Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders (2025)

Chapter: Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine

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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Appendix E

Related Reports of the National Academies of Sciences, Engineering, and Medicine

This appendix is a list of recent report recommendations relevant to preventing mental, emotional, and behavioral (MEB) disorders and promoting MEB health and well-being, including those related to interventions and the broader infrastructure for delivering interventions. This table adapts and expands a similar appendix that can be found in Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth (2019).

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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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TABLE E-1 Select Relevant Recommendations, Conclusions, and Messages

Reducing Suicide: A National Imperative (2002)
Recommendation 1. The National Institute of Mental Health (in collaboration with other agencies) should develop and support a national network of suicide research Population Laboratories devoted to interdisciplinary research on suicide and suicide prevention across the life cycle
Recommendation 2: National monitoring of suicide and suicidality should be improved. Steps toward improvement should include the following:
  • Funding agencies (including NIMH, NIA, NICHD, NIDA, NIAAA, CDC, SAMHSA, and DVA) should encourage that measures of suicidality (e.g., attempts) be included in all large and/or long-term studies of health behaviors, mental health interventions, and genetic studies of mental disorder. Funding agencies should issue program announcements for supplements to ongoing longitudinal studies to include the collection and analysis of these additional measures.
  • Suicidal patients should be included in clinical trials when appropriate safeguards are in place.
  • A national suicide attempt surveillance system should be developed and coordinated through the CDC.
  • Federal funding should be provided to support a surveillance system such as the National Violent Death Reporting System that includes data on mortality from suicide.
Recommendation 3: Because primary care providers are often the first and only medical contact of suicidal patients, tools for recognition and screening of patients should be developed and disseminated.
Recommendation 4: Programs for suicide prevention should be developed, tested, expanded, and implemented through funding from appropriate agencies including NIMH, DVA, CDC, and SAMHSA.
Community Programs to Promote Youth Development (2002)
Recommendation 1: Community programs for youth should be based on a developmental framework that supports the acquisition of personal and social assets in an environment, and through activities, that promote both current adolescent well-being and future successful transitions to adulthood.
Recommendation 2: Communities should provide an ample array of program opportunities that appeal to and meet the needs of diverse youth, and should do so through local entities that can coordinate such work across the entire community. Particular attention should be placed on programs for disadvantaged and underserved youth.
Recommendation 3: To increase the likelihood that an ample array of program opportunities will be available, communities should put in place some locally appropriate mechanism for monitoring the availability, accessibility, and quality of programs for youth in their community.
Recommendation 4: Private and public funders should provide the resources needed at the community level to develop and support community- wide programming that is orderly, coordinated, and evaluated in reasonable ways. In addition to support at the community level, this is likely to involve support for intermediary organizations and collaborative teams that include researchers, practitioners, funders, and policy makers.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Recommendation 5: Federal agencies that fund research on adolescent health, development, and well-being, such as the Department of Health and Human Services, the Department of Justice, and the Department of Education, should build into their portfolios new or more comprehensive longitudinal and experimental research on the personal and social assets needed to promote the healthy development and well-being of adolescents and to promote the successful transition from childhood through adolescence and into adulthood.
Recommendation 6: Public and private funders should support research on whether the features of positive developmental settings identified in this report are the most important features of community programs for youth. This research should encourage program design and implementation that meets the diverse needs of an increasingly heterogeneous population of youth.
Recommendation 7: All community programs for youth should undergo evaluation—possibly multiple evaluations—to improve design and implementation, to create accountability, and to assess outcomes and impacts. For any given evaluation, the scope and the rigor should be appropriately calibrated to the attributes of the program, the available resources, and the goals of the evaluation.
Recommendation 8: Funders should provide the necessary funds for evaluation. In many cases, this will involve support for collaborative teams of researchers, evaluators, theoreticians, policy makers, and practitioners to ensure that programs are well designed initially and then evaluated in the most appropriate way.
