the preceding chapter, although there are a number of interagency efforts, they tend to be focused on a single program or an isolated issue related to prevention rather than on a holistic vision. Historically, prevention has received far less attention than treatment in either mental health or physical health. A fundamental paradigm shift needs to occur. The substantial progress in prevention science summarized in this report calls for the adoption of a prevention perspective and a resolve to test and determine the most promising application of specific evidence-based preventive approaches.

Recommendation 13-1: The federal government should make the healthy mental, emotional, and behavioral development of young people a national priority, establish public goals for the prevention of specific MEB disorders and for the promotion of healthy development among young people, and provide needed research and service resources to achieve these aims.

Accomplishing this will require a more systematic approach at multiple levels—national, state, and local—and continued progress in prevention research.


The 1994 IOM report strongly recommended the creation of a mechanism to coordinate research and services across federal departments, suggesting the creation of a national scientific council as one model, possibly under an office in the White House. A variety of national-level groups (New Freedom Commission on Mental Health, 2003; U.S. Public Health Service, 2000) have concurred in saying that the nation should consider a strong, broad-based public health infrastructure to both monitor and deploy resources in mental and physical health care.

Current federal policy, research, and practice relevant to prevention of MEB disorders are fragmented across a wide variety of agencies. Research on prevention (and treatment) is organized to address individual disorders and problems. However, evidence that common risk factors lead to multiple interrelated disorders and problems, coupled with significant evidence on possible approaches to mitigating these factors, calls for a concerted strategic, national effort to coordinate research, policy, and practice aimed at preventing MEB disorders and promoting healthy development. This effort would build on the significant evidence currently available and continue to be informed by new research as it emerges.

Recommendation 13-2: The White House should create an ongoing mechanism involving federal agencies, stakeholders (including profes-

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