The Primary prevention is the prevention of mental illnesses or disorders in susceptible individuals or populations, through the promotion of health, including mental health. Its objective is to reduce the incidence and its strategy to eliminate the causal risk factors (risk reduction), which promotes, preserves, protects and restores health.
This is done by preventing exposure to hazards that cause illness or injury, altering unhealthy or unsafe behaviors that can lead to illness or injury, and increasing resistance to illness or injury in the event of occur exposure.
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Primary prevention not only refers to proactive or prophylactic “treatment” to prevent health problems before they arise, but also incorporates modification of the behaviors or risk factors that are associated with a given health outcome.
For people in general, primary prevention interventions include vaccines to prevent some diseases, changes in behaviors such as quitting cigarette smoking, starting a balanced diet, starting an exercise program, among others..
For entities that promote health, primary prevention includes: legislation and its application to prohibit or control the use of dangerous products (for example asbestos), forcing safe and healthy practices (for example, use of seat belts and bicycle helmets), inform about healthy and safe habits (for example eat well, exercise regularly, not smoke), campaign for immunization against infectious diseases, among others.
Some approaches involve active participation, like brushing and flossing to prevent tooth decay. Other approaches are passive: adding fluoride to municipal drinking water to harden tooth enamel and prevent cavities.
William Haddon made a useful contribution on how injuries occur and how to prevent them. The "Haddon Matrix" is a table showing the host, agent, and environmental factors involved, in contrast to the temporal sequence of an incident..
The cells of the matrix illustrate the range of risk or protective factors involved; Haddon emphasized the multidisciplinary nature of the possible interventions. For example in a motor vehicle collision:
Physicians are particularly well placed to play an essential role in promoting primary prevention goals, and they can contribute in a number of different capacities..
- Physicians often detect cases of environmental illness, thereby drawing attention to exposures that could have widespread consequences.
- They routinely counsel patients about the risks of exposure, so they often need to interpret and translate research results so that the patient understands them better..
- Public opinion studies have shown that people trust their doctors as highly reliable sources of information about health risks.
- Doctors can raise awareness of health problems and can help people understand the connections between their behavior and its consequent effects on the environment and human health. They can help bring about a major change in the public mindset..
- Doctors are also increasingly involved in health promotion, both at the health and public policy level..
Primary care is increasingly expanding to other important areas for the human being, such as psychiatry.
The concept of prevention in psychiatry is unique. Includes promotion of mental health, identification of risk factors throughout the life cycle, and appropriate early interventions.
Recently, emphasis has been placed on early intervention in the development of mental illness, leading to various preventive programs with varying degrees of success..
Preventive psychiatry is a branch of public health preventive medicine. Its objective is to promote good mental health in people and prevent the appearance or reduce the incidence of psychiatric illness in a population.
As in other public health efforts, the practice of preventive psychiatry requires the collaboration of related disciplines, including political, sociological, psychological, educational, psychotherapeutic, biochemical, pharmacological, nursing, and others..
Many approaches for the primary prevention of mental illnesses are being developed simultaneously: biological, psychoanalytic, behavioral, cognitive, family, cultural, sociological, political, among others..
An investigation of the Episcopal Hospital San Juan in New York, concluded in its results that there is evidence indicating that primary prevention can delay the onset of mental illness, especially schizophrenia.
Drug treatment for high-risk people, combined with cognitive behavioral therapy (CBT), has shown promising results in several studies.
According to the study, strategies that teach younger individuals to cope with stress and provide them with psychosocial support have been effective in preventing mood and anxiety disorders.
This is why early detection measures are also being widely applied to children and young people, especially those who are receiving forms of public assistance in many public school systems..
Primary prevention of mental and emotional disorders can occur through a variety of organic means. A very important approach is the reduction of exposure to environmental toxins, such as lead, the prevention of childhood encephalopathies and associated mental retardation..
Similarly, preventing congenital syphilis (or AIDS) saves countless children with organic psychoses. Genetic counseling in relation to the risk of transmission of manic-depressive illness, or the risk of schizophrenia, is another biologically-based primary psychiatric preventive measure..
In the realm of experience, educational and social support services for expectant parents can serve as primary psychiatric prevention measures, sometimes with measurable results, such as reducing the incidence of abusive behavior..
Psychiatric primary prevention is increasingly being practiced in mentally healthy people exposed to special mental health risks, as a way to make them strong against those risks.
For example, when functional families with presumably mentally healthy but congenitally deformed babies are treated by the psychiatrist, psychologist and doctor, so that acceptance of their child occurs before birth.
On the other hand, grief facilitation is a widely used measure for people who are at risk of death from a spouse or parent. The strategies used in grief facilitation can come from various disciplines.
The objective may be to provide defenses against pain and emotional discharge related to grief, with the aim of preventing or reducing the occurrence of a pathological structuring of these defenses..
Thus, family therapy techniques can increase mutual help and healthy interactions among surviving members. Network therapy can broaden and deepen immediate mutual assistance from family and community.
Primary prevention in cases of gender-based violence is the most strategic approach to ending violence against women and girls.
Primary prevention strategies:
- The implementation of infrastructure and institutions to address violence against women and girls.
- The promotion of gender equality through the expansion of women and girls' economic opportunities, access to basic services, education, social and political participation, as well as the breakdown of gender stereotypes harmful to women and girls.
- Changing discriminatory attitudes, norms and practices that perpetuate violence against women and girls through multi-faceted educational and social mobilization approaches and targeted campaigns.
- Developing programs and interventions that are based on scientific and behavioral change theories, for both community-based and school-based settings.
- Targeting the specific problems that correlate with violence against women and girls. For example, in cases of alcohol abuse, interventions could regulate the sale of alcohol or develop specific treatment programs for people with substance abuse problems..
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