Recommendation 10: Public and private funders should support collaboration between researchers and the practice community to develop social indicator data that build understanding of how programs are implemented and improve the ability to monitor programs. Collaborative efforts would further the understanding of the relationship between program features and positive developmental outcomes among young people.
Recommendation 11: Public and private funders should provide opportunities for individual programs and communities to increase their capacity to collect and use social indicator data. This requires better training for program staff and more support for national and regional intermediaries that provide technical assistance in a variety of ways, including Internet-based systems.
Reducing Underage Drinking: A Collective Responsibility (2004)
Recommendation 10-2: The U.S. Department of Health and Human Services and the U.S. Department of Education should fund only evidence-based education interventions, with priority given both to those that incorporate elements known to be effective and those that are part of comprehensive community programs.
Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities (2009)
Recommendation 13-1: The federal government should make the healthy mental, emotional, and behavioral development of young people a national priority, establish public goals for the prevention of specific [mental, emotional, and behavioral] MEB disorders and for the promotion of healthy development among young people, and provide needed research and service resources to achieve these aims.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Recommendation 13-2: The White House should create an ongoing mechanism involving federal agencies, stakeholders (including professional associations), and key researchers to develop and implement a strategic approach to the promotion of mental, emotional, and behavioral health and the prevention of MEB disorders and related problem behaviors in young people. The U.S. Departments of Health and Human Services, Education, and Justice should be accountable for coordinating and aligning their resources, programs, and initiatives with this strategic approach and for encouraging their state and local counterparts to do the same.
Recommendation 13-3: States and communities should develop networked systems to apply resources to the promotion of mental health and prevention of MEB disorders among their young people. These systems should involve individuals, families, schools, justice systems, health care systems, and relevant community-based programs. Such approaches should build on available evidence-based programs and involve local evaluators to assess the implementation process of individual programs or policies and to measure community-wide outcomes.
Recommendation 13-4: Research funders should establish parity between research on preventive interventions and treatment interventions.
Recommendation 13-5: The National Institutes of Health, with input from other funders of prevention research, should develop a comprehensive 10-year research plan targeting the promotion of mental health and prevention of both single and comorbid MEB disorders. This plan should consider current needs, opportunities for cross-disciplinary and multi-institute research, support for the necessary research infrastructure, and establishment of a mechanism for assessing and reporting progress against 10-year goals.
Funding and Implementation
Recommendation 12-1: Congress should establish a set-aside for prevention services and innovation in the Community Mental Health Services Block Grant, similar to the set-aside in the Substance Abuse Prevention and Treatment Block Grant.
Recommendation 12-2: The U.S. Departments of Health and Human Services, Education, and Justice should braid funding of research and practice so that the impact of programs and practices that are being funded by service agencies (e.g., the Substance Abuse and Mental Health Services Administration, the Office of Safe and Drug Free Schools, the Office of Juvenile Justice and Delinquency Prevention) are experimentally evaluated through research funded by other agencies (e.g., the National Institutes of Health, the Institute of Education Sciences, the National Institute of Justice). This should include developing appropriate infrastructure through which evidence-based programs and practices can be delivered and evaluated.
Recommendation 12-3: The U.S. Departments of Health and Human Services, Education, and Justice should fund states, counties, and local communities to implement and continuously improve evidence-based approaches to mental health promotion and prevention of MEB disorders in systems of care that work with young people and their families.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Recommendation 8-2: The U.S. Departments of Health and Human Services, Education, and Justice should develop strategies to identify communities with significant community-level risk factors and target resources to these communities.
Recommendation 11-4: Researchers and community organizations should form partnerships to develop evaluations of (1) adaptation of existing interventions in response to community-specific cultural characteristics; (2) preventive interventions designed based on research principles in response to community concerns; and (3) preventive interventions that have been developed in the community, have demonstrated feasibility of implementation and acceptability in that community, but lack experimental evidence of effectiveness.
