In order to determine the psychiatric services that are required for a community, it is essential to know the frequency of mental disorder in the given population and an understanding of the needs for treatment of the individuals with the disorder that ere identified. Community mental health is an approach that focuses on promoting mental health through positive change in the community. The field of community mental health is identified by several additional principles:
First, it adopts an ecological perspective— the view that the causes of mental disorders stem at least, in part from the social, economic and physical environments in which people live: factors such as poverty, disintegrating communities and poor schools etc.
Second, and perhaps most important of all, community psychology lays great importance on prevention — interventions designed to prevent mental disorders from developing in the first place. Three distinct types of preventions became the focus of attention in recent years: primary prevention, secondary prevention and tertiary prevention.
The rates of psychiatric disorder in the community vary frequently and it is difficult to determine this in any given community. Mental disorders have been found to be relatively common, with more that one in three people in most countries reporting enough symptoms for meeting the diagnostic criteria for at least one diagnosis at any point of time in life.
According to a global survey conducted by World Health Organization (WHO), anxiety disorders are the most common followed by mood disorders, while substance disorders and impulse-control disorders were constantly less prevalent.
The rates of psychiatric disorder in a community vary by region and such statistics are usually underestimates due to poor diagnosis and low reporting rates. Actual lifetime prevalence rates for mental disorders are estimated to be between 65% and 85%.
According to the US National Comorbidity Survey (NCS) nearly half of Americans (46.4%) meet the criteria of a mental disorder at some point of time in life. It was reported that almost 28.8% are diagnosed with anxiety disorder, 20.8% with mood disorder, 24.8% with impulse-control disorder and 14.6% with substance abuse disorder.
According to an international review of studies on the prevalence of schizophrenia and average figure of 0.4% for lifetime prevalence was established. This was consistently lower in poorer countries. Personality disorders are estimated to be fewer and small scale with a ratio of 1:7. Rates for specific disorders range from 0.8% to 2.8% differing across countries and communities based on gender, educational and other factors. According to a US survey, the rate of screening for personality disorders is 14.79%.
