Written by: Aparajita Vaid, Moitrayee Das

A decade ago, mental health issues became a household phenomenon in India. Everyone in the know had a therapist on call. Now, a new question arises: Is seeking therapy proactively, even without a diagnosed issue, becoming the next progressive step? Is preventive psychology the new frontier?

Preventive psychology refers to the identification of risk factors for mental health concerns to prevent them from developing into full-blown disorders. It can be distinguished into two distinct approaches — wellness-driven and risk-driven. The wellness-driven approach focuses on preventing issues before they arise and helping healthy individuals improve the quality of their lives by maximising their well-being. The risk-driven approach, on the other hand, involves early detection and intervention for individuals at risk, and minimising long-term effects and preventing relapse for those who experience serious mental health issues. Preventive psychology combines therapeutic guidance, psychosocial support, and resilience-building to promote mental well-being. Preventive psychology is much like vaccination for the soul — wherein resilience, skill-building, social support, etc., act as the antibodies.

Preventive psychology is not an unknown concept — prevention has been researched and discussed since the mid-19th century. It has roots in the concepts of community psychology — the Swampscott Conference in 1965 marks the origin, wherein professionals recognised the limitations of the traditional medical model that focused narrowly on individual treatment (Kloos & Karen Grover Duffy, 2012). This led to the realization that the large burden of mental health issues cannot be solved by individual treatment; instead, community-level preventive efforts are needed. Thus, psychologists were encouraged to consider larger social and environmental causes of psychological issues rather than focusing on just their symptoms. Several prevention programs have been developed since then, which are supported by sound empirical and conceptual foundations. However, the majority of the development in this area occurred in the past decade, and not much has progressed and/or been applied since then. “The reality is that less than 5% of mental health research funding goes to prevention research, even in countries that invest in prevention” (Arango et al., 2018).

The ignorance and limited application of preventive psychology are regrettable since it has multiple benefits. The greatest benefit is that it can assist in reducing the burden on mental health services. There is a huge disparity between the demand and supply of mental health services across the world, wherein the burden of disorders and issues is too high to be effectively tackled by the existing mental health force. Thus, if most cases are prevented or individuals are equipped with tools for self-management of symptoms, the burden will be significantly reduced. Albee (1999) also believes that “no mass disorder has ever been eliminated by treating one person at a time,” and that only prevention reduces incidence. Next, preventive services are usually cost-effective compared to long-term treatment of chronic conditions. One of the key barriers most people face to seeking therapy is its expensive and time-consuming nature. Thus, why not prevent the issues, which are both cheaper and quicker? Research has also found that “savings made due to the prevention of mental health disorders could be greater than for other medical conditions” (Arango et al., 2018). The wellness-driven approach within the field involves teaching coping skills and resilience strategies. This would ultimately empower individuals to handle stressors and manage their mental health, thus fostering long-term well-being. The wellness and risk-driven approaches together also have the potential to prevent suicides and self-harm. With a suicide rate of 12.4 per 100,000 population in India in 2022, preventive psychology can support the development of effective support networks and self-management strategies to help individuals avoid developing self-harming tendencies (NCRB, 2022). Even in cases where such tendencies emerge, a risk-driven approach can facilitate timely intervention and potentially avert loss of life due to suicide.

The effectiveness of preventive psychology can be exemplified by the ‘SPARK resilience’ program, which was implemented in the United Kingdom. Although this was a school-based positive education program, it closely resembles the principles of the wellness-driven approach within preventive psychology. The goal of this program was to foster emotional resilience and associated skills and to prevent depression, wherein children use hypothetical situations to explore how their thoughts trigger emotions and behaviors, helping them reflect and learn from the experience. The program had huge success and was implemented across Japan, Singapore, the Netherlands, and beyond. It was found that “students engaged in the program had dramatically lowered risks of depression and significantly higher levels of resilience” (Sutton, 2016).

Despite its multitude of benefits, preventive psychology is still not prioritised to tackle the mental health burden. The world is currently facing a global mental health crisis, which is only predicted to get worse. Globally, 1 in every 8 people lives with a mental disorder, and over two-thirds of people with mental health conditions don’t receive the care they need (Schwartz, 2024). India is not far behind, with approximately 151 million people experiencing mental health issues in a population of 1.4 billion (Data Commons, 2021). Adding to the burden, the country faces a severe shortage of mental health professionals, with only 0.24 licensed clinical psychologists per 100,000 people and a treatment gap of 28% to 83% across disorders (Ministry of Health and Family Welfare, 2023; World Health Organization, 2022). Compounding the issue further, only 1% of the total health budget is allocated to mental health, reflecting low policy prioritisation (Mahashur, 2024). The WHO has also predicted that mental health disorders could cost the world $16 trillion by 2030. These alarming figures highlight the severe burden of mental health issues both in India and across the world, which underscore the urgent need for preventive psychology measures to curb the crisis.