Recommendation 12-4: Federal and state agencies should prioritize the use of evidence-based programs and promote the rigorous evaluation of prevention and promotion programs in a variety of settings in order to increase the knowledge base of what works, for whom, and under what conditions. The definition of evidence-based should be determined by applying established scientific criteria.
Data Collection and Monitoring
Recommendation 2-1: The U.S. Department of Health and Human Services should be required to provide (1) annual data on the prevalence of MEB disorders in young people, using an accepted current taxonomy (e.g., the Diagnostic and Statistical Manual of Mental Disorders, the International Statistical Classification of Diseases) and (2) data that can provide indicators and trends for key risk and protective factors that serve as significant predictors for MEB disorders.
Recommendation 2-2: The Substance Abuse and Mental Health Services Administration should expand its current data collection to include measures of service use across multiple agencies that work with vulnerable populations of young people.
Workforce Development
Recommendation 12-6: Training programs for relevant health (including mental health), education, and social work professionals should include prevention of MEB disorders and promotion of mental, emotional, and behavioral health. National certifying and accrediting bodies for training should set relevant standards using available evidence on identifying and managing risks and preclinical symptoms of MEB disorders.
Recommendation 12-7: The U.S. Departments of Health and Human Services, Education, and Justice should convene a national conference on training in prevention and promotion to (1) set guidelines for model prevention research and practice training programs and (2) contribute to the development of training standards for certifying trainees and accrediting prevention training programs in specific disciplines, such as health (including mental health), education, and social work.
Recommendation 12-8: Once guidelines have been developed, the U.S. Departments of Health and Human Services, Education, and Justice should set aside funds for competitive prevention training grants to support development and dissemination of model interdisciplinary training programs. Training should span creation, implementation, and evaluation of effective preventive interventions.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Continuing a Course of Rigorous Research
Recommendation 4-3: Research funders* should fund preventive intervention research on (1) risk and protective factors for specific disorders; (2) risk and protective factors that lead to multiple mental, emotional, and behavioral problems and disorders; and (3) promotion of individual, family, school, and community competencies. (*The term “research funders” is used to refer to federal agencies and foundations who fund research on mental health promotion or prevention of MEB disorders.)
Recommendation 10-1: Research funders should invest in studies that (1) aim to replicate findings from earlier trials, (2) evaluate long-term outcomes of preventive interventions across multiple outcomes (e.g., disorders, academic outcomes), and (3) test the extent to which each prevention program is effective in different race, ethnic, gender, and developmental groups.
Recommendation 12-5: The National Institutes of Health and other federal agencies should increase funding for research on prevention and promotion strategies that reduce multiple MEB disorders and that strengthen accomplishment of age-appropriate developmental tasks. High priority should be given to increasing collaboration and joint funding across institutes and across federal agencies that are responsible for separate but developmentally related outcomes (e.g., mental health, substance use, school success, contact with justice).
Recommendation 7-2: Research funders should strongly support research to improve the effectiveness of current interventions and the creation of new, more effective interventions with the goal of wide-scale implementation of these interventions.
Screening Linked to Interventions
Recommendation 8-1: Research funders should support a rigorous research agenda to develop and test community-based partnership models involving systems such as education (including preschool), primary care, and behavioral health to screen for risks and early mental, emotional, and behavioral problems and assess implementation of evidence-based preventive responses to identified needs.
Implementatione. Programs focused on preventing suicide were included, although this is arguably often tertiary prevention because it can be achieved by identifying and treating MH/SUD
Recommendation 10-2: The National Institutes of Health should be charged with developing methodologies to address major gaps in current prevention science approaches, including the study of dissemination and implementation of successful interventions.
Recommendation 11-1: Research funders should fund research and evaluation on (1) dissemination strategies designed to identify effective approaches to implementation of evidence-based programs, (2) the effectiveness of programs when implemented by communities, and (3) identification of core elements of evidence-based programs, dissemination, and institutionalization strategies that might facilitate implementation.
