mented in everyday practice. The tide has begun to turn, with effectiveness trials beginning to emerge.
As discussed in Part I, young people develop in the context of their families, schools, and communities. Interventions designed to support healthy emotional and behavioral development and prevent disorder take place largely in the contexts of these support systems. Such interventions as prenatal care, home visiting, parenting skills training, programs designed to mitigate specific family-based strain (e.g., bereavement, dealing with a mentally ill parent), and some public policies share a goal of improving family functioning and creating nurturing environments. Many other interventions aimed at a range of problem behaviors have been developed to reach young people through schools, and community-wide approaches have begun to emerge. Some interventions combine aspects of family-based interventions with school-based approaches. These family, school, and community-wide approaches are discussed in Chapter 6.
Chapter 7 includes a discussion of preventive interventions that are targeted at specific disorders rather than at specific settings. Delivered in mental health, health, and school settings, these interventions deal directly with children, with parents, and with the whole family. Chapter 7 also includes interventions targeted at mental health promotion, including intervention strategies related to modifiable lifestyle factors.
The range of developmental phases in a young person’s life offers variable opportunities for intervention. Interventions are designed to address differential risk and protective factors prominent in a particular developmental stage or the emergence of symptoms that tend to occur at different ages. Most of the interventions discussed in Chapters 6 and 7, regardless of their mechanism, target young people during one or more developmental phases (see Figure II-1).
Preventive interventions are characterized by the level of risk of the population targeted for intervention. Screening, typically thought of in the context of indicated preventive interventions, in which individuals demonstrate elevated symptom levels that precede a diagnosis of disorder, may have applications for universal and selective interventions as well. The nation should proceed with caution, however. These issues are discussed in Chapter 8.
Family-, school-, and community-based interventions can help reduce the significant personal, family, and social costs of MEB disorders and related problem behaviors. These costs and available economic analyses of some of the interventions discussed in Chapters 6 and 7 are outlined in Chapter 9.
Finally, significant methodological advances since 1994 have increased the reliability of causal inferences possible from preventive intervention research and provided the field with solid guidelines on the design and