MENTAL HEALTH CRISIS RISK REDUCTION INTERVENTIONS
Our greater emphasis is on increasing public knowledge and practical skills of mental health literacy and on empowering people experiencing disabling symptoms as the person affected by the symptoms (either personally or through close contact) is seen as the primary agent in symptom management promoting resilience building, adaptation and coping to mental health crisis hence promoting mental health crisis risk reduction interventions (through our services, solutions, systems and programs).
The long-term goal of all three types of preventive intervention—universal, selective, and indicated—is the reduction of the occurrence of new cases of mental disorder. Usually, this is attempted through a risk reduction model, wherein the short-term goal is the reduction of the risk factors and the enhancement of the protective factors that have been shown to be associated with the onset of the disorder. Risk factors are those characteristics, variables, or hazards that, if present for a given individual, make it more likely that this individual, rather than someone selected from the general population, will develop a disorder. Many at-risk individuals also have variables in their background or life that serve as protective factors.
A well-documented description of the interplay between risk and protective factors is a critical scientific first step in establishing successful preventive intervention programs. Such a description is now available for some disorders, and research is under way to identify such factors for a number of others. The next step is to identify causal risk factors that may be malleable, that is, that can be altered through interventions. Then the effects of these interventions are tested in systematic, empirical, and rigorous ways, most often in preventive intervention trials. If risk factors can be decreased or in some way altered, and/or if protective factors can be enhanced, the likelihood that at-risk individuals would eventually develop the mental disorder would decrease.
As described, this risk reduction model is widely used for prevention of physical illness. To prevent physical disorders due to complex multiple causes, the strategy is to determine risk factors and then to target interventions to such risk factors or to people with these risk factors. Progress has been notable in many areas, including the three used as illustrations: cardiovascular disease, smoking cessation and prevention, and injury prevention. The universal preventive strategies mounted in these areas have demonstrated that effective interventions are possible even when knowledge about the mechanisms causing illness is incomplete.
In order to formulate effective interventions, prevention researchers harvest methodologies, data, theories, and principles from a bounty of disciplines. The core sciences, including neuroscience, genetics, epidemiology, and developmental psychopathology; research on risk and protective factors for the onset of mental disorders; previous preventive intervention research programs; and research on treatment interventions for mental disorders all contribute to the knowledge base for research on preventive interventions for mental disorders. For some mental disorders, the knowledge base is now at a stage comparable to that available for many physical disorders before successful large-scale prevention trials for those disorders were mounted.
World Mental Resilience Programs to integrates the concept of disaster risk reduction to the risk reduction of mental health interventions. Disaster risk reduction (DRR) is a systematic approach to identifying, assessing and reducing the risks of disaster. It aims to promote sustainable development by increasing the resilience of communities to any disasters they might face; in this case we refer to different mental health pandemics as disasters. DRR is normally used as policies intended to “define goals and objectives across different timescales and with concrete targets, indicators and time frames. The concept is also called disaster risk management (DRM).
Disaster risk reduction has been strongly influenced by mapping of natural disaster risks and research on vulnerability since the mid-1970s. Disaster risk reduction decreases the vulnerability of communities by mitigating effects of disasters, reducing severity and volume of risky events, and promoting improved resilience, we are now extending the same concept to sustainable mental health interventions. Since climate change is increasing the severity of hazardous events that can become disasters, DRR and climate change adaptation are often associated together in development efforts. There is potential for disaster risk reduction initiatives in most sectors of development and humanitarian work, now these initiatives can no longer overlook the integration of mental health interventions. Strategies and implementation can come from community volunteers, local agencies, federal governments, and even international groups such as the United Nations.
The Sendai Framework for Disaster Risk Reduction is an important international initiative that has helped many countries adopt both federal and local DRR strategies as of 2022 hence the integration of the Mental Health Crisis Support Practice framework can be a game changer in the disaster risk reduction of mental health breakdowns and challenges. The International Day for Disaster Risk Reduction, on October 13, has helped increase the visibility of DRR and promote a culture of prevention. Some of the main issues and challenges include the importance of communities and local organisations in disaster risk management, governance of disaster risk and how this relates to development, and gender sensitivity of disaster impacts and disaster prevention strategies.
Disaster risk reduction (DRR) is defined by United Nations Office for Disaster Risk Reduction (UNDRR) as those actions which aim to “prevent new and reducing existing disaster risk and managing residual risk, all of which contribute to strengthening resilience and therefore to the achievement of sustainable development”. The risk equation shows that disaster risk is a product of hazard, exposure, and climate change vulnerability (where ‘x’ represents interaction between the components).
Disaster risk is the potential loss of life, injury, or destroyed or damaged assets which could impact a society or community. Disaster risk results from the interaction of three factors: hazard(s), vulnerability and exposure, hence we are now extending the same concept in the sustainable development of sustainable mental health interventions. Disaster risk reduction is very wide-ranging: Its scope is much broader and deeper than conventional emergency management and includes objectives that align with many sectors of development and humanitarian work.
