Mental health is a level of psychological well-being or an absence of mental illness. It is the "psychological state of someone who is functioning at a satisfactory level of emotional and behavioural adjustment". From the perspective of positive psychology or holism, mental health may include an individual's ability to enjoy life, and create a balance between life activities and efforts to achieve psychological resilience.
According to the World Health Organization (WHO), mental health includes "subjective well-being, perceived self-efficacy, autonomy, competence, inter-generational dependence, and self-actualization of one's intellectual and emotional potential, among others." Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined.
A person struggling with their mental health may experience this because of stress, loneliness, Depression (mood), anxiety, relationship problems, death of a loved one, suicidal thoughts, grief, addiction, ADHD, Cutting, Self-harm, Self-Injury, burning, various mood disorders, or other mental illnesses of varying degrees, as well as learning disabilities. of the American Psychiatric Association, further defined mental hygiene as "the art of preserving the mind against all incidents and influences calculated to deteriorate its qualities, impair its energies, or derange its movements."
Dorothea Dix (1802–1887) was an important figure in the development of the "mental hygiene" movement. Dix was a school teacher who endeavored throughout her life to help people with mental disorders, and to bring to light the deplorable conditions into which they were put.Barlow, D.H., Durand, V.M., Steward, S.H. (2090). ''Abnormal psychology: An integrative approach'' (Second Canadian Edition). Toronto: Nelson. p. 16 This was known as the "mental hygiene movement". Before this movement, it was not uncommon that people affected by mental illness in the 19th century would be considerably neglected, often left alone in deplorable conditions, barely even having sufficient clothing. Dix's efforts were so great that there was a rise in the number of patients in mental health facilities, which sadly resulted in these patients receiving less attention and care, as these institutions were largely understaffed.
Emil Kraepelin in 1896 developed the taxonomy (general) of mental disorders which has dominated the field for nearly 80 years. Later the proposed disease model of abnormality was subjected to analysis and considered normality to be relative to the physical, geographical and cultural aspects of the defining group.
At the beginning of the 20th century, Clifford Whittingham Beers founded "Mental Health America – National Committee for Mental Hygiene", after publication of his accounts from lived experience in lunatic asylums, ''A Mind That Found Itself'', in 1908Amanda Peck (2013),''Mental Health America – Origins'', Retrieved June 9, 2015, from [http://www.socialwelfarehistory.com/organizations/mental-health-america-origins The Social Welfare History Project]. and opened the first outpatient mental health clinic in the United States.Clifford Beers Clinic. (2006, October 30). ''About Clifford Beers Clinic''. Retrieved June 1, 2007, from [http://www.cliffordbeers.org/aboutus.htm CliffordBeers.org]
The mental hygiene movement, related to the social hygiene movement, had at times been associated with advocating eugenics and sterilisation (medicine) of those considered too mentally deficient to be assisted into productive work and contented family life.[https://books.google.com/books?id=C9IOAAAAQAAJ&dq=%27moral+hygiene%27+%27social+hygiene%27+%27mental+hygiene%27+movement&source=gbs_navlinks_s Social Hygiene in 20th Century Britain] Taylor & Francis, Page 80 to 83[http://www.faqs.org/childhood/Gr-Im/Hygiene.html Encyclopedia of Children and Childhood in History and Society: Hygiene] Jacqueline S. Wilkie. In the post-WWII years, references to mental hygiene were gradually replaced by the term 'mental health' due to its positive aspect that evolves from the treatment of illness to preventive and promotive areas of healthcare.
Evidence from the World Health Organization suggests that nearly half of the world's population are affected by mental illness with an impact on their self-esteem, relationships and ability to function in everyday life.
Maintaining good mental health is crucial to living a long and healthy life. Good mental health can enhance one's life, while poor mental health can prevent someone from living an enriching life. According to Richards, Campania, & Muse-Burke, "There is growing evidence that is showing emotional abilities are associated with prosocial behaviors such as stress management and physical health." Their research also concluded that people who lack emotional expression are inclined to anti-social behaviors (e.g., drug and alcohol abuse, physical fights, vandalism), which are a direct reflection of their mental health and suppress emotions. Adults and children with mental illness may experience social stigma, which can exacerbate the issues.