Recommendation 11-2: Research funders should fund research on state- or community-wide implementation of interventions to promote mental, emotional, or behavioral health or prevent MEB disorders that meet established scientific standards of effectiveness.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Adaptation
Recommendation 11-3: Research funders should prioritize the evaluation and implementation of programs to promote mental, emotional, or behavioral health or prevent MEB disorders in ethnic minority communities. Priorities should include the testing and adoption of culturally appropriate adaptations of evidence-based interventions developed in one culture to determine if they work in other cultures and encouragement of adoption when they do.
Neuroscience Linkages
Recommendation 5-1: Research funders, led by the National Institutes of Health, should dedicate more resources to formulating and testing hypotheses of the effects of genetic, environmental, and epigenetic influences on brain development across the developmental span of childhood, with a special focus on pregnancy, infancy, and early childhood.
Recommendation 5-2: Research funders, led by the National Institutes of Health, should dedicate resources to support collaborations between prevention scientists and basic and clinical developmental neuroscientists. Such collaborations should include both basic science approaches and evaluations of the effects of prevention trials on neurobiological outcomes, as well as the use of animal models to identify and test causal mechanisms and theories of pathogenesis.
Recommendation 5-3: Research funders, led by the National Institutes of Health, should fund research consortia to develop multidisciplinary teams with expertise in developmental neuroscience, developmental psychopathology, and preventive intervention science to foster translational research studies leading to more effective prevention efforts.
Economic Analyses
Recommendation 9-1: The National Institutes of Health, in consultation with government agencies, private-sector organizations, and key researchers, should develop outcome measures and guidelines for economic analyses of prevention and promotion interventions. The guidelines should be widely disseminated to relevant government agencies and foundations and to prevention researchers.
Recommendation 9-2: Funders of intervention research should incorporate guidelines and measures related to economic analysis in their program announcements and provide supplemental funding for projects that include economic analyses. Once available, supplemental funding should also be provided for projects with protocols that incorporate recommended outcome measures.
Competencies
Recommendation 4-1: Research funders, led by the National Institutes of Health, should increase funding for research on the etiology and development of competencies and healthy functioning of young people, as well as how healthy functioning protects against the development of MEB disorders.
Recommendation 4-2: The National Institutes of Health should develop measures of developmental competencies and positive mental health across developmental stages that are comparable to measures used for MEB disorders. These measures should be developed in consultation with leading research and other key stakeholders and routinely used in mental health promotion intervention studies.
Page 326 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Technology
Recommendation 7-3: Research funders should support research on the effectiveness of mass media and Internet interventions, including approaches to reducing stigma.
Other Research Gaps
Recommendation 7-4: Research funders should address significant research gaps, such as preventive interventions with adolescents and young adults, in certain high-risk groups (e.g., children with chronic diseases, children in foster care), and in primary care settings; interventions to address poverty; approaches that combine interventions at multiple developmental phases; and approaches that integrate individual, family, school, and community-level interventions.
For Researchers
Recommendation 3-1: Research and interventions on the prevention of MEB disorders should focus on interventions that occur before the onset of disorder but should be broadened to include promotion of mental, emotional, and behavioral health.
Recommendation 7-1: Prevention researchers should broaden the range of outcomes included in evaluations of prevention programs and policies to include relevant MEB disorders and related problems, as well as common positive outcomes, such as accomplishment of age-appropriate developmental tasks (e.g., school, social, and work outcomes). They should also adequately explore and report on potential iatrogenic effects.
Recommendation 9-3: Researchers should include analysis of the costs and cost-effectiveness (and whenever possible cost-benefit) of interventions in evaluations of effectiveness studies (in contrast to efficacy trials).
Recommendation 11-4: Researchers and community organizations should form partnerships to develop evaluations of (1) adaptation of existing interventions in response to community-specific cultural characteristics; (2) preventive interventions designed based on research principles in response to community concerns; and (3) preventive interventions that have been developed in the community, have demonstrated feasibility of implementation and acceptability in that community, but lack experimental evidence of effectiveness.
