Benefits of prevention and promotion
Prevention-focused approaches in mental health are more cost-effective than treatment approaches, not to mention the fact the growing burden of mental ill-health cannot reasonably be stemmed by treating one individual at a time.
If we are to make a real difference to the mental health of Australians we need to break down the silos and look for economies of effort across all sectors.
Investing in the promotion of mental health and wellbeing and the prevention of mental ill-health leads not only to a more efficient use of mental health resources, but has a flow-on effect for a range of services including general health care, drug and alcohol services, education, child and family services and the justice system.
Return on investment
Australia spends many billions each year on dealing with the impact of mental ill-health, but return on investment (ROI) in the prevention end shows real promise – not just on reducing future costs, but also increasing productivity and participation.
The current evidence suggests there is ROI for prevention and promotion interventions. Overall, the following types of promotion and/or prevention interventions have shown a ROI, with some specifically focused on suicide prevention:
- Investment in early years approaches – especially prevention of conduct disorder in childhood through social and emotional learning programs and early intervention for conduct disorders, early childhood education, parenting programs and home visiting
- Suicide prevention through reducing access to means, training courses provided to all GPs, media guidelines and intensive follow-up after discharge from hospital
- Investment in early detection and intervention for psychosis, alcohol misuse and early detection of mental illness (e.g. depression) for those with chronic disease (e.g. diabetes)
- School-based intervention to reduce bullying and workplace health promotion programs
- Interventions targeting risk factors – e.g. debt advice services
- Investments in gatekeeper training for certain professions and the value of pre-service as well as inservice approaches
- Interventions that decrease social isolation – e.g. befriending for older adults.
It should be stated that it is ‘likely’ other mental health promotion and/or illness prevention programs would show a ROI if adequate research and program evaluation was conducted. Without prioritising research that measures ‘impact’, rather than the current practice of evaluating ‘reach’, the real ROI for many programs will remain unknown.
Building partnerships and setting a common agenda
Promotion and prevention approaches, by their nature, involve the domains of everyday life and a range of service settings. This provides an opportunity for meaningful partnerships so a “mental health is all policies approach” can be considered.
The costs to the economy of lower productivity, crime rates, chronic disease and an increased need for caregiving can all add to the economic costs of mental ill-health. A common lexicon across sectors is needed for mental health, mental health promotion, and prevention of mental ill-health. This is particularly important given returns from mental health promotion and illness prevention typically show up in a different sector from the one in which investments were made.
Expanding reach of mental health interventions
We need to look at whole of life, not just wait for an episode severe enough to warrant a response when thinking about mental health. Prevention and promotion initiatives should consider settings that allow for the greatest reach and influence using interventions shown to be effective or at least promising. This means interventions could and should consider their ability to:
- Enable communities to contribute to the prevention of mental ill-health
- Enable the workforce to prevent mental ill-health – where workforces include clinical and non-clinical workforces
- Enable systems to work better together to ensure that our responses to mental ill-health include a focus on prevention, treatment and recovery.