Models of prevention

-MR. MANISH BIJALWANM. SC NURSING 1ST YR

MODELS OF PREVENTION IN MENTAL HEALTH

“Health is a state of complete physical, psychological, and social

well-being and not simply the absence of disease or infirmity.”

(World Health Organization, 1948)

•Physical good health eludes billions of people

•Death and disease from preventable causes remain high

•Behavior is a key factor in determining health

PREVENTIVE HEALTH BEHAVIOR

• Refers to interventions that are designed to prevent disorders or diseases from occurrence.

• Prevention interventions can be: universal – targeted to the whole

population targeted – targeted to individuals or

groups at increased risk indicated – targeted to individuals

with early symptoms.

PREVENTIONS

After World War II, mental health professionals explored new ways of promoting mental

health and preventing mental illness in public at large,

COMMUNITY OR PREVENTIVE APPROACH

Originated by GERALD CAPLAN

(Child & Community Psychiatrist)

•Given by Caplan in 1964

• Include:I. Primary prevention

II. Secondary prevention

III. Tertiary prevention

THE PUBLIC HEALTH MODEL

•AIM:• reducing the incidence of mental

disorders within the population

•TARGET: • Individual

• Environment

1. PRIMARY PREVENTION

•STRATEGIES:• Assisting individual to increase their ability to cope effectively with stress• Targeting and diminishing harmful forces (stressors) within the environment.

1. PRIMARY PREVENTION

•ROLE OF NURSE:Focus on:

a) targeting of groups at risk b) the provision of educational

programs.

1. PRIMARY PREVENTION

a)ROLE OF NURSE IN TARGETING OF GROUPS AT RISK Teaching oparenting skills ochild developmentophysical and psychosocial effects of alcohol/drugs otechniques of stress managementoconcepts of mental health to various groups within the community

1. PRIMARY PREVENTION

a) ROLE OF NURSE IN TARGETING OF GROUPS AT RISK Providing education and support toounemployed or homeless individualsoindividuals in various transitional periods (e.g., widows and widowers, new retirees, and women entering the work force in middle life)

1. PRIMARY PREVENTION

b) ROLE OF NURSE IN THE PROVISION OF EDUCATIONAL PROGRAMS.

• offered in a variety of settings that are convenient for the public• Churches• Schools• Colleges• community centers•workplace of employee organizations•meetings of women’s groups• health fairs

1. PRIMARY PREVENTION

AIM:•minimizing early symptoms of psychiatric illness• reducing the prevalence and duration of illness.

2. SECONDARY PREVENTION

STRATEGIES:

• early identification of problems

• prompt initiation of effective treatment.

2. SECONDARY PREVENTION

ROLE OF NURSE:• focuses on recognition of symptoms and provision of or referral for, treatment

i. Ongoing assessment of individuals at high risk for illness• during home visits• day care or community health centers

2. SECONDARY PREVENTION

ROLE OF NURSE:• focuses on recognition of symptoms and provision of

or referral for, treatment

ii. Provision of care for individuals in whom illness symptoms have been assessed• individual or group counseling• medication administration• crisis intervention• suicide hotlines• shelters for abused persons• mobile mental health units

2. SECONDARY PREVENTION

ROLE OF NURSE:• focuses on recognition of symptoms and provision of

or referral for, treatment

iii. Referrals may come from • support groups• community mental health centers• emergency services• psychiatrists or psychologists• day or partial hospitalization.• Chemotherapy and various adjunct therapies center

2. SECONDARY PREVENTION

3. TERTIARY PREVENTION

AIM:• Reducing the residual defects that are associated with severe and persistent mental illness

3. TERTIARY PREVENTION

STRATEGIES:• Preventing complications of the illness• Promoting rehabilitation that is directed toward achievement of each individual’s maximum level of functioning

ROLE OF NURSE

• Family involvement

• Occupational and recreational activities

• Rehabilitation

• Teaching the client daily living skills

• Encouraging independence

• Referring clients for various aftercare services

• Community based programmes

3. TERTIARY PREVENTION

• Sreevani R; A guide to mental health and psychiatric nursing; 2nd edition; jaypee publication; pg no. 232-235

• Townsend Mary C; psychiatric mental health nursing- concepts of care in evidence based practice; 7th edition; jaypee publication; pg 882-883

• http://www.otago.ac.nz/christchurch/otago014033.pdf

• http://link.springer.com/chapter/10.1007/0-306-47641-X_4#page-2

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