Volume 5 Issue 5 May 2015
Consultation Liaison Psychiatry Focus: ‘Community Medicine’
Prevention is established mode of leading disease free life. Many mental disorders are associated with disability. Hence its prevention certainly can help in reducing disease burden & in turn improving quality of life of patients and society in general. However the prevention strategies are neglected and not practiced to the extent it should be. Here is an attempt to increase awareness about the same.
Levels of prevention of mental illnesses are: 1) Primary: To reduce incidence of new cases. 2) Secondary: Screening, early diagnosis & prompt treatment & 3) Tertiary: Reducing recurrence of disease & disability.
The prevention has three distinct strategies: Universal (for all), Selective (for high risk group) & Indicated (for high risk & symptomatic, however not meeting diagnostic criteria).
Improving nutrition, housing, access to education, economic security, good social support & legislations are universal strategies.
Promoting healthy starts of life by interventions during pregnancy (including healthy mother initiative, prevention of substances during pregnancy) & early childhood (school placements, parenting skill training) are types of selective strategies. Reducing child abuse & neglect, teaching children self defense, preventing bullying, and discrimination at school are also part of selective interventions. Provision of special schooling, children support groups and remedial education can help reducing psychiatric morbidity in special need children.
Indicated strategies aims at improving mental health care facilities at grass root level with easy access for diagnosis & management at early stages before the disability sets in, it also includes increasing awareness in primary health care providers towards mental illness, reducing stigma & prompt referral of early symptomatic cases for expert opinion. This can prevent the duration of untreated episode and symptoms can be managed at mild level thus helping in preventing disability in future.
Apart from above strategies, one should emphasize on improving coping strategies, time management, stress management, positive support group, healthy lifestyle including exercise to deal better with stress and not to succumb to illnesses.
K. J. Somaiya Medical College, Hospital & Research Centre, Mumbai
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