stress, and coercive parenting, although reductions were modest (Sanders, Ralph, et al., 2008).

The Netherlands has a comprehensive national infrastructure for health promotion and prevention that includes public health, mental health, and addiction. This infrastructure includes mechanisms that support research and dissemination of evidence-based programs and involves multiple sectors, such as the health system, the justice system, and schools. It is supported by a specialized professional workforce of trained health promoters and prevention workers, about half of whom are primarily or partly focused on mental health (Jané-Llopis and Anderson, 2006). One of the areas of priority is the care of children of mentally ill parents. The Netherlands, as well as Finland, have implemented country-wide systems to support the children of mentally ill parents in their health care systems (see Box 13-1).

Scotland launched the National Programme for Improving Mental Health and Well Being in 2001. The key aims include raising awareness and promoting mental health and well-being, eliminating stigma and discrimination, preventing suicide, and promoting and supporting recovery from mental illness. The priority areas include, among others, the mental health of infants, children, and young people. The national program includes campaigns; research, evaluation, and training initiatives; monitoring; partnerships; and implementation support at the national level as well as services and partnerships at the local level (Scottish Executive, 2003). It is guided by a National Advisory Council made up of a range of stakeholders from the public and private sectors in a variety of settings, including schools, prisons, and the health system (Jané-Llopis and Anderson, 2006). Information on Scotland’s progress is available at

Systematic attempts to affect the entire population have great value in public health, and integrative models in Europe and other countries may offer efficient approaches to supporting the development of young people, although empirical evidence to date appears to be lacking. Although these models still need more comprehensive study, as the United States moves forward with prevention, federal, state, and local governments should look for evidence-based progress in other countries and applicable lessons learned that can be adapted to systems here.


The gap between what is known and what is being done is far too large. It can be addressed only by continuing to refine the science and by a strong commitment to develop the infrastructure and put in place systems that allow for equitable delivery of preventive interventions on a population-based, large-scale basis. The United States needs to build on the extensive

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