SAMHSA’s Efforts Related to Prevention and Early Intervention

SAMHSA’s prevention and early intervention efforts promote informed decision making among professionals and healthy behaviors among consumers.

Strategic Prevention Framework (SPF)

SAMHSA’s SPF program is a five-step planning process that reflects a public health or community-based approach to delivering evidence-based substance abuse prevention and mental health promotion programs. The steps provide a roadmap to guide states, jurisdictions, tribes, and communities in the selection, implementation, and evaluation of effective, culturally appropriate, and sustainable prevention activities. The effectiveness of this process begins with a clear understanding of community needs and depends on the involvement of community members in all stages of the planning process. The SPF steps require a systematic approach to:

  1. Assess prevention needs based on epidemiological data
  2. Build prevention capacity
  3. Develop a strategic plan
  4. Implement effective community prevention programs, policies, and practices
  5. Evaluate efforts for outcomes

SAMHSA’s Partnerships for Success program brings the SPF to a national scale. It is designed to address two of the nation’s top prevention priorities:

  • Underage drinking among 12- to 20-year-olds
  • Prescription drug and illicit opioid misuse and abuse among 12- to 25-year-olds

Now Is The Time Initiative

SAMHSA created a continuum that includes prevention and intervention strategies as an important component to President Obama’s Now Is The Time initiative to protect America’s children, young adults, and their communities by reducing gun violence and increasing access to mental health services. This continuum includes Project Advancing Wellness and Resilience in Education (AWARE), which focuses on promoting prevention among school age youth in educational settings. The Healthy Transitions program extends this focus by creating treatment services and early intervention approaches for disconnected youth and young adults who are transitioning to adulthood.

Project AWARE

Partnering with the Departments of Education and Justice, SAMHSA has received funds to increase awareness of mental health issues and to connect young people with behavioral health issues and their families with needed treatment services. Expecting to reach 750,000 children and youth, Project AWARE has two components:

  • State Grants to build on the Safe Schools/Healthy Students State Planning and Community Pilot Program to create safe and supportive schools and communities to prevent violence, make schools safer, and increase access to mental health services
  • Mental Health First Aid (MHFA) to train teachers and other adults who interact with youth to detect and respond to mental illness in children and young adults, including how to seek treatment

Healthy Transitions

When compared with their peers, young adults (ages 18 to 25) with mental health conditions are more likely to experience homelessness, be arrested, drop out of school, and be underemployed. Mental disorders produce the greatest disability impact within this age group compared to all other chronic health conditions. Furthermore, 18- to 25-year-olds with mental health conditions are significantly less likely to receive mental health services than other adults.

SAMHSA’s Healthy Transitions program seeks to improve access to treatment and support services for youth and young adults ages 16 to 25 who have or are at risk of developing a serious mental health condition or substance use disorder.

Minority AIDS Initiative (MAI)

SAMHSA’s MAI supports efforts to increase access to substance use and HIV prevention services for the highest risk and hardest-to-serve racial and ethnic minority populations. Grantees must implement integrated, evidence-based substance use and HIV prevention interventions, including HIV testing that targets one or more high-risk population groups such as:

  • Young adults ages 18 to 24
  • African-American women
  • Adolescents
  • People who have been released from prison and jails within the past 2 years
  • Men who have sex with men

Also, MAI supports partnerships among public and private non-profit organizations to prevent and reduce the onset of substance use and transmission of HIV among high-risk populations.

For more information, go to the HIV, AIDS, and Viral Hepatitis topic.

Center for the Application of Prevention Technologies (CAPT)

The SAMHSA Center for the Application of Prevention Technologies (CAPT) is a national substance abuse prevention training and technical assistance system dedicated to strengthening prevention systems and the nation’s behavioral health workforce. CAPT’s prevention and early intervention efforts aim to help individuals make decisions and create environments that promote healthy behaviors.

Community Partnerships

CAPT identified 12 stakeholder groups as vital to the success of any community-level prevention effort. Traditional partners, including schools, law enforcement, and health care professionals, remain invaluable. But today’s continually evolving prevention landscape requires SAMHSA to “think outside the box” and reach out to new partners who can help it address emerging drug trends, access populations in greatest need, and extend the reach of its prevention efforts.

SAMHSA has submitted budget proposals to establish the Building Behavioral Health Coalitions program to support cross-fertilization among mental health and substance abuse prevention community coalitions and organizations. The program aims to expand their focus and activities to include a behavioral health approach.

Find information in SAMHSA’s National Prevention Week Toolkit to plan and hold an event to help prevent substance use and promote mental, emotional, and behavioral wellness while strengthening and creating community partnerships.

Science and Service

SAMHSA’s Service to Science (STS) is a national initiative designed to enhance the evaluation capacity of innovative programs and practices that address critical substance use prevention and related behavioral health needs. STS provides customized technical assistance that equips participants with the knowledge, tools, and skills needed to evaluate their efforts with increasing levels of methodological rigor. The program focuses on underage drinking and on the behavioral health needs of American Indians and Alaska Natives.

Screening and Early Intervention

One of the more promising developments in the field of prevention intervention is the emergence of defined screening techniques to detect behavioral health problems. When integrated into primary health care systems, school settings, and community-based programs, screening can lead to early interventions that can prevent problems from arising. For example:

  • SAMHSA’s Screening, Brief Intervention, and Referral to Treatment is a public health approach to deliver early intervention and treatment services for people with substance use disorders and those at risk of developing these disorders. Many different types of clinical settings provide opportunities for early intervention with at-risk substance users before more severe consequences occur. Since SAMHSA initiated the program in fiscal year 2003, more than 2 million individuals have been screened. Of those, 19% required a brief intervention, brief treatment, or referral to specialty treatment programs.
  • SAMHSA provides several screening and assessment tools for mental and/or substance use disorders and co-occurring disorders, and guidelines for screening and assessing teens for alcohol and drug use issues.
  • Addressing trauma is an important component of effective behavioral health service delivery. Research has shown that trauma, if not addressed, significantly increases the risk of mental and/or substance use disorders, chronic physical diseases, and early death. To meet this need, SAMHSA has proposed a new program line, Grants for Adult Trauma Screening and Brief Intervention.

