Counseling Across the Lifespan

Prevention and Treatment

Cindy L Juntunen, Jonathan P. Schwartz

• Publisher: SAGE Publications, Inc
• Year: 2015
• ISBN:
  9781483389141
• Edition: 2
• Topic: Psicologia
• Subtopic: Psicoterapia

This practical book helps readers provide effective mental, emotional, and behavioral health services to clients across the continuum of care, from health promotion through long-term treatment and remediation. Anchoring each chapter within a life stage—from childhood through older adulthood—the text identifies the nature and origin of various psychological issues and emphasizes the importance of anticipating and responding early to concerns that arise for large portions of the population. The Second Edition features new chapters and expanded coverage of important topics, such as sociocultural contextual factors and interprofessional health perspectives.

Chapter 1 Prevention and Treatment in a Developmental Context

Cindy L. Juntunen University of North Dakota

Jonathan P. Schwartz University of Houston

The need for effective and efficacious treatment of mental health disorders forms the bedrock for much of the theory, research, and practice guidelines used by psychologists, counselors, social workers, and other mental health providers. Such treatment is essential to support the health and well-being of millions of individuals and families in the United States alone. Mental illness is widely recognized as creating an “enormous public health burden” (Insel, 2008, p.iii) in the United States, and the World Health Organization (2014a) has identified mental illness and substance abuse as the worldwide leading cause of disability.

Accurate prevalence rates for mental disorders remain surprisingly elusive (see O'Connell, Boat, & Warner, 2009, for a thorough discussion beyond the scope of this chapter), but even isolated bits of information demonstrate the overwhelming impact of mental illness. For example, the World Health Organization (2014b) found that a completed suicide is reported every 40 seconds, with more than 800,000 suicides completed and reported every year around the world. In the United States, Healthy People 2020 set a goal of suicide reduction but has actually measured an increase in suicide rates of approximately 7% between 2007 and 2010 (U.S. Department of Health and Human Services, 2014). Slightly less than 19% of adults and slightly more than 20% of children in the United States are diagnosed with a significant mental illness, and these numbers do not include substance abuse (Substance Abuse and Mental Health Services Administration [SAMHSA], 2013). By the age of 40, nearly half of Canadian citizens will have been diagnosed with a mental illness or substance abuse disorder (Mental Health Commission of Canada, 2013). Given just these few findings, it is no surprise that there is consensus across multiple health organizations that mental health requires additional support and attention by governments and policymakers (O'Connell et al., 2009; SAMHSA, 2013; World Health Organization, 2013).

Of course, mental illness and the appropriate treatment of mental disorders have long been a focus of the national health agenda. However, in the past decade, concerns about mental illness have been increasingly accompanied by recommendations to address health promotion, prevention, and early intervention to support mental health. The cause of this focus is related to the staggering cost of health care, approximately 2 trillion dollars each year, causing President Obama to state that unless there is a “radical shift” to prevention and public health, it will have a negative impact on rising health care costs and ultimately health outcomes (Obama, 2008). In addition, increasing attention is being paid to health and mental health disparities. Research on mental health disparities suggest that only a small percentage of those with mental illness receive appropriate services (U.S. Department of Health and Human Services, 1999, 2001). Mental health disparities are particularly troubling, given the increased support in the research on the efficacy of prevention in meeting mental health and health needs (Crepaz et al., 2006; Durlak & Wells, 1997; Greenberg, Domitrovich, & Bumbarger, 2001).

Focusing on prevention, early intervention, and health promotion are consistent with the long-held belief that mental health care students and professionals need to be proficient in interventions appropriate for multiple points along the health and development continuum, including prevention and health promotion (Atkinson, 2002; Vera, Buhin, & Isacco, 2009). The increased attention to prevention is accompanied by several important changes in conceptualizations of health and health care, such as the patient-centered medical home promoted by the Patient Protection and Affordable Care Act (2010). Of particular relevance to this chapter and book are three issues related to mental health promotion and the prevention or treatment of mental illness: attending to the developmental context of health and illness, implementing programs and treatments at multiple points along the continuum of intervention, and developing competencies to work in interprofessional settings.

To put these issues in context, it is important to note that the parameters of mental health explicitly include mental, emotional, and behavioral health (O'Connell et al., 2009), drawing attention to the role of lifestyle factors, behaviors, social contexts, and relationships in overall health. Similarly, social and societal determinants of health are emphasized in policies proposed by Healthy People 2020 (Secretary's Advisory Committee, 2010) and the World Health Organization (2008). Societal determinants include environmental factors, such as poverty; infrastructure; and national, regional, and local policies. These factors are related to social networks, which can heavily influence individual choices and, eventually, health. As noted in Healthy People 2020, “Achieving health requires more than just controlling disease. It requires us to assure conditions in which people can be healthy. Health results from the choices that people are able to make in response to the options that they have” (Secretary's Advisory Committee, 2010, p. 4). The recognition of social and societal determinants of health in major national and global policy development reinforces the critical health promotion and illness prevention role of counselors, psychologists, soci...