Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders (2025) / Chapter Skim
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Less attention and fewer resources are dedicated to delivering services specifically devoted to preventing such disorders and promoting MEB health and overall well-being. Greater support for prevention could minimize the pain and suffering associated with MEB disorders, and, critically, reduce the burden on overtaxed treatment and recovery systems.
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; • Funding that is adequate and sustainable (Chapter 6) ; • Evidence-based policies that create and strengthen the social, eco nomic, and environmental conditions necessary for MEB disorder prevention and undergird population health (Chapter 7)
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,2 public health, and human services agencies and organizations, along with other sectors of society from community and grassroots organizations to the education system to employers. The committee found the infrastructure currently provides more structures and supports for substance use prevention compared 2 "Behavioral health" and "mental health" are used in this report when reflecting existing agencies or organizations or referring to outcomes discussed in specific studies, while the committee uses "MEB disorders" to encompass the frequently siloed issues of "mental health/ illness" and "substance use disorders."
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However, billing constraints can restrict health insurance reimbursement for integrated behavioral health and primary health care services or MEB preventive care delivery in nonclinical settings. Additionally, funding for public health communication and other strategies that target the entire community is grant-dependent and not sustained.
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SUMMARY 5 Early Health Care Education Public Health Childhood Behavioral Human Services Criminal Legal Other Systems Health EXISTING SYSTEMS Governance Funding Evidence Data GUIDING PRINCIPLES Health Equity (including attention to cultural context and communication) Implementation Prevention Science Workforce Strengthen protective factors Reduce risk factors MEB Health & Wellbeing FIGURE S-1 The prevention infrastructure for MEB disorders.
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These existing prevention strategies -- as critical aspects of the prevention and health promotion infrastructure -- are necessary but not adequate for meeting population MEB health needs and reducing preventable poor MEB outcomes that originate during preconception and early life, and can increase along the life course. RECOMMENDATION 2-1: The National Institutes of Health, Centers for Disease Control and Prevention, and philanthropic organizations should fund more research on the prevention of mental, emotional, and behavioral (MEB)
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An easily accessible, trustworthy, centralized repository of programs addressing MEB disorder prevention with transparent criteria, evaluations, and regular updates would greatly serve communities, coalitions, and other invested constituents. RECOMMENDATION 2-2: The Substance Abuse and Mental Health Services Administration (SAMHSA)
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Clearinghouse usability considerations include having straightforward search functions and being tailorable for different needs, concise, and jargon-free. The Workforce for Prevention of MEB Disorders The committee found that the MEB disorder prevention workforce is poorly characterized compared to the traditional behavioral health (BH)
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RECOMMENDATION 3-3: The Substance Abuse and Mental Health Services Administration should establish a Coordinating Office on the Mental, Emotional, and Behavioral Prevention Workforce or designate a lead office to coordinate prevention to delineate core competen cies, develop a strategic plan, review agency programs and grants for workforce linkages, coordinate with the Centers for Disease Control and Prevention and accrediting and licensure bodies, and strengthen academic-community partnerships. This enhanced coordination could be accomplished through collaboration between the Center for Substance Abuse Prevention and a new Center for Mental Health Promotion or a new joint Center for Prevention of Behavioral Disorders (see options supporting Recommendation 5-1)
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Federal agencies and others have explored measures of subjective wellbeing, and the committee asserts that they can be used in tracking MEB health. A measure of population well-being would provide a more expansive way to track progress of programs and policies, complementing specific national measures, such as overdose and suicide deaths, and framing a positive high-level target for the prevention infrastructure.
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Office of the National Coordinator of Health Information Technology and national public health organizations, such as the Association of State and Territorial Health Officials and the National Indian Health Board. Governance The governance structure for prevention of MEB disorders is fragmented, with separate lines of oversight and funding for mental health and substance use disorder (SUD)
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Congress could expand the Substance Abuse and Mental Health Services Administration's (SAMHSA's) ability to support state, tribal, and local MEB disorder prevention efforts by either estab lishing a Center for Prevention of Behavioral Disorders that inte grates the agency's prevention activities or by establishing a Center for Mental Health Promotion (equal to and working closely with the existing Center for Substance Abuse Prevention)
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children from birth to 18 years old. Such a commitment could ensure that all children in every community have access to the package of interventions they need to address risk factors and support positive trajectories to MEB health (e.g., reducing risk for, incidence, and severity of depression, anxiety, suicide, and substance use disorders, including alcohol use disorder, and improving general mental health and resilience along the life course as children grow up)
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However, its amendments, authorities, flexibilities, and waivers offer opportunities for greater adaptability and experimentation. Interventions to prevent MEB disorders and promote MEB health could be supported through a range of approaches that create more sustainable, coordinated, and adequate funding beginning with greater flexibility and innovation in federal sources.
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to provide guidance on how tax-exempt hospitals can use community benefit funding to support MEB disorder prevention in communities where behavioral disorders are priority health needs within the mandated Commu nity Health Needs Assessment. Specifically, the IRS should modify Lines 3, 6, 7, and 8 of Part II of IRS Schedule H (Form 990)
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, and private-sector entities (employers/payers) that will reap the savings from enhancing mental, emotional, and behavioral health at a popula tion level and eliminating MEB health disparities.
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RECOMMENDATION 7-2: Federal, state, and county officials should enact evidence-based policies to divert from the criminal legal system and reduce reliance on incarceration where appropriate, while simultaneously building a robust community prevention infrastructure, thus enabling protective factors that support mental, emotional, and behavioral health. Exposure to firearm violence is a major cause of MEB disorders.
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Studies should include direction and strength of associations as well as an assessment of causality. Examples for how the guiding principle of health equity and implementation science can be operationalized in the infrastructure are discussed in each chapter and include: • Shared governance with communities and people with lived experience; • Assurance that the evidence about programs is generalizable and represents the communities where they will be implemented and new knowledge generated feeds back into the evidence base; • A workforce that reflects the community is culturally and linguisti cally competent; and • Distribution of funding to support MEB health promotion efforts that targets the communities and subpopulations that bear the highest burden of risk factors and poor outcomes.
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