Prevention and Promotion in Mental Health - WHO

1 Mental Health : Evidence and ResearchDepartment of Mental Health and Substance DependenceWorld Health Organization GenevaISBN 92 4 156216 1 Prevention and Promotion in Mental HealthPrevention and Promotion in Mental Health are essentialsteps in reducing the increasing burden due to mentaldisorders. The World Health Organization s activities inthis area include generation, review and compilation ofevidence on strategies for Prevention and Promotion ,development of appropriate programmes and facilitationof partnerships and Health : Evidence and ResearchDepartment of Mental Health and Substance DependenceWorld Health Organization GenevaPrevention and Promotion in Mental Health Preface4 What is Prevention and Promotion in Mental Health ?

2 7 Concepts of Prevention and Promotion in the field of Mental Health 7 Prevention and Promotion in the field of Mental Health within overall public health10 How to generate evidence for the effectiveness of Prevention and Promotion in the field of Mental Health ?12 Research methods15 Evidence-based interventions and programmes 18 Outcome assessment22 Cost-effectiveness23 What is the role of the World Health Organization?25 The mandate and past activities 25 Future role26 References30 Annex 134 List of participants at the WHO Meeting on Evidence for Prevention and Promotion in Mental Health : Conceptual and Measurement Issues,in Geneva, 28-30th November Annex 237 Chronological description of WHO s activities and publications in Prevention and Promotion in the field of Mental health37 Annex 344 Annotated bibliography of selected publications44 WHO Library Cataloguing-in-Publication DataPrevention and Pr omotion in Mental Mental Health 2.

3 Mental disorders Prevention and control 3. Health Promotion 4. Evidence-based medicine 5. World HealthOrganization I. WHO Meeting on Evidence for Prevention and Promotion in Mental Health : Conceptual and Measurement Issues(2001: Geneva, Switzerland)ISBN 92 4 156216 1(NLM classification: WM ) World Health Organization 2002 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, WorldHealth Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: Requests for permission to reproduce or translate WHO publications whether for sale or for noncommercialdistribution should be addressed to Publications, at the above address (fax: +41 22 791 4806.))

4 Email: mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recom-mended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omis-sions excepted, the names of proprietary products are distinguished by initial capital World Health Organization does not warrant that the information contained in this publication is complete and correct andshall not be liable for any damages incurred as a result of its in FranceFor further details on this project, please contact:Dr. Shekhar SaxenaCoordinatorMental Health : Evidence and ResearchDepartment of Mental Health and Substance DependenceWorld Health OrganizationAvenue Appia 20, CH-1211, Geneva 27, SwitzerlandTel: + 4122 791 36 25, Fax: + 4122 791 41 60, Email: AcknowledgementThe World Health Organization Meeting on Evidence for Prevention and Promotion in Mental Health : Conceptual and MeasurementIssues was held in WHO Headquarters, Geneva, from 28 30th November 2001 and was attended by participants from WHOR egions and experts from within WHO HQ.

5 A complete list of participants is given in Annex Sartorius chaired the meeting, and Parameshvara Deva and Eva Jan -Llopis acted as co-rapporteurs and contributed to this WHO, Shekhar Saxena and Pallab K. Maulik have been responsible for preparing this document. Kathryn O Connell and MarkVanommeren provided technical assistance. Rosemary Westermeyer provided administrative and secretarial assistance was provided by Ali Hussein and designing and outlay assistance by Tushita Bosonet and Carine AND Promotion IN Mental HEALTHPREVENTION AND Promotion IN Mental Health Contents2 PREFACE5 The World Health Organization (WHO) defines Health as a state of complete physical, Mental andsocial well-being and not merely the absence of disease or infirmity.

6 Thus, in order to attain Health , improvement of the Mental Health of individuals is essential. Thisis all the more important because Mental disorders are responsible for a high degree of burdendue to illness. Owing to this growing burden of Mental disorders, it is essential that effective pre-ventive and promotional measures be taken in Mental Health to reduce the impact of Mental dis-orders on the individual and Department of Mental Health and Substance Dependence in WHO, Geneva, has the goal ofreducing the burden associated with Mental and neurological disorders and to promote mentalhealth worldwide.

7 The Department has identified Prevention of Mental disorders and Promotion of Mental Health as one of its priority project under the Mental Health Global Action Programme(mhGAP). The project will identify the most effective strategies in this field across different cul-tures and help countries to implement and evaluate considerable amount of research in the field of Prevention and Promotion in Mental Health hasbeen reported during recent years, but most of this research has come from the developed coun-tries with very little from the developing countries. Moreover, since most of the preventive andpromotional programmes cater to the local culture of the western world, it is not clear whetherthe strategies currently in place would be effective across different countries and is required to identify and assess those programmes that seem to hold the greatestpromise and are supported by adequate evidence-based is also a felt need to set up an information-generating system to share information amongresearchers so that they do not go about re-inventing the wheel.

8 Once the knowledge base forstandardized evidence-based programmes has been identified, governments will need to beurged to formulate and integrate policies and programmes related to Prevention and promotionin Mental Health , according to their specific has been involved in the field of Prevention and Promotion in Mental Health since itsinception over 50 years ago. It has coordinated a variety of activities, meetings, and programmeson Prevention and Promotion in Mental Health . Over the years, there have been several resolu-tions passed by the World Health Assembly and WHO Regional Offices urging the Organizationand its Member States to undertake steps towards Prevention and Promotion in Mental AND Promotion IN Mental Health PrefaceA meeting WHO Meeting on Evidence for Prevention and Promotion in Mental Health : Conceptualand Measurement Issues was convened in Geneva from 28-30th November 2001 to advance the work related to Prevention of Mental disorders and Promotion of Mental Health .

9 A group of experts from all WHO Regions discussed the definitional and conceptual issues around pro-motion and Prevention , shared the current state of evidence to further develop the field, andadvised WHO on its role in the area of Prevention and Promotion in Mental document based on the deliberations of the WHO meeting, the background papers anddocuments (Annexures 2 & 3) and other additional sources highlights some of the basic issuesin the field of Prevention and Promotion in Mental Health with special reference to the evidencebase. It also outlines the role of WHO in advancing current knowledge and disseminating infor-mation among Member States, especially among developing countries.

10 It is hoped that the infor-mation given here will assist in wider utilization of appropriate and effective interventions onprevention and Promotion towards reducing the burden of Mental disorders and in enhancingthe Mental Health of populations. Policy-makers will also find this document useful as it providesan overview of some of the important issues that are often debated among researchers and policy-makers, with respect to Prevention and Promotion in Mental SaracenoShekhar SaxenaDirectorCoordinatorDepartment of Mental HealthMental Health : Evidence and Research and Substance DependenceDepartment of Mental Health and Substance Dependence6 Prevention AND Promotion IN Mental HEALTHA bout 450 million people alive today suffer from Mental disorders, according to estimates given inWHO s World Health Report 2001.