Disaster risk management
Disaster management thinking and practice since the 1970s has included more focus on understanding why disasters happen. It has also focused on actions that can reduce risk before a disaster occurs. This has put more emphasis on mitigation and preparedness in addition to the response and recovery phases of disasters. It has been widely embraced by governments, disaster planners and civil society organisations, now this is embraced and integrated by World Mental Resilience Programs.
DRR is such an all-embracing concept that it has proved difficult to define or explain in detail, although the broad idea is clear enough. It is generally understood to mean the broad development and application of policies, strategies and practices to minimise vulnerabilities and disaster risks throughout society. Its policy goals and objectives are defined in disaster risk reduction strategies and plans.
The term 'disaster risk management' (DRM) is often used in the same context and to mean much the same thing. That is, a systematic approach to identifying, assessing and reducing risks of all kinds associated with hazards and human activities. DRM is more properly applied to the operational aspects of DRR: the practical implementation of DRR initiatives. In other words, disaster risk reduction is the policy objective of disaster risk management.
Resilience
Resilience is scientifically defined as the efficiency with which a system can reduce the extent and duration of a disruption. The concept can take two forms: hard and soft resilience. Hard resilience refers to the strength of a structure to withstand pressure, while soft resilience is whether a system can recover from a disruptive event without changing its core function. Alternatively, the United Nations International Strategy for Disaster Reduction (UNISDR) defines resilience as “the ability of a system, community or society exposed to hazards to resist, absorb, accommodate to and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions, now this concept is embraced and integrated to sustainable mental health interventions.
Vulnerability
According to the UNISDR, vulnerabilities are "the characteristics and circumstances of a community, system or asset that make it susceptible to the damaging effects of a hazard." The most vulnerable people or communities are those who have the most difficulties accessing resources they need to respond to an event. Vulnerability plays a critical role in the analysis of risk, as the risk a structure faces is proportional to its level of vulnerability. Risk is often defined by the likelihood of an event occurring and the vulnerability of the community to that event. The more vulnerable the community, the more risk they face the same applying to vulnerability and risks associated with mental health breakdowns and challenges.
Mitigation
Mitigation is the action taken before an event to reduce any possible negative outcomes or harmful effects. Natural risk assessments commonly use the term mitigation, while broader climate change reports tend to use adaptive capacity instead (mitigation holds another definition in the scope of climate change) although in mental health interventions both terms can be used with regards to mental health crisis, breakdowns or challenges. Although related, adaptive capacity refers more to the potential to adjust a system, while mitigation is the actual implementation of adjustments. Mitigation is often used interchangeably with risk reduction; however, the terms have a few key differences. Both aim to reduce the number of negative effects of hazards, but risk reduction focuses on reducing the likelihood of the event itself, while mitigation focuses on reducing the impact of the event.
Mitigation planning helps local governments lessen the impacts of hazards within their communities. No two locations have the same hazard risks and communities know their experiences best; for example, even if a hazard is not recorded in government data, locals will take note of anything that occurs in their neighborhood. Policymakers can use community input to create more efficient mitigation plans.
Sustainable development
Sustainable development was notorious for its "slippery nature" and ambiguities: multiple definitions have led to multiple interpretations in the agenda setting environment. However, in 1987, the Brundtland Report redefined sustainable development as "development that meets the needs of the present generation without compromising the ability of future generations to meet their own needs, now adopted to apply to the mental health wellness different needs hence, now the term has a clearer political interpretation.
Sustainable development balances between economic development, environmental protection, and social well-being making up overall mental health well-being. The economic systems aim to improve economic growth, equity, and efficiency; social systems work towards empowerment, social cohesion, and cultural diversity; and the biological/environmental system promotes genetic diversity, productivity, and resilience. In 2015 the Sustainable Development Goals were adopted as part of the broad intergovernmental agreement on development to 2030. Many of these objectives tie directly into disaster risk reduction, and sustainable development plans often mention DRR.
Sendai Framework for Disaster Risk Reduction
The Sendai Framework places the responsibility of reducing disaster risk primarily on federal governments through seven targets divided into two categories: substantial reductions and increases. It aims to reduce disaster mortality, people affected, economic loss, and damage to infrastructure and services. The remaining targets work to increase access to warning systems, aid to developing countries, and the number of countries with disaster risk reduction strategies. Since the adoption of the Sendai Framework in 2015, the number of countries with national DRR strategies has increased dramatically, from 55 to 123 countries in 2022.
The framework also details four priorities for action to be accomplished by 2030:
- Understanding disaster risk
- Strengthening disaster risk governance
- Investing in disaster risk reduction
- Enhancing disaster preparedness
These priorities acknowledge current shortcomings of DRR efforts, such as the lack of communication between local and federal governments and private programs, as well inequities faced by women and people with disabilities in the realm of disaster response.
