an important aspect of suicide prevention, not only to alleviate the effects of stress and loss experienced by the survivors of suicide, but to reduce the potential for further suicides, as survivors are at greater risk. […] Suicide prevention strategies must respond to diversity and sensitivities within communities, including the impacts of intergenerational trauma.
- #78 Public health primary prevention implemented by clinical high-risk services for psychosis | Translational Psychiatryhttps://www.nature.com/articles/s41398-022-01805-4
Clinical High Risk for Psychosis (CHR-P) services have been primarily developed to support young people with attenuated symptoms (indicated prevention). […] CHR-P services implement numerous public health prevention initiatives and promotion of good mental health beyond indicated prevention of psychosis. […] Prevention in young people, therefore, represents a promising avenue to improve outcomes of mental disorders. […] Primary prevention strategies may target the general population (i.e. universal); subgroups of people at higher-than-average risk of developing mental disorders (i.e. selective); or individuals with emerging or subthreshold manifestations of mental disorders (i.e. indicated). […] CHR-P services frequently encompass public health initiatives that selectively target CHR-P individuals or their carers/family or universal interventions targeting the general population, as well as promotion of good mental health and wellbeing.
- #79 Public health primary prevention implemented by clinical high-risk services for psychosis | Translational Psychiatryhttps://www.nature.com/articles/s41398-022-01805-4
Clinical High Risk for Psychosis (CHR-P) services have been primarily developed to support young people with attenuated symptoms (indicated prevention). […] CHR-P services implement numerous public health prevention initiatives and promotion of good mental health beyond indicated prevention of psychosis. […] Prevention in young people, therefore, represents a promising avenue to improve outcomes of mental disorders. […] Primary prevention strategies may target the general population (i.e. universal); subgroups of people at higher-than-average risk of developing mental disorders (i.e. selective); or individuals with emerging or subthreshold manifestations of mental disorders (i.e. indicated). […] CHR-P services frequently encompass public health initiatives that selectively target CHR-P individuals or their carers/family or universal interventions targeting the general population, as well as promotion of good mental health and wellbeing.
- #80 Public health primary prevention implemented by clinical high-risk services for psychosis | Translational Psychiatryhttps://www.nature.com/articles/s41398-022-01805-4
The primary aim of this systematic review is to provide an evidence-based systematic appraisal of public health initiatives implemented by CHR-P services worldwide, in the context of an established public health framework identifying social determinants of mental disorders. […] CHR-P services can impact academic/occupational performance, cognitive skills and quality of life and promote good mental health. […] Through these activities, CHR-P services can impact mental health literacy, attitude towards mental disorders, self-management skills, family and significant relationships, social skills, academic/occupational performance, cognitive skills, physical health and quality of life, and promote good mental health. […] This review supports the importance of increasing the roll out of these services across the globe and improved funding given the broader value and potential wider impact on population mental health of these services.
- #81 Public health primary prevention implemented by clinical high-risk services for psychosis | Translational Psychiatryhttps://www.nature.com/articles/s41398-022-01805-4
The primary aim of this systematic review is to provide an evidence-based systematic appraisal of public health initiatives implemented by CHR-P services worldwide, in the context of an established public health framework identifying social determinants of mental disorders. […] CHR-P services can impact academic/occupational performance, cognitive skills and quality of life and promote good mental health. […] Through these activities, CHR-P services can impact mental health literacy, attitude towards mental disorders, self-management skills, family and significant relationships, social skills, academic/occupational performance, cognitive skills, physical health and quality of life, and promote good mental health. […] This review supports the importance of increasing the roll out of these services across the globe and improved funding given the broader value and potential wider impact on population mental health of these services.
