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
 PERFORMANCE
OBJECTIVES
 DESCRIBE KNOWLEDGE
AND SKILLS NEEDED
 KNOW WHAT TO INCLUDE
IN PROGRAMS
 IDENTIFY EFEECTIVE
PREVENTION PROGRAMS
 Epidemiology: Mental
Illness
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
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)
 PRIMARY PREVENTION
 Intentional intervention

 To reduce incidence of

 Adjustment problems in

 Currently normal populations,

plus
 Promotion of mental health

functioning (Durlak & Wells, 1997)

 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

 MODEL (Cont’d)
TARGET
 Individual

 Group

 Family

 Organization

 Community
 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?

HAPPY PREVENTION!