|Year : 2017 | Volume
| Issue : 2 | Page : 69-70
Preventive psychiatry: Where do we stand?
Roy Abraham Kallivayalil1, Rakesh Kumar Chadda2
1 Department of Psychiatry, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India
2 Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
|Date of Web Publication||30-Jun-2017|
Rakesh Kumar Chadda
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kallivayalil RA, Chadda RK. Preventive psychiatry: Where do we stand?. Indian J Soc Psychiatry 2017;33:69-70
Mental disorders are very common with the World Health Organization estimating the lifetime prevalence at about 25%, and the recently released report of the National Mental Health Survey of India putting the figure at 13.7%. Mental and substance use disorders are a major contributor to the global burden of disease. Treatment gap for different mental disorders varies from about 70% in bipolar disorder to 86% in alcohol use disorders. Stigma, lack of awareness and lack of adequate mental health resources remain important impediments to access the mental health services. In the above background, preventive psychiatry has an important role to play to deal with the enormous burden and disability caused by the mental disorders.
Prevention of mental disorders appears a too ambitious concept, considering that we are not aware of the exact etiology of most of the mental disorders. There is enough evidence available for genetic contribution in genesis of many mental disorders including schizophrenia, depression, bipolar disorder, alcohol dependence and many others, but genetic contribution explains only a small percentage of the total cases. Biopsychosocial paradigm is applicable across most of the mental disorders. Psychosocial factors play a significant role in etiogenesis, accessing services, treatment, and rehabilitation of mental disorders. Using interventions in the psychological and social domains thus remains an important approach toward development of a prevention program in mental disorders.
Preventive psychiatry has largely been ignored by the mental health professionals and also does not find any significant mention in the medical curricula. The subject, however, carries enormous significance considering the high prevalence of mental and substance use disorders, and their substantial contribution to global burden of disease, and a large mental health gap. There are mentions to the preventive psychiatry in international literature much before the psychopharmacology revolution.
Psychosocial approaches for prevention may include creating awareness about mental disorders in the community, especially about the early features of identification, need for treatment, removing myths, and misconceptions about mental disorders and appraising about the services available. Mental health promotion remains an important component of any preventive program in psychiatry. Lifestyle modification, regular physical exercise, deep breathing exercises, staying away from drugs and alcohol, taking adequate sleep, avoiding social isolation, developing hobbies, keeping time for family, and recreation are some simple principles which can be of great help in staying away from mental disorders.
Considering the huge populations in India and South Asia (nearly 1.8 billion) and the severe shortfall in the number of mental health professionals, what we need in this region today is a public health approach. It is cost-effective  and will be acceptable to the community. We will be able to use the massive resources of primary care we already have to deliver preventive services in mental health with emphasis on primary prevention. We will need to tackle inequalities in the delivery of these services by implementing National Health Policy and National Mental Health Policy.
This special issue of the Indian Journal of Social Psychiatry is devoted to preventive psychiatry and carries a series of papers by leading experts in the field from India. The papers were presented in the National Symposium on Preventive Psychiatry, organized at the All India Institute of Medical Sciences, New Delhi on July 21, 2016. This issue has contributions on various aspects of preventive psychiatry from the leading experts in the field from India. The issue is divided into five sections with the first four sections devoted to the special symposium and the last section including some original papers on related areas. The issue covers role of preventive psychiatry in different groups of mental disorders, population groups, and the challenges faced by the profession. We expect that this issue will act as a resource on preventive psychiatry, especially for the mental health professionals working in the low-resource settings.
We would like to acknowledge the National Academy of Medical Sciences (India) for sponsoring the National Symposium on Preventive Psychiatry. This issue carries papers presented in the Symposium.
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