sixth grade (Kellam, Ling, et al., 1998). But some teacher characteristics are related to lower levels of mental, emotional, and behavioral problems for students. These include using classroom management strategies with a low level of aggressive behavior, having high expectations for students, and having supportive relations with students.

Programs promoting classroom and school procedures that encourage prosocial behavior, academic achievement, or increased positive bonding to school have important implications for children’s healthy development. For example, use of a group contingency to promote prosocial behavior in first grade students has been found to reduce aggressive behavior in first grade (Dolan, Kellam, et al., 1993) and through middle school (Muthén, Brown, et al., 2002). The effects persisted with a reduction 13 years later in the rate of diagnosis of alcohol and illicit drug abuse or dependence (Kellam, Brown, et al., 2008). Also, for the subgroup of boys who started first grade with high levels of aggressive behavior, this intervention reduced the rate of antisocial personality disorder (Petras, Kellam, et al., 2008) and mental health service use (Poduska, Kellam, et al., 2008).

Structural and policy changes can reduce risk associated with the transition to senior high school (Seidman, Aber, and French, 2004). This transition is associated with a decline in academic performance as well as an increase in delinquency, depression, suicidal thoughts, and substance use. However, policy changes, such as reduced school size, that create smaller working units with more supportive relations with teachers and peers have been shown to reduce this risk (Felner, Brand, et al., 1993).

A voluminous literature has emerged since the 1994 IOM report on the factors associated with MEB disorders in young people, with a consensus that these factors operate at multiple interrelated levels. Factors both specific to a given disorder and that provide a more generalized risk for multiple disorders provide important opportunities for the development of interventions that modify these factors and explore possible mediating mechanisms.