By Thomas F. Boat and Kelly J. Kelleher, JAMA Pediatrics, June 22, 2020
Two contradictory trends have emerged over the past quarter century. New brain and behavior science fueled an explosion of evidence on the effectiveness of promotion and prevention for child mental, emotional, and behavioral health. Meanwhile, young people in the US increasingly are identified as experiencing depression, anxiety, and other behavioral disorders. Increases of youth self-harm,1 use of emergency departments and inpatient care for psychiatric crises, and a flood of students seeking assistance for anxiety in counseling services2 underscore the depth of the problem, which contrasts starkly with results of research documenting better outcomes with prevention programs.
In response, the National Academies of Sciences, Engineering, and Medicine assembled a consensus committee to assess the evidence for promoting healthy mental, emotional, and behavioral development and preventing risks and to make recommendations for identifying and implementing more effective programs and policies for children and youth. The report3 was released September 2019 and notes multifaceted contributions to concerning outcomes including social and economic adversities; documents the lack of systematic implementation of existing strategies for fostering healthy mental, emotional, and behavioral development; and provides recommendations for more effective strategies and interventions to counter concerning trends. Recognizing that a previous focus on evidence-based prevention programs4 was insufficient to address rapid changes in family, community, technology, and other factors affecting children, the committee came to the conclusion that multisector efforts to promote healthy development, along with better implementation of prevention, is required to stem the tide of behavioral disorders. Further, the committee concluded that multisector strategies must be delivered across populations with an emphasis on community-level work and a life-course approach, beginning with preconception health. The report viewed child health care, along with the education system, as key venues for universally delivering programs that foster healthy mental, emotional, and behavioral development.
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