TABLE 8-1 Adaptation of World Health Organization Criteria to Prevention

World Health Organization Criteria

Adaptation for Selective and Indicated Prevention

The condition should be an important health problem.

The MEB disorders to be prevented through identification of this risk factor should be a serious threat to mental health or increase the likelihood of substance abuse or delinquent or violent behavior.

The natural history of the disease should be adequately understood.

The antecedent history of the disorder and its developmental link to target risk factors should be adequately described.

There should be a treatment for the condition.

There should be an effective intervention to address the identified risks or early symptoms and signs of the MEB disorder. Early preventive intervention should lead to better outcomes than a treatment after onset.

Facilities for diagnosis and treatment should be available.

Facilities or settings for screening and intervention should be available.

There should be a latent stage of the disease.

There should be identifiable risk or protective factors or a latent stage of the disorder to be addressed by prevention.

There should be a test or examination for the condition.

There should be validated screening tools or interview techniques to identify risks or early symptoms. Tools should have acceptable accuracy when compared with formal assessments.

The test should be acceptable to the population.

Screening approaches and guidelines should be acceptable to the population and not cause labeling.

There should be an agreed policy on whom to treat.

There should be agreed-on guidelines for whom to refer for assessment, prevention services, or treatment.

The total cost of finding a case should be economically balanced in relation to medical expenditure as a whole.

The cost of finding a case should be affordable, cost-effective, and reimbursable.

Case-finding should be a continuous process, not just a “once and for all” project.

Screening can be population-based or targeted to at-risk groups or individuals. It should be longitudinally implemented, as risks and early signs or markers of MEB disorders may develop over time.

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