If there is such a high need, why do we not use it? Many challenges barricade preventive psychology from being widely utilised to prevent mental health issues. The first is the widespread stigma around mental health in general, due to which people still view therapy as a ‘taboo,’ let alone consider a therapist when they are not facing any issues. Those who do face mental health issues shy away from seeking help because they deem their issues to be ‘not severe enough.’ My question here is — as we don’t wait for a high fever to take medicine, why the discrimination with our mental health? There is also a lack of awareness regarding mental health, owing to which most individuals at risk don’t even know that they are at risk or what a ‘risk’ even is. The risk of a heart attack seems plausible to most of us, but many will not believe they need to be protected against suicide or self-harm (Arango et al., 2018). It is also highly complicated to standardise preventive psychology programs, due to the subjectivity of risk factors and coping mechanisms. There cannot be one protocol for two people, as they come from different backgrounds, exhibit different personalities and tendencies, and have different genetics — all of which contribute to the development of mental health issues. It is also very difficult to quantify the absence of a problem, indicating prevention success, compared to the outcomes of treatment. All these factors need to be tackled with extensive research and testing, wherein lack of funding and attention towards preventive research acts as a barrier. Short political cycles, fragmented health systems, and bureaucratic inertia also limit the scalability of preventive programs.

How can we develop preventive psychology programs that work? The first step is to enhance policy and funding support towards preventive psychology research to develop stronger, evidence-based programs that are widely applicable. Next, a larger focus on the wellness-driven approach would be more widely applicable than the risk-driven approach. Within this, the association of mental health with only disorders and dysfunction needs to be expanded to include well-being and quality of life. These efforts should primarily be aimed at children and adolescents to ensure breaking of stigma and early prevention, intervention, and resilience building. To ensure maximum efficiency, psychologists should focus on long-term wellness and impart skills such as hardiness, self-esteem, emotional intelligence, problem-solving, and social connectedness, etc. These skills would ensure self-sufficiency within individuals and reduce the need for psychologists to actively perform them, significantly reducing the burden. However, all these efforts are futile if people are not open to preventive efforts for their mental health. Thus, efforts should be made to enhance mental health awareness to reduce stigma and normalize seeking therapy without a ‘problem.’ Because why wait for a ‘big bang’ to start living?

Albee, G. W. (1999). Prevention, not treatment, is the only hope. Counselling Psychology Quarterly, 12(2), 133–146. https://doi.org/10.1080/09515079908254084

Arango, C., Díaz-Caneja, C. M., McGorry, P. D., Rapoport, J., Sommer, I. E., Vorstman, J. A., McDaid, D., Marín, O., Serrano-Drozdowskyj, E., Freedman, R., & Carpenter, W. (2018). Preventive strategies for mental health. The Lancet Psychiatry, 5(7), 591–604. https://doi.org/10.1016/S2215-0366(18)30057-9

Data Commons. (2021). India – Place Explorer – Data Commons. Datacommons.org. https://datacommons.org/place/country/IND?utm_medium=explore&mprop=count&popt=Person&hl=en

Kloos, B., & Karen Grover Duffy. (2012). Community psychology : linking individuals and communities. Wadsworth Cengage Learning.

NCRB. (2022). ???? ??? ??????? ????? ??? ??????????? ??????? | National Crime Records Bureau. Ncrb.gov.in. https://www.ncrb.gov.in/accidental-deaths-suicides-in-india-year-wise.html?year=2022&keyword=

Schwartz, E. (2024, May 20). The Global Mental Health Crisis: 10 Numbers to Note. Project HOPE. https://www.projecthope.org/news-stories/story/the-global-mental-health-crisis-10-numbers-to-note/

Sutton, J. (2016, September 26). 12 Inspiring Real-Life Positive Psychology Examples. PositivePsychology.com. https://positivepsychology.com/positive-psychology-examples/#looking-at-real-life-examples-of-positive-psychology

Ministry of Health and Family Welfare. (2023). Mental illness: Unstarred question no. 1408, answered in Rajya Sabha (AU1408). Government of India.

World Health Organization. (2022). Addressing mental health in India. World Health Organization. https://iris.who.int/bitstream/handle/10665/364877/9789290210177-eng.pdf?sequence1

Mahashur, S. (2024, March 7). IMHO Blog. Centre for Mental Health Law & Policy. https://cmhlp.org/imho/blog/the-interim-union-budget-fy-2024-25-where-does-mental-h ealth-stand/

Moitrayee Das is an assistant professor at FLAME University, Pune, and Aparajita Vaid is a psychology graduate and alumna of FLAME University, Pune.

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