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Prevention: the new holy grail of treating mental illness – a response

2019-06-12T10:33:17+00:00 June 12th, 2019|blog|Comments Off on Prevention: the new holy grail of treating mental illness – a response

In response to Mark Rice-Oxley’s article Prevention: The new Holy Grail of Mental Illness in the Guardian on the 8th June.

Youth is the stage at which most mental disorders, often detected for the first time in adult life, emerge. Yes, provision of mental health services is weakest during adolescence and the focus on prevention for this age has only just begun. There are multiple risk factors for mental health disorders which are well established, many of which are mentioned in the article. Protective factors play a powerful role in mitigating the effect of such risk factors and are essential considerations in promoting positive mental health and in prevention. Many protective factors are community-based, such as, for example, the strong attachment of a single adult, the provision of adequate psychosocial stimulation during childhood and a close-knit community.  However, modern-day focus on prevention tends to revolve around bringing about individual change.

Individual change directed prevention can be beneficial in the early stage of a mental ill health condition with simple measures such as psychosocial support, self-help strategies and education delivered typically in non-clinical settings such as schools, for example, providing opportunities to reduce risk factors and strengthen protective factors. Prevention is also about GP’s and other primary care workers being educated better to engage young people to recognise mental and substance use disorders and to deliver simple treatments, together with teachers and parent education and engagement.

Fundamental to promoting youth mental health and preventing mental ill health is through strengthening the nurturing qualities of the family system and community networks while explicitly acknowledging the rights of young people. This means recognising families and communities as major players in determining the mental health of young people. Young people must be at the heart of all policy making and should be consulted on what constitutes a ‘whole school (or indeed a ‘whole college’ or ‘whole university’) approach’.

Few individuals around the globe have access to good quality mental health care, yet most will have access to a mobile phone. Digital technology holds promise for improving access to and quality of healthcare. Prevention can also be made possible through the provision of effective early intervention tools provided digitally, although rigorous assessment of effectiveness should be at the heart of such provision, alongside cost implications and careful considerations of potential risks.

Ultimately, as the saying goes, one expects ‘prevention to be better than the cure.’ However, little is known as to the cost effectiveness of mental ill health prevention compared with the provision of effective early intervention for example, where, as the article points out, there is clearly a need for resource allocation. Due to long waiting lists and the growing burden of poor mental health perhaps we should be focussing on both the cure as well as prevention?


Dr Nihara Krause, Consultant Clinical Psychologist

Founder and CEO stem4


stem4 is a teenage mental health charity which focusses on prevention and early intervention through the provision of mental health education in secondary schools. It provides education and training to students, parents, education professionals, GPs and school nurses. stem4 are the proud developers of the Calm Harm app to help manage self-harm and Clear Fear app to help manage anxiety, together with over one million twenty thousand downloads across the world.