Primary prevention of mental disorder and promotion of mental health. Special Section.

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The historical antecedents of primary prevention are to be found in the methods of public health but also in insights from counseling and psychotherapy. Primary prevention is defined as being proactive and is aimed predominately at high-risk groups not yet affected by the condition to be prevented. Its success is measured in a decline in the incidence (new cases) of a condition compared with controls. Only through prevention can we reduce incidence. It is the only feasible way to deal with the gap between the enormous number of individuals at risk for emotional disturbance and the limited availability of treatment resources. This paper presents strategies for implementing effective prevention programs and examines the arguments espoused by those who are opposed to prevention theory and its implementation. Opposition is strongest from those who accept an organic disease model of mental disorders and from conservative groups that oppose social change aimed at the empowerment of exploited groups.