- #82 From Prevention to Preemption: A Paradigm Shift in Psychiatryhttps://www.psychiatrictimes.com/view/prevention-preemption-paradigm-shift-psychiatry
Universal prevention has been a focus of psychiatric research for the past 4 decades. Using a public health approach, research has shown that mitigating major risk factors, such as poverty and early life stress, and promoting protective factors can improve behavioral outcomes. […] While we certainly can do much more to implement what we already know, it may soon be time for us to consider a shift from universal prevention provided in the broad population to preemptive approaches. Preemptive interventions target those at greatest risk for mental illness and those with subdiagnostic signs or symptoms, and they provide what previously has been labeled selective and indicated prevention. […] A trajectory model will be critical, recognizing that chronic disorders evolve for years or even decades before they are diagnosed in their late stages (for example, dementia or psychosis).
- #83 From Prevention to Preemption: A Paradigm Shift in Psychiatryhttps://www.psychiatrictimes.com/view/prevention-preemption-paradigm-shift-psychiatry
Universal prevention has been a focus of psychiatric research for the past 4 decades. Using a public health approach, research has shown that mitigating major risk factors, such as poverty and early life stress, and promoting protective factors can improve behavioral outcomes. […] While we certainly can do much more to implement what we already know, it may soon be time for us to consider a shift from universal prevention provided in the broad population to preemptive approaches. Preemptive interventions target those at greatest risk for mental illness and those with subdiagnostic signs or symptoms, and they provide what previously has been labeled selective and indicated prevention. […] A trajectory model will be critical, recognizing that chronic disorders evolve for years or even decades before they are diagnosed in their late stages (for example, dementia or psychosis).
- #84 From Prevention to Preemption: A Paradigm Shift in Psychiatryhttps://www.psychiatrictimes.com/view/prevention-preemption-paradigm-shift-psychiatry
A preemptive approach promises to reduce morbidity and mortality by intervening early, before the full syndrome develops, and re-aligning the trajectory of development so the individual identified as at risk has the greatest opportunity for the best outcome. […] In the meantime, there is much we can do with known predictors and proven intervention strategies that are in need of broader implementation in the community. We know already that a history of psychosis predicts a subsequent psychotic episode and that a suicide attempt is the highest risk factor for a subsequent completed suicide. Yet, more than 30% of those with a first psychotic episode will discontinue treatment in the first year, increasing their risk of relapse 5-fold, and fewer than 50% of adolescents presenting to emergency departments after a suicide attempt receive any follow-up. […] While research develops transformative information and tools for preemption, we need more effective implementation of currently available treatments to ensure the best outcomes. In the near-term, preventing relapse will have the greatest impact on public health.
- #85 Preventive psychiatry: a blueprint for improving the mental health of young peoplehttps://pmc.ncbi.nlm.nih.gov/articles/PMC8129854/
The approach to promotion of good mental health is currently fragmented. […] We leverage the knowledge gained from the review to develop a blueprint for future research and practice of preventive psychiatry in young people: integrating universal and targeted frameworks; advancing multivariable, transdiagnostic, multiendpoint epidemiological knowledge; synergically preventing common and infrequent mental disorders; preventing physical and mental health burden together; implementing stratified/personalized prognosis; establishing evidencebased preventive interventions; developing an ethical framework, improving prevention through education/training; consolidating the costeffectiveness of preventive psychiatry; and decreasing inequalities. […] An urgent individual, societal, and global level response is needed to reduce the incidence and burden of mental disorders in young people.
- #86https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
Preventive psychiatry aims at the reduction of mental disorders and behavioural problems by identifying risk and protective factors and applying evidence-based interventions in the framework of primary, secondary and tertiary prevention. […] The concept of prevention in psychiatry has evolved over the last few decades and covers a wide range of strategies and objectives for primary, secondary, and tertiary prevention. […] Promotion of mental health and wellness is a related concept. The distinction between mental health promotion and mental disorder prevention lies in their targeted outcomes. […] However, differences between prevention, treatment, and care are not always clear, and its boundaries are less defined. […] There is an urgent need to identify the action required to accomplish overall goals in mental health prevention.
