Prevention in Psychiatry CR104, February 2002, 94 pp, £7.50 Summary

It is a truism that prevention is better than cure, yet preventive activities generally have low priority among interventions undertaken by psychiatrists. This report aims to provide psychiatrists and others involved in the promotion of mental health and the care of people with mental illnesses with an evidence-based approach to preventive interventions.

It begins with a background section, introducing concepts related to mental health promotion and the prevention of psychiatric disorders. Prevention is then considered in relation to the different stages of the life cycle, beginning in the womb and ending with the approach of death. Life cycle chapters are provided for the prenatal period and infancy; childhood, puberty and early adolescence; late adolescence and young adulthood; adulthood; older people; and the stage of approaching death. Account is taken of the fact that the influences acting at one stage of the life cycle will impact on the rates of disorder in later stages. Further, traumatic events such as physical or sexual abuse will impact not only on the individual concerned throughout the life cycle, but on subsequent generations.

Preventive activities are then considered in relation to the different settings in which they can take place. Settings considered include the neighbourhood and the community; early years provision, school and higher education; the work-place; residential care settings; the criminal justice system and prisons; primary care settings; the general hospital; and specialist psychiatric settings. In all of these, preventive activities relevant to psychiatric disorders need to be placed and maintained on the agenda, and the report provides practical, evidence-based information on how this may be achieved.

The Working Party has tried to keep the report brief and clear. To make the material more accessible, some information has been summarised and presented in the form of bullet points. A small number of key references to each section are provided for those readers wishing to pursue the subject further.