''Sueki'', (2013) carried out a study titled “''The effect of suicide–related internet use on users’ mental health: A longitudinal Study”''. This study investigated the effects of suicide-related internet use on user’s suicidal thoughts, predisposition to depression and anxiety and loneliness. The study consisted of 850 internet users; the data was obtained by carrying out a questionnaire amongst the participants. This study found that browsing websites related to suicide, and methods used to commit suicide, had a negative effect on suicidal thoughts and increased depression and anxiety tendencies. The study concluded that as suicide-related internet use adversely affected the mental health of certain age groups it may be prudent to reduce or control their exposure to these websites. These findings certainly suggest that the internet can indeed have a profoundly negative impact on our mental health.
Psychiatrist Thomas Szasz compared that 50 years ago children were either categorized as good or bad, and today "all children are good, but some are mentally healthy and others are mentally ill". The social control and forced identity creation is the cause of many mental health problems among today's children.[http://www.szasz.com/latimes3152001.html "With Friends Like These, Pity America's Kids" Author Szasz. The Los Angeles Times, Op-Ed, March 15, 2001] A behaviour or misbehaviour might not be an illness but exercise of their free will and today's immediacy in drug administration for every problem along with the law over-guarding and regard of a Minor (law)'s status as a Child#Age of responsibility shakes their personal self and invades their internal growth.
Research has shown that there is Social stigma attached to mental illness.Office of the Deputy Prime Minister – Social Exclusion Unit: "[https://web.archive.org/web/20081229152129/http://www.cabinetoffice.gov.uk/media/cabinetoffice/social_exclusion_task_force/assets/publications_1997_to_2006/factsheet_stigma.pdf Factsheet 1: Stigma and Discrimination on Mental Health Grounds]". 2004. In the United Kingdom, the Royal College of Psychiatrists organized the campaign ''Changing Minds'' (1998–2003) to help reduce stigma.Royal College of Psychiatrists: [http://www.rcpsych.ac.uk/campaigns/previouscampaigns/changingminds.aspx Changing Minds]. Due to this stigma, responses to a positive diagnosis may be a display of denialism. It is very important to improve your emotional mental health by surrounding yourself with positive relationships. We as humans, feed off companionships and interaction with other people. Another way to improve your emotional mental health is participating in activities that can allow you to relax and take time for yourself. Yoga is a great example of an activity that calms your entire body and nerves. According to a study on well-being by Richards, Campania and Muse-Burke, "mindfulness (psychology) is considered to be a purposeful state, it may be that those who practice it believe in its importance and value being mindful, so that valuing of self-care activities may influence the intentional component of mindfulness."
Emotional mental disorders are a leading cause of disabilities worldwide. Investigating the degree and severity of untreated emotional mental disorders throughout the world is a top priority of the World Mental Health survey initiative (WMH) survey initiative, which was created in 1998 by the World Health Organization (WHO). "Neuropsychiatric disorders are the leading causes of disability worldwide, accounting for 37% of all healthy life years lost through disease.These disorders are most destructive to low and middle-income countries due to their inability to provide their citizens with proper aid. Despite modern treatment and rehabilitation for emotional mental health disorders, "even economically advantaged societies have competing priorities and budgetary constraints".
The World Mental Health survey initiative has suggested a plan for countries to redesign their mental health care systems to best allocate resources.
"A first step is documentation of services being used and the extent and nature of unmet needs for treatment. A second step could be to do a cross-national comparison of service use and unmet needs in countries with different mental health care systems. Such comparisons can help to uncover optimum financing, national policies, and delivery systems for mental health care."
Knowledge of how to provide effective emotional mental health care has become imperative worldwide. Unfortunately, most countries have insufficient data to guide decisions, absent or competing visions for resources, and near constant pressures to cut insurance and entitlements. WMH surveys were done in Africa (Nigeria, South Africa), the Americas (Colombia, Mexico, United States), Asia and the Pacific (Japan, New Zealand, Beijing and Shanghai in the China), Europe (Belgium, France, Germany, Italy, Netherlands, Spain, Ukraine), and the middle east (Israel, Lebanon). Countries were classified with World Bank criteria as Low income (Nigeria), lower middle-income (China, Colombia, South Africa, Ukraine), higher middle-income (Lebanon, Mexico), and high-income.
