This presentation includes detail on the level of prevention of mental illness

1. Unit IX
Concept of Prevention of Mental
Disorders by Using Levels of
Prevention
Presented By:
Sapana Dahal
M.Sc. Nursing 2nd Year
6/4/2023 1

2. Objectives
At the end of the session, all the participants will
be able to explain about Prevention of Mental
Disorders.
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3. Contents
• Introduction
• Aims of Prevention
• Models of Prevention
• Articles
• References
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4. Introduction
• An ounce of prevention is worth a pound of
cure" or "Curing is costly , prevention is
priceless."
• It works by focusing on reducing risk factors
and enhancing protective factors associated
with mental illness
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5. Introduction Contd…
Prevention is defined as “Approaches and
activities aimed at reducing the likelihood that a
disease or disorder will affect an individual,
interrupting or slowing the progress of the
disorder or reducing disability.”
-WHO
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6. Aims of Mental Illness Prevention
To reduce the:
• Incidence, prevalence, and recurrence of
mental disorders.
• Time spent with symptoms.
• Risk factors for developing a mental illness
• Impact of the illness in the affected person,
their families, and the society
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7. Aims of Mental Illness Prevention
Contd…
• To increase resilience
• To help people cope with stressors adaptively
• To increase positive outcomes
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8. Aims of Mental Illness Prevention
Contd…
• To change the resources and policies of the
environment so that they do not cause stress
but rather enhance people’s functioning.
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9. Aims of Mental Illness Prevention
Contd…
A study by the National Research Council and
the Institute of Medicine (2009)on prevention of
mental disorders and substance abuse among
young people demonstrated the value of:
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10. Aims of Mental Illness Prevention
Contd…
• Strengthening families
• Strengthening individuals
• Promoting mental health in schools
• Promoting mental health through health care
and community programs
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11. Models of Prevention
• Public health prevention model
• Medical model
• Nursing model.
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12. Public Health Prevention Model
“Patient" is the community rather than the
individual, and the focus is on the amount of
mental health or illness in the community as a
whole, including factors that promote or inhibit
mental health.
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13. Public Health Prevention Model
Contd…
Use of this model require that mental health
professionals be familiar with skills such as
community needs assessment, identifying and
prioritizing target or high-risk groups, and
intervening treatments such as consultation,
education, and crisis intervention.
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14. Public Health Prevention Model
Contd…
Community Needs Assessment
• Services are developed and delivered based on
a culturally sensitive assessment of
community needs.
• Four techniques are used to estimate service
needs:
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15. Public Health Prevention Model
Contd…
Community Needs Assessment
Social indicators
Key informants
Community forums
Epidemiological studies
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16. Public Health Prevention Model
Contd…
Identifying and Prioritizing Target or High-risk
groups
After the analysis of community needs
assessments, specific high-risk groups begin to
emerge.
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17. Public Health Prevention Model
Contd…
Demographic data might show that a community has
many preadolescent females, and socioeconomic
indicators may suggest that many of these young
women live in single- parent households and in poverty.
Community forums and surveys of key informants may
reveal few recreational and social services for children
and adolescents.
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18. Public Health Prevention Model
Contd…
Epidemiological studies may report high
correlations among poverty, single- parent
households, and adolescent pregnancy. Therefore,
community mental health providers might consider
adolescents in this community to be at risk for
mental health problems and target them for
intervention.
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19. Public Health Prevention Model
Contd…
Interventions :
Applies three levels of preventive intervention to
mental illness and emotional disturbance.
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20. Public Health Prevention Model
Contd…
• Primary prevention: Primary prevention targets
both individuals and the environment. Emphasis
is two fold:
• Assisting individuals to increase their ability to
cope effectively with stress.
• Targeting and diminishing harmful forces
(stressors) within the environment.
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21. Public Health Prevention Model
Contd…
Nursing in primary prevention is focused on the
targeting of groups at risk and the provision of
educational programs such as:
• Teaching parenting skills and child
development to prospective new parents.
• Teaching physical and psychosocial effects of
alcohol/drugs to elementary school students.
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22. Public Health Prevention Model
Contd…
Secondary prevention
Accomplished through early identification of
problems and prompt initiation of effective
treatment.
