Prevention & early signs

Mental health promotion is about creating the conditions that help people feel well. It is for everybody, the way clean water and safe roads are for everybody. It happens in homes, schools, workplaces and neighborhoods.

Examples

• School programs that teach children how to name feelings, solve problems and get along with others
• Safe parks, libraries and community spaces where people can gather
• Workplaces with fair workloads and kind managers
• Families spending regular, relaxed time together
• Healthy daily habits like sleep, movement and time with friends

The WHO says school-based social and emotional learning programs work especially well, in rich and poor countries alike. Skills like calming down, asking for help and getting along with others protect children for years.

Prevention focuses on risk factors, the things that raise the chance of mental health problems, such as violence, poverty, bullying or loneliness. It also strengthens protective factors, the things that help people cope, such as good relationships and coping skills.

Prevention can be aimed at

• Everyone (for example, an anti-bullying program for a whole school)
• Groups facing more risk (for example, support for new parents, carers or people who have lost a job)
• Individuals showing early signs (for example, a short course of support for a teen who is starting to withdraw)

Suicide prevention is one well-known example. Steps like limiting access to dangerous means and careful media reporting help save lives. The “Suicide prevention: the basics” guide covers this in depth.

Early help (often called early intervention) means acting when you first notice changes, rather than waiting until things are very hard. Researchers who studied age of onset around the world say that promotion, prevention and early help before or at the start of a mental health condition improve outcomes.

Waiting is common. People hope things will pass, or worry about what others will think. But many difficulties start young and go unnoticed, and the CDC notes that early diagnosis and access to services can make a real difference.

Early help can look like

• A conversation with a trusted adult, friend or family member
• A visit to a doctor, nurse or school counselor
• A few sessions of talking therapy
• Joining a support or peer group
• Changing something at work or school that is causing stress

Prevention does not stop once someone has had a hard time. Staying connected, keeping healthy routines and knowing your own early signs all help to prevent setbacks. Many people use what they learned during a hard patch to stay well for years.

What helps people stay well

• Knowing their personal warning signs and having a plan
• Regular check-ins with themselves and with someone they trust
• Keeping up the routines and skills that helped
• Staying connected to friends, family and community
• Knowing how to get back in touch with support quickly

In the first years of life, a child’s brain is growing very fast. Safe, stable and nurturing relationships and surroundings give a strong foundation for both mental and physical health.

Protective factors

• At least one warm, responsive caregiver
• Predictable routines for sleep, meals and play
• Lots of talking, reading, singing and play
• Enough food, a safe home and health care
• Caregivers who have support themselves

Risk factors

• Violence in or around the home
• A caregiver struggling with substance use or untreated mental health problems
• Unstable housing or not enough food
• Harsh or frightening discipline

During the school years, children learn to manage feelings, make friends and handle challenges. Many children have fears, worries or tough behavior now and then. It becomes a concern when difficulties are severe, last a long time, and get in the way of school, home or play.

Protective factors

• Feeling connected to school and to caring adults there
• Good friendships and a sense of belonging
• Learning social and emotional skills
• Regular activity, enough sleep and healthy food
• Strong relationships with family, friends and community

Risk factors

• Bullying
• Ongoing family conflict or violence
• Learning difficulties that go unnoticed
• Big losses or changes, like a death or a move

The teenage years bring huge changes in the body, brain, friendships and identity. The WHO estimates that about 1 in 7 young people aged 10 to 19 around the world experience a mental health condition, and that many of these go unnoticed and without help.

In the United States in 2023, 4 in 10 high school students said they had persistent feelings of sadness or hopelessness. Feeling connected at school, at home and in the community can protect teens from poor mental health, drug use and violence.

Protective factors

• Knowing that someone cares about them
• Trusted adults at school, at home and in the community
• Healthy sleep, movement and ways to cope with stress
• Parents who talk openly, spend time together and stay involved

Risk factors

• Bullying, including online
• Peer pressure
• Sexual violence
• Harsh parenting or serious money problems at home
• Discrimination, for example because of race, sexuality or gender identity

Adult life brings many pressures at once: work, money, relationships, raising children and caring for parents. In 2022, about 23 in 100 U.S. adults (59.3 million people) lived with a mental illness. Young adults aged 18 to 25 had the highest rate.

Protective factors

• Strong social connections and stable, positive relationships
• Positive coping skills
• Meaningful work or activity
• Fair, supportive workplaces
• Time for rest, movement and fun

Risk factors

• Social isolation
• Heavy workloads, long hours or little control at work
• Harassment, bullying or discrimination
• Job insecurity or money worries
• Conflict between work and home demands

Pregnancy, a new baby, raising children and caring for an ill or older relative are all times when stress can build. Caring for a spouse with a long-term condition such as dementia is a known risk for mental health problems in older adults.

What protects parents and caregivers

• Practical help, like meals, childcare or someone to sit with a loved one
• Respite: regular breaks from caring
• Advice and information about what to expect
• Someone to talk to who understands
• Time to sleep, eat and move

If you are pregnant or have a new baby and feel low, anxious or overwhelmed, you can call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262).

In 2023, about 15 in 100 adults aged 70 and over around the world lived with a mental health condition, most often anxiety or depression. These are not a normal part of ageing, and support helps at any age.

Risk factors

• Loneliness and social isolation, which affect about a quarter of older people
• Ageism (being treated as less valuable because of age)
• Loss of a partner or friends
• Loss of purpose after retirement
• Health problems or losing independence
• Abuse or neglect

What helps

• Befriending, community groups, creative arts and learning
• Volunteering and activities with younger generations
• Safe, accessible housing and transport
• Physical activity and a balanced diet
• Support for carers

Some things inside us can make us more vulnerable, such as genes, long-term illness, substance use, or not having had the chance to learn coping skills. Other personal factors protect us, like being able to calm ourselves, solve problems and ask for help.

