• By Kevin Mount
  • Posted on Monday 23rd March, 2009

National Academies outline pathway to prevention

Prevention is being given a massive boost this week with the publication of the US National Academies report Preventing Mental, Emotional and Behavioral Disorders Among Young People. It marks another important milestone on the journey toward a world where as much effort goes into the prevention of impairments to children's health and development as to treating disorders when they occur.Two-fifths of young people will have experienced mental, emotional or behavioral disorder by the time they are 16. In the US alone the cost runs to an estimated quarter of a trillion dollars a year.The concept of prevention is still too little understood by policy and practice. As the report explains, it must occur before any impairment emerges. It anticipates future problems by asking, "What will be good for the child five, ten, or more years from now?"The indivisibility of physical and mental health sits at the heart of the report. Good physical health promotes good mental health. Poor mental health produces poor physical health. Effective prevention means that people live longer.The interdisciplinary nature of prevention is re-emphasized. Its locus is not in mental health clinics but in schools. It is common in parenting classes and it is at the heart of many community programs. It also has a place in government taxation policy, to restrict the use of alcohol or tobacco, for example.Understanding how disorders develop is the key to the work of preventionists. The first symptoms typically occur two to four years before the onset of a full-blown disorder and it is in this window of opportunity, generally ignored by children's services agencies, when preventive programs make a difference.With all these considerations in view, Preventing Mental, Emotional and Behavioral Disorders argues that a new order of public and clinical health care, alongside education, social care and community agencies will be needed if the well-being of US children is to improve.Coverage continues tomorrow with a look at how the prevention world has changed since the last National Academies report on the issue Reducing Risks for Mental Disorders: Priorities for Preventative Intervention Research. On Wednesday, Prevention Action returns to the far reaching recommendations of the report, setting out the implications for research, US Federal and state policy, clinical practice and the promotion of effective prevention strategies. The effects of the economic crisis combining with the outlook of the Obama administration mean the report is likely to be taken seriously.There will be public discussion of the report on Wednesday in the Lecture Room of the National Academy in Washington, DC. Details about how readers can join the meeting in person or via the internet are given below. A summary of the day's discussions will be published on Thursday. We end the week with more comments on the report from around the world.• To be part of the discussion of the report on March 25 join the debate in person or join the debate online. It runs from 1:00-5:00pm EST (5.00-9.00pm GMT) on Wednesday in the Lecture Room of the National Academy of Sciences at 2101 C Street, NW in Washington, DC. Register at National Academies.• Get copies of the report from The National Academies Press or by telephone from (+1-202-334-3313 or +1-800-624-6242) or from [For more on the prevention investment argument, see We can't prevent conduct disorder? Yes, we can]References National Research Council and Institute of Medicine of the National Academies, Preventing Mental, Emotional and Behavioral Disorders Among Young People, The National Academies Press, Washington, D.C., 2009Institute of Medicine, Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research, The National Academies Press, Washington, D.C., 1994Michaud, C.M. And colleagues, 'The burden of disease and injury in the United States', Population Health Metrics, 4, 11, 2006

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