PREVENTION IN MENTAL HEALTH
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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.

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PRESENTER

  • ROBERT K. CONYNE, Ph.D.

    PROFESSOR EMERITUS

    COUNSELING PSYCHOLOGIST

    UNIVERSITY OF CINCINNATI


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LEARNING OBJECTIVES

  • TO UNDERSTAND MENTAL HEALTH PREVENTION CONCEPTS

  • TO DIFFERENTIATE KNOWLEDGE AND SKILLS

  • TO LEARN A MODEL FOR PREVENTION


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PERFORMANCE OBJECTIVES

  • DESCRIBE KNOWLEDGE AND SKILLS NEEDED

  • KNOW WHAT TO INCLUDE IN PROGRAMS

  • IDENTIFY EFEECTIVE PREVENTION PROGRAMS


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Epidemiology: MentalIllness

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)


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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


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LITERACY

  • 20 MILLION ILLITERATE ADULTS (13%)

  • 20 MILLION MARGINALLY LITERATE

    -----------------------

  • 4 MILLION OF THESE PEOPLE ARE REACHED


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COST OF MENTAL ILLNESS

1996:

-DIRECT COST: $69 BILLION.

-INDIRECT COST: $78.6 BILLION

(Surgeon General)


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ONE POPULATION: AFRICAN AMERICANS

  • POVERTY: 1999, 22%

  • HOMELESS: 40% OF HOMELESS POPULATION

  • INCARCERATION: HALF OF ALL STATE & NATIONAL PRISONERS


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AFRICAN-AMERICANS (CONTD)

  • ACCESS: 20% FEWER ARE COVERED BY EMPLOYER-BASED HEALTH INS.

  • USE: ONLY ONE-HALF THAT OF WHITES; EMERGENCY USE HIGH


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INCIDENCE

  • TO REDUCE DEVELOPMENT OR RATE OF DEVELOPMENT OF:

  • NEW CASES OF A DISORDER OR PROBLEM


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TO REDUCE INCIDENCE

  • DECREASE:

    STRESS + EXPLOITATION

  • INCREASE:

    COPING SKILLS +SELF-ESTEEM+

    SUPPORT

    (Albee, modified, 1982)


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Intentional intervention

To reduce incidence of

Adjustment problems in

Currently normal populations, plus

Promotion of mental health functioning (Durlak & Wells, 1997)

PRIMARY PREVENTION


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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


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WHY PRIMARY PREVENTION?

  • TOO MANY PROBLEMS/NOT ENOUGH HELPERS

  • TOO MUCH AFTER-THE-FACT

  • LIMITED REACH

  • DE-CONTEXTUALIZED

  • STRESSORS/STRENGTHS IGNORED


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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


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PREVENTIVE COUNSELING PRECEPTS

  • BEFORE-THE-FACT

  • HEATHY PEOPLE/AT RISK

  • DEVELOP COMPETENCE

  • REDUCE INCIDENCE

  • GROUP AND COMMUNITY FOCUSED


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PRECEPTS (Cont’d)

  • ECOLOGICAL FOCUS

  • CULTURALLY VALID

  • SOCIAL JUSTICE VALUE

  • COLLABORATIVE PROCESS

  • EMPOWERING


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PREVENTION SKILL SETS

  • Primary prevention perspective

  •   Personal attributes & behaviors

  • Ethical skills

  • Marketing skills

  • Multicultural skills

  • Group facilitation skills


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PREVENTION SKILL SET (Cont’d)

  • Collaboration skills

  • Organizational & setting dynamic skills

  • Trends & political dynamic skills

  • Research & evaluation skills

    (Conyne, 2004) 


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PREVENTIVE COUNSELING MODEL (Conyne, 2004)

  • PURPOSIVE STRATEGIES

  • TARGETS

  • METHODS


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PREVENTIVE COUNSELING MODEL (Cont’d)

PURPOSIVE STRATEGIES:

  • SEEK SYSTEM CHANGE

  • SEEK PERSON CHANGE


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TARGET

Individual

Group

Family

Organization

Community

MODEL(Cont’d)


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MODEL(Cont’d)

METHODS

  • DIRECT: Education, Organization

  • INDIRECT: Consultation, Media


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EFFECTIVE PREVENTION PROGRAMS

  • TARGETED

    LIFE TRAJECTORIES CHANGED

  • NEW SKILLS EMERGED


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EFFECTIVE PREVENTION PROGRAMS (CONT’D)

  • SOCIAL SUPPORT DEVELOPED

  • NATURAL SUPPORT SYSTEMS IMPROVED

  • NEW CASES REDUCED


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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?


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CRITERIA (Cont’d)

  • IS IT FEASIBLE?

  • USE EXISTING RESOURCES?

  • IS IT COLLABORATIVE?

  • STRESSORS & STRENGTHS?

  • IS THE METHOD SPECIFIED?

  • INTERVENOR ROLES?

  • ARE THERE RESULTS?



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