Note: For those of you reading this post for the first time as a part of Friday Update, 7-10-15, know that the original post was written 5-1-14. We are featuring the original post again, as we have received a number of requests for some of the more popular background posts written about HR 3717 that are still relevant to current discussions about H.R. 2646.

Morning Zen Guest Blogger ~ Dennis Embry

Note: This post was originally sent to the Wall Street Journal as a response to an editorial that focused on HR 3717 – The Helping Families in Mental Health Crisis Act. As this response has not yet been published in the Wall Street Journal, Dr. Embry has given the Children’s Mental Health Network permission to feature it on our website as a Morning Zen post. We are most happy to continue the growth of knowledge about effective strategies for meeting the needs of youth with emotional challenges and their families. 

Mental, Emotional, and Behavioral Disorders Are Preventable. Letter to the Wall Street Journal Signed by 23 Leading Prevention Scientists
The Wall Street Journal editorial of April 1, 2014 (The Definition of Insanity) stated, “…there is no known way to prevent severe mental illness.” This statement is scientifically and verifiably false, easily established by the scores of gold-standard, randomized control studies indexed in the US National Library of Medicine (www.pubmed.gov). These are studies funded by the National Institutes of Health, the Centers for Disease Control and Prevention, private foundations, or comparable entities in OECD countries. Many of these prevention studies include long-term, randomized control follow-up from five to twenty years later, much longer than any preserved randomized psychotropic medication study published at pubmed.gov.

Further, the highest independent entities for such issues in the United States – the National Research Council and the Institute of Medicine (both chartered by Congress in 1863) – issued a significant and influential report in 2009, Preventing Mental, Emotional, and Behavioral Disorders Among Young People.(1) Page 1 of that report, which is based on an extensive review of the scientific literature, concludes unequivocally that several evidence-based practices are available now to prevent or delay mental illnesses among children and adolescents. The report then reviews the relevant literature for each developmental phase and setting (e.g., family, school, community) of the nation’s young people.

The signatories of this letter are among the scientists whose work has shown in gold-standard, randomized longitudinal control studies to prevent, avert, or reduce one or more than one mental illness, including members of the IOM Committee issuing the finding that mental illnesses are preventable. We note that one of the witnesses at Congressman Murphy’s hearings was Dr. E. Fuller Torrey, who is the Executive Director of the Stanley Medical Research Institute that funded the first randomized, longitudinal trial to prevent first episode psychosis(2)—the proximal condition that triggered the events in Tucson, Virginia Tech, and Aurora. That study was published in the Archives of General Psychiatry, an official publication of the American Medical Association. There are replications already happening. Other gold-standard studies protect against or prevent the much earlier predictors of serious mental illness and, then in turn, can prevent serious conditions in later life.

The editorial misses the verifiable fact that scores of strategies on the National Registry of Evidence-Based Programs and Practices (operated by the Substance Abuse and Mental Health Services Administration) are proven to prevent, reduce, treat, and even help people recover from serious mental, emotional, or behavioral disorders. Many of the same practices can be found on the list of the non-partisan, independent Coalition for Evidence Based Policy. Sadly, members of Congress, Governors, state legislators, mayors and families across America have scant awareness any of these rigorously proven preventive strategies, which are well documented to collectively save local, state, and the federal governments billions by the independent analyses from the Washington State Institute for Public Policy.

Other countries have lower prevalence rates of mental, emotional, and behavioral disorders, perhaps because they are using the prevention science that United States citizens developed, U.S. taxpayers and foundations funded. A front-page article in the WSJ on December 28, 2010(3) pointed out that 40 million out of 75 million young people in the US had at least one prescription for a psychotropic medication, suggesting we cannot treat our way out of the epidemic. We cordially invite the Wall Street Journal to have its excellent reporters create a series of articles based on the world-class, gold-standard science that can prevent, reduce, or avert mental, emotional, and behavioral disorders that are now epidemic in the United States.

