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Protection against mental ill-health should be available to all – even nurses

Prevention is a novel concept in mental health, but its importance should not be overlooked 

Prevention is a relatively novel concept in mental health, but its importance should not be overlooked 


Photo: Neil 'Connor

The maxim that prevention is better than cure is well established and accepted. It has driven public health initiatives such as immunisation and screening. In the early days of public health, it informed initiatives to provide clean water and housing.

Now it has become a discussion point in mental health. Yet it has some inherent challenges. First, the concept of cure is rarely, if ever, voiced in mental health. Instead we are content with terms such as symptom control, self-management and recovery. This represents progress from an era where expectations for people were so low that treatment was considered futile.

Continuum of vulnerability

However, there is a growing evidence base for a view that sees all of us on a continuum of vulnerability to poor mental health. Just as in physical health there are interventions that are protective, and some are within the grasp of us all.

The importance of early experiences is recognised and social interventions such as reducing unemployment and providing a school and home environment that is secure and nurturing are considered preventive.

'Do we really need to shoehorn people into resilience classes when the environment they work in remains unaddressed and potentially damaging?'

Some risk factors are outside our control. Factors such as birth trauma, genetics and childhood abuse can manifest in mental health issues later in life. A sensitive approach to those facing adversity is essential. As are the services that intervene before problems occur. Much was made in early public health initiatives of spending ‘upstream’ so problems are not encountered later.

That is why support to families in adversity, those fleeing persecution, those trafficked and abused, or those for whom the challenges of parenting are overwhelming is vital. Anti-bullying interventions in schools, a recognition of good nutrition and exercise can all help prevent problems later on.

Protective workplaces 

But we should also consider the culture in healthcare organisations. Are there factors that can be addressed that would make nurses' workplaces less toxic to their mental health? Do we really need to shoehorn people into resilience classes when the environment they work in remains unaddressed and potentially damaging?

Mental health can be determined by the meanings we place on events, and sometimes our interpretations can be skewed. But if a child can benefit from an environment that is free of bullying, where there is a recognition of the importance of supporting them to grow and flourish, then why can’t we?


Ian Hulatt is consultant editor of Mental Health Practice  

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