Prevention and early intervention as pillars of modern psychiatric care

This lecture examines how prevention and early intervention can be integrated into modern mental health care across the life course, based on the known non-genetic risk factors for psychiatric disorders. Mental health risks for major psychiatric disorder risks include a variety of pre/maternal health factors, including maternal health, obstetric complications, the use of some medication during pregnancy, traumatic and adverse childhood experiences, the presence of somatic illnesses such as autoimmune disorders, and a variety of socioeconomic risks, including discrimination, social exclusion, migration, climate change, poor access to health services and others. Drawing on evidence from population mental health research, it examines effective universal, selective and indicated approaches, from perinatal support and early childhood interventions to school-based programmes and care for people with emerging psychiatric symptoms. It also considers secondary prevention after the onset of a disorder. Effective universal prevention requires coordinated national strategies, defined outcomes, implementation plans, and collaboration among community stakeholders. Selective and indicated interventions should be tailored to developmental stage and risk profile. Evidence supports approaches such as cognitive behavioural therapy, parenting programmes, and physical activity for specific populations and outcomes, although no single intervention is most effective across all ages and disorders. Early intervention services are generally valued by service users and may be cost-effective or cost-neutral in high-income settings; however, benefits vary by disorder and context, and access remains uneven. Effective secondary preventive measures, including person-centered and integated psycho-medical interventions, are not yet consistently implemented or accessible nor integrated into routine care.