From a philosophical perspective, promoting the general welfare and protecting society’s most vulnerable individuals are part of the nation’s foundation, codified in the founding documents of the nation. Government has an obligation to ensure the health, safety, and welfare of its citizens. Thus, government has a responsibility to address unmet mental health needs, particularly for children.

Second, economics suggests that the public sector should intervene when one person’s action or behavior adversely impacts others (i.e., negative externalities). Young people who suffer from MEB disorders impose costs on society beyond those that they suffer themselves: the costs of health and other care; disruptions of work, school, or family; the costs to the criminal justice system and other service systems for actions resulting from MEB disorders; and, in the case of young people, the costs of special education or other remedial services. Preventing MEB disorders and promoting mental health thus benefits not only the individuals who would have directly experienced these problems and their families, but also society as a whole. Similarly, the basic human suffering that individuals with MEB disorders and their families experience calls for public preventive intervention, as there are strategies available that can avoid some of that suffering.

Third, a political science perspective calls on government to intervene in areas in which shared interests require shared solutions—such issues as public education, global warming, national defense, and others for which wider societal action is needed. Political science considers inequities when considering how and when society should be involved in the affairs of its citizens. The distribution of the burden imposed by preventable MEB disorders is one such inequity warranting collective decision making to include population-level issues that affect communities as a whole. Finally, the basic ethical principles of justice, beneficence, and fidelity call for reasonable actions to protect the nation’s young people and promote their well-being.

Collectively, these different perspectives provide a strong rationale for government to employ its resources to prevent a large future burden of MEB disorders that, directly or indirectly, affects all of society. The case is particularly compelling in the instance of preventable disorders among young people. Government, communities, and families should be called on to make changes with documented benefit in their lives.


In 1994, in response to a congressional request, the Institute of Medicine (IOM) published Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research, a landmark assessment of research related to prevention of mental disorders (referred to throughout as the 1994 IOM report). The report acknowledged incremental progress since the nation was

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