Nat'l Experts Meeting: From Science to Practice, Taking Behavioral Health Prevention and Promotion to Scale

Taking behavioral health promotion to national scale

SAMSHA, December 9, 2010

Dennis D. Embry, Ph.D.senior scientist/president

PAXIS Institute

1Thursday, December 9, 2010

Key messages…

MEB’s are preventable.

Break-even for MEB

prevention is one year.

MEB prevention

improves US business.

Effective MEB prevention

helps national security.

MEB prevention

helps US global success.

MEB prevention

balances gov’t budgets.

MEB prevention saves Social Security & Medicare.

MEB prevention heals past inequities.


Use personalized

business models to

communicate to cost-efficiency and benefits.

Allow decision makers and advocates to adjust cost

savings to their location.

Key message by showing dollar benefits

Show short-term benefits



Show long-term benefits, too


Show multiple outcomes to unite

stakeholders

Allow people to see benefits of universal access versus

rationing of prevention

Show costs of doing nothing

Show break-even point and ROI over short,

medium and long term



Key message by showing clear visual results

Why not help our serious at-risk children with omega-3 to prevent psychosis? 0%

6%

12%

18%

24%

30%

PsychosisOmega-3 Placeo

27.5%

4.9%

Per

cent

age

with

Psy

chos

is a

t 12

mon

ths

This cost $12 to

achieve

See p.214, IOM Report

Amminger, G. P., M. R. Schafer, et al. (2010). "Long-Chain {omega}-3 Fatty Acids for Indicated Prevention of Psychotic Disorders: A Randomized, Placebo-Controlled Trial." Arch Gen Psychiatry 67(2): 146-154.


Reaching the faithful๏ Tell stories of how faith-based groups can use

IOM cited prevention strategies

๏ Pastor Smith uses Triple P to counsel his parishioners having common problems with their children. “It’s very easy for me to relate Triple P strategies to Scripture.”

๏ St. John’s uses the Good Behavior Game. “The Game helps us not only with behavior and academics, but also helping students understand how early Christians had to cooperate.”


Reaching businesses๏ Give examples of immediate benefits to

productivity. “Having workplace Triple P has reduced our employees having to take time off for dealing with problems of their children.”

๏ Link business competition. “Other rich democracies have extensive universal prevention, and those countries have more viable small business sector than the US.”

๏ Link to major cost of business, such as depression is now major cause of disability.


Reaching the First Peoples

๏ Link key cultural wisdom to proven science of prevention, such as:

๏ the use of omega-3 sources by virtually First Peoples—and discovered by the Arctic peoples

๏ the Good Behavior Game mimics common traditional practices of assuring cooperation among children


Reaching the right๏ Universal access enables individual

responsibility; rationing limits it.

๏ Link to accepted prevention practices like universal inoculations of childhood diseases or access to car safety seats.

๏ Link to balancing budgets, national security and global competition.


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Key message by showing global competion

All of these other rich democracies have nearly

universal access to prevention for MEBs, compared to the rationing

model in the US.

Having “fitter” employees allows these countries to have higher paying manufacturing jobs and

compete globally.


Nearly 75 percent of the nation's 17- to 24-year-olds are ineligible for service

• Medical/physical problems, 35 percent.

• Illegal drug use, 18 percent.

• Mental Category V (the lowest 10 percent of the population), 9 percent.

• Too many dependents under age 18, 6 percent.

• Criminal record, 5 percent.

Army Times, Nov 5, 2009 • www.missionreadiness.org/PAEE0609.pd


http://www.missionreadiness.org/PAEE0609.pd

http://www.missionreadiness.org/PAEE0609.pd

Reaching to the left๏ Link prevention to remedying historic

disparities such as:

๏ Good Behavior Game increases high-school graduation and college entry rates and reduces lifetime incarceration rates of inner city kids.

๏ Will help with maintaining Social Security, Medicare and Medicaid


5-Year Olds

65-Year Olds

Who are lessand less able…

Who are livinglonger though get

progressively sicker…

Requiring more wealth transfer

But elders voting to stop funds to kids

Key message by showing age dependencies


Reaching to the center๏ Emphasize that MEB’s affect every family,

every school, every neighborhood, and every business.

๏ Example: “How many of you know a reasonably OK middle class or upper class family with a child or teen with a mental illness, learning disability or addictions problem?”


Reaching state legislators, county & city leaders

๏ Show how prevention for everyone will help balance the local budget and keep it balanced over time.

๏ Show data how universal access to prevention will help the jurisdiction specifically

๏ Share such data with advocates for local emotional impact


Promote existing prevention sustainability mechanisms

Existing laws and policies have been and can be used prevent

MEB’s using featured IOM strategies such as Triple P for

parents, Good Behavior Game for teachers, and omega-3 for

children to adults.


Key message for every sector

In every communication say…

๏ Mental, emotional and behavioral disorders are preventable like most childhood diseases and childhood injuries.

๏ MEB’s harm and kill more children, youth and young adults than any childhood diseases, and the prevention of MEB’s is less expensive than childhood medical vaccines.

“Mental illness is preventable, just like many childhood diseases,tra!c injuries or even addictionsare preventable.”

“Yes, it is preventable. Read all about it, in the ‘09 IOM Report on the Prevention of Mental, Emotional, & Behavioral Disorders. We’ve been conditioned to think these were just manageable…”

O'Connell, M. E., T. Boat, et al., Eds. (2009). Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. . Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth and Young Adults: Research Advances and Promising Interventions. Washington, DC, Institute of Medicine; National Research Council.

TO READ THE IOM REPORT, GO TO: http://bit.ly/IOMPREV


My perspectiveFull disclosure as a prevention scientist and advocate

Descendent of a freed slave

Born premature, exposed to alcohol & tobacco and diagnosed

educably mentally retarded

Parents hospitalized for mental illness and die of addictions

Gay man in20-year relationship


thank youIf not not now, when…

If not us, who…


Health & Medicine

Nat'l Experts Meeting: From Science to Practice, Taking Behavioral Health Prevention and Promotion to Scale