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

The pill and ‘baby blues’: does experiencing depression with hormonal contraception predict postpartum depression?

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Flo Martin explores a recent cohort study of Danish registry data that investigate whether women with a history of depression associated with using hormonal contraception were also at a higher risk of developing postpartum depression.

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The Body Project peer-led eating disorders prevention programme shows promise for bulimia nervosa and purging disorder

Across the three trials, 10.6% of Body Project participants went on to develop an eating disorder in comparison to 17.4% of the control groups, indicating promise in the intervention.

Georgie Parker summarises a recent study which outlines the results of three trials exploring the effectiveness of a peer-led dissonance-based programme for preventing the onset of eating disorders.

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Interventions to foster resilience in nursing staff may help (a little) in the short-term

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Olga Lainidi summarises a recent systematic review and meta-analysis investigating the effectiveness of resilience interventions on the mental health of nursing staff.

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Can social recovery therapy improve social disability in young people?

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In her debut blog, Jude Madani summarises the findings of the PRODIGY trial, which looked at the clinical and cost-effectiveness of social recovery therapy for the prevention and treatment of long-term social disability among young people with emerging severe mental illness.

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Do school-based depression and anxiety prevention programmes work?

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Ariadna Albajara Saenz blogs a systematic review that suggests school-based depression and anxiety prevention programmes are likely to have a significant public health impact when implemented on a large scale.

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No evidence that medication can prevent PTSD in people exposed to trauma, according to new Cochrane review

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In his debut blog, Richard Meiser-Stedman explores a recent Cochrane systematic review which finds no evidence for the use of medication to prevent the onset of PTSD in people who have been exposed to a traumatic event.

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The global burden of disease from mental disorders remains high

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Alejandro Arguelles Bullon summarises the latest Global Burden of Disease study (2019) looking at the prevalence, incidence and impact that mental disorders have on our lives, which shows no reduction in the burden over the last 30 years.

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Oral health self-care behaviours in people with a serious mental illness

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This review of the of oral health self-care behaviours in people with serious mental illness (SMI) included 33 studies. Most of the included studies (18) were cross-sectional and a mjority (20)were considered to be of weak design.

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Age at onset of mental disorders: global meta-analysis provides data for targeting effective interventions

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Dona Matthews summarises a comprehensive global meta-analysis that presents our best current knowledge on the age of onset of various mental disorders. This review has major implications for our mental health promotion and prevention efforts.

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Psychotherapy and antidepressant tapering can help people at risk of depression relapse, but more evidence needed before we can provide personalised treatment

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Jessica Scaife reviews a individual patient data meta-analysis exploring the continuation of antidepressants versus sequential psychological interventions to prevent relapse in depression.

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