mental illness prevention

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Introduction

Prevention is better than cure, as the old saying goes. There are many well-publicised strategies about prevention of physical health problems and how to ensure physical wellbeing, but we know that mental wellbeing is equally as important.

What we already know

Whereas treatments for mental illness are targeted at specific conditions, the prevention of mental illness is aimed at everyone. Mental and physical wellbeing are unavoidably linked and physical illness is known to increase the risk of mental illness, with NICE estimating that 20% of individuals with a chronic physical health problem are likely to have depression (1).

From a young age, we know there is a social inequality in the distribution of mental illness, with children from the poorest households having a three-fold greater risk of mental illness than children from the richest households (2). We also know that low educational level, unemployment, debt and social isolation in older people are associated with higher frequency of mental disorders.

A 2011 report (3) evaluated a range of interventions aimed at preventing mental illness during various stages of life, particularly focussing on the potential cost reductions of these interventions. Some were aimed at early intervention in high-risk groups, but successful interventions aimed at the general population included:

  • School-based Social and Emotional Learning programmes are cost-saving for the public sector and reduce healthcare burden and costs associated with criminality in later years
  • Low-cost interventions in primary care offer good value for money in reducing alcohol-related harm
  • Reducing mental health problems resulting from debt (individuals who initially have no mental health problems but find themselves having unmanageable debts within a 12-month period have a 33% higher risk of developing depression and anxiety-related problems compared to the general population who do not experience financial problems) by using a range of debt advice interventions
  • Befriending of older adults leading to a reduction in depressive symptoms

Areas of uncertainty

There are many studies looking at specific interventions to reduce the impact or development of mental illness in those who are already unwell, but we have yet to find many effective interventions to prevent mental illness in the general population. Studies have made initial suggestions, e.g. higher fish consumption is associated with a reduced risk of depression or that social media may have a role in suicide prevention but causal relationships are yet to be determined.

What’s in the pipeline

Research is ongoing in many different areas and aimed at a diverse range of groups within the general population. We know that social factors are some of the toughest to address and take the longest to change.

ROAMER (A Roadmap for Mental Health Research in Europe), a project funded by the European Commission, aims to “create a coordinated roadmap for the promotion and integration of research in mental health and well-being across Europe” and one if its main objectives is to inform the public about the importance of mental health and wellbeing research. The project has predicted that estimated returns of £1 investment could be as high as £10.27 (for early screening) or £17.97 (for mental disorder prevention).

References

  1. NICE (2009) Depression in Adults with Chronic Physical Health Problem: Treatment and Management. London: NICE.
  2. Royal College of Psychiatrists. No health without public mental health: the case for action.
  3. Mental health promotion and mental illness prevention: The economic case. Knapp, McDaid, Parsonage (eds.). DoH/Centre for Mental Health

Acknowledgement

Written by: Josephine Neale
Reviewed by:
Last updated: Sep 2015
Review due: Sep 2016

Our mental illness prevention Blogs

Lockdown loneliness: who is lonely before and during the pandemic?

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Aggelos Stamos reviews a recent cohort study led by the team behind the UCL COVID-19 Social Study on the predictors of loneliness before and during the COVID-19 pandemic.

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Media reporting of suicide: do we need more than guidelines?

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Anna Sri summarises a recent systemic review and meta-analysis led by Thomas Niederkrotenthaler, which explores the association between media reporting of suicide and actual suicidal behaviour in the community; a phenomenon known as the Werther effect.

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Suicide prevention gatekeeper training and its long-term efficacy #WSPD2020

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In his debut blog for World Suicide Prevention Day 2020, Steven MacDonald-Hart summarises a systematic review that explores the long-term efficacy of suicide prevention gatekeeper training.

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Universal interventions to prevent mental illness in medical students

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Tayla McCloud summarises a systematic review and meta-analysis on the effectiveness of universal programmes for the prevention of suicidal ideation, behaviour and mental ill health in medical students.

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Is air pollution associated with poor mental health?

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Ioannis Bakolis summarises a systematic review and meta-analysis exploring the association between air pollution exposure and the risk of mental health difficulties such as depression, anxiety and suicide.

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Suicide awareness materials: do they help people with suicidal ideation?

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Edel Ennis writes her debut blog and reviews an online RCT on the effects of suicide awareness materials on individuals with recent suicidal ideation or attempt. Do stories of hope and recovery help protect people from suicide?

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Preventive group therapy for the children of depressed parents: a qualitative evaluation

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Tamsin Ford summarises a qualitative evaluation of a preventive group intervention for the children of depressed parents, which raises more questions than it answers.

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Flu pandemics, schizophrenia and the immune system: could history repeat itself?

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Sameer Jauhar summarises a recent narrative review about the risk of schizophrenia linked to the Spanish Influenza Pandemic over 100 years ago. He relates this work to our current pandemic and considers the possibility of a link between COVID-19 and an increased risk of psychosis.

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Preventing depression: what do we need to succeed?

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Can we prevent depression globally? Emma Corcoran, Molly Bird and Natalie Shoham summarise a recent review that considers what is needed to eradicate the worldwide depression epidemic, and why.

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Media reporting of suicide loss: learning from family and friends who have been bereaved by suicide

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Hannah Scott writes her debut blog on a recent qualitative study which looks at the experiences of people bereaved by suicide regarding media reporting of the death.

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