PREVENTION IN MENTAL HEALTH

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• PREVENTION IN MENTAL HEALTH

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PRESENTER

• ROBERT K. CONYNE, Ph.D.
• PROFESSOR EMERITUS
• COUNSELING PSYCHOLOGIST
• UNIVERSITY OF CINCINNATI

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LEARNING OBJECTIVES

• TO UNDERSTAND MENTAL HEALTH PREVENTION CONCEPTS
• TO DIFFERENTIATE KNOWLEDGE AND SKILLS
• TO LEARN A MODEL FOR PREVENTION

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PERFORMANCE OBJECTIVES

• DESCRIBE KNOWLEDGE AND SKILLS NEEDED
• KNOW WHAT TO INCLUDE IN PROGRAMS
• IDENTIFY EFEECTIVE PREVENTION PROGRAMS

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Epidemiology Mental Illness

• Adults (under 55)
• 20 of U.S. adults per year (44 million)
• Children/Adolescents
• 20 of 9-17 years old per year (U.S. Surgeon
  General)

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SUBSTANCE ABUSE

• 1962 4 MILLION TRIED ILLEGAL DRUGS
• 1999 87.7 MILLION
• USERS OVER AGE 12
• -1979 25.4 MILLION
• -1992 12 MILLION
• -1999 14.8 MILLION

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LITERACY

• 20 MILLION ILLITERATE ADULTS (13)
• 20 MILLION MARGINALLY LITERATE
• -----------------------
• 4 MILLION OF THESE PEOPLE ARE REACHED

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COST OF MENTAL ILLNESS

• 1996
• -DIRECT COST 69 BILLION.
• -INDIRECT COST 78.6 BILLION
• (Surgeon General)

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ONE POPULATION AFRICAN AMERICANS

• POVERTY 1999, 22
• HOMELESS 40 OF HOMELESS POPULATION
• INCARCERATION HALF OF ALL STATE NATIONAL
  PRISONERS

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AFRICAN-AMERICANS (CONTD)

• ACCESS 20 FEWER ARE COVERED BY EMPLOYER-BASED
  HEALTH INS.
• USE ONLY ONE-HALF THAT OF WHITES EMERGENCY USE
  HIGH

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INCIDENCE

• TO REDUCE DEVELOPMENT OR RATE OF DEVELOPMENT OF
• NEW CASES OF A DISORDER OR PROBLEM

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TO REDUCE INCIDENCE

• DECREASE
• STRESS EXPLOITATION
• INCREASE
• COPING SKILLS SELF-ESTEEM
• SUPPORT
• (Albee, modified, 1982)

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PRIMARY PREVENTION

• Intentional intervention
• To reduce incidence of
• Adjustment problems in
• Currently normal populations, plus
• Promotion of mental health functioning (Durlak
  Wells, 1997)

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DEGREE OF RISK (Institute of Medicine, 1994)

• Universal for all
• Selective Based on risk markers
• Indicated Based on specific risk
• indicators and showing early signs, but no
  mental disorder

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WHY PRIMARY PREVENTION?

• TOO MANY PROBLEMS/NOT ENOUGH HELPERS
• TOO MUCH AFTER-THE-FACT
• LIMITED REACH
• DE-CONTEXTUALIZED
• STRESSORS/STRENGTHS IGNORED

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PRIMARY PREVENTIVE COUNSELING (Conyne, 2004)

• APPLICATION OF BROAD RANGE OF COUNSELING
• HEALTHY AND/OR AT RISK TARGETS
• TO AVERT FUTURE PROBLEMS AND
• TO PROMOTE GROWTH

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PREVENTIVE COUNSELING PRECEPTS

• BEFORE-THE-FACT
• HEATHY PEOPLE/AT RISK
• DEVELOP COMPETENCE
• REDUCE INCIDENCE
• GROUP AND COMMUNITY FOCUSED

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PRECEPTS (Contd)

• ECOLOGICAL FOCUS
• CULTURALLY VALID
• SOCIAL JUSTICE VALUE
• COLLABORATIVE PROCESS
• EMPOWERING

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PREVENTION SKILL SETS

•   Primary prevention perspective
•   Personal attributes behaviors
• Ethical skills
• Marketing skills
• Multicultural skills
• Group facilitation skills

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PREVENTION SKILL SET (Contd)

• Collaboration skills
• Organizational setting dynamic skills
• Trends political dynamic skills
• Research evaluation skills
• (Conyne, 2004) 

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PREVENTIVE COUNSELING MODEL (Conyne, 2004)

• PURPOSIVE STRATEGIES
• TARGETS
• METHODS

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PREVENTIVE COUNSELING MODEL (Contd)

• PURPOSIVE STRATEGIES
• SEEK SYSTEM CHANGE
• SEEK PERSON CHANGE

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MODEL (Contd)

• TARGET
• Individual
• Group
• Family
• Organization
• Community

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MODEL (Contd)

• METHODS
• DIRECT Education, Organization
• INDIRECT Consultation, Media

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EFFECTIVE PREVENTION PROGRAMS

• TARGETED
• LIFE TRAJECTORIES CHANGED
• NEW SKILLS EMERGED

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EFFECTIVE PREVENTION PROGRAMS (CONTD)

• SOCIAL SUPPORT DEVELOPED
• NATURAL SUPPORT SYSTEMS IMPROVED
• NEW CASES REDUCED

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EFFECTIVENESS CRITERIA

• WHATS BEING PREVENTED?
• WHATS BEING PROMOTED?
• IS IT BEFORE-THE-FACT?
• DOES IT INVOLVE HEALTHY AND/OR AT RISK PERSONS?
• IS THERE SYSTEM CHANGE?

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CRITERIA (Contd)

• IS IT FEASIBLE?
• USE EXISTING RESOURCES?
• IS IT COLLABORATIVE?
• STRESSORS STRENGTHS?
• IS THE METHOD SPECIFIED?
• INTERVENOR ROLES?
• ARE THERE RESULTS?

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HAPPY PREVENTION!