This 2000 report presents a review of the literature on preventive interventions in mental health and the use of tobacco, alcohol, and the misuse of licit and illicit drugs. After an extensive search of peer-reviewed journals, 54 articles from 1964 to 1999 that demonstrate positive outcomes from preventive substance abuse and mental health interventions are summarized in this document and the authors recommend six preventative services for consideration by managed care organizations. 

From the report:

Programs and services that prevent substance abuse and mental health disorders have the potential to lessen an enormous burden of suffering and to reduce both the cost of future treatment and lost productivity at work and home. The availability and accessibility of these interventions to the millions of Americans whose health care is provided by managed care organizations depend upon the services’ status as covered benefits. At a time when cost containment is a driving force in decisions about benefits, the ability to persuade managed care enrollees to demand coverage for these preventive interventions and to encourage managed care organizations to provide them may be enhanced with evidence of their effectiveness and their positive impact on cost.

To compile and disseminate that evidence, the Offices of Managed Care in both the Center for Mental Health Services and the Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, jointly supported this review of the literature on preventive interventions to promote mental health and the use of tobacco, alcohol, and the misuse of licit and illicit drugs. After an extensive search of peer-reviewed journals, 54 articles from 1964 to 1999 that demonstrate positive outcomes from preventive substance abuse and mental health interventions are summarized in this document. The following six preventive services are recommended for consideration by managed care organizations:

• Prenatal and infancy home visits.
• Targeted cessation education and counseling for smokers, especially those who are pregnant.
• Targeted short-term mental health therapy.
• Self-care education for adults.
• Presurgical educational intervention with adults.
• Brief counseling and advice to reduce alcohol use.

While the documented state of the art is in an early stage of development, intervention research has produced solid evidence that selected preventive programs and services are associated with positive outcomes and that the cost of providing them may be offset by savings elsewhere in the health care system. As efforts to expand this knowledge base move forward, managed care stakeholders can utilize available research results to inform their decisions about coverage for and provision of interventions with the potential to prevent substance abuse and mental health disorders.

Full report: http://mentalhealth.samhsa.gov/publications/allpubs/SMA00-3437/default.asp 

U.S. Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). (2000). Special report: Preventive interventions under managed care: mental health and substance abuse services.  Dorfman, S.