The coordinated surveys on emotional mental health disorders, their severity, and treatments were implemented in the aforementioned countries. These surveys assessed the frequency, types, and adequacy of mental health service use in 17 countries in which WMH surveys are complete. The WMH also examined unmet needs for treatment in strata defined by the seriousness of mental disorders. Their research showed that "the number of respondents using any 12-month mental health service was generally lower in developing than in developed countries, and the proportion receiving services tended to correspond to countries' percentages of gross domestic product spent on health care".
"High levels of unmet need worldwide are not surprising, since WHO Project ATLAS experiment' findings of much lower mental health expenditures than was suggested by the magnitude of burdens from mental illnesses. Generally, unmet needs in low-income and middle-income countries might be attributable to these nations spending reduced amounts (usually <1%) of already diminished health budgets on mental health care, and they rely heavily on out-of-pocket spending by citizens who are ill equipped for it".
Archaeological records have shown that trepanation was a procedure used to treat "headaches, insanities or epilepsy" in several parts of the world in the Stone age. It was a surgical process used in the Stone Age. Paul Broca studied trepanation and came up with his own theory on it. He noticed that the fractures on the skulls dug up weren't caused by wounds inflicted due to violence, but because of careful surgical procedures. "Doctors used sharpened stones to scrape the skull and drill holes into the head of the patient" to allow evil spirits which plagued the patient to escape. There were several patients that died in these procedures, but those that survived were revered and believed to possess "properties of a mystical order".[http://mentalillness.umwblogs.org/stone-age/trepanation/] [https://books.google.co.in/books?id=wisNNoceOzoC&pg=PA243&lpg=PA243&dq=kidd+1946+trepanation&source=bl&ots=NcyMWx28o2&sig=JLGpBlHq4kuDp0ow1B0hc5Rj_ik&hl=en&sa=X&ved=0ahUKEwibl-6_u6TXAhUH2o8KHS9sB3cQ6AEIKjAA#v=onepage&q=kidd%201946%20trepanation&f=false]
Lobotomy was used in the 20th century as a common practice of alternative treatment for mental illnesses such as schizophrenia and depression. The first ever modern leucotomy meant for the purpose of treating a mental illness occurred in 1935 by a Portuguese neurologist, António Egas Moniz. He received the Nobel Prize in medicine in 1949. [https://psychcentral.com/blog/archives/2011/03/21/the-surprising-history-of-the-lobotomy/]. This belief that mental health illnesses could be treated by surgery came from Swiss neurologist, Gottlieb Burckhardt. After conducting experiments on six patients with schizophrenia, he claimed that half of his patients recovered or calmed down.
Psychiatrist Walter Jackson Freeman II believed that "an overload of emotions led to mental illness and “that cutting certain nerves in the brain could eliminate excess emotion and stabilize a personality,” according to a National Public Radio article [https://www.npr.org/templates/story/story.php?storyId=5014565&ps=rs]."
"Exorcism is the religious or spiritual practice of evicting demons or other spiritual entities from a person, or an area, they are believed to have possessed."
Mental health illnesses such as Huntington's disease (HD), Tourette syndrome and schizophrenia were believed to be signs of Demonic possession by the Devil. This led to several mentally ill patients being subjected to exorcisms. This practice has been around for a long time, though decreasing steadily until it reached a low in the 18th century. It seldom occurred until the 20th century when the numbers rose due to the attention the media was giving to exorcisms. Different belief systems practice exorcisms in different ways.
Psychotherapy is the general term for scientific based treatment of mental health issues based on modern medicine. It includes a number of schools, such as gestalt therapy, psychoanalysis, cognitive behavioral therapy and Dialectical behavior therapy.
Group therapy involves any type of therapy that takes place in a setting involving multiple people. It can include Psychodynamic psychotherapy groups, activity groups for expressive therapy, support groups (including the Twelve-step program), problem-solving and psychoeducation groups.
