Prevention and early intervention are singled out as fundamental elements in minimizing the impact of any potentially serious health condition. Early intervention represents a field of a remarkable achievement in the last twenty years, given the early intervention services available for people experiencing various illnesses. Unfortunately, such achievements are yet to be witnessed in the field of mental health, which remains neglected. From a traditional point of view, mental healthcare has been primarily reactive, palliative, and adult-focused. In most cases, mental healthcare is oriented to provide health benefits to the adult population during crisis events and major emergencies. Such experiences are also common in pediatric populations, whereby mental health presentations to emergency settings are frequent scenarios. Efforts to address this issue are evident in the deinstitutionalization and implementation of community mental healthcare. Unfortunately, these efforts have only partially resolved the issue as underinvestment in mental health has resulted in increased presentations in acute settings. Underinvestment, coupled with the large variability worldwide in the implementation of community mental health services, continues to hamper early intervention efforts. Early intervention is increasingly becoming critical with the focus on altering the trajectory of mental illness. Indisputably, early interventions have numerous benefits to mental health, and nurses have a duty to implement evidence-based interventions early for people with emerging mental health conditions.
Benefits to Early Intervention in Mental Health
A benefit of early intervention in mental health is that it allows for more effective healthcare pathways through taking action long before the mental health issue worsens or preventing its onset. Unfortunately, the biggest challenge facing mental healthcare is the delay in care for persons showing symptoms of mental illness (Colizzi et al., 2020; Hercelinskyj et al., 2020). In the United States, it is estimated that the median delay between mental illness symptoms onset and treatment is seven years (Wang et al., 2004). This delay in the treatment of mental illness is considered a serious public health problem. One of the reasons given for the delay is the failure of persons with mental disorders to seek medical help. The help-seeking process is considered an important phase of early intervention in mental health. A critical stage in the help-seeking process is ensuring that treatment contact occurs in a timely manner after the first onset of a mental issue. Although a majority of mentally ill persons eventually establish treatment contact, delays in seeking treatment remain pervasive (Wang et al., 2004). Taking action long before a person’s mental illness worsens helps to address efficacy and safety concerns surrounding treatment approaches utilized (Colizzi et al., 2020). According to Lake and Turner (2017), widely and commonly used treatments for mental disorders in the initial stages include psychotherapeutic techniques, such as insight-oriented therapy, electroconvulsive therapy, cognitive behavioral therapy, and transcranial magnetic stimulation. Psychotropic medications are also used in the treatment of mental disorders, especially in severe cases. Unfortunately, treatment approaches such as prescription of psychotropic medications are linked to efficacy concerns and serious adverse effects such as weight gain, neurologic disorders, increased risk of heart disease and diabetes, and sudden cardiac death. With early intervention in mental health, more effective healthcare pathways are guaranteed, and such efficacy and safety concerns and potential adverse effects on the patient are prevented.
Early interventions in mental health are important in disclosing the presence of both mental health issues and a person’s at-risk status. During communication of information about the at-risk status for mental disorders to individuals and their families, an ethical concern that usually arises is whether telling them about their at-risk status can cause harm (Sommer et al., 2016). It is important to consider this concern in light of the anticipated gain of the early intervention, which might be the mitigation or prevention of possible social and cognitive impairments of the mental disorder and full manifestation of a major mental disorder. Communication of information to an individual about an increased risk for a major mental disorder may cause anxiety from a negative point of view. However, such disclosure can be beneficial for both the individual and the family by validating perceived social and cognitive problems or emergent adverse mental health experiences (Sommer et al., 2016). Disclosure of the presence of mental health issues and at-risk status, enabled by early interventions in mental health, also provides an opportunity to educate the individual and family. For instance, it provides an opportunity to educate them about other potential risk environments or factors, recognition of early symptoms of mental illness, and the need for lifestyle adjustments (Sommer et al., 2016). There are more extensive discussions around considerations regarding ethical aspects of disclosing the presence of mental health issues and at-risk status in the context of early interventions (Appelbaum, 2015; Mittal et al., 2015). The ethical aspects notwithstanding, individuals stand to benefit in terms of validation of perceived social and cognitive problems and emergent mental health issues. This validation paves the way for further medical attention and lifestyle adjustments.
Early interventions in mental health are beneficial as they allow healthcare providers to give more personalized care to the patient. The personalization of care may be in terms of tailoring health interventions that are specific to identified sociodemographic and mental health-related risk factors (Colizzi e al., 2020). The said personalized care might also be in terms of activation of interventions that are specific to the mental illness stage. To this effect, there are suggestions for the application of clinical staging models to improve health benefits (Hercelinskyj et al., 2020). The application of clinical staging models can be through addressing the needs of individuals who present themselves at different stages along the continuum between health and disease. Despite the challenges that healthcare providers might have in this regard, reformulation of health services in the said perspective has been found to increase the prevention of mental health problems, the effectiveness of early intervention strategies, disease control, and overall care (Colizzi e al., 2020). The mentioned aspects have positive impacts on the health and well-being outcomes of a broader population, which is one of the primary objectives of healthcare providers. Reformulating health services to a specific patient with mental illness can go a long way in reducing disease burden and overall costs on the healthcare system.
