310 likes | 498 Views
PREVENTION IN MENTAL HEALTH. PRESENTER. ROBERT K. CONYNE, Ph.D. PROFESSOR EMERITUS COUNSELING PSYCHOLOGIST UNIVERSITY OF CINCINNATI. LEARNING OBJECTIVES. TO UNDERSTAND MENTAL HEALTH PREVENTION CONCEPTS TO DIFFERENTIATE KNOWLEDGE AND SKILLS TO LEARN A MODEL FOR PREVENTION.
E N D
PRESENTER • ROBERT K. CONYNE, Ph.D. PROFESSOR EMERITUS COUNSELING PSYCHOLOGIST UNIVERSITY OF CINCINNATI
LEARNING OBJECTIVES • TO UNDERSTAND MENTAL HEALTH PREVENTION CONCEPTS • TO DIFFERENTIATE KNOWLEDGE AND SKILLS • TO LEARN A MODEL FOR PREVENTION
PERFORMANCE OBJECTIVES • DESCRIBE KNOWLEDGE AND SKILLS NEEDED • KNOW WHAT TO INCLUDE IN PROGRAMS • IDENTIFY EFEECTIVE PREVENTION PROGRAMS
Epidemiology: MentalIllness 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)
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
LITERACY • 20 MILLION ILLITERATE ADULTS (13%) • 20 MILLION MARGINALLY LITERATE ----------------------- • 4 MILLION OF THESE PEOPLE ARE REACHED
COST OF MENTAL ILLNESS 1996: -DIRECT COST: $69 BILLION. -INDIRECT COST: $78.6 BILLION (Surgeon General)
ONE POPULATION: AFRICAN AMERICANS • POVERTY: 1999, 22% • HOMELESS: 40% OF HOMELESS POPULATION • INCARCERATION: HALF OF ALL STATE & NATIONAL PRISONERS
AFRICAN-AMERICANS (CONTD) • ACCESS: 20% FEWER ARE COVERED BY EMPLOYER-BASED HEALTH INS. • USE: ONLY ONE-HALF THAT OF WHITES; EMERGENCY USE HIGH
INCIDENCE • TO REDUCE DEVELOPMENT OR RATE OF DEVELOPMENT OF: • NEW CASES OF A DISORDER OR PROBLEM
TO REDUCE INCIDENCE • DECREASE: STRESS + EXPLOITATION • INCREASE: COPING SKILLS +SELF-ESTEEM+ SUPPORT (Albee, modified, 1982)
Intentional intervention To reduce incidence of Adjustment problems in Currently normal populations, plus Promotion of mental health functioning (Durlak & Wells, 1997) PRIMARY PREVENTION
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
WHY PRIMARY PREVENTION? • TOO MANY PROBLEMS/NOT ENOUGH HELPERS • TOO MUCH AFTER-THE-FACT • LIMITED REACH • DE-CONTEXTUALIZED • STRESSORS/STRENGTHS IGNORED
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
PREVENTIVE COUNSELING PRECEPTS • BEFORE-THE-FACT • HEATHY PEOPLE/AT RISK • DEVELOP COMPETENCE • REDUCE INCIDENCE • GROUP AND COMMUNITY FOCUSED
PRECEPTS (Cont’d) • ECOLOGICAL FOCUS • CULTURALLY VALID • SOCIAL JUSTICE VALUE • COLLABORATIVE PROCESS • EMPOWERING
PREVENTION SKILL SETS • Primary prevention perspective • Personal attributes & behaviors • Ethical skills • Marketing skills • Multicultural skills • Group facilitation skills
PREVENTION SKILL SET (Cont’d) • Collaboration skills • Organizational & setting dynamic skills • Trends & political dynamic skills • Research & evaluation skills (Conyne, 2004)
PREVENTIVE COUNSELING MODEL (Conyne, 2004) • PURPOSIVE STRATEGIES • TARGETS • METHODS
PREVENTIVE COUNSELING MODEL (Cont’d) PURPOSIVE STRATEGIES: • SEEK SYSTEM CHANGE • SEEK PERSON CHANGE
TARGET Individual Group Family Organization Community MODEL(Cont’d)
MODEL(Cont’d) METHODS • DIRECT: Education, Organization • INDIRECT: Consultation, Media
EFFECTIVE PREVENTION PROGRAMS • TARGETED LIFE TRAJECTORIES CHANGED • NEW SKILLS EMERGED
EFFECTIVE PREVENTION PROGRAMS (CONT’D) • SOCIAL SUPPORT DEVELOPED • NATURAL SUPPORT SYSTEMS IMPROVED • NEW CASES REDUCED
EFFECTIVENESS CRITERIA • WHAT’S BEING PREVENTED? • WHAT’S BEING PROMOTED? • IS IT BEFORE-THE-FACT? • DOES IT INVOLVE HEALTHY AND/OR AT RISK PERSONS? • IS THERE SYSTEM CHANGE?
CRITERIA (Cont’d) • IS IT FEASIBLE? • USE EXISTING RESOURCES? • IS IT COLLABORATIVE? • STRESSORS & STRENGTHS? • IS THE METHOD SPECIFIED? • INTERVENOR ROLES? • ARE THERE RESULTS?