Introduction

The aims of tertiary prevention are to reduce the complications and disability associated with established disorders, particularly those which have become chronic. Thus tertiary prevention includes not only active intervention aimed at the presenting condition itself but also rehabilitation to reduce potential secondary problems (Henderson, 1988).

Tertiary prevention in child mental health relies heavily on the family; tight-knit extended families where the members are available to help each other are ideal. Parents also need ready access to comprehensive professional and welfare support in the community to help them cope with their children's disability.

Impairment, disability and handicap

Central to the concept of tertiary prevention is an understanding of the concepts of impairment, disability and handicap. The World Health Organisation International Classification distinguishes these three different levels of the consequences of disease. Impairment means loss or abnormality of psychological, physiological or anatomical structure or function – body parts or systems do not work. Disability is the resulting loss or restriction of the ability to perform an activity – the things people cannot do which they would normally be expected to do. Handicap is the disadvantage resulting from impairment or disability for a given individual, that limits or prevents the fulfilment of roles in life which would normally be achieved, taking into account age, sex and social and cultural factors.