March 19, 1999

Last year's National Advisory Mental Health Council Workgroup Report on Mental Disorders Prevention Research put forward the following recommendations:

1. Adopt an expanded definition of prevention research. NIMH should expand risk-factor research to encompass biological, psychological, and sociocultural factors; extend preventive intervention and service-level research to include prevention of relapse, comorbidity, and disability; and emphasize the importance of integration across pre-intervention, preventive intervention, and preventive services research.



2. Strengthen epidemiologic foundations of prevention research. NIMH must invest in obtaining information about prevalence and incidence of mental disorders in the U.S. population across the life span and the factors that contribute to their onset and course.



3. Stimulate pre-intervention and intervention studies of early childhood risks for adverse developmental outcomes. NIMH should encourage pre-intervention studies of prenatal, perinatal, and early-life risk and protective factors that are relevant to a variety of negative mental health outcomes in childhood, adolescence, and adulthood.



4. Expand research on depression and anxiety across the life span. NIMH should facilitate rapid progress in research on the prevention of depression and anxiety disorders in children, adolescents, and adults, using a wide range of strategies.



5. Refine and advance the empirical basis for conduct disorder prevention research. NIMH should integrate a growing body of basic research on the biological, psychosocial, and environmental roots of conduct disorder and its correlates and foster the inclusion of multiple risk indicators in prevention trials of conduct disorder.



6. Broaden disorders and populations targeted for prevention research. NIMH should expand the scope of disorders targeted for intervention; stimulate studies for reducing relapse; and increase preventive interventions with larger social units, such as families, peers, schools, and communities.



7. Expand studies on comorbidity prevention. NIMH should sponsor a research effort to identify risk and protective factors for co-occurring illnesses, with particular attention to the links between mental and substance-abuse disorders, and between mental and physical disorders.



8. Develop a program of preventive services, including prevention policy research. Given the paucity of preventive services research in the NIMH portfolio, NIMH should provide both the staffing and financial resources needed to stimulate and nurture a new research area of preventive services.



9. Encourage and support long-term follow-up in prevention research. NIMH should facilitate essential longitudinal follow-up in prevention research through appropriate grant review and funding mechanisms.



10. Build prevention research capacity, especially through training grants. NIMH training grants should provide support for the training infrastructure, such as salaries for training directors and increased training-related expenses.