Three levels of prevention:

It’s important to identify the three levels of prevention within a general public health framework before diving into mental illness prevention.

Within a public health framework there are three stages of prevention. Primary, Secondary, and Tertiary.

(“3 Stages of Prevention,” 2024)

I’ll work backwards, starting with tertiary prevention, also known as tertiary care. Tertiary care is when an individual has been diagnosed with an illness and needs intensive care to sustain life as best as possible for as long as possible. This can be best seen with:

  • Hospice care and individuals requiring attention in ways that specialists are employed to specifically treat. 
  • High-dose chemotherapy 
  • Organ transplants. 

Tertiary care shows that an individual has surpassed any other level of prevention and needs action to prolong life beyond their individual choice.

Secondary prevention can be seen as preventing illness by implementing screening procedures and preventing recurrences of illness from those screenings. Examples include:

  • Mammograms for breast cancer
  • Testing for pre-diabetes, Sexually Transmitted Illnesses (STI) such as HIV, HPV, and herpes
  • Screenings for the gamut of mental illness. 

Secondary care has the best results when there are follow-up steps to prevent additional occurrences of illness after the screening and subsequent diagnosis. For HIV this includes taking antiretroviral therapy (ART) to make sure an individual’s viral load remains Undetectable, ensuring they cannot transmit HIV to another sexual partner. Secondary prevention for Pre-Diabetes would include a healthy diet to assist the body in maintaining a healthy A1C, further offsetting the impacts one may have from an actual diabetes diagnosis.

Primary prevention is the gold standard for preventing illness before any onset. This can include a healthy lifestyle such as exercise, stress management, and consuming the proper foods for one’s body. Primary prevention isn’t as easy as it sounds, especially since we live in a society promoting instant gratification, sugary foods and beverages, and a sedentary lifestyle.

Within this relatively new framework of “mental illness prevention”, we are looking at the ability to utilize secondary prevention methods to offset an individual’s potential to experience the relapse of symptoms of their illness. Return Home focuses on assisting those in recovery from serious mental illness by incorporating education at the intersection of mental health, emotional health, and spiritual health. By integrating these three dimensions of wellness, it becomes easier to maintain stability through a harmonic effect. This offers individuals the ability to notice when one element is out of balance and providing that specific component the attention it deserves.

If primary prevention is to be used in the area of mental illness prevention, it can be integrated on all levels of the social ecological model.

(L. Golden & L. Wendel, 2020)

Beginning with a larger picture, policies preventing homelessness, poverty, and adverse childhood events (ACEs) can have quite an impact on the occurrences of mental illness. There’s also the potential for societal beliefs – policy to influence the ways in which insurance works with individuals needing trauma informed therapy, or if they can receive this more intense level of therapy at all. Zooming in a bit, we see there is a space for communities to hold space for their members in a way that prevents mental illness. This could include:

  • Trauma Informed Therapeutic practices offered at local clinics free of charge
  • Primary and Secondary educational systems becoming aware of, and trained in recognizing when someone is experiencing an ACE and how to interrupt the cycle of trauma
  • Increasing outreach for individuals who have experienced physical trauma to offer beneficial methods to offsetting the costs that come with the impacts to the body-mind connection, such as somatic therapy.

Interpersonal levels of prevention could include:

  • Training in Mental Health First Aid to recognize when it’s time to step in and intervene with someone’s plan to die by suicide, or notice without doubt the symptoms of schizophrenia & bipolar disorder.
  • Checking in on friends and loved ones who have changed their normal patterns of interaction.
  • Paying attention to, and pursuing a loving conversation when there are perceived small shifts in an individual’s appearance, behaviors, or interactions with others. These can be indicative of larger issues, such as going through a grieving process. 

Personal levels of prevention are completely up to each individual when focusing on one person at a time. There are many different paths to prevention, and it’s unique to each individual. Examples include:

  • Meditation or another form of introspection to understand the mind and factors impacting mental wellness
  • Exercise to reduce cortisol levels
  • Eating healthy so one feels better when navigating everyday life
  • And tapping into one’s own intuition to better trust their Higher Self or whatever one may relate to a power greater than lower-case “s” self. 

Ultimately the field of mental illness prevention is one that is still being discovered, and you could be on the forefront by picking up a practice that can impact your life in ways those around you might be able to notice! It’s a personal choice to be an advocate of mental health, and we each choose to which level we’re willing to step up and meet the challenge. Advocacy is a gift that keeps on giving, as we continue to educate we also continue growing.

References

3 Stages of Prevention. (2024). [Website]. In PDHI . https://www.pdhi.com/workplace-wellness-programs/how-wellness-programs-support-the-3-stages-of-prevention/

L. Golden, T., & L. Wendel, M. (2020). The Social Ecological Model of Health [Journal]. In Frontiers. https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2020.00131/full

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