The primary prevention of mental health conditions

A review of the strongest and most up-to-date evidence on the primary prevention of mental health conditions

Key messages:

• Mental health conditions can be prevented: There is considerable scientific evidence to show that many conditions (in particular depression, anxiety conditions, certain behavioural disorders in childhood, and alcohol and substance use conditions) can be prevented from occurring in the first place. 

• A large number of factors influence the development of mental health conditions and some of these are not inevitable.

• Many evidence-based interventions have been shown to effectively address modifiable risk factors and protective factors. 

• Primary prevention requires an approach targeting multiple factors in the settings where people live, learn, work, play and age.

• Implementing primary prevention initiatives early in life is important since a large proportion of mental health conditions commence in childhood, adolescence, and early adult life.

Download: Evidence review: The primary prevention of mental health conditions (PDF, 900 KB)

The burden of mental ill-health in Victoria is significant and not decreasing. Despite a major increase in treatment availability and uptake, this has not reduced the prevalence and population-level impact of mental health conditions in almost 25 years, and indeed, the prevalence of these conditions appears to be increasing among young people.

In June 2020, VicHealth commissioned Prevention United to complete a review of the strongest and most up-to-date peer-reviewed evidence and grey literature on the primary prevention of mental health conditions. The evidence review responds to two key questions: 

• Can mental health conditions be prevented? 
• Can this be achieved through primary prevention activity? 

The answer to both questions was yes.  

According to recent burden of disease studies, at least 21% of the burden of disability and premature death associated with mental health conditions is preventable – and it is thought that the actual proportion of the burden that can be averted is much higher.

The evidence review found that it is possible to prevent the onset of mental health conditions by reducing people’s exposure to risk factors and/or increasing their exposure to protective factors for these conditions. There are a considerable number of risk and protective factors for mental health conditions, with major risk factors including child maltreatment, intimate partner violence, bullying, racism and socioeconomic disadvantage.

The research evidence shows there is a corresponding range of effective primary prevention initiatives that influence these factors and reduce the occurrence of several conditions. Importantly, the current evidence shows that primary prevention requires a multimodal approach that targets multiple factors in the settings where people live, learn, work, play and age. Since a large proportion of mental health conditions commence in childhood, adolescence, and early adult life, it is important to implement primary prevention initiatives early in life.

The challenge now is to take these evidence-based initiatives to scale across the Victorian population and ensure they are properly implemented, while also continuing to build the emerging evidence base around effective interventions.