MENTAL HEALTH PERSPECTIVES
Frank S. G. Wills
Psychiatry is usually thought of as a field that attempts to restore lost functions, rather than to preserve existing ones. Most psychiatrists spend a great deal of their time treating existing illness.
However, many of us are strongly concerned to try to keep illnesses from occurring in the first place. This essay will focus on three topics: (1) some common psychiatric problems in people who are old, (2) characteristics of common conditions in people who are mentally retarded and, (3) a piece of psychiatric preventive medicine that can be practiced without a medical license.
Primary prevention, which is the ideal of the field of preventive medicine, is the creation of conditions that will prevent one or more diseases from occurring. Classic examples are sanitation of food and water supplies, pest control, and vaccination programs. Secondary prevention involves early diagnosis and prompt treatment to shorten the duration of illness, reduce its severity, reduce the possibility of contagion, and limit after-effects. Tertiary prevention aims to limit the degree of disability and promote rehabilitation in chronic and irreversible diseases and states. We can include habilitation as an aspect of rehabilitation.
Most people would think that the bulk of work with people who are mentally retarded and old would be tertiary prevention. It is certainly important work, but it need not be and actually is not the main work. Most of the work that is being done, which is referred to in other parts of this book, is primary and secondary prevention.
For instance, there are many preventable or treatable conditions that are confused with dementia in people who are old. The most common is the consequence of the side effects of medications the person is taking. Symptoms of physical disease, clinical depression, effects of alcohol, and symptoms of head trauma also can be seen in