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Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities
ity to accomplish normal developmental tasks, such as establishing healthy interpersonal relationships, succeeding in school, and transitioning to the workforce. These disorders also affect the lives of their family members.
A 1994 report by the Institute of Medicine (IOM), Reducing Risks forMental Disorders: Frontiers for Preventive Intervention Research, highlighted the promise of prevention. In response to a subsequently burgeoning research base and an increasing understanding of the developmental pathways that lead to MEB problems, the Substance Abuse and Mental Health Services Administration, the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism requested a study from the National Academies to review the research base and program experience since that time, focusing on young people. The Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults was formed under the auspices of the Board on Children, Youth, and Families to conduct this review (see Box S-1 for the complete charge).
The 1994 IOM report reaffirmed a clear distinction between prevention and treatment. The current committee supports this distinction. The prevention of disability, relapse, or comorbidity among those with currently existing disorders are characteristics and expectations of good treatment. Although treatment has preventive aspects, it is still treatment, not prevention. The strength of prevention research using this concept of prevention, coupled with the need for focused research on risks prior to the onset of illness, warrants the field’s continued use of a typology focused on interventions for those who do not have an existing disorder. Interventions classified as universal (population-based), selective (directed to at-risk groups or individuals), or indicated (targeting individuals with biological markers, early symptoms, or problematic behaviors predicting a high level of risk) are important complementary elements of prevention. Going beyond the 1994 IOM report, we strongly recommend the inclusion of mental health promotion in the spectrum of mental health interventions.
The volume and quality of research since 1994 have increased dramatically. Clear evidence is available to identify many factors that place certain young people or groups of young people at greater risk for developing MEB disorders, as well as other factors that serve a protective role. Box S-2 summarizes key advances since 1994.
A number of specific preventive interventions can modify risk and promote protective factors that are linked to important determinants of mental, emotional, and behavioral health, especially in such areas as family functioning, early childhood experiences, and social skills. Interventions are also available to reduce the incidence of common disorders or problem behaviors, such as depression, substance use, and conduct disorder. Some interventions reduce multiple disorders and problem behaviors as well as