The practice of mindfulness meditation has several mental health benefits, such as bringing about reductions in depression (mood), anxiety and Psychological stress.Social work in mental health
Social work in mental health, also called psychiatric social work, is a process where an individual in a setting is helped to attain freedom from overlapping internal and external problems (social and economic situations, family and other relationships, the physical and organizational environment, psychiatric symptoms, etc.). It aims for harmony, quality of life, self-actualization and personal adaptation across all systems. Psychiatric social workers are mental health professionals that can assist patients and their family members in coping with both mental health issues and various economic or social problems caused by mental illness or psychiatric dysfunctions and to attain improved mental health and well-being. They are vital members of the treatment teams in Departments of Psychiatry and Behavioral Sciences in hospitals. They are employed in both outpatient and inpatient settings of a hospital, nursing homes, state and local governments, substance abuse clinics, correctional facilities, health care services...etc.Abraham P. Francis, Social Work in Mental Health: Contexts and Theories for Practice
In psychiatric social work there are three distinct groups. One made up of the social workers in psychiatric organizations and hospitals. The second group consists members interested with mental hygiene education and holding designations that involve functioning in various mental health services and the third group consist of individuals involved directly with treatment and recovery process.
Psychiatric social workers conduct psychosocial assessments of the patients and work to enhance patient and family communications with the medical team members and ensure the inter-professional cordiality in the team to secure patients with the best possible care and to be active partners in their care planning. Depending upon the requirement, social workers are often involved in illness education, counseling and psychotherapy. In all areas, they are pivotal to the aftercare process to facilitate a careful transition back to family and community.
Role of social workers made an impact with 2003 invasion of Iraq and War in Afghanistan (2001–14) social workers worked out of the NATO hospital in Afghanistan and Iraq bases. They made visits to provide counseling services at forward operating bases. Twenty-two percent of the clients were diagnosed with Posttraumatic stress disorder, 17 percent with depression, and 7 percent with alcohol abuse.Dao, 2009 In 2009, a high level of suicides was reached among active-duty soldiers: 160 confirmed or suspected Army suicides. In 2008, the Marine Corps had a record 52 suicides.Zoroya, 2010 The stress of long and repeated deployments to war zones, the dangerous and confusing nature of both wars, wavering public support for the wars, and reduced troop morale have all contributed to the escalating mental health issues.Knickerbocker, 2010 Military and civilian social workers are primary service providers in the veterans’ health care system.
Mental health services, is a loose network of services ranging from highly structured Inpatient care psychiatric units to informal support groups, where psychiatric social workers indulges in the diverse approaches in multiple settings along with other paraprofessional workers.
The first officially recorded treatment practices were in 1714, when Quebec opened wards for the mentally ill. In the 1830s social services were active through charity organizations and church parishes (Social Gospel Movement). Asylums for the insane were opened in 1835 in Saint John and New Brunswick. In 1841 in Toronto, when care for the mentally ill became institutionally based. Canada became a self-governing dominion in 1867, retaining its ties to the British crown. During this period age of Capitalism#Industrial capitalism began, which lead to a social and economic dislocation in many forms. By 1887 asylums were converted to hospitals and nurses and attendants were employed for the care of the mentally ill. The first social work training began at the University of Toronto in 1914. In 1918 Clarence Hincks & Clifford Whittingham Beers founded the Canadian National Committee for Mental Hygiene, which later became the Canadian Mental Health Association. In the 1930s Dr. Clarence Hincks promoted prevention and of treating sufferers of mental illness before they were incapacitated/early detection.
World War II profoundly affected attitudes towards mental health. The medical examinations of recruits revealed that thousands of apparently healthy adults suffered mental difficulties. This knowledge changed public attitudes towards mental health, and stimulated research into preventive measures and methods of treatment. In 1951 Mental Health Week was introduced across Canada. For the first half of the twentieth century, with a period of deinstitutionalisation beginning in the late 1960s psychiatric social work succeeded to the current emphasis on community-based care, psychiatric social work focused beyond the medical model’s aspects on individual diagnosis to identify and address social inequities and structural issues. In the 1980s Mental Health Act was amended to give consumers the right to choose treatment alternatives. Later the focus shifted to workforce mental health issues and environment.Mental Health Social Work Practice in Canada, Cheryl Regehr & Graham Glancy
The 18th century was a very unstable period in Indian history, which contributed to psychological and social chaos in the Indian subcontinent. In 1745 of lunatic asylums were developed in Bombay (Mumbai) followed by Calcutta (Kolkata) in 1784, and Madras (Chennai) in 1794. The need to establish hospitals became more acute, first to treat and manage Englishmen and Indian ‘sepoys’ (military men) employed by the British East India Company.Sharma, 2004; Thara, Padmavati & Srinivasan, 2004 The First Lunacy Act (also called Act No. 36) that came into effect in 1858 was later modified by a committee appointed in Bengal in 1888. Later, the Indian Lunacy Act, 1912 was brought under this legislation. A rehabilitation programme was initiated between 1870s and 1890s for persons with mental illness at the Mysore Lunatic Asylum, and then an occupational therapy department was established during this period in almost each of the lunatic asylums. The programme in the asylum was called ‘work therapy’. In this programme, persons with mental illness were involved in the field of agriculture for all activities. This programme is considered as the seed of origin of psychosocial rehabilitation in India.
