when. The braiding of programmatic funding from service agencies, such as the Substance Abuse and Mental Health Services Administration, with evaluation funding from research agencies, such as the National Institute of Mental Health, would advance these efforts. Establishment of an ongoing national monitoring system that is capable of regular reporting on the incidence and prevalence of specific disorders, as well as the rates of exposure to key risk and protective factors, is needed to assess performance compared with national goals.

Determining what is “evidence-based” is an important component of ensuring that these efforts have a positive impact on the lives of young people. Priority should be given to programs that have been tested and replicated in real-world environments, that have reasonable cost, and that are supported by tools that will help to implement key elements of the programs with fidelity. Federal and state agencies should not endorse programs that lack empirical evidence solely on the basis of general community endorsement. In turn, states and communities need to consider the relevance of available models to their own needs, priorities, and cultural contexts. They should evaluate programs and systems that they adopt, so as to continue to build the prevention knowledge base. Programs should also engage in and document the results of quality improvement efforts to continuously enhance program outcomes.

Recommendation: 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. (13-3)

Concurrently, concerted attention should be paid to developing a workforce that has the knowledge base and skill sets necessary to research, implement, and disseminate relevant interventions in diverse community contexts and cultures. Training and certification programs for the next generation of professionals working with young people should include the latest knowledge of the early trajectories of disorders and of prevention approaches in a life-course framework. Box S-3 provides a list of other specific recommendations relevant to putting knowledge into practice.



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