Stronger effort needed to prevent mental, emotional, and behavioral disorders in young people

Feb 13, 2009

The federal government should make preventing mental, emotional, and behavioral disorders and promoting mental health in young people a national priority, says a new report from the National Research Council and Institute of Medicine. These disorders -- which include depression, anxiety, conduct disorder, and substance abuse -- are about as common as fractured limbs in children and adolescents. Collectively, they take a tremendous toll on the well-being of young people and their families, costing the U.S. an estimated $247 billion annually, the report says.

Research has shown that a number of programs are effective at preventing these problems and promoting mental health, the report says. Such programs could be implemented more broadly, but currently there is no clear federal presence to lead these efforts. The White House should create an entity that can coordinate agency initiatives in this area, set public goals for prevention, and provide needed research and funding to achieve them, said the committee that wrote the report.

"There is a substantial gap between what is known about preventing mental, emotional, and behavioral disorders and what is actually being done," said Kenneth E. Warner, committee chair and dean of the University of Michigan School of Public Health. "It is no longer accurate to argue that these disorders can never be prevented. Many can. The nation is well-positioned to equip young people with the skills and habits needed to live healthy, happy, and productive lives in caring relationships. But we need to develop the systems to deliver effective prevention programs to a far wider group of children and adolescents."

Most mental, emotional, and behavioral disorders have their roots in childhood and adolescence, the report notes. Among adults who have experienced these disorders, more than half report the onset as occurring in childhood or early adolescence. In any given year, an estimated 14 percent to 20 percent of young people have one of these disorders.

First symptoms typically occur two to four years before the onset of a full-blown disorder - creating a window of opportunity when preventive programs might make a difference, the report says. And some programs have shown effectiveness at preventing specific disorders in at-risk groups. For example, the Clarke Cognitive-Behavioral Prevention Intervention, which focuses on helping adolescents at risk for depression learn to cope with stress, has prevented episodes of major depression in several controlled experiments.

Other programs have demonstrated broader preventive effects in general populations of young people, the report says. Programs that can be offered in family or educational settings show particular promise in promoting mental health and addressing major risk factors.

One example of an effective school-based program is the Good Behavior Game, which divides elementary school classes into teams and reinforces desirable behaviors with rewards such as extra free time and other privileges. Studies have shown that the program significantly reduces aggressive and disruptive behavior during first grade. The one-year intervention also has benefits over the long term, lowering the students' risk of alcohol and drug abuse, as well as rates of suicidal thoughts and attempts. And it significantly reduces the likelihood that highly aggressive boys will be diagnosed with antisocial personality disorder as adults. Research has shown that programs that focus on enhancing social and emotional skills can also improve students' academic performance, the report notes.

Still other programs improve children's mental health and behavior by enhancing parenting skills, the report says. The Positive Parenting Program, for example, uses a range of approaches, from a television series on how to handle common child-rearing problems to in-person skills training for parents struggling to handle children's aggressiveness or lack of cooperation. These methods have been shown to lower kids' disruptive behaviors, a positive change that persisted one year later.

The report recommends that the White House create an entity to lead a broad implementation of evidence-based prevention approaches and to direct research on interventions. The new leadership body should set public goals for preventing specific disorders and promoting mental health and provide the funding to achieve them. The departments of Education, Justice, and Health and Human Services should align their resources and programs with this strategy. These agencies should also fund state, county, and community efforts to implement and improve evidence-based programs. At the same time, the report cautions, federal and state agencies should not support programs that lack empirical evidence, even if they have community endorsement.

The committee also urged continued research to build understanding of what interventions work for whom and when, and how best to implement them. The National Institutes of Health should develop a comprehensive 10-year plan to research ways to promote mental health and prevent mental, emotional, and behavioral disorders in young people. In addition, agencies and foundations should establish equality in research funding between ways to prevent mental and behavioral disorders and ways to treat these problems, the report says; currently, the balance is weighted toward research on treatment.

The report also discusses screening programs that attempt to identify children with risk factors for mental, emotional, or behavioral disorders. Screening can be helpful for targeting interventions, but it should be used only if it meets certain criteria, including that the disorders to be prevented are a serious threat to mental health and that there is an effective intervention to address the risks or early symptoms. Parents should be given detailed information about the purpose and methods of screening, and the wishes of those who don't want their children included should be respected. Without community acceptance and sufficient capacity to respond to the needs identified, screening is of limited value, the committee noted. It added that approaches to connecting screening with specific interventions need to be tested.

Source: National Academy of Sciences

Explore further: CDC charges Johns Hopkins to lead development of Ebola training module

add to favorites email to friend print save as pdf

Related Stories

Can sexting be an illness? Experts are split

Jun 15, 2011

(AP) -- Married men sometimes behave badly. They covet. They flirt. They philander. And when they get caught, they occasionally adopt the insanity defense, telling spouses that an inner demon made them lose ...

Indian youth suicide crisis baffles

Mar 21, 2011

(AP) -- Chelle Rose Follette fashioned a noose with her pajamas, tying one end to a closet rod and the other around her neck. When her mother entered the bedroom to put away laundry, she found the 13-year-old ...

Recommended for you

Study reveals state of crisis in Canadian foster care system

Oct 24, 2014

A new study of foster care in Canada led by a researcher at Western University reveals a shrinking number of foster care providers are available across the country to care for a growing number of children with increasingly ...

Researchers prove the benefits of persimmons for diet

Oct 24, 2014

Alba Mir and Ana Domingo, researchers from the Department of Analytical Chemistry of the University of Valencia, under the supervision of professors Miguel de la Guardia and Maria Luisa Cervera, from the same department, ...

Hand blenders used for cooking can emit persistent chemicals

Oct 24, 2014

Eight out of twelve tested models of hand blenders are leaking chlorinated paraffins when used according to the suppliers' instructions. This is revealed in a report from Stockholm University where researchers analyzed a ...

User comments : 2

Adjust slider to filter visible comments by rank

Display comments: newest first

AMMBD
1 / 5 (1) Mar 02, 2009
none of these good ideas are going to work unless mental health insurance is treated the same as physical health insurance. you just try to get help when you needed & see how far (not) you get.
Arkaleus
not rated yet Mar 09, 2009
This is the kind of reasoning that happens when you transfigure a failure of parenting into a medical condition.

If a person is psychotic because of a brain disorder, that's one thing, but for otherwise normal and healthy children to end up with mental health issues is not a medical issue - it's a social and personal failure of those who raised them.

Do you really think our culture is able to successfully raise healthy minds? Does your definition of a healthy mind even make sense? If you can't answer these questions, then you shouldn't have children:

"What nature is best, and why?"

"What nature do I want my child to have?"

"What is the best way for me to develop the desired nature into my child?"

If we raise children to be nothing but pleasure drones for a consumer culture, then the derranged and degenerate progeny of that plan is going to inherit our society and reshape it to resemble themselves. Good luck with that.