PREVENTION IN MENTAL HEALTH

1. PREVENTION IN MENTAL HEALTH

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

3. LEARNING OBJECTIVES • TO UNDERSTAND MENTAL HEALTH PREVENTION CONCEPTS • TO DIFFERENTIATE KNOWLEDGE AND SKILLS • TO LEARN A MODEL FOR PREVENTION

4. PERFORMANCE OBJECTIVES • DESCRIBE KNOWLEDGE AND SKILLS NEEDED • KNOW WHAT TO INCLUDE IN PROGRAMS • IDENTIFY EFEECTIVE PREVENTION PROGRAMS

5. 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)

6. 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

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

8. COST OF MENTAL ILLNESS 1996: -DIRECT COST: $69 BILLION. -INDIRECT COST: $78.6 BILLION (Surgeon General)

9. ONE POPULATION: AFRICAN AMERICANS • POVERTY: 1999, 22% • HOMELESS: 40% OF HOMELESS POPULATION • INCARCERATION: HALF OF ALL STATE & NATIONAL PRISONERS

10. AFRICAN-AMERICANS (CONTD) • ACCESS: 20% FEWER ARE COVERED BY EMPLOYER-BASED HEALTH INS. • USE: ONLY ONE-HALF THAT OF WHITES; EMERGENCY USE HIGH

11. INCIDENCE • TO REDUCE DEVELOPMENT OR RATE OF DEVELOPMENT OF: • NEW CASES OF A DISORDER OR PROBLEM

12. TO REDUCE INCIDENCE • DECREASE: STRESS + EXPLOITATION • INCREASE: COPING SKILLS +SELF-ESTEEM+ SUPPORT (Albee, modified, 1982)

13. Intentional intervention To reduce incidence of Adjustment problems in Currently normal populations, plus Promotion of mental health functioning (Durlak & Wells, 1997) PRIMARY PREVENTION

14. 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

15. WHY PRIMARY PREVENTION? • TOO MANY PROBLEMS/NOT ENOUGH HELPERS • TOO MUCH AFTER-THE-FACT • LIMITED REACH • DE-CONTEXTUALIZED • STRESSORS/STRENGTHS IGNORED

16. 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

17. PREVENTIVE COUNSELING PRECEPTS • BEFORE-THE-FACT • HEATHY PEOPLE/AT RISK • DEVELOP COMPETENCE • REDUCE INCIDENCE • GROUP AND COMMUNITY FOCUSED

18. PRECEPTS (Cont’d) • ECOLOGICAL FOCUS • CULTURALLY VALID • SOCIAL JUSTICE VALUE • COLLABORATIVE PROCESS • EMPOWERING

19. PREVENTION SKILL SETS • Primary prevention perspective •   Personal attributes & behaviors • Ethical skills • Marketing skills • Multicultural skills • Group facilitation skills

20. PREVENTION SKILL SET (Cont’d) • Collaboration skills • Organizational & setting dynamic skills • Trends & political dynamic skills • Research & evaluation skills (Conyne, 2004) 

21. PREVENTIVE COUNSELING MODEL (Conyne, 2004) • PURPOSIVE STRATEGIES • TARGETS • METHODS

22. PREVENTIVE COUNSELING MODEL (Cont’d) PURPOSIVE STRATEGIES: • SEEK SYSTEM CHANGE • SEEK PERSON CHANGE

23. TARGET Individual Group Family Organization Community MODEL(Cont’d)

24. MODEL(Cont’d) METHODS • DIRECT: Education, Organization • INDIRECT: Consultation, Media

25. EFFECTIVE PREVENTION PROGRAMS • TARGETED LIFE TRAJECTORIES CHANGED • NEW SKILLS EMERGED

26. EFFECTIVE PREVENTION PROGRAMS (CONT’D) • SOCIAL SUPPORT DEVELOPED • NATURAL SUPPORT SYSTEMS IMPROVED • NEW CASES REDUCED

27. 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?

28. CRITERIA (Cont’d) • IS IT FEASIBLE? • USE EXISTING RESOURCES? • IS IT COLLABORATIVE? • STRESSORS & STRENGTHS? • IS THE METHOD SPECIFIED? • INTERVENOR ROLES? • ARE THERE RESULTS?

29. HAPPY PREVENTION!