Thursday, November 17, 2011

Why prevention?

OK, ok.  We are really going to do this.  Write a blog.  Regularly!  So, here we go:

It seems that a good way to launch a blog might be to start at the beginning...for us, that means prevention.  Our quest makes sense to most people—we want to prevent problem adolescent behaviors like substance abuse, suicide, violence, delinquency, school drop-out,  and unwanted teen pregnancy.  What doesn't always click for people is that we want to do this BEFORE they begin.  That means our work must begin before kids begin experimenting with drugs or alcohol, before the first attempt to end their life, before the first assault or shoplifting, before a young person drops out of school, and before a young couple stands staring at the results of the pregnancy test.

That doesn't mean that we don't recognize the need for treatment, or the importance of getting to those just starting to engage in problem behaviors.   Even if we are wildly successful in our work, there will still be some who start down the path towards where their behaviors begin to interfere with their quality of life.  Our society needs professionals and caring people to help set folks back on a path to a healthy life, and who can treat any social, emotional, or mental illness.  We believe that the entire continuum of care (to use a slightly worn phrase) is necessary—but WE focus on the end of the continuum that begins before problem behaviors are established.

In our society prevention just isn't very sexy.  In general, it seems that most people reluctantly concede that prevention makes sense...most of us go to the dentist before we get a toothache and change the oil in our car before it quits on us.  We accept the idea that good preventative dental care like brushing our teeth will help us avoid cavities and pain later.  But we suspect that not everyone reading this blog flosses their teeth regularly.  For many of us, there just isn't that sense of urgency around the need to floss—and there are just so many other things to do!

This is the real dilemma that we face in our work.  Without the evidence that something is going awry, communities often feel no urgency about taking action.  With the complexities involved in behavioral and mental health, the signals can be so subtle that even when things ARE amiss, we may not recognize it at first.  This may seem like a dismal prognosis for our work, but we do not see it as so.  The science of prevention has made huge strides in understanding the underlying causes of mental, emotional, and behavoral disorders.  We know more about the risk factors for problem adolescent behaviors and the protective factors that can buffer their negative effects.  As a society, we now know how to prevent the problems listed in our mission statement—we just aren't acting on that knowledge.

A young person in our current society is as likely to experience a mental, emotional, or behavioral disorder in their lifetime as they are to break a limb.  Here in our country somewhere between 14 and 20 percent of young people experience such a disorder at a given point in time. Research indicates that half of all lifetime cases of diagnosable mental illness in adults began by age 14, and three-fourths by age 24.  Some estimates say that 40 percent of our young people in the U.S. have had at least one psychiatric disorder by the time they are 16.  In 2006 about one in five youth between the ages of 12 and 17 had received treatment or counseling for mental, emotional, or behavioral disorders.  It is difficult to ignore the fact that these disorders are likely to affect a young person that we know.

If we know how to prevent problems AND that they are prevalent, we have two compelling reasons to act.  The first is a moral obligation...we can help our youth avoid the pain and suffering that often accompanies these illnesses and behaviors.  If we know how to help them avoid it, we should.  The second is a financial incentive...once the problems are full blown they create a tremendous burden on our public systems.  Jails and treatment programs are more expensive than preventative measures are.  For example, recent research into the use of the Communities That Care system of mobilizing a community (the one that we use) has been shown to generate a return of more than $5 for every dollar invested.  That means that for every dollar spent on mobilizing the community around healthy youth and prevention science, society can expect to spend $5 less in dealing with the problems that will emerge if we do not act. 

From our perspective prevention just makes sense.  We hope you agree.

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