Primary prevention in perspective.

Discussion of primary prevention has been made difficult by lack of clarity of underlying concepts and assumptions. Is the purpose to prevent diagnosable mental illness or to prevent unhappiness and social incompetence? What are the implications of the assumption that societal stress causes mental illness? Is there a clear distinction made between major and minor mental illness? Except for a few specific conditions there is little evidence that primary prevention has been effective. The authors feel that research and program evaluation in prevention is sorely needed but should be funded separately and with discretion. Scarce mental health funds should not be diverted from direct treatment for this purpose.