The burden of suffering experienced by children with mental health needs and their families has created a health crisis in this country. Growing numbers of children are suffering needlessly because their emotional, behavioral, and developmental needs are not being met by those very institutions which were explicitly created to take care of them. It is time that we as a Nation took seriously the task of preventing mental health problems and treating mental illnesses in youth.

The mental health needs of our children have elicited interest from the highest levels of government, including the White House and members of both the House of Representatives and the Senate. This Report of the Surgeon General's Conference on Children's Mental Health: A National Action Agenda represents an extraordinary level of collaboration among three major Federal Departments: the Department of Health and Human Services, the Department of Education, and the Department of Justice.

This report introduces a blueprint for addressing children's mental health needs in the United States. It reflects the culmination of a number of significant activities over the past year. A new public-private effort to improve the appropriate diagnosis and treatment of children with emotional and behavioral conditions was launched with a White House meeting convened in March 2000. Participants raised serious concerns about the appropriate diagnosis and treatment of emotional and behavioral difficulties in children, and emphasized the need to take actions to address this issue. On June 26, 2000, I hosted the Surgeon General's Listening Session on Children's Mental Health. Public input on critical issues in children's mental health was solicited via the World Wide Web and by mailing requests to over 500 individuals. Approximately 50 individuals provided input at a day of thoughtful discussion about the gaps in our knowledge on children's mental health. This input helped shape the agenda for a national conference.

On September 18 and 19, 2000, the Surgeon General's Conference on Children's Mental Health: Developing a National Action Agenda was held in Washington, DC. Three hundred participants were invited, representing a broad cross-section of mental health stakeholders, including youth and family members, professional organizations and associations, advocacy groups, faith-based practitioners, clinicians, educators, healthcare providers, and members of the scientific community and the healthcare industry. This conference enlisted their help in developing specific recommendations for a National Action Agenda on Children's Mental Health. A related meeting on Psychopharmacology for Young Children: Clinical Needs and Research Opportunities, was held by the National Institute of Mental Health and the Food and Drug Administration on October 2nd and 3rd, 2000. Recommendations from these two meetings formed the basis of this national action agenda. Action steps reflect the consensus recommendations of the participants at the national conference.

One of the chief priorities in the Office of the Surgeon General and Assistant Secretary for Health has been to work to ensure that every child has an optimal chance for a healthy start in life. When we think about a healthy start, we often limit our focus to physical health. But, as clearly articulated in the Surgeon General's Report on Mental Health, mental health is fundamental to overall heath and well-being. And that is why we must ensure that our health system responds as readily to the needs of children's mental health as it does to their physical well-being.

One way to ensure that our health system meets children's mental health needs is to move toward a community health system that balances health promotion, disease prevention, early detection and universal access to care. That system must include a balanced research agenda - - including basic, biomedical, clinical, behavioral, health services, school-based and community-based prevention and intervention research - - and it must include a re-invigorated approach to mental health. There is no mental health equivalent to the federal government's commitment to childhood immunization. Children and families are suffering because of missed opportunities for prevention and early identification, fragmented services, and low priorities for resources. Overriding these problems is the issue of stigma, which continues to surround mental illness.

Responsibilities for children's mental healthcare is dispersed across multiple systems: schools, primary care, the juvenile justice system, child welfare and substance abuse treatment. But the first system is the family, and this agenda reflects the voices of youth and family. The vision and goals outlined in this agenda represent an unparalleled opportunity to make a difference in the quality of life for America's children.

David Satcher, M.D., Ph.D.
Assistant Secretary for Health and Surgeon General