Berkeley-Hill, superintendent of the European Hospital (now known as the Central Institute of Psychiatry, established in 1918), was deeply concerned about the improvement of mental hospitals in those days. The sustained efforts of Berkeley-Hill helped to raise the standard of treatment and care and he also persuaded the government to change the term ‘asylum’ to ‘hospital’ in 1920.Harrison, 1994 Techniques similar to the current token-economy were first started in 1920 and called by the name ‘habit formation chart’ at the CIP, Ranchi. In 1937, the first post of psychiatric social worker was created in the child guidance clinic run by the Dhorabji Tata School of Social Work (established in 1936), It is considered as the first documented evidence of social work practice in Indian mental health field.
After Independence in 1947, general hospital psychiatry units (GHPUs) where established to improve conditions in existing hospitals, while at the same time encouraging outpatient care through these units. In Amritsar a Dr. Vidyasagar, instituted active involvement of families in the care of persons with mental illness. This was advanced practice ahead of its times regarding treatment and care. This methodology had a greater impact on social work practice in the mental health field especially in reducing the stigmatisation. In 1948 Gauri Rani Banerjee, trained in the United States, started a master’s course in medical and psychiatric social work at the Dhorabji Tata School of Social Work (Now TISS). Later the first trained psychiatric social worker was appointed in 1949 at the adult psychiatry unit of Yervada mental hospital, Pune.
In various parts of the country, in mental health service settings, social workers were employed—in 1956 at a mental hospital in Amritsar, in 1958 at a child guidance clinic of the college of nursing, and in Delhi in 1960 at the All India Institute of Medical Sciences and in 1962 at the Ram Manohar Lohia Hospital. In 1960, the Madras Mental Hospital (Now Institute of Mental Health (Chennai)), employed social workers to bridge the gap between doctors and patients. In 1961 the social work post was created at the NIMHANS. In these settings they took care of the psychosocial aspect of treatment. This had long-term greater impact of social work practice in mental health.Dr. Ratna Varma, Psychiatric Social Work in India
In 1966 by the recommendation Mental Health Advisory Committee, Ministry of Health, Government of India, NIMHANS commenced Department of Psychiatric Social Work started and a two-year Postgraduate Diploma in Psychiatric Social Work was introduced in 1968. In 1978, the nomenclature of the course was changed to MPhil in Psychiatric Social Work. Subsequently, a PhD Programme was introduced. By the recommendations Mudaliar committee in 1962, Diploma in Psychiatric Social Work was started in 1970 at the European Mental Hospital at Ranchi (now CIP), upgraded the program and added other higher training courses subsequently.
A new initiative to integrate mental health with general health services started in 1975 in India. The Ministry of Health, Government of India formulated the National Mental Health Programme (NMHP) and launched it in 1982. The same was reviewed in 1995 and based on that, the District Mental Health Program (DMHP) launched in 1996 and sought to integrate mental health care with public health care.Khandelwal et al. 2004 This model has been implemented in all the states and currently there are 125 DMHP sites in India.
National Human Rights Commission (NHRC) in 1998 and 2008 carried out systematic, intensive and critical examinations of mental hospitals in India. This resulted in recognition of the human rights of the persons with mental illness by the NHRC. From the NHRC's report as part of the NMHP, funds were provided for upgrading the facilities of mental hospitals. This is studied to result in positive changes over the past 10 years than in the preceding five decades by the 2008 report of the National Human Rights Commission of India and National Institute of Mental Health and Neurosciences.Nagaraja & Murthy, 2008 In 2016 Mental Health Care Bill was passed which ensures and legally Entitlement access to treatments with coverage from insurance, safeguarding dignity of the afflicted person, improving legal and healthcare access and allows for free medications.http://indianexpress.com/article/what-is/mental-healthcare-bill-passed-parliament-lok-sabha-4588288/ In December 2016, Disabilities Act 1995 was repealed with Rights of Persons with Disabilities Act, 2016
Lack of any universally accepted single licensing authority compared to foreign countries puts social workers at general in risk. But general bodies/councils accepts automatically a university-qualified social worker as a professional licensed to practice or as a qualified clinician. Lack of a centralized council in tie-up with Schools of Social Work also makes a decline in promotion for the scope of social workers as mental health professionals. Though in this midst the service of social workers has given a facelift of the mental health sector in the country with other allied professionals.Sahu, K.K. 2014
The countless aspect about this organization is that WCH is open to women of all ages, including pregnant women that experience poor mental health. WCH not only provides care for good mental health, but they also have a program called the "Women's Mental Health Program" where doctors and nurses help treat and educate women regarding mental health collaboratively, individually, and online by answering questions from the public.
