of success. Increasingly, parents are bringing their children to physicians’ offices with behavioral concerns. Schools and primary care settings may be less stigmatizing for children and families and may enable exploration of emotional and behavioral health issues more openly than a mental health setting.
Successes in other areas, such as prevention of smoking, suggest that approaches that involve complementary components at multiple levels are needed. Involving multiple community systems has the potential to leverage resources and implement approaches that support young people throughout their development rather than only in a particular grade or a particular school.
Multiple federal programs have required state and local grantees to implement evidence-based programs. This has both raised awareness regarding evidence-based programs and created a missed opportunity to learn about effective implementation and how adaptation of programs to local circumstances might affect outcomes. This information is needed not only at the national level, but also to inform the community on progress, determine changes needed, and sustain interest in community-wide efforts. Creating systems that support the implementation of preventive interventions, allow their continuous improvement, and facilitate the introduction of new approaches, while evaluating results, should complement national research and planning efforts.
Recommendation 13-3: States and communities should develop networked systems to apply resources to the promotion of mental health and prevention of MEB disorders among their young people. These systems should involve individuals, families, schools, justice systems, health care systems, and relevant community-based programs. Such approaches should build on available evidence-based programs and involve local evaluators to assess the implementation process of individual programs or policies and to measure community-wide outcomes.
Both the identification of problems and resources and the development of solutions will vary by community. However, monitoring systems, a key component of public health, should be integral to any state or community-wide system in order to track the incidence and prevalence of MEB disorders as well as key risk and protective factors and provide information needed to guide efforts. Many states are implementing monitoring systems similar to available national surveys, such as Monitoring the Future, the Youth Risk Behavior Survey, and the National Household Survey of Drug Use and Health (Mrazek, Biglan, and Hawkins, 2004; Boles, Biglan, and Smolkowski, 2006). These surveys provide estimates of substance use and, in some cases, data on adolescents’ self-reported antisocial behavior