Author: Jane Park, Western University of Health Sciences, 3rd year
As a third year medical student currently rotating on family medicine, I spend a significant portion of clinic days determining a patient’s vaccination status. For a 1 year old patient, I scroll through the electronic medical record to check if they have received the Hib, PCV, IPV, COVID-19, MMR, Varicella, Hep A, Hep C 3rd dose vaccines… and the list goes on.
Vaccines are scientifically well-established ways for a person’s body to learn how to defend itself from a disease without a full-blown infection. Thanks to vaccines, a person can be better protected from infections ranging from a common cold to cancer.
When it comes to a mental illness, I have wondered what its vaccine analogue could be. Granted, a psychiatric disorder may not have a singular seeding source like in a viral pneumonia. The pathophysiology of a viral respiratory infection often pale in complexity in comparison to the psychopathology of a mental illness, given the nature of mental health- an area where an empirical observation (e.g. appetite loss) may or may not present itself based on mood (e.g. depressive mood), a currently non-quantifiable state. And a person’s mood and affective experience can involve numerous factors including but not limited to socioeconomic stressors, genetics, hormonal development, and thought pattern development, all of which are also often non-observable and difficult to control.
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In addition to vaccines, in family medicine, I am frequently taught the importance of patient education for disease prevention. For example, a newly sexually active patient is educated on the importance of condom use for sexually transmitted disease (STD) prevention. As STDs are often transmitted via bodily fluids, it only makes sense for physicians to promote physical barriers like condoms to help lower the risk of STD infections in patients.
When it comes to mental illness, I again wonder what its preventive education analogue could be. Poor mental health often contributes to deterioration in social, physical (e.g. increased substance use/abuse risk), and economic (e.g. increased poverty risk) well-being, all of which in turn affect the overall health of a patient. Should it not be of importance, then, to prevent a development of a mental health disorder in an at-risk individual, with minor signs of mental disorders or genetic risk factors for mental illness?
Today, there are diseases like Alzheimer’s disease where AChe inhibitors have been trialed on for use almost analogous to vaccines. The term and idea of “mental hygiene” has existed since the early 1900s including but not limited to promoting a healthy lifestyle and mental health, also analogous to preventive medical care. However, no current clear preventive protocols seem to be in practice on either a national level or a community level.
As a third year medical student, I have yet to fully understand the intricacies of a disease process or the healthcare system. At the same time, because I am not yet bound by the current ways-of-doing, I continue to ponder on the possibility of developing preventive care of prevalent mental disorders, starting from identifying at-risk populations, all the way to providing generalized ‘vaccine-like’ care for mental illnesses. Could we start with including mental illnesses in the assessment of family histories of illnesses (in patient history taking) in our medical education system, to identify at-risk patients? Would providing at-risk patients with a clear, well-developed education on coping-mechanisms, cognitive behavior therapies and medication counseling be a good start? What are your thoughts?
References:
https://www.cdc.gov/vaccines/hcp/conversations/understanding-vacc-work.html
https://publichealth.jhu.edu/departments/mental-health/about/origins-of-mental-health
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2408392
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360426