Underage Drinking

Of the nearly 440,000 drug abuse-related emergency visits made by patients aged 20 or younger, more than 40% involved alcohol, according to SAMHSA’s 2011 Drug Abuse Warning Network (DAWN) Report. Research shows that parents are the leading influence when it comes to their children’s decisions about alcohol. Yet, many parents of teens continue to underestimate the extent of alcohol used by youth.

Talk. They Hear You.” SAMHSA’s underage drinking prevention campaign, encourages parents and caregivers to start talking to their children as early as nine years old about the dangers of alcohol. The Too Smart to Start program works with communities on the local level to promote underage alcohol use prevention messages to influence the attitudes and behaviors of youth, their parents, and the broader community.

Learn about Strategies to Prevent Binge or Heavy Episodic Drinking Among Adolescents and Young Adults – 2015. Also, review a Report to Congress on the Prevention and Reduction of Underage Drinking – 2013 and the 2012 Town Hall Meetings: Mobilizing Communities to Prevent and Reduce Underage Alcohol Use.

For more information, go to the Underage Drinking topic.

Sober Truth on Preventing Underage Drinking Act (STOP Act)

Results from SAMHSA’s 2013 National Survey on Drug Use and Health show that, nationwide, 36.6% of the estimated 8.7 million underage drinkers were provided free alcohol by adults 21 or older. The STOP Act of 2006 was the nation’s first comprehensive legislation on underage drinking. One major component is the grant program, which provides additional funds to current or former grantees under the Drug Free Communities Act of 1997 to prevent and reduce alcohol use among youth ages 12-20. Another component is the National Adult-Oriented Media Public Service Campaign, which educates parents on how to speak with their 9- to 15-year-olds about underage drinking—visit SAMHSA’s “Talk. They Hear You.” campaign. The third component is the federal Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD), which provides high-level leadership from SAMHSA and other federal agencies to coordinate federal efforts to prevent and reduce underage drinking and is responsible for the annual report to Congress. For more information, visit the Stop Underage Drinking website, the interagency portal on underage drinking prevention.

Prescription Drug Misuse and Abuse

Pain relievers accounted for 46% of the more than 1.2 million emergency department visits involving nonmedical use of prescription medicines, over-the-counter drugs (OTC), and other types of pharmaceuticals.

According to a 2013 Monitoring the Future survey, prescription drugs are the second most abused category of drugs among youth. Further, older adults are among those most vulnerable to medication misuse and abuse because they use more prescription and OTC medications than other age groups.

Learn more about Strategies to Prevent the Non-Medical Use of Prescription Drugs – 2013 (PDF | 1.7 MB).

For more information, go to the Prescription Drug Misuse and Abuse and Alcohol, Tobacco, and Other Drugs topics.


The Drug Abuse Warning Network (DAWN) estimated more than 200,000 emergency visits resulting from drug-related suicide attempts in 2011, with almost all involving a prescription drug or over-the-counter medication. Also, more than 80% of patients attempting suicide had some form of follow-up after the emergency department visit. In addition, suicidal thoughts are a significant concern, since having serious thoughts of suicide increases the risk of a person making an actual suicide attempt. There are at least 25 attempted suicides for each suicide death. In 2012, an estimated 9 million adults (3.9%) aged 18 or older had serious thoughts of suicide in the past year.

SAMHSA’s Suicide Prevention Resource Center (SPRC) is a national center that helps advance suicide prevention efforts in states, tribal communities, campus organizations and coalitions, and organizations that serve populations with high suicide rates. SPRC also provides technical assistance training and resource materials. Learn about the Garrett Lee Smith Suicide Prevention Program and how SAMHSA is helping grantees implement the 2012 National Strategy for Suicide Prevention. In addition, SAMHSA supports the National Suicide Prevention Lifeline, 1-800-273-TALK (8255).

For more information, visit the Suicide Prevention topic.

Mandatory Drug Testing

The Federal Drug-Free Workplace Program, as mandated by Executive Order 12564 and Public Law 100-71, is a comprehensive program to address:

  • Illicit drug use by federal employees
  • Certification of drug-free workplace plans
  • Identification of safety-sensitive positions subject to random drug testing

SAMHSA’s Division of Workplace Programs has oversight responsibility of the Department of Health and Human Services’ (HHS) certified laboratories operating under the Mandatory Guidelines for Federal Workplace Drug Testing Programs requirements. The HHS-certified laboratories conduct forensic drug testing for federal agencies, under Executive Order 12564 and Public Law 100-71, and specific, federally regulated industries. Both of these are critical public health and safety programs ensuring that individuals in sensitive and safety-related federal positions are not using illegal drugs and that drug testing laboratories produce accurate results.

National Prevention Week and National Prevention Day

National Prevention Week is a SAMHSA-supported annual health observance dedicated to increasing public awareness of, and action around, substance abuse and mental health issues. During National Prevention Week, community organizations across the country host health fairs, block parties, educational assemblies, town hall meetings, memorial walks, social media campaigns, and outdoor events. National Prevention Week 2015 will take place May 17-23, 2015.

SAMHSA’s 10th National Prevention Day took place on February 3, 2014. Prevention Day provides a forum for participants to share best practices, experiences, and information specific to the prevention of substance abuse and the promotion of mental health, as well as to network with other grantees and partners.

Last Updated: 01/20/2017