title: Does telephone counselling have preventive value?
abstract: Major developments in health care frequently result not from careful planning by professional health care providers, but from social processes whereby a heightened awareness of need leads to new strategies and resources for community support. The development of a network of hospitals in eighteenth-century England was 'the outcome of individual initiative and of coordinated voluntary effort and subscription'. The evolution of mental health care in the United States was influenced greatly by the enthusiasm and advocacy of reformers such as Dorothea Dix and Clifford Beers. The development of telephone counselling services, now an integral part of community mental health care, resulted from a recognition that the psychosocial stresses of twentieth-century life could perhaps be alleviated through support offered by telephone. This recognition has led to the mobilising of many thousands of volunteers who serve in hundreds of telephone counselling services worldwide. For telephone counselling as for many other new developments, the initial period of growth has been followed by one of reflection and evaluation. That telephone counselling services have earned a place in the community mental health network and are here to stay is beyond doubt, though the ways in which they can be used to greatest advantage are still being clarified. At the level of primary prevention there is as yet no convincing evidence that telephone counselling services have reduced the incidence of psychological disorder. It must be added, however, that mental health professionals have also had relatively little success in reducing the occurrence of psychological disorder, and only with carefully designed programs directed toward specific at-risk groups. The evidence is more encouraging at the level of secondary prevention.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D003156:Community Mental Health Services; D003376:Counseling / Q000379:methods*; D006801:Humans; D001523:Mental Disorders / Q000517:prevention & control* / Q000534:rehabilitation / Q000628:therapy; D011322:Primary Prevention; D012017:Referral and Consultation; D012944:Social Support; D013689:Telephone; D000092864:Suicide Prevention