The politics of primary prevention in mental health: The need for a theoretical basis

Abstract

Primary prevention of health and mental health problems and corresponding prevention programmes are based on a non-theoretical concept. The scope of preventive action is discussed only towards an interventive pragmatism. Therefore studies or discussions on prevention nearly exclusively talk about methodology, techniques and evaluation of preventive interventions by professionals. This article is to bring into mind some issues in the field of primary prevention in mental health, which have been discussed for years by various professionals, but still remain in the realm of exhortation. These issues deal with the implicit and explicit principles of preventive interventions in the area of mental health. The author will try to illustrate his notion that efforts in primary prevention are influenced by unexplicated ideologies underlying the diverse conceptualizations of preventive interventions and the subjective professional self-concepts of people doing prevention work as mental health professionals. These ideologies basically stem from a medical model, which has been mixed with a traditional “parental” educational understanding of solving psychosocial problems. As a consequence the author argues for the development of a theoretical basis of primary prevention, which will present a framework for research and action, being independent of unexplicated ideologies, though not value-free. This framework will have considerable implications for practical preventive work and research.