agencies at the state level, and in all of the training programs and specialized prevention research centers that are expected to be in place at that time. To achieve such a goal will require support from federal, state, and private sources.

Finally, mechanisms must be created that make it feasible and even attractive for talented mid-career scientists to switch into preventive intervention research. Mechanisms to accomplish this include research scientist awards and awards to establish chairs for distinguished scientists in prevention research. Both of these mechanisms have precedents within NIH. As with the institutional training grants, it is essential that these programs cover the full costs. If policymakers decide that the national interest requires the development of this field, then barriers to that development must be completely removed.

COORDINATION

Federal agencies doing preventive intervention research and providing prevention services are decentralized and uncoordinated and have minimal awareness of each other's efforts. Few projects directly assess or attempt to intervene in the common phenomenon of co-morbidity among mental disorders, including drug and alcohol abuse. Even though NIMH is clearly the lead agency in research regarding the etiology and treatment of mental disorders, it has not taken a lead role in regard to the exchange of knowledge about preventive interventions with other federal agencies or with state agencies. In part, this lack of leadership regarding prevention knowledge exchange reflects the biomedical emphasis of NIMH, but it also is a result of NIMH 's inability to coordinate its prevention programs with NIDA and NIAAA and other federal programs. Because many other DHHS agencies, such as SAMHSA, the Administration on Children, Youth and Families (ACYF), CDC, and HRSA; other departments, such as Education and Defense; and state agencies conduct their own preventive intervention research and provide prevention services, it is essential that coordination efforts include them as well as the NIH research institutes.

There is no central clearinghouse within the government on prevention of mental disorders. There have been few prevention conferences outside of a single institute or agency. There is no organized system for the exchange of knowledge regarding prevention research, including effective intervention programs, with state public health departments, advocacy groups, or universities (see Chapter 11).

Many problems that exist within the federal government also exist in the network of private foundations mentioned earlier in this chapter.



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