Early intervention strategies in mental health are beneficial, as they help to reduce the mortality and long-term morbidity that are usually associated with mental health disorders. Problems related to mortality and long-term morbidity that are averted by early intervention strategies in mental health include premature death, poor functioning, social isolation, and reduced educational and vocational productivity (Gibb et al., 2010; Morgan et al., 2017). According to McGorry and Mei (2018), the timing of interventions is important in the prevention of the mentioned adverse outcomes and the entrenchment of symptoms of mental illness. Young people, in particular, illustrate the need for mental healthcare before they reach the threshold for a traditional major mental illness diagnosis that may be characterized by distress, functional impairment, and warning signs of mental illness (Walker et al., 2015). In such situations, early interventions become crucial since they may help in the prevention or reduction of the severity of the full-threshold mental disorder. The biggest challenge, in this regard, is the lack of access to mental health services. McGorry and Mei (2018) argue that young people are victims of the lack of access to mental health services due to multiple reasons. Some of these reasons include reduced or lack of mental health literacy, stigma by community members, inadequate health system structures, and poor access to appropriate mental health services. Poor service utilization for young people with mental health problems is alarming. These weaknesses that are largely pronounced in young populations form a barrier to early intervention strategies in mental health for this population. The creation of the barrier has called for the need to establish youth-specific and stigma-free early intervention services for young people.
Early intervention strategies in the mental health context have economic benefits. The economic benefits are felt not at the individual level but at the wider population level. When implementing early intervention strategies for persons with mental health issues, it is important to assess the economic feasibility of such interventions (Sommer et al., 2016). The economic benefit of early intervention strategies in the mental health context is evident in the decrease in the expenses required to address mental health in the wider population. Early interventions in mental health help to avert or improve cognitive and social functioning in mentally ill persons. Thus, the number of patients who transition to more severe mental problems is reduced, which translates to a reduction in the expenses that would be channeled to treating persons with severe mental problems (Sommer et al., 2016). In other words, the costs of an early intervention strategy in preventing one transition to severe mental illness outweigh the economic burdens of one affected individual (Fineberg et al., 2013). Multiple factors influence whether an early intervention strategy is cost-effective. Some of these factors include the costs of the early intervention strategy, lifetime risk for mental disorder in a given population, and the effectiveness of the intervention. The effectiveness of the intervention has to do with what proportion of individuals the development of a mental disorder can be averted due to early intervention (Sommer et al., 2016). The bottom line is that early intervention in the mental health context is important in preventing a broader spectrum of mental health problems that can have adverse economic impacts over the long term.
Evidence-Based Nursing Intervention for an Emerging Mental Health Condition
Since mental health issues are increasingly becoming a burden for both global economies and healthcare systems, there are calls to implement evidence-based nursing interventions in the management of emerging mental health conditions. One evidence-based nursing intervention that could be implemented when working with someone with an emerging mental health condition is illness management and recovery (IMR). IMR is a mental illness treatment framework that is usually designed to allow patients to be involved actively in their recoveries. The objective is to help mentally ill individuals to set and pursue their recovery goals while learning illness management skills that help in the attainment of the goals (Jensen et al., 2019; Mueser et al., 2006). The patient is introduced to ongoing weekly sessions in which the nurse or behavioral health practitioner assists the patient with the development of treatment plans and identification of goals. In this regard, the nurse or behavioral health practitioner teaches the patient recovery methodologies, stress management techniques, and behavioral health facts (Drake et al., 2001). In IMR, the practitioner also teaches the patient how he or she can build and maintain social support networks, use prescribed medications effectively, and reduce chances of drug abuse resuming drug use. Other teaching techniques that are included in IMR are motivational sessions and cognitive-behavioral therapy.
Prevention and early intervention are important in minimizing the impact of any health condition. Early intervention is important in preventing the adverse effects of mental health illness. A benefit of early intervention in mental health is that it allows for more effective healthcare pathways through taking action long before the mental health issue worsens or preventing its onset. It helps to disclose the presence of both mental health issues and a person’s at-risk status. It allows healthcare providers to give more personalized care to mentally ill patients. It is instrumental in reducing the mortality and long-term morbidity usually associated with mental health disorders. Moreover, early intervention strategies in mental health have economic benefits that are not felt at the individual level but at the wider population level. As mental health issues increasingly become a burden, there are calls for the implementation of evidence-based nursing interventions. An evidence-based nursing intervention found to be effective in the management of emerging mental health conditions is IMR. IMR is a mental illness treatment framework designed to allow patients to be involved actively in their recoveries.
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