Proposal for a special interest group in prevention of mental illness

Procedure for establishing a special interest group:

1. (a) Any member wishing to establish a special interest group shall write to the Registrar with relevant details.

2. (b) The Registrar shall forward the application to the Central Executive Committee.

3. (c) If the Central Executive Committee approves the principle of establishing such a special interest group then it will direct the Registrar to place a notice in the Psychiatric Bulletin, or its equivalent, asking members of the College to write in support of such a group and expressing willingness to participate in its activities.

4. (d) If at least 120 members reply to this notice within 4 months of publication, then the Central Executive Committee shall formally approve the establishment of the special interest group.

In accordance with this procedure, the Central Executive Committee has approved a proposal for the establishment of a special interest group in the prevention of mental illness.

Background to the proposal

In 1917 Noguchi & Moore discovered that cerebral syphilis was the cause of ‘general paralysis of the insane’; treatment of syphilis with penicillin has eradicated this condition. It has also been found that giving vitamin supplements to people with alcohol dependence syndromes prevents alcoholic dementia. The incidence of vascular dementia has been reduced by the careful management of diabetes mellitus and hypertension, and some significant success has been recorded in the prevention of mental retardation, post-traumatic stress disorder, conduct disorders in children, substance misuse, eating disorders and post-partum depression. We therefore know that the primary prevention of mental illness is achievable because it has been done, albeit on a small scale. It is important to bring under one umbrella the various disparate efforts at preventive psychiatry and the ways of evaluating their delivery and effectiveness. A public health approach to mental illness is likely to be as effective as such an approach has been to physical illness.

We all undertake a measure of preventive psychiatry in our everyday work. Most of this is secondary or tertiary prevention. For various reasons, however, we attempt very little primary prevention.

There are two main reasons for our diffidence. First, we believe that the causes of mental illness are, in general, unknown, and therefore that we can not begin to prevent these illnesses if we do not know what has caused them. Second, we think that what needs to be done is outside the normal remit of our work, that it is up to others – society as a whole or the government – to put in place the measures that would be likely to reduce the incidence of mental illness. We now do have a far better understanding of the causes of mental illness and are therefore in a much better position to engage in primary prevention. In our highly connected world, we would provide an avenue for mental health workers to undertake tasks directly, or advise others, regarding what individuals, families, local communities and governments can do to reduce the incidence of mental illness in our world.

Members are invited to write in support of this group and express willingness to participate in its activities. Interested members should write to the Registrar care of Miss Sue Duncan at the College. If 120 members reply to this notice within 4 months of publication, then the Central Executive Committee shall formally approve the establishment of this special interest group.