FIGURE 8-1 Schema of opportunities for screening and prevention.

symptoms that do not yet qualify for a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) diagnosis; chronic disease and other functional impairments, such as neurodevelopmental disabilities; and genetic, environmental exposure, or other biological predisposing factors (see also Chapter 4). Screening at any of these levels will identify youth, individually or collectively, who should be candidates for preventive interventions, assessment, and (if indicated) specific treatment.

Screening should be easily and quickly performed, affordable, and reasonably accurate as a detection tool. There are a number of screening measures and approaches related to MEB disorders that meet these criteria (Stancin and Mizell Palermo, 1997). However, for a number of reasons discussed in this chapter, screening for risks and behaviors or biomarkers associated with a higher likelihood of future MEB disorders has not been widely adopted. The idea of screening for risk factors is considerably different than screening for specific disorders, as is carried out in newborn screening for metabolic disorders that need immediate treatment, such as phenylketonuria. Nevertheless, identification of elevated risks can guide public investments and mobilize communities to pursue needed resources to reduce these risks. While individual risks and behaviors or biomarkers can be identified and receive attention through such settings as primary health care and the school system, there are few specifically identified systems for screening and follow-up at the community or group risk levels. One exception is the Communities That Care approach (see Chapter 11), which has a protocol for helping communities profile their community-level risk and