Prevention of mental disorders are measures that try to decrease the chances of a mental disorder occurring. A 2004 WHO report stated that "prevention of these disorders is obviously one of the most effective ways to reduce the disease burden." The 2011 European Psychiatric Association (EPA) guidance on prevention of mental disorders states "There is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions." A 2011 UK Department of Health report on the economic case for mental health promotion and mental illness prevention found that "many interventions are outstandingly good value for money, low in cost and often become self-financing over time, saving public expenditure". In 2016, the National Institute of Mental Health re-affirmed prevention as a research priority area.
Methods
Parenting
Parenting may affect the child's mental health, and evidence suggests that helping parents to be more effective with their children can address mental health needs.
Assessing parenting capability has been raised in child protection and other contexts. Delaying of potential very young pregnancies could lead to better mental health causal risk factors such as improved parenting skills and more stable homes, and various approaches have been used to encourage such behaviour change. Some countries run conditional cash transfer welfare programs where payment is conditional on behaviour of the recipients. Compulsory contraception has been used to prevent future mental illness.
Pre-emptive CBT
Use of cognitive behavioral therapy (CBT) with people at risk has significantly reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and also given significant improvements in explanatory style, hopelessness, and dysfunctional attitudes. In 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT for people at risk of psychosis. As of 2018, some health providers now advocate pre-emptive use of CBT to prevent worsening of mental illnesses.
Mental silence meditation
Sahaja meditators scored above control groups for emotional well-being and mental health measures on SF-36 ratings, leading to proposed use for mental illness prevention, although this result could be due to meditators having other characteristics leading to good mental health, such as higher general self care.
Internet- and mobile-based interventions
A review found that a number of studies have shown that internet- and mobile-based interventions can be effective in preventing mental disorders.
Specific diseases
Depression
For depressive disorders, when people participated in interventions, some studies show the number of new cases is reduced by 22% to 38%. These interventions included CBT. Such interventions also save costs. Depression prevention continues to be called for.
Anxiety
For anxiety disorders, use of cognitive behavioral therapy (CBT) with people at risk has significantly reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and also given significant improvements in explanatory style, hopelessness, and dysfunctional attitudes. Other interventions (parental inhibition reduction, behaviourism, parental modelling, problem-solving and communication skills) have also produced significant benefits. People with subthreshold panic disorder were found to benefit from use of CBT. for older people, a stepped-care intervention (watchful waiting, CBT and medication if appropriate) achieved a 50% lower incidence rate of depression and anxiety disorders in a patient group aged 75 or older. for younger people, it has been found that teaching CBT in schools reduced anxiety in children, and a review found that most universal, selective and indicated prevention programs are effective in reducing symptoms of anxiety in children and adolescents. for university students mindfulness has been shown to reduce subsequent anxiety.
Psychosis
In those at high risk there is tentative evidence that psychosis incidence may be reduced with the use of CBT or other types of therapy. In 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT for people at risk of psychosis.
There is also tentative evidence that treatment may help those with early symptoms. Antipsychotic medications are not recommended for preventing psychosis.
For schizophrenia, one study of preventative CBT showed a positive effect and another showed neutral effect.
