Introduction
 In 1960, Gerald Caplan (Psychiatrist) described
levels of prevention specific to psychiatry.
 Primary prevention
 Secondary prevention
 Teritiary prevention
Primary prevention
 Prevent the occurrence of mental disorders by
strengthening individual, family and group coping
abilities.
Role of a nurse in primary
prevention
 Individual centered intervention:
- Antenatal care: adverse effects of irradiation,
drugs and prematurity.
- Ensure obstetrical assistance to guard against ill
effects of anoxia and injury to new born.
Contd...
 Diet: dietary corrections to infants who have
metabolic disorders.
 Treatment for endocrine disorders
 Training programme: physically and mentally
handicapped children( deaf, blind, mentally
subnormal )
 Counselling: Parents of physically and mentally
handicapped children. ( parents need to accept
and emotionally support the child)
 Fostering bonding behaviours: Warmth,
acceptance, intimate relationship.
School
 Teach growth and development of child to parents
and teachers.
 Identify problems of scholastic performance and
emotional disturbance among school children
 Timely intervention and referral services.
Family centered interventions to ensure
harmonious relationship
 Consulting parents about appropriate disciplinary
measures.
 Promoting open health communication families.
 Crisis counselling to the parents of physically and
mentally handicapped children.
Contd...
 Ensure harmonious relationship among members
of the family and teaching healthy adaptive
techniques at the time of stress.
Family
Mental health education services
 At child guidance clinic: Child rearing practices
 At parent teacher association: triad relationship
between teacher child parent.
 At extramural services: regarding integration of
mental health into general health practices.
 Strengthening social support
 Promoting educational services in the field of
mental health and mental hygiene
 Providing marital counselling ( for marital
problems)
 Crisis intervention can be given at:
- Mental hygiene clinics
- Psychiatric first aid centres and walk in clinics
Mental health education
 Conduct mass health education programme
regarding prevention of mental illness and
promotion of mental health.
- Film shows, flash cards and other audio visual aids
can be used.
 Educate health workers regarding prevention of
mental illness.
Society- centered preventive measures
 Community development
 Culturally deprived families need biological and
psychosocial supplies: Proper food, education,
health facilities and recreation facilities.
 Collection and evaluation of epidemiological bio
statistical data.
Secondary Prevention
 It targets people who show early symptoms of
mental health disturbance.
Role of a nurse in secondary prevention
 Early diagnosis and case finding:
- Educating the public, community leaders (how to
recognize early symptoms of mental illness)
 Case finding: through screening and periodic
examination of population at risk, monitoring of
patients. ( clinics, schools, home , health care and
work place)
 Community mental health nurses can detect early
signs of increased levels of anxiety, decreased
ability to cope with stress, failure to perceive self
and environment.
 Early reference
 Screening programmes
 Early and effective treatment for patient and family
members.( counselling services)
 Training of health personnel
 Consultation services: Basic care providers need
guidance and consultation.
- Puerperial psychosis, anxiety, peptic ulcer etc...
 Crisis intervention
- techniques: Abreaction, manipulation,
clarification
- Guide the individual time can help them to cope
with the crisis situation in a better way.
Tertiary prevention
 Reduce the severity, discomfort and disability
associated with their illness.
 Monitoring the progress of discharged patients in
half way homes, houses with regard to their
medication regimen, coordination of care.
Role of a nurse
 Active participation of family members in
treatment programme.
 Occupational and recreational activities should be
organized in the hospital.
 Community based programs : Day hospitals, night
hospitals, after care clinics, half way homes, foster
homes , follow up care.
 Follow up care of the discharged patient, proper
communication by health professionals.
 Collaborative relationship between mental health
care providers and community agenciesRehabilitation.
 Training in Community Living program( TCL)
 Foster a realistic attitude towards the patients with
mental illness.
Mental health services
 Mental health agencies: Government at national
level
- 42 mental health hospitals ( bed availability of
20893)
- Private sector – 5096 beds
 Mental health agencies: voluntary
- In developing suicide prevention and crisis
support
- Formation of self help of families
- Organizing community based housing facilities for
short term and long term care of persons with
chronic illness.
- Setting up of day-care centres
- Sheltered employment facilities
- Life skill training programs for school drop out
children
- Public mental health education
Non governmental organizations
 NGOs are recognized by governments as non-
profit or welfare oriented organizations.
 It plays a key role as advocate, service provider and
researchers on a range of issues pertaining to
human and social development.
Partial hospitalization