Institute on Drug Abuse, 1997; National Institute on Alcohol Abuse and Alcoholism, 2002; Maryland Governor’s Office of Crime Control and Prevention, 2003). However, there is wide variation in the evidence criteria used to identify and classify programs as well as the terminology used to describe them (research-based, evidence-based, model, promising, etc.). Impressive advances have been made in the development and documentation of efficacious interventions that successfully reduce an array of risk factors or enhance protective factors for MEB disorders and substance abuse. Increasingly, there is evidence that some of these interventions can be effectively implemented in community settings. And there is a relatively young but growing body of evidence that some interventions are cost-effective.

Despite these substantial developments, translating existing knowledge into widespread reductions in the incidence and prevalence of MEB disorders of young people remains a challenge. Prevention science and practice still lack empirically tested strategies for widespread dissemination of evidence-based interventions and an infrastructure of schools, family service organizations, or health care providers to reliably deliver evidence-based interventions.

The astonishing number of young people with MEB disorders has placed extraordinary demands on the education, child welfare, and justice systems as children and youth with unmet needs enter those systems. As well, it has sparked interest in preventive approaches that may help stem the tide. Many interventions have been demonstrated to be efficacious (i.e., tested in a research environment), and several have been demonstrated to be effective (i.e., tested in the real world). However, implementation of any intervention on a large scale and demonstration that it reliably improves mental health outcomes remain a daunting challenge. Similarly, a shared public vision about prevention of MEB disorders or promotion of mental health, which prioritizes the healthy development of young people and places prevention of MEB disorders on equal footing with physical health disorders, is seriously lacking. Collective attention to the fact that the vast majority of MEB disorders begins in youth will require transformation in multiple systems that work with young people.


Recognizing significant changes in the policy and research contexts and substantial increases in the availability of prevention research, 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 that the Board on Children, Youth, and Families of the National Research Council and Institute of Medicine provide an update on progress since release of

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