IOM Calls for National Focus on Prevention Among Youths

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

The 526-page report, Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities, updates the landmark 1994 IOM report on prevention, Reducing Risks for Mental Disorders, which focused on the entire life span. In the past 15 years, research has shown that half of all lifetime psychiatric disorders begin before age 14 and three-fourths begin by age 25, and research on risk factors among children and adolescents has burgeoned. The authors of the new report, which cites more than 1,500 references and includes an appendix listing 45 meta-analyses, were tasked with reviewing this large body of research, as well as findings from prevention intervention research, developmental neuroscience, cost-benefit analyses, and implementation-dissemination studies. The report describes methodological advances in prevention research and outlines key components of a prevention infrastructure.

Specific prevention practices that have emerged in a variety of settings, including schools, primary care, and community services, are highlighted. Such programs could be implemented more broadly, but currently there is no clear federal presence to lead these efforts. The report calls on the White House to create an entity to lead a broad implementation of evidence-based prevention approaches and to fund research. The Departments of Education, Justice, and Health and Human Services should align their resources and programs with this strategy, and the National Institutes of Health should develop a ten-year research plan. All agencies that fund research should establish equality between prevention and treatment research; currently, the balance is weighted toward research on treatment, the report notes. No agency should support programs that lack empirical evidence, even if they have community endorsement.

The report was sponsored by the Substance Abuse and Mental Health Services Administration, the National Institute on Drug Abuse, the National Institute of Mental Health, and the National Institute on Alcohol Abuse and Alcoholism. The full report is available on the IOM Web site at www.iom.edu .