WASHINGTON — A new report from the National Academies of Sciences, Engineering, and Medicine offers a blueprint that the U.S. can use to expand evidence-based interventions to prevent mental, emotional, and behavioral disorders and improve mental health.  

The committee that wrote the report began its study in 2023, and the report was finalized before recent major structural and workforce changes within federal health agencies were reported.   The report identifies the infrastructure — funding, workforce, data systems, governance, and partnerships — needed to successfully implement effective approaches to improve mental health in an array of settings and for people at all life stages.   Many indicators of mental and behavioral health and well-being for people living in the U.S. are worsening, the report says. Low-income communities, rural communities, and racial and ethnic minority communities are particularly affected.  

“The costs associated with our nation’s mental health and substance use crises are unbearably high, measured in lost and shattered lives of children, parents, siblings, and friends, and in lost workers, human potential, and economic productivity,” said Marcella Alsan, Angelopoulos Professor of Public Policy at Harvard Kennedy School, and co-chair of the committee.  

“But the crises individuals and communities face are often preventable. Effective prevention programs are available at every level — from equipping individuals with skills, to strengthening parenting effectiveness, to training teachers and agricultural extension workers,” she said. “We need to build systems and supports to make evidence-based interventions available to all who need them.”

Rising mental and behavioral health disorders

Research has revealed the growing incidence of many mental and behavioral disorders and their consequences:

• Suicide is the 11th leading cause of death overall (48,100 deaths in 2021), the second leading cause among people ages 10-14 and 25-34, and the third leading cause for ages 15-24. Suicide deaths have been increasing, with a slight reprieve during the pandemic, only to return to pre-pandemic levels. The U.S. suicide death rate is the highest among 10 peer nations.

• Deaths related to alcohol have increased by 29.3 percent from 2016-2017 to 2020-2021.

• Over the decade between 2011 and 2021, adolescents reporting feelings of sadness and hopelessness increased from 28 percent to 42 percent.

• The economic cost of mental illness is an estimated $282 billion annually.

• The well-being of Americans — how people evaluate their lives as a whole — has declined, placing the U.S. 23rd among other nations.

Infrastructure to expand interventions is needed

Many interventions, both programs and policies, to prevent mental, emotional, and behavioral disorders have been demonstrated to be effective, the report says. For example, school-based socioemotional learning and other prevention programs have been shown to support young people in a range of ways — improving social skills, mental health, prosocial behavior, and academic achievement, and preventing antisocial behavior and substance misuse.  

An infrastructure to support mental health through the delivery of preventive interventions already exists across government agencies at all levels, academic and other organizations that provide training and technical assistance, multiple national associations, and other components — but it is fragmented and unevenly developed, the report says.  

This infrastructure can be strengthened, coordinated, and robustly funded to close gaps and provide the interventions needed in every community, the report says. It offers numerous recommendations to federal agencies, Congress, and others to achieve this outcome.  

Examples of recommended actions:

• The National Institutes of Health, Centers for Disease Control and Prevention, and philanthropic organizations should address research gaps related to intervention development and implementation — prioritizing interventions that target inequities in emotional, mental, and behavioral health, that are needed for different age groups, and that are co-created with the populations they are intended to serve.

• The Substance Abuse and Mental Health Services Administration should manage and maintain a centralized and dynamic clearinghouse that practitioners can use to find evidence-based programs, with standard criteria for inclusion and evaluation. The clearinghouse should include information about intervention effectiveness, guidance for implementation, and a focus on prevention strategies that address the needs of diverse communities.

• Congress should consider a range of options, including increasing funding for interventions on early-life risk factors for mental, emotional, and behavioral disorders, or new funding for the main agencies of the U.S. Department of Health and Human Services that support prevention. Congress should also adopt and support the implementation of new or innovative funding mechanisms to generate sustainable and sufficient resources — for example, offering incentives such as tax credits for large-scale social impact investing that supports universal prevention.

“With resources and data, leadership and partnerships, and a number of evidence-based approaches — at the programmatic and policy levels — to draw on, our nation can do better in intervening across different settings and along the life course to promote well-being and prevent mental, emotional, and behavioral disorders,” said committee co-chair Marthe Gold, senior research scholar at the New York Academy of Medicine and the Logan Professor Emerita in the Department of Community Health and Social Medicine at the City University of New York Medical School.  

The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, engineering, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln.  

Contact:
Megan Lowry, Media Relations Manager
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202-334-2138; email news@nas.edu