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SAMHSA News - November/December 2007, Volume 15, Number 6

Mental Health Report to Congress

Focus on Promotion, Prevention

A new SAMHSA report to Congress promotes the use of research-based approaches that enhance parenting support skills and child resilience-even in the face of adversity.

Promotion and Prevention in Mental Health: Strengthening Parenting and Enhancing Child Resilience emphasizes that these proactive approaches help prevent mental health problems from developing or can greatly mitigate them if they do occur-especially among children and youth.

Written by SAMHSA's Center for Mental Health Services, the report is a response to a request from the Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education.

SAMHSA Administrator Terry L. Cline, Ph.D., announced the report before the 23rd Annual Rosalynn Carter Symposium on Mental Health Policy in Atlanta, GA.

Dr. Cline noted that the report's recommendations advance the growing medical consensus that mental health needs must be aggressively addressed early in life in order to fully promote the Nation's public health interests.

In the report, SAMHSA identifies opportunities and makes recommendations on how to expand these programs to reach and assist families in need. Those recommendations include:

  • Communicate the economic and social benefits of prevention.

  • Ensure families help make decisions about programs, from the planning phase through the evaluation phase.

  • Provide family members, caregivers, community leaders, and educators with the latest knowledge for strengthening parenting and building child resilience so that informed decisions about appropriate interventions can be made easily.

  • Assemble a workforce capable of effectively using age- and culturally appropriate evidence-based practices.

  • Build on existing programs to maximize available knowledge and resources.

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A Public Health Approach

"Mental health is everyone's responsibility" is a message at the core of the public health approach. Focusing promotion and prevention efforts on children and their parents increases the likelihood that mental health problems will be addressed before they evolve into serious mental illnesses.

Statistics show, according to the SAMHSA report, that half of all diagnosable mental illnesses begin by age 14, and three-fourths of all lifetime cases start by age 24.

Accordingly, the report says promotion and prevention programs should include families, schools, primary health care, juvenile justice, child welfare, and substance abuse services.

Furthermore, successful promotion and prevention efforts hinge on the identification of risk and protective factors (see Risk and Protective Factors). Left untreated, behavioral problems in young children can lead to conditions such as substance abuse, delinquency, and violence.

Parents and caregivers are more likely to be involved in services if services are provided in accessible settings-such as in schools or doctors' offices-and if they are culturally appropriate.

In short, addressing the needs and issues of parents and primary caregivers increases the potential for positive outcomes for children's mental health.

While many evidence-based prevention programs already exist, according to the report, the critical next step is for more communities to engage into a broad-based effort to put these programs into action.

To access the report online, visit SAMHSA's Web site at For a free print copy, call SAMHSA's Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727). Request inventory number SMA07-0186.


Risk and Protective Factors

Promoting resilience in children includes building awareness of the complex interaction of risk and protective factors that affect mental wellness or mental illness in children. These factors include the following:

Risk factors

  • Poor social skills

  • Family poverty

  • Classroom aggression

  • Harsh or ineffective parenting skills.

Protective factors

For an individual:

  • Positive temperament

  • Self-confidence

  • Sense of identity.

For a family:

  • Parenting that's structured and caring

  • Connections with supportive family networks

  • Recognition for accomplishments.

For more information on children's mental health, read SAMHSA News online, May/June 2007, and visit SAMHSA's Web site at


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