- #87https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
We need to connect the dots and develop an evidence-based systemic approach if progress is to be realized in this direction. […] Primary prevention aims at reducing the incidence of disease. […] Primary prevention has been further divided into universal, selective, and indicated prevention. […] The protective factors refer to conditions that improve people’s resistance to risk factors and have been defined as those factors that modify, ameliorate, or alter a person’s response to some environmental hazard that predisposes to a maladaptive outcome. […] There are a few general principles for effective prevention programs by addressing the factors that play causal roles, reverse or reduce risk factors, enhance protective factors to increase competency in multiple domains, and have to be age specific, developmentally appropriate, and culturally sensitive.
- #88https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
Preventive psychiatry has a role in managing work stress, returning people to work as soon as possible following illness, and preventing work-related health problems, especially among the most vulnerable. […] Thus, preventive psychiatry, located within a public mental health framework, provides an opportunity to recognize more explicitly important preventive elements of the existing psychiatric practice. […] Prevention of violence and hostility between adults and young people has been long recognized as a core task of preventive psychiatry. […] Hence, a fundamental shift is needed in the way we view health services. Prevention should be guided by available evidence, and mental disorders have multiple determinants. […] Accordingly, preventive strategy should address these multiple causes and their interactions. […] Effective programs can reduce risk of mental disorders.
- #89https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
Preventive psychiatry has a role in managing work stress, returning people to work as soon as possible following illness, and preventing work-related health problems, especially among the most vulnerable. […] Thus, preventive psychiatry, located within a public mental health framework, provides an opportunity to recognize more explicitly important preventive elements of the existing psychiatric practice. […] Prevention of violence and hostility between adults and young people has been long recognized as a core task of preventive psychiatry. […] Hence, a fundamental shift is needed in the way we view health services. Prevention should be guided by available evidence, and mental disorders have multiple determinants. […] Accordingly, preventive strategy should address these multiple causes and their interactions. […] Effective programs can reduce risk of mental disorders.
- #90 WHO EMRO | Promotion of mental health and prevention of mental disorders: priorities for implementation | Volume 21, issue 7 | EMHJ volume 21, 2015https://www.emro.who.int/emhj-volume-21-2015/volume-21-issue-7/promotion-of-mental-health-and-prevention-of-mental-disorders-priorities-for-implementation.html
The best practice interventions identified in this review have achieved success across a diverse range of countries and contexts. However, few have been scaled up at a country level. Therefore, evidence of the feasibility of implementing these in an effective and sustainable manner in the EMR needs to be strengthened. […] There is an urgent need to invest in building the policy, practice and research capacity for mental health promotion and prevention in the EMR to ensure that resources are in place for implementing and evaluating the interventions identified as best practices and good practices in the local context.
- #91https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
The evidence-based risk and protective factors for prevention in mental health are social, environmental, economic, individual and family-related, and genetic factors. […] Some of the specific mental disorders for which preventive strategies have been used are conduct disorders in children, depression, anxiety, eating disorder and suicide, old age problems, alcohol and drug abuse. […] Prevention of mental disorders is a public health priority. […] Mental disorders have multiple determinants. Prevention must be multi-prolonged and multidisciplinary effort. […] Effective prevention can reduce the risk of mental disorders. […] Successful programs and policies should be made widely available. […] Protecting human rights is a major strategy to prevent mental disorder. […] Preventive psychiatry can mitigate negative stereotypes about professionals that undermine public confidence in modern specialist psychiatric expertise and evidence-based interventions.
- #92https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
The evidence-based risk and protective factors for prevention in mental health are social, environmental, economic, individual and family-related, and genetic factors. […] Some of the specific mental disorders for which preventive strategies have been used are conduct disorders in children, depression, anxiety, eating disorder and suicide, old age problems, alcohol and drug abuse. […] Prevention of mental disorders is a public health priority. […] Mental disorders have multiple determinants. Prevention must be multi-prolonged and multidisciplinary effort. […] Effective prevention can reduce the risk of mental disorders. […] Successful programs and policies should be made widely available. […] Protecting human rights is a major strategy to prevent mental disorder. […] Preventive psychiatry can mitigate negative stereotypes about professionals that undermine public confidence in modern specialist psychiatric expertise and evidence-based interventions.