The second organization is the Centre for Addiction and Mental Health (CAMH). CAMH is one of Canada's largest and most well-known health and addiction facilities, and it has received international recognitions from the Pan American Health Organization and WHO Collaborating Centres. They practice in doing research in areas of addiction and mental health in both men and women. In order to help both men and women, CAMH provides "clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues." Each year, roughly 30,000 Americans take their lives, while hundreds of thousands make suicide attempts (Centers for Disease Control and Prevention). In 2004, suicide was the 11th leading cause of death in the United States (Centers for Disease Control and Prevention), third among individuals ages 15–24. Despite the increasingly availability of effectual depression treatment, the level of unmet need for treatment remains high. By way of comparison, a study conducted in Australia during 2006 to 2007 reported that one-third (34.9%) of patients diagnosed with a mental health disorder had presented to medical health services for treatment.
There are many factors that influence mental health including:
Mental illness, disability, and suicide are ultimately the result of a combination of biology, environment, and access to and utilization of mental health treatment.
Public health policies can influence access and utilization, which subsequently may improve mental health and help to progress the negative consequences of depression and its associated disability.
Emotional mental illnesses should be a particular concern in the United States since the U.S. has the highest annual prevalence rates (26 percent) for mental illnesses among a comparison of 14 developing and developed countries.
In ''A Mind That Found Itself'' (1908) Clifford Whittingham Beers described the humiliating treatment he received and the deplorable conditions in the mental hospital. One year later, the National Committee for Mental Hygiene (NCMH) was founded by a small group of reform-minded scholars and scientists – including Beer himself – which marked the beginning of the "mental hygiene" movement. The movement emphasized the importance of childhood prevention. World War I catalyzed this idea with an additional emphasis on the impact of maladjustment, which convinced the hygienists that prevention was the only practical approach to handle mental health issues.
After realizing that simply changing the location of mental health care from the state hospitals to nursing houses was insufficient to implement the idea of deinstitutionalization, the National Institute of Mental Health in 1975 created the Community Support Program (CSP) to provide funds for communities to set up a comprehensive mental health service and supports to help the mentally ill patients integrate successfully in the society. The program stressed the importance of other supports in addition to medical care, including housing, living expenses, employment, transportation, and education; and set up new national priority for people with serious mental disorders. In addition, the Congress enacted the Mental Health Systems Act of 1980 to prioritize the service to the mentally ill and emphasize the expansion of services beyond just clinical care alone. Later in the 1980s, under the influence from the Congress and the Supreme Court, many programs started to help the patients regain their benefits. A new Medicaid service was also established to serve people who were diagnosed with a "chronic mental illness." People who were temporally hospitalized were also provided aid and care and a pre-release program was created to enable people to apply for reinstatement prior to discharge. Not until 1990, around 35 years after the start of the deinstitutionalization, did the first state hospital begin to close. The number of hospitals dropped from around 300 by over 40 in the 1990s, and finally a Report on Mental Health showed the efficacy of mental health treatment, giving a range of treatments available for patients to choose.
However, several critics maintain that deinstitutionalization has, from a mental health point of view, been a thoroughgoing failure. The seriously mentally ill are either homeless, or in prison; in either case (especially the latter), they are getting little or no mental health care. This failure is attributed to a number of reasons over which there is some degree of contention, although there is general agreement that community support programs have been ineffective at best, due to a lack of funding.
The 2011 National Prevention Strategy included mental and emotional well-being, with recommendations including better parenting and early intervention programs, which increase the likelihood of prevention programs being included in future US mental health policies.