RECENT ADVANCES IN EVIDENCE FOR PREVENTION OF MENTAL DISORDERS I

Promoting Mental Health: Concepts, Emerging Evidence, Practice Helen Herrman, University of Melbourne, Australia Shekhar Saxena, World Health Organization, Geneva Rob Moodie, Victorian Health Promotion Foundation, Australia WPA Section on Public Policy and Psychiatry Mental Health Ability to think and learn, and the ability to live with one’s own emotions and the reactions of others A state of balance, many factors Inseparable from physical health More than the absence of disease Mental Health: Missed Opportunities The impact of social & economic conditions on mental health Governments can influence this impact Mental Health Promotion Decisions in the education, welfare, housing, employment and health sectors influence mental health Social connections Tolerance of difference Economic participation Partnerships: mental health in schools, family support, living with chronic illness WHO Western Pacific Region Resolution endorsed by the Regional Committee, 12 September 2001, urges Member States to encourage recognition of mental health as a valued community resource and to involve general health services as well as non-health sectors, such as education, employment, business and family welfare, and nongovernmental organizations in supporting mental health and preventing mental disorders; to ensure that national development programmes take into account the impact of social and economic factors on mental health UN General Assembly Resolution A/Res/58/173 UN Resolution, General Assembly December 2003 58/173 The right of everyone to the enjoyment of the highest attainable standard of physical and mental health UN General Assembly Resolution A/Res/58/173 Calls upon States to guarantee that the right of everyone to the enjoyment of the highest attainable standard of physical and mental health will be exercised without discrimination of any kind. UN General Assembly Resolution A/Res/58/173 Reaffirms that the achievement of highest attainable level of health is a most important worldwide social goal, the realization of which requires action on the part of many other social and economic sectors in addition to the health sectors. Mental Health Promotion Victorian Health Promotion Foundation (VicHealth) With Rob Moodie, Lyn Walker, Irene Verins VicHealth’s focus: together with clinical care ...the social and economic costs of mental ill health are increasing …reducing these costs can only be achieved through mental health promotion and prevention, at community and country levels, alongside treatment and rehabilitation for mental disorders PROMOTION    PREVENTION EARLY INTERVENTION   TREATMENT REHABILITATION VICHEALTH’S FOCUS Mental Health Promotion Framework Determinants of mental health Social Connectedness Freedom from discrimination & violence Economic participation Population Groups Rural, Youth, Older, Indigenous, New arrivals Settings for Action Family, sport & recreation, transport, education, environment, work, the arts, culture, health Health Promotion Actions Policy development, Legislative reform, Research, monitoring and evaluation, Project development and funding, Communications and advocacy Mental Health Promotion Framework Intermediate Long Term  Less stress, outcomes Individuals Increased mental health literacy Less family disruption Community Accessible & appropriate services Safe environments Enhanced capacity Organisational Healthy Policies & programs Partnerships in mental health promotion Benefits Better physical health, Longer life expectancy, Less mental illness Higher productivity Improved quality of life anxiety, depression WHO Global Project on Mental Health Promotion Promoting Mental Health: Concepts, Emerging Evidence, Practice A Report from the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Victorian Health Promotion Foundation (VicHealth) and The University of Melbourne 2004 Forthcoming……. The Full Report Promoting Mental Health: Concepts, Emerging Evidence, Practice. A Report from the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Victorian Health Promotion Foundation (VicHealth) and The University of Melbourne Herrman H, Saxena S & Moodie R. Geneva, WHO 2005 Promoting Mental Health Contributors AFR Nigeria South Africa Canada Chile USA Islamic Republic of Iran Finland France Ireland Netherlands Norway Spain Sweden Switzerland The former Yugoslav Republic of Macedonia United Kingdom India AMR EMR EUR SEAR WPR Australia New Zealand There is no health without mental health Mental health is an integral part of health The goals and traditions of public health and health promotion can be applied just as usefully in the field of mental health as they have been in heart health, infectious diseases and tobacco control Mental health is more than the absence of mental illness Mental health is described by WHO as: ... a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community Mental health is determined by multiple factors Mental health and mental illnesses are determined by many interacting social, economic, psychological, and biological factors Just as health and illness in general Mental health is linked to behaviour Mental, social, and behavioural problems interact so as to intensify each other’s effects on well-being e.g. substance abuse, depression, violence, and abuse of women and children Mental health can be enhanced by effective public health interventions Despite uncertainties and gaps in the evidence We know enough about the links between social experience and mental health to make a compelling case to apply locally appropriate policy and practice interventions to promote mental health Basic civil, political, economic, social, and cultural rights are fundamental to the promotion of mental health Without the security and freedom provided by these rights it is very difficult to maintain a high level of mental health Inter-sectoral linkage is the key for mental health promotion Mental health can be improved through the collective action of society Improving mental health requires policies and programs in government and business sectors including education, labour, justice, transport, environment, housing, and welfare, as well as specific activities in the health field Mental health is everybody’s business Communities, commercial organizations, and health professionals There is an important role of the decision-makers in governments at local and national levels and of international organizations Specific Evidence-Based Interventions: Examples Early childhood interventions Home visiting for pregnant women Pre-school learning and social programs Combined nutritional and psychosocial interventions in disadvantaged populations Specific Evidence-Based Interventions: Examples Mental health promotion in schools Child-friendly schools Mental health interventions at work Stress prevention programmes Specific Evidence-Based Interventions: Examples Social support to old age populations Befriending initiatives Community and day centres for older people Programmes for vulnerable groups eg Minorities, indigenous people, migrants People affected by conflicts and disasters eg psychological and social interventions during the reconsolidation phase after disasters Evidence-Based Interventions: Examples Better access to education, Micro-credit schemes Housing improvement Economic, social advancement of women Housing policies Violence prevention programmes Community development programmes Communities That Care Integrated rural development Community policing initiatives Conclusions Mental health promotion and Treatment and prevention of mental illnesses Unique perspective of psychiatry Partnerships are vital Mental health in public health Within and between countries Traditional social structures, NGOs, central governments