Preventive psychiatry in clinical practice

Abstract

In the last two and a half decades, there have been series of global burden of disease studies which have highlighted significant disability attributable to mental and behavioral disorders with a huge treatment gap. Integration of the preventive strategies in the clinical practice has the potential to reduce the disability due to mental illnesses. The patients come to the clinic with an intention to get treated and investigated for the symptoms they have. At this point, they may also be amenable to the advice related to prevention. Therefore, the clinical encounter can be seen as an opportunity to implement preventive strategies. Preventive efforts in clinical practice must be guided by knowledge about the epidemiological data related to specific mental illnesses and about the evidence-based preventive strategies available for specific mental illnesses. These should be directed toward all those persons (patients, caregivers accompanying and at home, teachers, employers, etc.) who are present and also toward those who are not present during the clinical encounter and must be age, gender, and culture sensitive. Sociodemographic characteristics of a person seeking relief from a problem in the clinical encounter help in directing the preventive efforts. The preventive efforts are also driven by the fact that the patient has the first episode or established or treatment refractory mental illness and the short or long duration of illness. For prevention-minded clinical practice, it helps to have a template so that the assessments and interventions relevant for prevention can be carried out as per that scheme; it also helps in orienting the practicing mental health professionals. While making various assessments, making a list of the likely issues to be addressed by preventive efforts during clinical encounter ( first and subsequent) is also helpful.

Keywords

• Clinical practice
• mental health
• prevention
• preventive psychiatry