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Prevention is possible, so why isn’t it happening? By Stephen Carbone

Reflections by Next Generation & Prevention Research Fellow Dr. Monika Raniti

The ALIVE National Centre has launched the Ready, Set, Translate: The ALIVE Mental Health Research Virtual Café Translation Conversations. In April, Dr Stephen Carbone, CEO and founder of Prevention United, presented on “Prevention is possible, so why isn’t it happening? If you missed it, the recording is available here on our YouTube channel. 

Thank you to our Next Generation & Prevention Research Fellow Dr. Monika Raniti who has kindly provided a reflection on this talk here.

 

What is prevention?  

  • Universal, selective and indicated prevention are all types of primary prevention because they about preventing the onset of a condition.
  • Prevention is not the same as early intervention.

 

Why is prevention important?  

  • Prevention is better than a cure (or at least as good), for example, reduces cost, averts distress.
  • Increased mental health expenditure in Australia has not decreased the prevalence of mental ill health or suicide rates.

 

What can we do?  

  • We need to take a public health/mental health promotion approach that focusses on both individual behavioural change AND structural and social change and communities and groups (which has been less of a focus historically)
  • We need to tackle the many risk and protective factors that have been identified, for example, biological, social, psychological cultural, economic, social determinants of mental health. Note that risk and protective factors can vary across the life course and some are more malleable or potent than others.
  • Given that the onset of most mental disorders is early in life, makes sense to focus on perinatal period, children and youth.
  • We have some effective approaches we can use such as public education and awareness, skills building for individual and parents, increasing social support and connection, creating mental healthy environments, strengthening community action and having mentally healthy public policies.

 

What’s holding us back?  

  • We need more effective interventions especially at the community and policy level, better systems infrastructure (breadth, scale, quality), dedicated and recurrent funding (less than 1% of Federal mental health funding is spent on prevention), leadership and governance structures (whole-of-government response), better delivery systems, partnerships, a workforce skilled in mental health promotion practice, and better data to track outcomes.
  • Prevention and prevention research is complex, for example, multiple risk and protective factors contribute to multiple disorders (but this is also a strength of a primary prevention approach)
  • There is low research engagement (ALIVE is only one of a few groups working in this area) and low political engagement.
  • Childhood adversity is a major contributor to mental ill health and needs more attention.

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