Preventing mental illness

For the past couple of decades, prevention has been the buzzword in health care – and rightly so. Of course we would all be best served if we could prevent ourselves from getting sick in the first place rather than dealing with the consequences of illness that has already set in.

Healthy lifestyles, vitamin supplements, vaccines and a slew of different prevention regimens have made it into the spotlight in recent years to help people prevent all sorts of ailments from arthritis to diabetes and heart disease.

In mental health care the talk has been a little different. There are a number of lifestyle measures we recommend to avoid triggering the onset of a disorder or worsening symptoms – getting adequate and regular sleep and exercise, avoiding things such as illicit drugs, alcohol or caffeine and learning to manage stress are all important.

But prevention has not been at the centre of mental health discussions and many have been skeptical as to whether we really can prevent a person from developing schizophrenia, depression, bipolar disorder or other psychiatric illnesses.

A series of recent studies focused on strategies to prevent mental illness and have yielded some promising results.

Some studies conducted over the past decade have examined whether improved childhood nutrition may prevent antisocial behaviour; whether drug treatment could prevent schizophrenia or bipolar disorder from developing in young people at high risk; and whether suicide prevention programs are effective. Some of these have yielded positive results.

More recently, three studies have also shown some promise in the prevention of mental health issues. One study conducted in the Netherlands aimed to determine whether a brief intervention could keep patients on the brink of clinical depression from developing the disorder.

In this study, 200 patients with sub-threshold depression were randomly assigned to receive either care as usual from their primary health care provider or the usual care plus an experimental intervention. The intervention consisted of a self-help manual on how to manage moods as well as six brief phone conversations with a prevention worker about how to apply the techniques in the manual.

A year later, 18% of the control group had developed clinical depression while only 12% of the experimental group had. This difference was considered statistically significant and reported this April in the British Journal of Psychiatry.

Another study, done in the US, examined whether a school based program called the PATHS curriculum could prevent certain behaviour problems in children. This curriculum is designed to help school children develop social and emotional competence by practicing self-control strategies. At seven months and again at one year after the curriculum, the children exhibited better verbal fluency and inhibitory control than those not in the PATHS curriculum and they also showed fewer behaviour problems.

Finally, a third study conducted in Norway focused on preventing suicide among individuals in the early stages of schizophrenia since this is a particularly high risk group. In this study, researchers employed a media education campaign in two communities to see if increased awareness would help to bring people in earlier for treatment and thereby prevent suicide.

The two communities with the education campaign were compared against two similar communities without such an intervention. Over four years, individuals seeking first time treatment for schizophrenia were assessed and researchers did find that those exposed to the education campaign had significantly fewer suicidal thoughts and behaviours than the control group. By seeking earlier treatment, these individuals appeared to reduce their risk of suicide.

These three studies only mark the beginning of the kind of research that needs to be carried out extensively in the field of mental health to learn what kinds of simple interventions can be used to help to minimize or prevent mental health conditions from developing.

In these examples, the methods used were relatively cost effective and straight forward to implement and were also non-medical in nature and yet had positive results in reducing a variety of mental health problems.

 

Current Studies

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