Adolescent Health Services: Missing Opportunities (2009)
RECOMMENDATION 3: Providers of adolescent primary care services and the payment systems that support them should make disease prevention, health promotion, and behavioral health—including early identification, management, and monitoring of current or emerging health conditions and risky behavior—a major component of routine health services.
RECOMMENDATION 4: Within communities—and with the help of public agencies—health care providers, health organizations, and community agencies should develop coordinated, linked, and interdisciplinary adolescent health services.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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RECOMMENDATION 11: The Federal Interagency Forum on Child and Family Statistics should work with federal agencies and, when possible, states to organize and disseminate data on the health and health services, including developmental and behavioral health, of adolescents. These data should encompass adolescents generally, with subreports by age, selected population characteristics, and other circumstances.
Accounting for Health and Health Care: Approaches to Measuring the Sources and Costs of Their Improvement (2010)
RECOMMENDATION 1.1: Work should proceed on two projects that are distinct but complementary in nature. One accounts for inputs and outputs in the medical care sector; the other involves developing a data system designed to track current population health and coordinate information on the determinants of health (including but not limited to medical care).
For the Public’s Health: The Role of Measurement in Action and Accountability (2011)
RECOMMENDATION 2: The committee recommends that the Department of Health and Human Services support and implement the following to integrate, align, and standardize health data and health-outcome measurement at all geographic levels:
  • A core, standardized set of indicators that can be used to assess the health of communities.
  • A core, standardized set of health-outcome indicators for national, state, and local use.
  • A summary measure of population health that can be used to estimate and track health-adjusted life expectancy for the United States.
RECOMMENDATION 3: The committee recommends that the Department of Health and Human Services produce an annual report to inform policy makers, all health system sectors, and the public about important trends and disparities in social and environmental determinants that affect health.
RECOMMENDATION 7: The committee recommends that the Department of Health and Human Services work with relevant federal, state, and local public-sector and private-sector partners and stakeholders to facilitate the development of a performance measurement system that promotes accountability among governmental and private-sector organizations that have responsibilities for protecting and improving population health at local, state, and national levels.
Primary Care and Public Health: Exploring Integration to Improve Population Health (2012)
RECOMMENDATION 1: To link staff, funds, and data at the regional, state, and local levels, HRSA and CDC should join efforts to undertake an inventory of existing health and health care databases and identify new data sets, creating from these a consolidated platform for sharing and displaying local population health data that could be used by communities.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Priorities for Research to Reduce the Threat of Firearm-Related Violence (2013)
Priority: Improve understanding of risk factors that influence the probability of firearm violence in specific high-risk physical locations.
Examples of topics that could be examined:
  • What are the characteristics of high- and low-risk physical locations?
  • Are the locations stable or do they change?
  • What factors in the physical and social environment characterize neighborhoods or subneighborhoods with higher or lower levels of gun violence?
  • Which characteristics strengthen the resilience of specific community locations?
  • What is the effect of stress and trauma on community violence, especially firearm-related violence?
  • What is the effect of concentrated disadvantage on community violence, especially firearm-related violence?
Priority: Improve understanding of whether interventions intended to diminish the illegal carrying of firearms reduce firearm violence.
Examples of research questions that could be examined:
  • What is the degree to which background checks at the point of sale are effective in deterring acquisition of firearms by those who are legally disqualified from owning one?
  • What is the public health impact of removing firearms from persons who develop a disqualifying characteristic, for example, mental illness, with potential for violence?
  • Do programs that focus on changing norms in a community decrease illegal gun carrying?
Priority: Improve understanding of whether reducing criminal access to legally purchased guns reduces firearm violence.
Examples of topics that could be examined:
  • Are there methods to enhance the reporting of stolen guns in order to reduce illegal access?
  • To what degree would mandatory reporting of transfer of private ownership of guns be effective in reducing illegal access?
  • To what extent do focused interventions (for example, “server training,” straw-purchase stings) targeted at high-risk retailers found to be disproportionately associated with gun crimes reduce illegal access?
