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Concept Version 11
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Preventing Psychological Disorders

Focusing on the prevention of mental illness, rather than only on treating existing mental illness, has numerous health and economic benefits.

Learning Objective

  • Give examples of primary, secondary, and tertiary approaches to preventing psychological disorders


Key Points

    • Prevention of mental illness has a number of benefits, ranging from improvements in individuals' well-being to positive economic and social changes.
    • Risk factors for mental illness include both genetic and environmental influences.
    • Prevention efforts involve assessing risk factors for mental illness. There are three levels of prevention: primary, secondary, and tertiary.
    • Primary prevention targets individuals who are at high risk for developing a disorder based on biological, social, or psychological risk factors (e.g., teaching emotion-regulation skills to teens).
    • Secondary prevention seeks to diagnose and treat a disorder in its early stages (e.g., rape crisis counseling).
    • Tertiary prevention targets individuals who already have a disorder by seeking to reduce or eliminate the negative impact of the disorder (e.g., Alcoholics Anonymous, or AA).

Terms

  • predisposition

    The state of being susceptible to something, especially to a disease or other health problem.

  • stressor

    An environmental condition or influence that causes distress for an organism.

  • intervention

    The action of interfering in a course of events.

  • primary prevention

    Efforts to avoid occurrence of disease either through eliminating disease agents or through increasing resistance to disease. Examples in the context of physical health include immunization against disease, maintaining a healthy diet and exercise regimen, and avoiding smoking.


Full Text

Prevention of mental illness has a number of benefits, ranging from improvements in individuals' well-being to positive economic and social changes. The 2004 report of the World Health Organization (WHO) Prevention of Mental Disorders stated that "prevention of these disorders is obviously one of the most effective ways to reduce the [disease] burden." Similarly, the 2011 European Psychiatric Association (EPA) guidance on prevention of mental disorders states that "There is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions."

Risk Assessment

Risk factors for mental illness include both genetic and environmental influences. Environmental influences include early childhood relationships and experiences (such as abuse or neglect), poverty, the effects of race and racism, and major life stressors (such as a breakup, the loss of a job, or the death of a loved one). Other risk factors may include family history of mental illness (such as depression or anxiety), temperament, and attitudes (e.g., pessimism).

Some mental disorders have a genetic link. Usually this link is a predisposition to developing the disorder, which means that while an individual may be more likely than other individuals to develop it, there is no guarantee that they will. Primary prevention (discussed below) can help reduce the likelihood that a genetically predisposed individual will develop a given disorder.

Risk factors and genetics

A person’s risk of developing schizophrenia increases if a relative has schizophrenia—the closer the genetic relationship, the higher the risk.

Three Levels of Prevention

Prevention falls into three levels: primary, secondary, and tertiary. Primary prevention targets individuals who are at a high risk for developing a disorder; secondary prevention targets those who are in the early stages of a disorder; and tertiary prevention targets individuals who already have a disorder by seeking to reduce or eliminate its negative impact.

Primary Prevention

Primary prevention includes methods to avoid the occurrence of a disorder or disease altogether. Most population-based health promotion efforts are of this type. This method targets individuals and groups who have a high risk of developing a mental illness based on biological, social, or psychological risk factors. Primary prevention programs might include teaching parents effective parenting skills, distributing condoms to students who are at high risk for STIs or teen pregnancy, or providing social support to children of divorce. Research has found such programs to be highly effective, and financially speaking the cost of implementing such primary prevention programs is often much lower than the ultimate cost of caring for individuals after they have been diagnosed with the disorder or disease.

Secondary Prevention

Secondary prevention includes methods to diagnose and treat a disorder or disease in its early stages before it causes significant distress. This approach also aims to lower the rate of established cases. An example of a secondary prevention program is rape crisis counseling. After being raped, an individual may develop or be in the early stages of developing a number of disorders such as depression, anxiety, or post-traumatic stress disorder (PTSD). Early intervention through counseling can help minimize the progression of one or more of these mental health issues.

Tertiary Prevention

Tertiary prevention includes methods to reduce the negative impact of existing disorders or diseases by reducing complications and restoring lost function. These methods include interventions that prevent relapse, promote rehabilitation, and reduce the nature of the disorder. Examples of tertiary prevention programs include Alcoholics Anonymous (AA), diabetes control programs, and home visits to those who are chronically ill.

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