(Volume 4) - Mental Health Disorders - Vula - University of Cape Town

Interventions: evidence, gaps andrecommendationsA brief review of the literature on interventions targeting the six focus areaswas undertaken, drawing equally on policy documents, discussion withexperts and managers, and an inventory of existing interventions that wasconducted in 2006 (Draper & Corrigall, 2006). Current policies and legislationrelevant to each topic were consulted to establish the existing policies withregard to interventions, but formal consultation with Government and otherstakeholders remains outstanding and is crucial to the development of policiesand programmes based on the recommendations presented here. Since thisintergovernmental and cross-sectoral consultation will occur at theDevelopment and Health Summit planned to take place in June 2007, thereader should regard the recommendations recorded in this report as subjectto further discussion and input from stakeholders. Before discussing thefindings of the review, however, it is important to define a few terms:Mental Health is “a state of well-being in which the individual realises his orher own abilities, can cope with the normal stresses of life, can workproductively and fruitfully, and is able to make a contribution to his or hercommunity” (WHO, 2005:2)Mental Disorder Prevention “aims at reducing incidence, prevalence,recurrence of mental disorders, the time spent with symptoms, or the riskcondition for a mental illness, preventing or delaying recurrences and alsodecreasing the impact of illness in the affected person, their families and thesociety” (WHO, 2004:17)Mental Health Promotion aims to affect the determinants of mental healthin order to:‣ increase mental health;‣ reduce mental disorders;‣ reduce inequalities;‣ build social capital;‣ create health gain; and‣ narrow the gap in health expectancy among different countries andgroups(WHO, 2004:16)Given that sub-optimal mental health (low self-esteem or compulsivebehaviour, for example) is associated with multiple mental and physicaldisorders, poor educational outcomes, poor work performance and substanceabuse, focusing on the prevention of mental disorders alone would limit thehealth benefits of intervention programmes. As such, mental-healthpromotion (which includes mental-illness prevention) is by far the superiorpublic-health approach to reducing the total Burden of Disease in the Western27