Preventing Mental, Emotional, and Behavioral Disorders Among Young People Progress and Possibilities (2009) / Chapter Skim
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13 Toward an Improved Approach to Prevention
13 Toward an Improved Approach to Prevention
Pages 377-396
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From page 377... ...
It is now evident that the incidence of some of these disorders, such as depression, can be significantly reduced. There is also evidence to support multiple approaches aimed at strengthening individual, family, and community competencies that have been causally linked to mental, emotional, and behavioral health, either by reducing malleable risk factors for disorders or enhancing protective factors.
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From page 378... ...
is organized to address individual disorders and problems. However, evidence that common risk factors lead to multiple interrelated disorders and problems, coupled with significant evidence on possible approaches to mitigating these factors, calls for a concerted strategic, national effort to coordinate research, policy, and practice aimed at preventing MEB disorders and promoting healthy development.
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From page 379... ...
Similarly, consideration should be given to the approaches that both promote healthy development and have the greatest potential to affect multiple disorders, such as those aimed at strengthening families. In developing the strategy, priority should be placed on educating the public on the potential to improve support of the nation's young people, including efforts to reduce the stigma associated with mental, emotional, and behavioral problems, and on engaging relevant professional and intergovernmental organizations in a coordinated approach to improving support systems for young people and their families.
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From page 380... ...
. • Identify specific opportunities to braid the funding of research and practice so that the impact of programs and practices that are being funded by service agencies, such as the Substance Abuse and Men tal Health Services Administration (SAMHSA)
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From page 381... ...
A new, ongoing interagency mechanism focused on the emotional and behavioral health of young people could build on and extend the current White House effort to help America's youth. This current effort, a "nationwide effort to raise awareness about the challenges facing our youth, particularly at-risk boys, and to motivate caring adults to connect with youth in three key areas: amily, school, and community," already recognizes many of the core findf ings outlined in this report.
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From page 382... ...
. In the long run, consideration needs to be given to an effective, broad-based, strong public health network that can provide adequate data to monitor progress and support the delivery of high-quality preventive services focused on mental and physical health in a variety of sectors.
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From page 383... ...
Creating systems that support the implementation of preventive interventions, allow their continuous improvement, and facilitate the introduction of new approaches, while evaluating results, should complement national research and planning efforts. Recommendation 13-3: States and communities should develop net worked systems to apply resources to the promotion of mental health and prevention of MEB disorders among their young people.
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From page 384... ...
Guidelines, model training programs, and accredita tion standards are needed for training both researchers and prac titioners on prevention of MEB disorders and promotion of mental health. Research training programs that facilitate creation of multi disciplinary training teams will advance translational prevention research efforts aimed at integrating developmental neuroscience and preventive intervention research (see Chapters 5 and 12)
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From page 385... ...
Recommendation 13-4: Federal agencies and foundations fund ing research on the prevention of MEB disorders should establish parity between research on preventive interventions and treatment interventions. Multiple federal agencies, across several departments, fund research related to prevention.
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From page 386... ...
. However, it also calls on the prevention community to embrace mental health promotion as within the spectrum of mental health research.
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From page 387... ...
3. Preventive interventions are provided as a routine component of school, health, and community service systems, reducing stigma to a minimum.
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From page 388... ...
However, a brief discussion and a few examples illustrate that our recommendations are not merely utopian dreams, but rather a call for the nation to make available to children and families the types of services and initiatives that are already being implemented in other countries. Europe as a whole is working toward a comprehensive strategy on mental health, with a strong focus on mental health promotion and the prevention of MEB disorders (Jané-Llopis and McDaid, 2005)
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From page 389... ...
TOWARD AN IMPROVED APPROACH 389 TABLE 13-1 Examples of Potential Components of a Prevention System That Supports Developmental Phases Developmental Illustrative Intervention Stage In the Absence of Interventions Opportunities Conception, High risk of postpartum Pregnant women screened routinely pregnancy, depression for risk factors and provided postpartum needed interventions, such as mood management training, home visitation, and nutritional counseling to prevent maternal depression during child's critical developmental stages Baby at risk for problems of Well-baby visits to screen and attachment, later preschool or intervene for developmental school problems, or later problems, abnormal feeding depression if mother is depressed patterns, interactions with mother or other caretaker Infancy Infant at risk for abnormal Screening is offered for age development appropriate behaviors and evidence of normal brain development Early behavioral difficulties On-time remedial interventions are increase risk for later bonding offered, such as parent training and problems, negative patterns of referral to a developmental parent-child interactions specialist Preschool years Child does not receive early Caregivers are encouraged to read cognitive stimulation to their children Child does not learn self-efficacy, In-home and out-of-home prosocial skills, or appropriate enrichment experiences such as school behaviors early childhood education are offered for the child to build skills needed for school and social success Families receive needed parenting support to foster nurturing relationships Primary school Child has difficulty establishing Families and schools increase positive relationships with peers, nurturance and decrease punitive caregivers, or teachers experiences Child does not experience early Children learn skills to enhance successes school performance and manage problem behaviors continued
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From page 390... ...
. The green paper launched a process that included consultation with relevant European institutions, governments, health professionals, and stakeholders in the research community and other civic sectors (Commission of the European Communities, 2005)
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From page 391... ...
. In addition, many countries are working to integrate mental health promotion and prevention efforts both with the systems that address physical health and with antipoverty programs, recognizing that poverty is a major factor in the development of MEB disorders (Jané-Llopis and Anderson, 2005)
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From page 392... ...
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.
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From page 393... ...
Preventive care for children of the mentally ill is an integral part of the mental health and primary health care system. Care of children of parents with mental illness is one of five mental health priority areas.
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From page 394... ...
When IOM's report Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research was published in 1994, the majority of available studies were efficacy studies, with a few addressing the effectiveness of interventions. The report called on the field to continue to develop rigorous efficacy and effectiveness evaluations while at the same time moving further toward the final stage in the proposed prevention research cycle to "facilitate large scale implementation and ongoing evaluation of the pre
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From page 395... ...
One of the areas of greatest need is to develop strategies and outcome measures to ensure that high-quality evidence-based approaches are successfully adapted for use in a broad array of different cultural, ethnic, and linguistic settings. As research on development and implementation of specific interventions continues, states and communities need to also continuously refine effective interventions and implementation approaches.
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