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Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities
in pediatrics are not formally trained to recognize chronic health disorders as risk factors for MEB disorders of youth.
Requirements for training in preventive medicine25 are largely silent with regard to prevention of MEB disorders. Core knowledge is expected to include “behavioral aspects of health,” but the requirements do not otherwise address MEB disorders or their prevention. The certifying examination for preventive medicine does not specifically test knowledge or skills directed to prevention of MEB disorders. Drug use training in preventive medicine residency largely focuses on tobacco (Abrams, Saitz, and Sancet, 2003).
None of the medical specialty training requirements emphasize the need to be conversant with screening for risk or protective factors for mental disorders or to understand systems that are in place to manage risk as well as reinforce protective factors. The overall lack of attention to training related to prevention of MEB disorders contrasts with a consensus in the pediatric community that training for residents should be enhanced to prepare them for more knowledgeable, competent behavioral/mental health screening and care (American Academy of Pediatrics, 2001; American Academy of Pediatrics Task Force on Mental Health, in preparation). The American Board of Family Medicine (ABFM) has identified similar needs for their trainees (personal communication with Larry Green, ABFM board member, October 8, 2007).
Master’s-level social work training (the routine degree for practitioners) currently is provided by approximately 200 programs accredited by the Council on Social Work Education. Accreditation standards do not address substance use in general or prevention in this realm (Straussner and Senreich, 2002). Curriculum requirements emphasize content in human behavior, clinical diagnosis, treatment planning, and service delivery. Prevention frameworks and program examples are included in the Human Behavior and Social Environment course sequences required of all social work graduate curricula. While a 1996 report (Perry, Albee, et al., 1996) found that only 12 schools offered a course in prevention (not specifically prevention of MEB disorders), most schools of social work have elective courses in drug and alcohol abuse prevention, and many offer courses in mental health interventions, as well as child maltreatment prevention and treatment.
Preventive medicine is a three-year training program for physicians that combines a year of clinical medicine and 24 months of academic and practicum training, leading to an M.P.H.