Introduction
• In 1964psychiatrist Gerald Caplan describe levels of prevention specific to
psychiatry.He described primary prevention as an efforts directs towards reducing the
incidence of mental disorder in a community.
3.
• Secondary preventionrefers to decreasing
the duration of disorder while tertiary
prevention refers to reducing the level of
impairment.
4.
PUBLIC HEALTH MODEL
•It was given by Gerald Caplan in 1964It includes:Primary preventionSecondary
preventionTertiary prevention
5.
PRIMARY PREVENTION:-
• Primaryprevention seeks to prevent the
occurrence of mental disorders by
strengthening individual, family and group
coping abilities
6.
• AIM:-Reducing theincidence of mental
disorder within the population.TARGET:-
IndividualEnvironment
7.
• STRATEGIES:-Assisting individualto increase
their ability to cope effectively with
stress.Targeting and diminishing harmful
forces i.e, stressor within the environment.
8.
Role of Nurse:-• 1.Individual centered
interventionAntenatal care to the
mother and educating her regarding
the adverse effects of irradiation,
certain drugs and prematurityDietary
corrections to those infants suffering
from metabolic disorders.Correction of
endocrine disorders.Liberalization of
laws regarding termination of
pregnancy, when it is unwanted.
9.
• Counseling theparents of physically and mentally handicapped children, with particular
reference to the nature of defects.Fostering bonding behaviors.Explaining importance
of warm, accepting, intimate relationship and avoiding the prolonged separation of
mother and child are essential.
10.
2. Interventions orientedto the child in the
school:-
• Teaching growth and development
to parents and
teachers.Identifying the problems
of scholastic performance and
emotional disturbances among
school childrenSchool teachers
can be taught to recognize the
beginning symp toms of problems
and referring to appropriate
agencies.
11.
3. Family centeredinterventions to
ensure harmonious relationship:-
• Consulting with parents about appropriate disciplinary measures.Promoting open
health communication in families.Rendering crisis counseling to the parents of
physically and mentally handicapped children.Ensuring harmonious relationship
among members of the family and teaching healthy adaptive techniques at the time of
stress producing events
13.
4. Interventions orientedto keep families
intact:-
• Mental health education about child rearing practices.Strengthening social support for
the frustrated aged and helping them to retain their usefulness.Promoting educational
services in the field of mental health and mental hygiene.Providing marital counseling
for those having marital problems
14.
5. Interventions for
familiesin crisis:-
• In developmental crisis situations such as the
child passing through adolescence, birth of a
new baby, retirement or menopause, death
of a wage earner by the family describe by
the spouse etc.
15.
• Crisis interventioncan be given at:Mental hygiene clinicsPsychiatric first-aid
centersWalk-in clinics
16.
6. Mental health
education:-
•Conduct mass health education programs
through film shows, flash cards and
appropriate audio-visual aids regarding
prevention of mental illnesses and pro-
motion of mental health in the
community.Educate health workers
regarding prevention of mental illness.
17.
7. Society-centered preventivemeasure:-
• Community development culturally deprived families need biological and psychosocial
supplies.They need better hygienic living conditions, proper food, education, health
facilities, and recreational facilities.
18.
Otherwise, psychopathy,
alcoholism, drugaddiction, crime
and mental illness, will result in
such situations.
• Collection and evaluation of
epidemiological, biostatistical
data.
19.
Secondary Prevention:-
• Secondaryprevention targets people who
show early symptoms of mental health
disruption but regain premorbid level of
functioning through aggressive treatment.
20.
TARGET:-Recognition of symptomsand
provision of referral for
treatmentOngoing assessment of
individuals at high risk for illness.
-during home visit.Day care or
community health centre.
21.
Role of Nurse:-
•Early diagnosis and case finding:This can be achieved by educating the public,
community leaders in how to recognize early symptoms of mental illness.Community
mental health nurses detect:early signs of increased levels of anxiety, decreased ability
to cope with stress and provide direct services as appropriate.
22.
• Early reference:-Thepublic should be
educated to refer these cases to proper
hospitals as soon as they recognize early
symptoms of mental illness.
24.
• Screening programs:-Simplequestionnaires should be developed to identify the
symptoms of mental illness in the communityEarly and effective treatment for patient,
and family members, provide counseling services to caregivers of mentally ill patients.
25.
• Training ofhealth personnel:-Orientation courses should be provided to health workers
to detect cases in the course of their routine work.
26.
• Consultation services:-Nursesworking in general hospitals may come across various
conditions such as puerperal psychosis, anxiety states, peptic ulcer, ulcerative colitis,
bronchial asthma etc. These basic care providers need guidance and consultation to
deal with these conditions in an effective manner.
TERTIARY PREVENTION:-
• Tertiaryprevention targets those with mental
illness and helps to reduce the severity,
discomfort and disability associated with
their illness.
29.
• DISABILITY:-Disability is“any restriction or
lack of ability to perform an activity in the
manner or within the range considered
normal for the human being”.
30.
• AIM:-Reducing theresidual defects that are
associated with severe and persistent mental
illness.
31.
• STRATEGIES:-Preventing complicationsof the
illness.Promoting rehabilitation that is
directed towards the achievement of each
individuals maximum levels of functioning.
32.
Role of Nurse:-
•Family involvementOccupational and recreational activitiesRehabilitationTeaching the
client daily living skillsEncouraging independenceReferring clients to various aftercare
servicesCommunity based programmes.
33.
PSYCHIATRIC
REHABILITATION:-
• Rehabilitation isthe process of enabling the
individual to return to his highest possible
level of functioning. It is an important
component of the community mental health
program, and is under taken at the level of
tertiary prevention.
34.
Definition:-
• Rehabilitation is“ an attempt to provide the
best possible community role which will
enable the patient to achieve the maximum
range of activity, interest and of which he is
capable”. –Maxwell Jones [1952]
35.
Rehabilitation:-
V O CAT I O N A L R E H A B I L I TAT I O N M E D I C A L
R E H A B I L I TAT I O N S O C I A L
R E H A B I L I TAT I O N P S Y C H O L O G I C A L R E H A B I L I TAT I O N
36.
Indications:-
• The followingdisorders are indicated commonly for rehabilitation:Chronic
schizophreniaChronic organic mental disordersMental retardationAlcohol and drug
dependence
37.
Principles of
Rehabilitation:-
• Increasingindependence would be the first
step in rehabilitation process.Primary focus is
on improvement of capabilities and
competence of clients with psychiatric
problems.Maximum use must be made of
residual capacities.Patient’s active
participation is very essential.Skill
development, therapeutic environment are
fundamental interventions for a successful
rehabilitation process.
38.
Psychiatric Rehabilitation Approaches:-
•A. Psycho education: Includes diagnosing the problem, telling the person what to
expect regarding illness and discussing treatment alternatives.B. Working with families:
Encouraging family members to get involved in treatment and rehabilitation programs.
39.
• C. Grouptherapy: Positive aspects of group therapy include an opportunity for ongoing
contact with others, sharing their views about problems and problem solving abilities.
40.
• D. Socialskills training: It involves teaching specific living skills that the patient is
expected to have in order to survive in the community
![Definition:-
• Rehabilitation is “ an attempt to provide the
best possible community role which will
enable the patient to achieve the maximum
range of activity, interest and of which he is
capable”. –Maxwell Jones [1952]](/proxy?url=https%3A%2F%2Fimage.slidesharecdn.com%2Fpresentation37-260413031445-af2b8801%2F85%2FFEMALE-PELVIS-in-obstetrics-science-bscn-34-320.jpg)