Signatories:

• Abigail Gewirtz, Ph.D., L.P., Associate Professor, Institute of Child Development, University of Minnesota, St. Paul, MN
• Anthony Biglan, Ph.D., Senior Scientist, Oregon Research Institute, Eugene, OR
• Aysenil Belger, Ph.D., Professor and Director, Neuroimaging Research, Department of Psychiatry, University of North Carolina, Chapel Hill, NC
• Bill Beardslee, M.D., Director, Baer Prevention Initiatives, Department of Psychiatry, Boston Children’s Hospital, Boston, MA
• Daniel Shaw, Ph.D., Chair/Professor, Department of Psychology, University of Pittsburgh, Pittsburg, PA
• David Shern, Ph.D., President/CEO, Mental Health America, Alexandria, VA
• Dennis D. Embry, Ph.D., President/Senior Scientist, PAXIS Institute, Tucson, AZ
• Diana Fishbein, Ph.D., Director/Professor, Center for Translational Research on Adversity, Neurodevelopment and Substance abuse (C-TRANS), Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
• Emilie Phillips Smith, Ph.D., Professor, Human Development and Family Studies, Pennsylvania State University, University Park, PA
• Faith Elizabeth Fuller MBA, President of Financial, Analytic, and Strategic Services for Nonprofit and Government Agencies, Berkeley CA
• Hanno Petras, Ph.D., Chief Methodologist, JBS International, North Bethesda, MD
• Holly C. Wilcox, Ph.D. Associate Professor, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
• Irwin Sandler, Ph.D., Professor, Department of Clinical Psychology, Arizona State University, Tempe, AZ
• Liepa Boberiene, Ph.D., Washington Liaison, American Orthopsychiatric Association, Washington, DC
• Linda A. Randolph, MD, MPH, President and CEO, Developing Families Center, Inc., Washington, DC
• Mark T. Greenberg, Ph.D. Director, Prevention Research Center, Penn State University, University Park, PA
• Mimi M. Kim, Ph.D., Research Investigator, Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC
• Nicholas Ialongo, Ph.D., Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
• Ricardo F. Muñoz, Ph.D., Professor, Department of Psychology & Psychiatry, University of California, San Francisco, CA
• Ron Prinz, Ph.D., Carolina Distinguished Professor, Psychology Department, University of South Carolina, Columbia, SC
• Teresa LaFromboise, Ph.D., Professor, Development and Psychological Sciences, Graduate School of Education, Stanford University, Stanford, CA
• Ty Ridenour, Ph.D., M.P.E., Research Associate, Division of Behavioral Health and Criminal Justice Research, Research Triangle Institute International
• Yi-Yuan Tang, Ph.D., Professor/Director, Texas Tech Neuroimaging Institute, Department of Psychology, Texas Tech University, Lubbock, TX

References Cited

• National Research Council & Institute of Medicine (2009). Preventing mental, emotional, and behavioral disorders among young people: progress and possibilities. Washington, DC: National Academies of Science, pp. 576.
• Amminger, G. P., Schäfer, M. R., Papageorgiou, K., Klier, C. M., Cotton, S. M., Harrigan, S. M., … & Berger, G. E. (2010). Long-chain ω-3 fatty acids for indicated prevention of psychotic disorders: a randomized, placebo-controlled trial. Archives of General Psychiatry, 67, 146-154.
• Mathews, A. W. (2010, December 28). So young and so many pills: More than 25% of kids and teens in the U.S. take prescriptions on a regular basis, Wall Street Journal.

Dennis D. Embry, Ph.D., is a prominent prevention scientist in the United States and Canada, trained as clinician  and developmental and child psychologist. He is president/senior scientist at PAXIS Institute in Tucson and co-investigator at Johns Hopkins University and the Manitoba Centre for Health Policy. His work and that of colleagues is cited in 2009 the Institute of Medicine Report on The Prevention of Mental, Emotional, and Behavioral Disorders Among Young People. Clinically his work has focused on children and adults with serious mental illnesses. He was responsible for drafting of the letter signed by  23 scientists, who collectively represent scores of randomized prevention trials of mental illnesses published in leading scientific journals. In March 2014, his work and the work of several signatories was featured in a Prime-TV special on the Canadian Broadcast Corporation on the prevention of mental illnesses among children—which have become epidemic in North America.