The prevention of mental health problems in Canada: A survey of provincial policies, structures, and programs.

Abstract

AbstractThe purpose of this research was to obtain a profile of state of prevention in mental health in Canada. In all provinces and territories, we obtained information from departments of children's mental health, adult mental health, and health promotion regarding administrative supports, personnel, policies, budgets, inter - ministerial collaboration, training, and programs allocated for prevention. The findings indicate that rhetoric of prevention is present in many government policy documents and there are many interesting prevention projects that have been implemented. However, there has not been a reallocation of funding in health field from treatment and rehabilitation services to prevention programs, and funding for prevention remains a very low level. Recommendations to improve state of prevention are made.There is abundant epidemiological information to suggest that psychosocial problems will never be brought under control by treating affected individuals one a time. As Offord recently put it, the of suffering from child psychiatric disorders is extremely high, and one - to - one clinical interventions can never make a large dent in reducing this burden (1995, p. 287). Kramer (1992) recently documented what he called pandemic of mental and emotional disorders, demonstrating that prevalent global social trends such as population growth, poverty and family breakdown are resulting in exorbitant numbers of children and adults suffering from one psychosocial problem or another. Using a conservative estimate of prevalence rate of 12% for mental, behavioural and developmental disorders in children around world, Kramer reports that the total number of cases of mental disorders in children under 18 years of age would increase from 237.8 in 1990 to 261.5 in year 2000, increase of 10%. In more developed regions number of cases would increase from 37.8 to 38.2 million (Kramer, 1992, p. 15). In his review of epidemiological studies for child psychiatric disorders, Offord (1995) states that based on DSM - III criteria, five community studies reported prevalence rates of 17.6% to 22%. A Canadian study estimated that approximately 26% of school - age children experience mental health problems (Offord, Boyle, & Szatmari, 1987). Although prevalence rates for psychological problems vary depending on informants, instrumentation, and definitions of disorders, Offord estimates that at very least, 12% of children and adolescents have clinically important mental disorders, and least half of them are deemed severely disordered or handicapped by their mental (1995, p. 285). This figure is congruent with one reported by Institute of Medicine (IOM) (1994), according to which least 12% of children in U.S. from one or more mental disorders - including austim, attention deficit hyperactivity disorder, severe conduct disorder, depression, and alcohol and psychoactive substance abuse and dependence (p. 487). The same report states that 20% of adults in U.S. actively suffer from a psychiatric impairment, and 32% can be expected to develop such illness during their life time.Even in a utopian scenario in which therapeutic interventions would be successful 100% of time, there would never be enough mental health professionals to reach all those in need (Albee, 1990). Moreover, as Albee (1990, p. 370) has noted: ... as history of public health methods (that emphasize social change) has clearly established, no mass disease or disorder afflicting humankind has ever been eliminated by attempts treating affected individuals. This realization, coupled with simple yet powerful notion that an ounce of prevention is worth a pound of cure, has led governments and mental health professionals to develop prevention and mental health promotion programs.In spite of this clear need to shift to a more preventive orientation, governments have not provided infrastructures that are needed for advancement of primary prevention in mental health (Goldston, 1991; IOM, 1994). …