Prevention of mental disorders, substance abuse, and problem behaviors

March 3, 2011

Many mental, emotional and behavioral disorders can be prevented before they begin and there is robust scientific base of evidence to support this conclusion, according to a report in the March issue of the American Psychiatric Association’s journal Psychiatric Services.

The article highlights and expands on the research identified in the 2009 Institute of Medicine report Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Examples of evidence-based prevention interventions include parenting programs, particularly for parents of children preschool through middle school age, and prevention of depression, particularly with high risk groups, using cognitive-behavioral strategies and psychoeducational, family-based approaches. The report identifies three levels of prevention approaches:

• universal approaches addressing an entire population;
• selective approaches for people at elevated risk; and
• indicated approaches for people showing early signs of illness.

Prevention is developmental in perspective and often interdisciplinary in practice, according to the authors. Prevention focuses on young people because half of all mental, emotional, and behavioral disorders start by age 14 and three-fourths start by age 24. Also, there is typically a period of two to four years between the first symptoms and onset of a diagnosable disorder.

The article includes specific recommendations for psychiatrists and other mental health clinicians for individual practice and for advocating for broader system changes. “Our main recommendation for psychiatrists and practicing mental health clinicians is to think and act more preventively.” Among the specific recommendations for psychiatrists are:

• Understand evidence-based practices for mental health promotion and prevention. Look for
opportunities when these might apply.
• Encourage the developmental competencies of children. Use preventive strategies for children at risk,
such as children of parents with a mental illness or children with family stresses (such as divorce or
job loss).
• Support the and parenting skills of parents.
• Promote widespread use of evidence-based prevention and health promotion in schools, in
communities, and in health care.
• Advocate for addressing the common risk factors for mental illness, such as poverty and exposure to

Implementing prevention would require “a paradigm shift to implementing strategies before the onset of illness and treating the population before waiting for people to come to our door,” the authors note.

Explore further: Sudden death of a parent may pose mental health risks for children, surviving caregivers

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2.7 / 5 (7) Mar 03, 2011
Nowhere is it mentioned a major cause of mental illness, that being the damage inflicted on otherwise healthy fetuses by unthinking, uncaring, addicted and substance-abusive mothers-to-be. Women wanting to have children should be screened for a history of drug, alcohol, and tobacco use as they are now for other diseases. A strict monitoring program during their entire pregnancy should be imposed, and if these women are found to be endangering the health of their children they should be immediately incarcerated until she gives birth.

It will soon be possible to monitor pregnant women electronically, remotely, and in real time, to ensure that what they are ingesting will not harm their babies. There is no reason for expectant mothers not to submit to this, and it is an ethical imperative that it be done whenever practical.

With the ability to create a human life comes an awesome responsibility. That pending new life will belong to the child, not the mother. It is not hers to ruin.

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