Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders (2025) / Chapter Skim
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7 The Evidence Base on Policies
7 The Evidence Base on Policies
Pages 217-250
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First, policies indirectly influence the upstream factors that promote MEB well-being, such as economic stability, health care and education quality and accessibility, as well as neighborhood and social context. Second, policies can directly affect MEB health by promoting protective factors and reducing risk factors.
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and for which the evidence base has grown considerably in recent years: mass incarceration and firearm violence. The committee points to their role as important indirect and direct factors in MEB health, especially for low-income and minoritized communities, veterans, and children.
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ECONOMIC POLICIES AND MEB HEALTH Income Support, Earnings Replacement, and Employment Support Income support policies, such as the EITC and Child Tax Credit, have shown positive effects on MEB health. Both policies function to alleviate poverty, which places stress on families.
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. Research has shown that the expanded Child Tax Credit was associated with a reduction in anxiety symptoms for recipients (Batra et al., 2023; Cha et al., 2023; Nam and Kwon, 2024)
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. As the frequency and severity of natural disasters increases due to climate change, the consequences, including destruction of housing and displacement, pose additional risks for MEB disorders (SAMHSA, 2024a,b)
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. National Academies reports have underscored how opportunities for educational attainment contribute to improved health, health equity, and well-being (IOM, 2013; NASEM, 2019b,c, 2023)
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. The literature also indicates that the social environment of sexual and gender diverse youth affects their behavioral health outcomes (Newcomb et al., 2019; Hatzenbuehler, 2011)
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. Social Media Policies The 2023 National Academies report Social Media and Adolescent Health examined the effects of social media on the mental and physical health of U.S.
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As briefly discussed above, there are several domains where the relationship between MEB disorders and policies is clear, and others, such as social media, where there is a need for more evidence of effects on MEB health and well-being. Basing public policy on the best available knowledge is essential to enhancing protective factors and mitigating risk factors.
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. The year 2023 marked 50 years of mass incarceration in the United States, defined by a period of unprecedented legal and policy decisions that have led to massive expansion of the use of incarceration as punishment, especially for drug use and crimes related to MEB disorders, and restrictions on the rights of people with criminal records, including limited access to publicly funded social services.
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. Several states and jurisdictions have passed laws or instituted new policies to decarcerate, which have been rigorously studied, including addressing youth lawbreaking outside the criminal legal system; halting the use of confinement in response to probation violations and low-level drug offenses; and reinvesting dollars earmarked for youth incarceration to community alternatives to build community supports and prevention infrastructure (Mendel, 2023a; The Annie E
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Most states have passed statutes to create problem-solving courts, also called "drug," "treatment," or "mental health" courts, that divert people with hazardous drug and alcohol use and MEB disorders from the carceral system (OJP, 2020)
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Community prevention infrastructure refers to a range of investments and interventions that create protective factors and help reduce exposure to risk factors. For youth, school-based evidence-based programs, for example, may reduce problem behavior, strengthen coping skills and behavioral regulation, lessen aggressive behavior, and over the long-term lead to other positive outcomes, such as lower criminal legal system involvement (WSIPP, 2023)
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. The MEB disorders related to alcohol impairment are evident in motor vehicle crashes associated with driving while intoxicated -- which is a major cause of PTSD, affecting an estimated 2.5–7 million U.S.
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She also noted that the prevention infrastructure for MEB disorders needs to be maximally accessible to youth, families, and communities at risk for firearm violence (Richmond, 2024)
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framework to structure and guide the development and implementation of its community action plan. Rates of violent crime were also among the highest in Chi cago, with consequences for the mental, emotional, and behavioral health of residents.
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. Firearm violence disproportionately affects Black children and adolescents, with higher rates of exposure to assaults, police shootings, and community violence.
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Researchers in Washington state found that requirements for a permit to purchase assault rifles reduced firearm violence incidents, including those with an assault weapon for individuals under 21 (Bhullar et al., 2024)
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health, directly contributing to poor MEB outcomes, including suicide, depression, and anxiety, especially for youth and heavily affected communities. RECOMMENDATION 7-3: Federal, state and local policy makers should implement evidence-based policies to prevent firearm violence -- a risk factor for mental, emotional, and behavioral disorders -- including but not limited to safe and secure gun storage, community violence interventions, and lethal means safety counseling.
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. However, MEB health outcomes are not consistently included as a policy target, which represents a missed opportunity to learn whether and to what extent policies are effective at preventing MEB disorders.
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policies that would mitigate risk factors and promote protective factors to prevent MEB disorders. Map the Constituents: Community members and leaders, pol 3.
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org/10.1001/jama.2024.13004. 3 https://implementationresearch.wustl.edu/support-your-research/di-methods-tool-2/ (accessed January 16, 2025)
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https://aspe.hhs.gov/sites/default/files/documents/ 8228e700f6e369df9382ac8e0d3976c1/primary-prevention-convening-brief.pdf (accessed December 16, 2024)
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2024. Washington State assault weapon firearm violence before and after firearm leg islation reform.
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https://hsph.harvard.edu/news/guns-suicide/ (accessed January 14, 2025)
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Center for Law and Social Policy. https://www.clasp.org/sites/default/files/ publications/2020/08/GWC2029_Center%20For%20Law.pdf (accessed January 3, 2024)
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Center for Criminal Justice Research: Cincinnati. https://ojjdp.ojp.gov/sites/g/files/xyckuh176/files/ pubs/reform2/ch3_d.html#340 (accessed January 3, 2025)
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The Sentencing Project. https://www.sentencingproject.org/reports/why-youth-incarceration fails-an-updated-review-of-the-evidence/ (accessed December 16, 2024)
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https://www. nhvrc.org/wp-content/uploads/NHVRC_Yearbook_2018_FINAL.pdf (accessed January 3, 2025)
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Presented on February 22, 2024, at Meeting 2 of the Committee on a Blue print for a National Prevention Infrastructure for Behavioral Health Ddisorders. https:// www.nationalacademies.org/event/41980_02-2024_blueprint-for-a-national-prevention infrastructure-for-behavioral-health-disorders-meeting-2 (accessed October 5, 2024)
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Santa Monica, CA: RAND Corpora tion. https://www.rand.org/pubs/research_reports/RRA243-9.html (accessed January 3, 2024)
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https://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2010/collateralcosts1pdf. pdf (accessed January 3, 2025)
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https:// www.thetrevorproject.org/survey-2023/ (accessed January 14, 2025)
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Department of Health and Human Services. https:// www.acf.hhs.gov/sites/default/files/documents/opre/FLASHVOutreachRecruitment_ 508_v2_0.pdf (accessed January 6, 2025)
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