Focuses on recognition of symptoms and
provision of, or referral for, treatment such as:
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23. Public Health Prevention Model
Contd…
• Ongoing assessment of individuals at high risk
for illness exacerbation
• Referral for treatment of individuals in whom
illness symptoms have been assessed.
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24. Public Health Prevention Model
Contd…
Tertiary prevention : It is accomplished in two
ways:
• Preventing complications of the illness.
• Promoting rehabilitation that is directed
toward achievement of each individual's
maximum level of functioning.
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25. Public Health Prevention Model
Contd…
Nursing in tertiary prevention focuses on helping
clients learn or relearn socially appropriate
behaviors so that they may achieve a satisfying
role within the community such as:
• Consideration of the rehabilitation process at
the time of initial diagnosis and treatment
planning.
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26. Public Health Prevention Model
Contd…
• Teaching the client daily living skills and
encouraging independence to his or her
maximum ability.
• Referring clients for various aftercare services
• Monitoring effectiveness of aftercare services.
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27. Medical Prevention Model
• Focuses on biological and brain research to
discover the specific causes of mental illness, with
primary prevention activities focused on the
prevention of illness in the individual patient.
• It consists of the following steps:
Identify a disease that warrants the development of
preventive intervention program.
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28. Medical Prevention Model
Contd…
Identify the most likely cause of the disease.
 Launch and evaluate an experimental
preventive intervention program based on the
results of those studies.
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29. Nursing Prevention Model
• It stresses the importance of promoting mental
health and preventing mental illness by
focusing on resilience, risk factors, protective
factors, vulnerability, and human responses.
• The "patient" may be an individual, family, or
community
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30. Nursing Prevention Model
Contd…
It assumes that problems are multi-causal, that
everyone is vulnerable to stressful life events,
and that any disability or problem may arise as a
consequence.
It is based on the application of the nursing
process and incorporates the following aspects:
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31. Nursing Prevention Model
Contd…
• Assessment
• Planning
• Implementation
• Evaluation
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32. Nursing Prevention Model
Contd…
Assessment
Risk Factors and Protective Factors
Target Populations
Universal
Selective
Indicated
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33. Nursing Prevention Model
Contd…
It involves identifying individuals and groups of
people who are vulnerable developing mental
disorders or who may display maladaptive
coping responses to specific stressors or risk
factors.
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34. Nursing Prevention Model
Contd…
Planning and Implementation
The nurse focuses on decreasing risk factors or
increasing protective factors through
• Health education
• Environmental change
• Social support
• Stigma reduction
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35. Nursing Prevention Model
Contd…
Health education
• It involves the strengthening of individuals and
groups through competence building or
resilience.
• Competence building
• Self-Efficacy
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36. Nursing Prevention Model
Contd…
Health education related to competence building
or increasing self-efficacy includes four types of
interventions:
• Increasing awareness of issues and events
related to health and illness, including normal
developmental tasks and problems.
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37. Nursing Prevention Model
Contd…
• Increasing understanding of potential stressors,
possible outcomes (both adaptive and
maladaptive), and alternative coping
responses.
• Increasing knowledge of where and how to
obtain needed resources.
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38. Nursing Prevention Model
Contd…
• Increasing the abilities of the individual or group
by improving such coping skills as problem
solving, communication skills, tolerance of
stress and frustration, motivation, hope, anger
management, and self-esteem.
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39. Nursing Prevention Model
Contd…
Programs and Activities:
Mental health education can take place in any
setting, can have a formal or informal structure,
can be directed toward individuals or groups.
Groups of children or adolescents can discuss peer
relationships, sexuality, or potential problem areas,
such as drug abuse or promiscuity
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40. Nursing Prevention Model
Contd…
Environmental Change
• It involves the modification of an individual's
or group's immediate environment or the
modification of the larger social system.
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41. Nursing Prevention Model
Contd…
Organizations and Politics:
Nurses affect environmental changes at a larger
organizational and political level by advocacy
and influencing health care structures and
policies.
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42. Nursing Prevention Model
Contd…
Social Support
As a primary prevention strategy, supporting
social systems means strengthening the social
supports in place to enhance their protective
factor and developing ways to buffer or cushion
the effects of a potentially stressful event.
