Prevention, treatment, and rehabilitation are three integral components of the “whole course of treatment” for any disorder. Most mental disorders are chronic and may lead to some degree of disability. Therefore, prevention and rehabilitation are an important part of psychiatry, if not more important.
I. Overview
Prevention is an extension of the scope of clinical psychiatry and an important part of it, not a public health effort that leaves the practice of psychiatry or a special specialty that is simply in a scientific position.
Two, the three levels of prevention of mental disorders
(I) Primary prevention
Primary prevention, that is, etiological prevention, prevents or reduces the occurrence of mental disorders by eliminating and reducing the causes or causative factors, and belongs to the most active and proactive preventive measures. The main elements include.
1.Promoting mental health care, fully strengthening the popularization and education of mental health knowledge, providing timely and correct psychological counseling services, and improving people’s self-care of mental health is an effective way to reduce the occurrence of mental disorders related to various stress factors.
2.Strengthen genetic counseling and prevent inbred marriage to reduce the incidence of mental disorders.
3.For some “high-risk groups” who are prone to mental disorders, including those with special psychological qualities and those who are engaged in high psychological stress occupations, special psychological interventions should be taken to provide psychological catharsis to prevent and reduce the emergence of mental disorders.
4.Regularly conduct epidemiological surveys of mental disorders, study the incidence of mental disorders in the population, incidence patterns, influencing factors and sub-situations, combine with changes in the composition of the regional population, provide a basis for relevant departments to formulate planning, make decisions, and prevent the occurrence of mental disorders from a macroscopic perspective.
(II) Secondary prevention
The focus of secondary prevention is on early detection, early diagnosis, early treatment, and striving for a good prognosis after remission of the disease and preventing relapse. Because many mental disorders have chronic or subacute onset, insidious symptoms, and lack of clear characteristics of clinical manifestations, opportunities for timely intervention are often lost. Therefore, secondary prevention of mental disorders is an extremely important part of the prevention and treatment work. Its main elements include.
1. actively, deeply and systematically disseminate knowledge about mental disorders to the public, improve people’s ability to identify mental disorders at an early stage, and detect people with mental abnormalities as early as possible. At the same time, it is necessary to improve people’s prejudice against mental disorders as well as people with mental illness, to seek medical treatment in time, and to control the disease in the nascent state.
2.For those who have confirmed suspected mental disorders, we will instruct patients and their families to seek medical consultation in a timely manner to clarify the diagnosis and actively treat the disease to achieve complete remission. At the same time, actively follow up and consolidate treatment to reduce rekindling and relapse.
3.Establish psychiatry and psychological counseling departments within general hospitals to provide consultation-liaison and consultation and training to help non-psychiatrists detect and treat patients with mental disorders early.
(C) Tertiary prevention
The main point of tertiary prevention is to do a good job of rehabilitation training for people with mental disabilities, to maximize the recovery of patients’ social functions, to reduce functional disabilities, to delay the process of disease decline, and to improve patients’ quality of life. Its main contents include.
1.Actively seek the attention and support of government departments at all levels for mental disorders, coordinate the work of all relevant departments, constitute a system of prevention and rehabilitation of mental disorders, and provide help to reduce mental disabilities and improve the quality of life and life security of people with mental disorders.
2. For patients whose condition has stabilized after treatment, various forms of psychological treatment and rehabilitation training are provided. Let patients correctly understand the disease, further correctly understand themselves, overcome character weaknesses, and correctly cope with various psychosocial problems and conflicts in real life. At the same time, patients are urged to take medication on time and in the right amount to prevent the deterioration of the disease and to make efforts to reduce disability so that patients can recover their psychological and social functions to the maximum extent.
3.Establish various work and recreation treatment stations, work stations and recreation stations to provide patients with various rehabilitation training, as well as health education and disease counseling, so that patients can resume family life and social functions as soon as possible.
4.Make regular follow-up visits for discharged patients so that they can receive timely and targeted medical guidance and services. Adjust the living environment of discharged patients, mobilize family members to support and participate in the rehabilitation activities of patients, guide family members to formulate life plans for patients, and make efforts to solve patients’ mental health problems and practical difficulties in daily life.
5. Care for and meet the reasonable requirements of patients with mental disorders, and pay attention to the influence of psychological and social environment on disease prognosis and relapse. Find ways to properly address the patients with mental disorders as well as those with mental disabilities to resume work or re-employment, which has a rather important role in supporting their psychological state and committing to the social environment to receive exercise.
Rehabilitation of mental disorders
In the modern medical concept, rehabilitation refers to the restoration of somatic functions, psychological functions and vocational abilities. It is the improvement of the ability to move around, to improve the ability to take care of oneself, to promote the reintegration of social activities and to improve the quality of life.”
Rehabilitation psychiatry is a branch of rehabilitation medicine, which is consistent with the rehabilitation of somatic diseases, that is, using all available means to correct the pathological manifestations of mental disorders as much as possible, and to restore the mental functions adapted to social life to the maximum extent. The main targets of rehabilitation psychiatry services include people with various types of mental illnesses and mental disorders with disabilities, most of whom are patients with severe mental illnesses and mainly chronic psychiatric patients.
There are three basic principles of rehabilitation of mental disorders, namely: functional training, comprehensive rehabilitation, and return to society. Functional training refers to the use of various rehabilitation methods and means to train patients with mental disorders in various functional activities, including mental activities, physical activities, language communication, daily life, occupational activities and social activities; comprehensive rehabilitation is the guideline and policy of rehabilitation, so that patients can achieve comprehensive and overall rehabilitation of psychological, physical and social functions; and return to society is the goal and direction of rehabilitation.
The main tasks of mental disorder rehabilitation are.
1, life skills training and psychosocial function rehabilitation Carefully train behavioral skills in life, learning and work, including the ability to live independently, basic work skills, interpersonal skills, problem solving skills, stress coping skills, etc., so that patients can re-integrate into society.
2.Training in self-management of medication includes making patients understand the importance of medication for prevention and treatment and accept medication consciously; learning about psychotropic medication, understanding the effects of medication, adverse reactions, etc., learning to identify common adverse drug reactions and being able to handle them in a simple way.
3. Learn the function of seeking help from a doctor Consciously seek help from a doctor when needed, ask questions and requests to the doctor correctly, and be able to effectively describe the problems and symptoms they have. When the condition shows signs of relapse, be able to promptly reflect it to the doctor in order to get reasonable treatment.