Primary prevention refers to the protection of health by personal and community wide effects, such as preserving good nutritional status, physical fitness, and emotional well-being, immunising against infectious diseases, and making the environment safe. There are no precise boundaries between the primary, secondary and tertiary levels of prevention. (IIME 2002) 69 A notable exception to this use of the term is found in the area of cardiovascular disease prevention and control where secondary prevention is commonly used to refer to prevention of a second heart attack. 70 In the mental health field primary prevention is further divided into approaches designated as universal, selective or indicated prevention, depending on whether they are applied to the whole population (universal) or sub-groups (selective) or those at an early stage of risk (indicated). A similar approach was used by the AIHW in development of the indicator framework for monitoring the National Health Priority Areas.