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43. Nursing Prevention Model
Contd…
Four types of interventions in social support:
• Social support patterns can be used to assess
communities and neighborhoods to identify
problem area and high-risk groups.
• Links can be improved between community
support systems and formal mental health
services.
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44. Nursing Prevention Model
Contd…
• Naturally existing caregiving networks can be
strengthened.
• Individuals and groups can be helped to
develop, maintain, expand and use their social
networks.
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45. Nursing Prevention Model
Contd…
Informal Support Groups:
The members share a common experience, work
together toward a common goal, and use their
strengths to gain control over their lives.
Common Self-help groups such as Alcoholics
Anonymous,Parents Without Partners, Recovery,
and Parents Anonymous
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46. Nursing Prevention Model
Contd…
Stigma Reduction
An important aspect of mental health promotion
involves activities related to dispelling myths and
stereotypes associated with vulnerable groups.
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47. Nursing Prevention Model
Contd…
Three types of stigma have been identified
(Corrigan and Wassel, 2008):
• Public stigma
• Self-stigma
• Label avoidance stigma
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48. Nursing Prevention Model
Contd…
Evaluation
It is necessary to determine whether the specific
strategy implemented was the most effective,
appropriate, and efficient.
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49. Articles
A Study conducted on “Recent advances in the
prevention of mental disorders” concluded that
depression and anxiety can be prevented. Prevention
of first-episode psychosis appears promising.
Economic evaluations provide support for
prevention of depression, anxiety, and first-episode
psychosis
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50. Articles Contd…
but more studies evaluating costs and benefits
are needed to strengthen the knowledge base,
particularly regarding long-term outcomes,
which include chronicity of the prevented
disorder, as well as later occurrence of important
comorbid mental and physical health problems.
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51. Articles Contd…
Promising areas for further development include
internet or computer-based prevention strategies,
mindfulness-based interventions, and integration
of prevention programs within occupational
settings. (
Mendelson T, Eaton WW,2018 )
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52. Articles Contd…
A study conducted on Workplace interventions for
common mental disorders: a systematic meta-review
concluded that the impact primary and secondary level
prevention had on work-related aspects such as
absenteeism, presenteeism and productivity remained
relatively unexplored. Many of the more popular
approaches to stress management, such as counselling,
have limited evidence bases in terms of efficacy.
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53. Articles Contd…
In contrast, CBT-based stress management interventions
produced substantial benefits in terms of symptom
reduction, but this did not translate to notable
improvements in work-related outcomes such as
absenteeism and productivity. Tertiary interventions with
a specific focus on the workplace, such as exposure
therapy, PFT and CBT-based RTW programs had
evidence for improving work-related outcomes such as
absenteeism.
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54. Articles Contd…
It demonstrated that there are now a number of
evidence-based primary, secondary and tertiary
work-related interventions that can be
implemented either within the workplace or can
incorporate a specific work-related focus. (
Joyce S, Modini M, Christensen H, Mykletun
A, Bryant R, Mitchell PB, Harvey SB. 2016 )
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55. References
• Stuart G. Principles and Practice of Psychiatric
Nursing: Prevention and Mental Health
Promotion.10th Edition. United States of
America; Elsevier Mosby Publishers.2014.
• Townsend M. Psychiatric Mental Health
Nursing: Community Mental Health Nursing .7th
Edition. New Delhi; Jaypee Brothers
Publishers;2012.
• Stanhope M, Lancaster J. Public Health Nursing:
Mental Health Issues 8th Edition. The United
States of America: Elsevier Publishers.2014.
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56. References
• Park K. Preventive and Social Medicine : Mental
Health.25th Edition.Pune; Banarsidas Bhanot
Publishers.2019.
• Mendelson T, Eaton WW. Recent advances in the
prevention of mental disorders. Social psychiatry
and psychiatric epidemiology. 2018 Apr;53:325-
39.
• Joyce S, Modini M, Christensen H, Mykletun A,
Bryant R, Mitchell PB, Harvey SB. Workplace
interventions for common mental disorders: a
systematic meta-review. Psychological medicine.
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57. THANK YOU
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