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Prevention in Mental Health summary of lectures
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Complete summary of the lectures given at the Radboud University.
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SOWPSB3DH25E - Prevention SummaryLec 1
Almost half of the adult population (43,5%) has experienced a mental disorder in their live,
due to an incidence of 1 out of 5 adults per year. The most common mental disorders are
depression, anxiety disorders and substance abuse. 1 out of 5 persons have experienced
depression. Also, the last decades the number of suicide increased by 15% and the
incidence of burn out increased due to temporary contracts. Women seem to struggle more
with their mental health than men, but maybe it’s more common for women to talk about their
problems than that’s the case for men. Children of parents with a mental disorder are a
group with a high risk to develop a mental disorder themselves. In families with mentally ill
parents, domestic violence and child abuse is more common. This can lead to a broad
spectrum of both mental and physical diseases. These children can by consequence suffer
from aggression, bullying, anxiety, depression and eating disorders. When this is noticed by
parents or teachers it is important to confront the child with this behavior and to talk about it
to prevent the onset of a serious mental disorder.
Identification of problems or problematic behavior at early age can be very effective to
prevent the later onset of mental disorders, but also the development of effective prevention
programmes is important. This is for example the case for bullying behavior. Bullying can
lead to depression and suicide if it’s ignored by the surrounding of the offender and the
victim. The Bully Project is an American movement that tackles this ignoring behavior and
focuses on making the subject of being bullied a subject to talk about. In this way, bullying
behavior is aimed to reduce and problems like depression and suicide are aimed to be
prevented. Almost 8 percent of young people in the Netherlands are being cyber bullied.
Mentalhealthonline is a programme aimed to reduce suicide attempts among young people
by offering online help. The program is made for members of school care teams, teachers,
social workers and other professionals. It consists of eight short lessons focused on
signalling and prevention.
The most important challenges for mental health prevention are the range (mental health
care only reaches a limited amount of people with mental health disorders in society),
globalisation, economic problems, conflicts, chronic diseases, fleeing from war and a limited
budget for mental health care. Prevention care has different response options for these
problems; doing more of the same (increasing the number of psychotherapists), making
mental health care primary health care (=short term help), providing preventive courses,
training courses and support groups, reducing violence, using the internet (eHealth),
changing the social policy of municipalities (eg. poverty policy, refugee policy), improving the
quality of neighbourhoods and social capital (social networks, cohesion) and investing in
networks for joint effort.
Something else that’s problematic is that child health care pays little attention to the
parent-child relation. About 30 percent of the Dutch children between 1 and 12 have an
insecure attachment relation with their parent.
,30% of the incidence of dementia can be prevented by good night rest, keeping a healthy life
style (food, not smoking, exercise), keeping the brain active and social contacts. This is
where health promotion comes to play. Mental health promotion is part of the prevention of
mental disorders. For example, physical exercise in healthy people contribute to both their
physical and mental health by the reduction of risk on developing diseases.
Naive prevention is the opposite of professional prevention. Naive prevention is the
phenomenon of individuals, groups, organisations and society as a whole, protecting
themselves against damage and diseases to survive. Naive prevention includes biological,
psychological and social forms and mechanisms. It can be innate or learned. People are
natural preventive beings. Naive prevention is seen in daily life. Knowledge of naive
prevention is an essential condition for preventing persons from becoming too dependant on
professional health care. Where naive prevention fails, professional prevention has the task
to repair and improve preventive capacities and health promotive competences. Some
preventive mechanisms in animals are camouflage, birds migrating to the south, winter
storage of food and living in groups. Some daily preventive mechanisms of people are
reflexes, brushing your teeth, eating healthy, exercising, insuring yourself, wearing a winter
coat, condom use and wearing your seatbelt. Knowledge of naive prevention is important to
get insight into the preventive society, to discover preventive mechanisms, to gain
awareness and motivation for prevention, to complement the role of professional prevention
and to prevent proto-professionalisation. Proto-professionalisation means making people
dependent on professional care for their own health and well-being. This includes that
people make less use of their own preventive mechanisms. A participation society reduces
proto-professionalisation. In a participation society, people are responsible for their own
health. They have to organise it themselves.
Since the middle of the 19th century societal preventive actions in the context of public
health are held which had large social effects. Prevention is an essential part of health care
and health policy. Preventive effects of social policy are for example poverty and income
policty, safety, and neighbourhood renovation. The ten main prevention successes in the
period of 1900-2010 are:
1. vaccinations
2. safer workplaces
3. safer and healthier foods
4. motor-vehicle safety
, 5. control of infectious diseases
6. decline in deaths from coronary heart disease and stroke
7. family planning
8. recognition of tabacco as a health hazard
9. healthier mothers and babies
10. fluoridation of drinking water
As you can see from the list above, professional prevention has had it’s effects in several
areas of society. This is obtained through influencing behavior and influencing the
envirionment. Prevention and promotion in mental health and mental disorders is the main
focus of this course.
The most important topics for public health in the Netherlands are overweight and diabetes,
alcohol consumption and smoking, mental disorders and caregivers. Mental disorders
include depression in all age groups, loneliness among elderly, suicide and dementia.
‘Alles is gezondheid’ is a national prevention program that brings together activities in three
areas. First, it promotes health and prevents diseases in the environment in which people
live, work and recieve education. Second, it gives prevention a prominent place in health
care. Third, it keeps health protection up to standard.
The organisation of Mental Health Prevention in the Netherlands has a strongly developed
national infrastructure focused at prevention and health promotion. The picture beneath this
alinea shows an overview. This overview looks pretty complex. The main message is the
picture is that the organisation of mental health prevention is rooted on different levels in
society and that all types of organisations (schools, health care, municipalities, the
government) are concerned with the topic.
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