Mental Health Prevention Strategies
Prevention of Mental Health Problems is the Way Forward
When we think about mental health problems we invariably think about existing issues and what people can do to solve or overcome them. In this sense, we generally think of either therapy or medical solutions to the problems. Mental health issues are becoming more prominent and the 2014 Health Survey England reported that 26 per cent of adults said they had been given a diagnosis of ‘at least one mental illness’ in their lifetime (Bridges, 2015 cited in David Harper’s BPS article ‘Beyond Individual Therapy‘).
Much less funding, research or effort has been put into place that is focused on mental health prevention strategies and there may be numerous reasons, including social, economic and political rationales for this obvious disparity.
Fire Prevention & Fire Fighting
We all acknowledge the invaluable work carried out by the fire service but unlike mental health problems, fire prevention strategies are well funded and in many cases are legal requirements requiring organisations to put methods and practices in place as well as easily accessible fire-extinguishers.
Individual Psychiatric Medication Data
Psychiatric medication is still the default intervention in mental health – the Healthcare Commission (2007) noted that 92 per cent of their service-user sample had taken medication.
The cost of antidepressant medication rose from over £50m in 1991 to nearly £400m in 2002 (Social Exclusion Unit, 2004).
This cannot simply be due to an increase in the size of the population (the population in England increased by only 2 per cent between 1991 and 2001) or inflation (7.5 per cent in 1991 dropping relatively steadily to 1.3 per cent in 2002).
This trend has continued: Ilyas and Moncrieff (2012) report that there were 15,000 prescriptions of antidepressants in 1998 but over 40,000 in 2010 (during this period the population increased by only 5.5 per cent), and they note that the total amount spent on all psychiatric drugs, adjusted for inflation, rose from over £544m in 1998 to £881m in 2010.
There have been rapid increases in the prescription of other drugs too – prescriptions of methylphenidate for children (better known by one of its trade names: Ritalin) have risen from 6000 in 1994 (Timimi, 2004) to over 922,000 in 2014 – a 153-fold increase in just over 20 years – costing over £34m a year (Health & Social Care Information Centre, 2015a).
It is important to note that these figures only relate to community prescribing (by GPs and as outpatients) and don’t cover medication prescribed in hospital. (David Harper, Beyond Individual Therapy, 2016)
Individual Psychological Therapy Data
Comparable year-on-year figures aren’t available for psychological therapy though we know that, in 2014–15, 1,250,126 people were referred and 815,665 people began receiving therapy under the Improving Access to Psychological Therapies initiative (Health and Social Care Information Centre, 2015b).
As clinical psychologists predominantly provide individual therapy (Norcross & Karpiak, 2012), we can use the numbers of clinical psychologists as a proxy measure of the increasing availability of psychological therapy over time.
There were 362 members of the British Psychological Society’s Division of Clinical Psychology in 1970 (Hall et al., 2002) but this had risen to 10,202 by 2011 (British Psychological Society, 2012), a 28-fold increase.
There were 11,279 clinical psychologists registered with the Health and Care Professions Council in January 2015 (HCPC, 2015) – (David Harper, Beyond Individual Therapy, 2016)
Individual Mental Health Prevention Strategies
It is known that there are a wide range of individual factors impacting on any persons mental health or the likelihood that they will develop mental health issues at some point during their lives.
Perhaps more importantly, as most of us are likely to face numerous challenges during our life-course, is our degree of resilience to those challenges. Resilience is a ‘measure’ of how well we cope with challenges and difficulties and also how fast we are able to ‘put them behind us’ or ‘bounce-back’ from adversity.
Although research suggests that a certain amount of resilience is genetic and therefore inherited, the larger proportion of being resilient is derived from our early developmental experiences. Resilient people tend to have experienced highly supportive primary care (parenting), the experience of ‘unconditional love’ or unconditional regard’ from social connections at home and within educational provisions and many more.
Individual mental health prevention strategies therefore should be focused on the development of resilience and coping skills in order to allow people to experience the normal challenges associated with the ‘life course’ and be able to ‘deal with’ them whilst retaining a healthy perspective on them.
In this endeavour we recommend following an appropriate psycho-educational programme targeted at developing these specific skills such as the Thrive Programme.
Institutional Mental Health Prevention Strategies
A high percentage of our private clients, as well as our public sector clients, will often cite difficulties in the workplace as being one of the principal causes of their mental health problems.
Organisations and businesses almost always operate within a hierarchical structure with directors, managers and staff members who each hold differing levels of ‘power’. It is these power structures that can, if not organised well, lead to problems between people, for example ‘abuse of power’ or the belief that being in a senior position somehow licenses talking ‘down’ to other people!
This type of behaviour can have very damaging effects on a person, particularly if they also have existing vulnerabilities, and can often lead to taking time-off with work related stress or other mental health problems.
The Health and Safety Executive commissioned a team of psychologists to determine the main causes of work related stress so that organisations can adopt the appropriate management strategies and tools. These approaches are known as the Management Standards.
Paul is an experienced and qualified mental health and safety consultant (NEBOSH) and can help your business with the implementation of these standards.