Excerpt

This report builds on a highly valued predecessor, the 1994 Institute of Medicine (IOM) report entitled Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. That report provided the basis for understanding prevention science, elucidating its then-existing research base, and contemplating where it should go in the future. This report documents that an increasing number of mental, emotional, and behavioral problems in young people are in fact preventable. The proverbial ounce of prevention will indeed be worth a pound of cure: effectively applying the evidence-based prevention interventions at hand could potentially save billions of dollars in associated costs by avoiding or tempering these disorders in many individuals. Furthermore, devoting significantly greater resources to research on even more effective prevention and promotion efforts, and then reliably implementing the findings of such research, could substantially diminish the human and economic toll.

Contents

• The National Academies
• Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions
• Board on Children, Youth, and Familiies
• Acknowledgments
• Preface
• Acronyms
• Summary
  • PUTTING KNOWLEDGE INTO PRACTICE
  • CONTINUING A COURSE OF RIGOROUS RESEARCH
• 1. Introduction
  • CORE CONCEPTS
  • INTERVENTION RATIONALE
  • STUDY BACKGROUND
  • THE COMMITTEE’S CHARGE
  • ORGANIZATION OF THE REPORT
• I. Overview and Background
  • 2. The Nature and Extent of the Problem
    • RESEARCH METHODS AND DATA
    • PREVALENCE OF MENTAL, EMOTIONAL, AND BEHAVIORAL DISORDERS
    • IS PREVALENCE INCREASING OR DECREASING?
    • INCIDENCE OF MENTAL, EMOTIONAL, AND BEHAVIORAL DISORDERS
    • FACTORS AFFECTING PREVALENCE AND INCIDENCE
    • CONCLUSIONS AND RECOMMENDATIONS
  • 3. Defining the Scope of Prevention
    • ISSUES IN DEFINING PREVENTION
    • THE CURRENT APPROACH
    • RECONSIDERING MENTAL HEALTH PROMOTION
    • CONCLUSION AND RECOMMENDATION
  • 4. Using a Developmental Framework to Guide Prevention and Promotion
    • A DEVELOPMENTAL FRAMEWORK
    • A DEVELOPMENTAL PERSPECTIVE ON THE STUDY OF MENTAL HEALTH PROMOTION
    • A DEVELOPMENTAL PERSPECTIVE ON RISK AND PROTECTIVE FACTORS
    • TARGETING INTERVENTIONS FOR PREVENTION AND PROMOTION
    • CONCLUSIONS AND RECOMMENDATIONS
  • 5. Perspectives from Developmental Neuroscience
    • GENETICS
    • BRAIN DEVELOPMENT
    • NEURAL SYSTEMS
    • RELEVANCE OF DEVELOPMENTAL NEUROSCIENCE TO PREVENTION
    • CONCLUSIONS AND RECOMMENDATIONS
• II. Preventive Intervention Research
  • 6. Family, School, and Community Interventions
    • PREVENTION AIMED AT FAMILY FUNCTIONING
    • PREVENTION THROUGH SCHOOLS
    • COMMUNITY INTERVENTIONS
    • CONCLUDING COMMENTS
  • 7. Prevention of Specific Disorders and Promotion of Mental Health
    • PREVENTION OF SPECIFIC DISORDERS
    • PREVENTION OF SUBSTANCE USE AND ABUSE
    • PREVENTION OF SCHIZOPHRENIA DURING A PRODROMAL STAGE
    • MENTAL HEALTH PROMOTION
    • CONCLUSIONS AND RECOMMENDATIONS: CHAPTERS 6 AND 7
  • 8. Screening for Prevention
    • CRITERIA FOR SELECTIVE AND INDICATED PREVENTION SCREENING
    • CONCLUSIONS AND RECOMMENDATIONS
  • 9. Benefits and Costs of Prevention
    • COST-BENEFIT AND COST-EFFECTIVENESS ANALYSIS
    • ECONOMIC NEED FOR PREVENTION
    • COST-EFFECTIVENESS OF PREVENTIVE INTERVENTIONS
    • CONCLUSIONS AND RECOMMENDATIONS
  • 10. Advances in Prevention Methodology
    • EVALUATING A PREVENTIVE INTERVENTION WITH A RANDOMIZED PREVENTIVE TRIAL
    • BUILDING RIGOROUS CAUSAL INFERENCES FROM RANDOMIZED FIELD TRIALS
    • EMERGING OPPORTUNITIES FOR PREVENTION TRIALS
    • NONRANDOMIZED EVALUATIONS OF INTERVENTION IMPACT
    • ADVANCES IN STATISTICAL ANALYSIS OF PREVENTION TRIALS
    • METHODOLOGICAL CHALLENGES AHEAD FOR PREVENTION RESEARCH
    • CONCLUSIONS AND RECOMMENDATIONS
• III. New Frontiers
  • 11. Implementation and Dissemination of Prevention Programs
    • IMPLEMENTATION APPROACHES
    • EXAMPLES OF EXPERIENCE WITH IMPLEMENTATION OF EXISTING PREVENTION PROGRAMS
    • IMPLEMENTATION CHALLENGES
    • STRATEGIES THAT COMPLEMENT THE IMPLEMENTATION OF EVIDENCE-BASED INTERVENTIONS
    • RESEARCH NEEDS
    • CONCLUSIONS AND RECOMMENDATIONS
  • 12. Prevention Infrastructure
    • FUNDING
    • SYSTEMS THAT SUPPORT DELIVERY OF PREVENTIVE SERVICES
    • CREATING A TRAINED WORKFORCE
    • CONCLUSIONS AND RECOMMENDATIONS
  • 13. Toward an Improved Approach to Prevention
    • A NEW NATIONAL DISCOURSE
    • DEVELOPING STATE AND LOCAL SYSTEMS
    • MONITORING, FUNDING, AND TRAINING
    • REFINING AND EXPANDING PREVENTION RESEARCH
    • ENVISIONING THE FUTURE
    • CONCLUDING THOUGHTS
• References
• Glossary
• Appendixes
  • A Biographical Sketches of Committee Members and Staff
  • B Open Session and Workshop Agenda
  • C Sources of Data on Prevalence of MEB Disorders of Young People
  • D Preventive Intervention Meta-Analyses
  • E Tables of Risk Factors
  • F Intervention Research Portfolio One-Year Snapshot: Summary Analysis

This study was supported by Grant No. NO1-OD-4-2139, Task Order #181 between the National Academy of Sciences and the Department of Health and Human Services.

Suggested citation:

National Research Council and Institute of Medicine. (2009). Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions. Mary Ellen O’Connell, Thomas Boat, and Kenneth E. Warner, Editors. Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.