  • How do firearms move from federal firearms licensed dealers to high-risk/criminal possessors? How can we develop detailed analyses of this illegal area of firearm distribution?
Priority: Improve understanding of the effectiveness of actions directed at preventing access to firearms by violence-prone individuals.
Examples of topics that could be examined:
  • What would be the effects of altering environmental alcohol availability, such as reducing the number of off-premise alcohol outlets, on firearm violence?
  • How effective are policies and enforcement of laws preventing gun sales to people with specific psychiatric diagnoses?
  • To what extent does enforcement of laws requiring removal of firearms from the homes of people with a history of intimate partner violence reduce homicide and injury?
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Priority: Determine the degree to which various childhood education or prevention programs reduce firearm violence in childhood and later in life.
Examples of topics that could be examined:
  • Are school-, family-, and community-based risk-reduction and health-promotion programs effective in reducing firearm violence?
  • Are gun safety programs effective in reducing unintentional injury to children from firearms?
  • Are school personnel (for example, nurses, resource officers, teachers) effective at detecting students at risk of causing firearm violence?
Priority: Do programs to alter physical environments in high-crime areas result in a decrease in firearm violence?
Examples of topics that could be examined:
  • Is there a correlation between alcohol sales for off-premises consumption and firearm violence in high-risk neighborhoods? Do laws and enforcement regarding sales of alcohol affect gun violence? What are the effects on firearm violence of community engagement programs to improve the physical environment? Is there a reduction in firearm violence among youth living in neighborhoods where community policing is practiced?
  • For community programs that are considered to have sufficient effectiveness in reducing gun violence, what are the factors that affect adoption, fidelity vs. adaptation, and sustainability or scale-up of programs so that they have a public health impact?
Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 (2014)
FINDING 5-1: Four social and behavioral domains of health are already frequently collected in clinical settings. The value of this information would be increased if standard measures were used in capturing these data.
FINDING 7-1: Standardized data collection and measurement are critical to facilitate use and exchange of information on social and behavioral determinants of health. Most of these data elements are experienced by an individual and are thus collected by self-report. Currently, EHR vendors and product developers lack harmonized standards to capture such domains and measures.
RECOMMENDATION 7-2: The Office of the Director of the National Institutes of Health (NIH) should develop a plan for advancing research using social and behavioral determinants of health collected in electronic health records. The Office of Behavioral and Social Science Research should coordinate this plan, ensuring input across the many NIH institutes and centers.
RECOMMENDATION 7-3: The Secretary of Health and Human Services should convene a task force within the next 3 years, and as needed thereafter, to review advances in the measurement of social and behavioral determinants of health and make recommendations for new standards and data elements for inclusion in electronic health records. Task force members should include representatives from the Office of the National Coordinator for Health Information Technology, the Center for Medicare & Medicaid Innovation, the Agency for Healthcare Research and Quality, the Patient-Centered Outcomes Research Institute, the National Institutes of Health, and research experts in social and behavioral science.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Implementing Juvenile Justice Reform: The Federal Role (2014)
RECOMMENDATION 3-3: OJJDP should take a leadership role in local, state, and tribal jurisdictions with respect to the development and implementation of administrative data systems by providing model formats for system structure, standards, and common definitions of data elements. OJJDP should also provide consultation on data systems as well as opportunities for sharing information across jurisdictions.
RECOMMENDATION 5-2: OJJDP should initiate and support collaborative partnerships at the federal, state, local, and tribal levels and should use them strategically to advance the goal of a developmentally appropriate juvenile justice system.
Vital Signs: Core Metrics for Health and Health Care Progress (2015)
This report provides a detailed analysis of measurement of individual and population health outcomes and costs, identifying fragilities and gaps in available systems, and considering approaches and priorities for developing the measures necessary for a continuously learning and improving health system. It notes, “Substantial disparities exist among and within subpopulations in the United States with respect to the relative impact of each of the domains of influence on health and health care, including disparities by race, ethnicity, income, education, gender, geography, and urban or rural populations. In the aggregate, this issue represents one of the greatest health and health care challenges faced by the nation.”