- #93https://journals.lww.com/indianjpsychiatry/fulltext/2017/59040/primary_prevention_in_psychiatry_in_general.20.aspx
An effective primary prevention program in psychiatry can work at macro level aimed at changing the society and the culture and at microlevels aimed at individuals, small groups or social networks. […] Effective prevention can help in reducing stigma, discrimination, and human rights violations associated with mental disorders. […] However, primary prevention has not been recognized as a responsibility by the mental health professionals. […] Primary prevention strategies can also be employed for the patients visiting psychiatric services and also for their caregivers. […] Universal primary prevention strategies can be introduced by improving the general outpatient and inpatient facilities and display of mental health education material at prominent places. […] Caregiver self-help and support groups can be formed for tackling stigma and promoting advocacy.
- #94https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
The evidence-based risk and protective factors for prevention in mental health are social, environmental, economic, individual and family-related, and genetic factors. […] Some of the specific mental disorders for which preventive strategies have been used are conduct disorders in children, depression, anxiety, eating disorder and suicide, old age problems, alcohol and drug abuse. […] Prevention of mental disorders is a public health priority. […] Mental disorders have multiple determinants. Prevention must be multi-prolonged and multidisciplinary effort. […] Effective prevention can reduce the risk of mental disorders. […] Successful programs and policies should be made widely available. […] Protecting human rights is a major strategy to prevent mental disorder. […] Preventive psychiatry can mitigate negative stereotypes about professionals that undermine public confidence in modern specialist psychiatric expertise and evidence-based interventions.
- #95https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
The evidence-based risk and protective factors for prevention in mental health are social, environmental, economic, individual and family-related, and genetic factors. […] Some of the specific mental disorders for which preventive strategies have been used are conduct disorders in children, depression, anxiety, eating disorder and suicide, old age problems, alcohol and drug abuse. […] Prevention of mental disorders is a public health priority. […] Mental disorders have multiple determinants. Prevention must be multi-prolonged and multidisciplinary effort. […] Effective prevention can reduce the risk of mental disorders. […] Successful programs and policies should be made widely available. […] Protecting human rights is a major strategy to prevent mental disorder. […] Preventive psychiatry can mitigate negative stereotypes about professionals that undermine public confidence in modern specialist psychiatric expertise and evidence-based interventions.
- #96https://journals.lww.com/ijsp/fulltext/2017/33020/preventive_psychiatry__overview.3.aspx
Preventive psychiatry has a role in managing work stress, returning people to work as soon as possible following illness, and preventing work-related health problems, especially among the most vulnerable. […] Thus, preventive psychiatry, located within a public mental health framework, provides an opportunity to recognize more explicitly important preventive elements of the existing psychiatric practice. […] Prevention of violence and hostility between adults and young people has been long recognized as a core task of preventive psychiatry. […] Hence, a fundamental shift is needed in the way we view health services. Prevention should be guided by available evidence, and mental disorders have multiple determinants. […] Accordingly, preventive strategy should address these multiple causes and their interactions. […] Effective programs can reduce risk of mental disorders.
- #97 Preventive psychiatry: a blueprint for improving the mental health of young peoplehttps://pmc.ncbi.nlm.nih.gov/articles/PMC8129854/
The approach to promotion of good mental health is currently fragmented. […] We leverage the knowledge gained from the review to develop a blueprint for future research and practice of preventive psychiatry in young people: integrating universal and targeted frameworks; advancing multivariable, transdiagnostic, multiendpoint epidemiological knowledge; synergically preventing common and infrequent mental disorders; preventing physical and mental health burden together; implementing stratified/personalized prognosis; establishing evidencebased preventive interventions; developing an ethical framework, improving prevention through education/training; consolidating the costeffectiveness of preventive psychiatry; and decreasing inequalities. […] An urgent individual, societal, and global level response is needed to reduce the incidence and burden of mental disorders in young people.