“The best time to influence the character of a child is 100 years before they are born” – W.R. Inge
Promotion, prevention and early intervention may have the greatest impact on health and well-being for people (Colizzi et al, 2020). These strategies are recognised as essential elements in reducing the impact of any serious health problem. Early childhood years are important because of the greater sensitivity and vulnerability of early brain development which may have long-lasting impacts on every sphere of functioning into adulthood. Most mental disorders have their peak of incidence in the transition from childhood into young adulthood with up to 1 in 5 people experiencing clinical problems before the age of 25, and 50% of these already symptomatic by 14. Mental health services have proven to be ineffective to provide care during this critical period. In order to meet this need for early intervention, prevention programmes need to be re-designed by promoting multidisciplinary collaborations in an integrated service of primary healthcare.
Research shows that there are a number of factors that influence mental health from before birth to adulthood, after which it can still be modulated but to a lesser extent (Colizzi et al, 2020). Risk and protective factors can alter gene expression and stress response with long-lasting health effects. Children carrying certain genetic variants are at increased risk of behaviour problems but only when raised in a dysfunctional family. Selective prevention strategies targeting physiologic reactivity, cognitive control and self-regulation through parenting and classroom-based activities may represent a huge preventive action and ensure the earliest possible access to intervention. Promotion focuses on strengthening the capacities and resources of individuals and communities to increase control over mental health. Prevention aims to reduce the incidence, prevalence and severity of the problem. According to the WHO, population level interventions should have a promotion focus. Multimodal preventive programmes that provide interventions of pre-school and family support have the most long-lasting positive effects.
References
Colizzi, M., Lasalvia, A., & Ruggeri, M. (2020). Prevention and early intervention in youth mental health: Is it time for a multidisciplinary and trans-diagnostic model for care? International Journal of Mental Health Systems, 14(1). doi:10.1186/s13033-020-00356-9