Protective

• Social and emotional skills
• Positive coping skills
• Healthy sleep, movement and eating
• A sense of purpose or meaning

Risk

• Poor coping skills or emotional wellbeing
• Substance use
• Long-term physical illness
• Family history of mental health problems

Families can be a powerful source of safety and support. When home is stressful or unsafe, it can weigh heavily on mental health, especially for children.

Protective

• Warm, stable relationships
• Open, honest conversations
• Spending time together
• Fair, consistent and non-violent discipline

Risk

• Violence or abuse in the home
• Harsh parenting
• A caregiver struggling without support
• Serious money or housing problems

The places where we live, learn, work and gather affect how we feel. Communities that offer supportive connections, and safe public spaces where people can meet, help reduce loneliness and build trust.

Protective

• Feeling connected to school
• Safe parks, libraries and community centers
• Faith communities, clubs and teams
• Supportive workplaces

Risk

• Bullying or harassment
• Community violence
• Isolation, with few places to meet others
• Unsafe or stressful workplaces

Some of the biggest influences on mental health are the conditions people live in: money, housing, education, safety and fairness. The WHO says prevention works best when it addresses individual, social and structural factors together.

Risk

• Poverty and money insecurity
• Discrimination and racism
• Violence and conflict
• Poor access to education or health care

Protective

• Access to quality education
• Safe, affordable housing
• Fair pay and job security
• Laws and policies that protect people from discrimination

Mood changes are often the first thing people notice. Feelings might become stronger, last longer, or seem to come from nowhere. Some people feel sad; others feel numb, as if they can’t feel much at all.

Things to notice

• Feeling sad, tearful or hopeless most days
• Feeling worthless or guilty
• Being irritable, frustrated or restless
• Worrying much more than usual, or feeling on edge
• No longer enjoying things you used to love

In children, low mood may show up as frequent tantrums, irritability or seeming fearful and worried much of the time.

Sleep and mental health are closely linked. Stress and worry can keep the mind busy at night, and poor sleep makes it harder to handle emotions the next day. That can turn into a cycle.

Things to notice

• Trouble falling or staying asleep
• Waking very early and not getting back to sleep
• Sleeping much more than usual and still feeling tired
• Finding it very hard to get out of bed because of low mood
• Low energy during the day

When we are under strain, the brain often struggles to concentrate, remember things or make decisions. Thoughts can also become more negative, harsh or stuck on the same worries.

Things to notice

• Trouble concentrating at school or work
• Forgetting things more than usual
• Thoughts racing, or the same worry going round and round
• Being very hard on yourself
• Thinking that things will never get better

Changes in what we do are often easier for others to see than changes in how we feel. A friend might notice that you have stopped coming to practice before you notice it yourself.

Things to notice

• Struggling with routine tasks like cooking, cleaning or paying bills
• Dropping hobbies, sports or activities
• Falling behind at school or work
• Drinking or using other substances more, or to cope
• Taking more risks than usual
• Self-harm, like cutting or burning the skin

When people are struggling, they often pull away from others, even though connection is one of the things that helps most. Others become more short-tempered and get into more arguments.

Things to notice

• Cancelling plans or avoiding friends and family
• Spending much more time alone
• Arguing more, or being easily annoyed
• Feeling like nobody understands
• Feeling lonely even when around others

The mind and body are deeply connected. Stress and low mood can show up as physical symptoms, and the CDC notes that depression raises the risk of physical conditions like heart disease and diabetes.

Things to notice

• Changes in appetite, or weight changes you did not plan
• Feeling tired all the time
• Headaches or stomachaches with no clear medical cause (common in children)
• Tense muscles, a tight chest or a racing heart
• Getting ill more often

When stress hits, the body speeds up: faster heart, quicker breathing, tense muscles. Slow breathing, especially a long out-breath, sends a message to the body that it is safe to relax. NIMH suggests making regular time for relaxing activities like breathing exercises and meditation.

Quick try

1. Breathe in through your nose for 4 counts.
2. Breathe out slowly through your mouth for 6 counts.
3. Repeat for 2 minutes.

Physical activity helps the body use up stress energy and can lift mood. NIMH notes that just 30 minutes of walking every day can boost your mood and improve your health, and shorter bits of movement still count.

Easy ideas

• A walk at lunchtime
• Dancing to three songs in the kitchen
• Stretching before bed
• Gardening or playing with a pet

Strong social connection is one of the most powerful protective factors. Friends and family can give emotional support and practical help, and just knowing someone is there can make stress feel smaller.

Try this week

• Send a “thinking of you” message
• Have a meal with someone
• Join a group, class or team
• Say yes to one invitation

When we are stressed, our thoughts can become harsh or all-or-nothing (“I always mess up”). NIMH suggests noticing negative or unhelpful thoughts and questioning them. This skill is at the heart of many talking therapies.

Try it

1. Write the thought down.
2. Ask: Is this 100% true? What would I say to a friend who thought this?
3. Write a kinder, more balanced thought.

Our bodies like rhythm. A regular sleep schedule, regular meals and a bit of daily structure help the brain manage mood and stress. NIMH also suggests setting priorities and saying no to new tasks when you feel overloaded.

Small steps

• Go to bed and wake up at the same time
• Eat breakfast, even something small
• Write tomorrow’s top three tasks the night before
• Notice how caffeine and alcohol affect your mood

Focusing on positive things does not mean ignoring problems. It helps balance the brain’s natural habit of noticing threats. NIMH suggests reminding yourself each day of things you are grateful for, being as specific as you can.

Ideas

• Write three good things at the end of each day
• Thank someone for something specific
• Spend time on something that matters to you, like helping others