RECOMMENDATION 4: With the engagement and involvement of the Executive Office of the President, the Secretary of the Department of Health and Human Services should develop and implement a strategy for working with other federal and state agencies and national organizations to facilitate the use and application of the core measure set.
RECOMMENDATION 5: The Secretary of the Department of Health and Human Services should establish and implement a mechanism for involving multiple expert stakeholder organizations in efforts to develop as necessary, maintain, and improve each of the core measures and the core measure set as a whole over time.
Mental Disorders and Disabilities Among Low-Income Children (2015)
Poverty is a risk factor for child disability, including disability associated with mental disorders. At the same time, child disability is a risk factor for family poverty. In times of economic hardship in the United States, more children with mental disorder–related disabilities will qualify for benefits because they meet the income eligibility threshold.
Children living in poverty are more likely than other children to have mental health problems, and these conditions are more likely to be severe. Low-income families containing a child with a disability may be particularly vulnerable in times of economic hardship. Access to Medicaid and income supports via the SSI disability program may improve long-term outcomes for both children with disabilities and their families.
Investing in the Health and Well-Being of Young Adults (2015)
RECOMMENDATION 6-1: State and local public health departments should establish an office to coordinate programs and services bearing on the health, safety, and well-being of young adults. If a separate office is not established for young adults, these responsibilities should be assigned to the adolescent health coordinator.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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RECOMMENDATION 6-2: Each community should establish a multi-stakeholder private-public coalition on “Healthy Transitions to Adulthood,” with the goal of promoting the education, health, safety, and wellbeing of all young adults. State or local public health agencies should take the lead in convening these coalitions.
RECOMMENDATION 8-2: Federal and state governments should continue encouraging programs that serve marginalized populations to make better use of administrative data for describing the overlap of populations across service systems and young adults’ trajectories into and out of these systems, and for evaluating policies and programs affecting young adults.
Advancing the Power of Economic Evidence to Inform Investments in Children, Youth, and Families (2016)
This committee assessed available means of establishing economic evidence to support investments in health and well-being interventions and promotion. The report details methods and makes recommendations to program developers, funders, policy makers, etc. about the use of this economic evidence.
Parenting Matters: Supporting Parents of Children Ages 0–8 (2016)
RECOMMENDATION 1: The U.S. Department of Health and Human Services, the U.S. Department of Education, state and local agencies, and community-based organizations responsible for the implementation of services that reach large numbers of families (e.g., health care, early care and education, community programs) should form a working group to identify points in the delivery of these services at which evidence-based strategies for supporting parents can be implemented and referral of parents to needed resources can be enhanced. Based on its findings, the working group should issue guidance to service delivery organizations on increasing parents’ access to evidence-based interventions.
RECOMMENDATION 2: The U.S. Department of Health and Human Services, the Institute of Education Sciences, the Patient-Centered Outcomes Research Institute, and private philanthropies should fund research focused on developing guidance for policy makers and program administrators and managers on how to scale effective parenting programs as widely and rapidly as possible. This research should take into account organization-, program-, and system-level factors, as well as quality improvement. Supports for scaling efforts developed through this research might include cost tools, measurement toolkits, and implementation guidelines.
Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change (2016)
RECOMMENDATION 2: The U.S. Department of Health and Human Services should evaluate its own service programs and collaborate with other stakeholders, particularly the criminal justice system and government and state agencies, for the purpose of identifying and eliminating policies, practices, and procedures that directly or indirectly discriminate against people with mental and substance use disorders.
Communities in Action: Pathways to Health Equity (2017)
CONCLUSION 3-2: Based on its review of the evidence, the committee concludes that health inequities are the result of more than individual choice or random occurrence. They are the result of the historic and ongoing interplay of inequitable structures, policies, and norms that shape lives.
Page 332 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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RECOMMENDATION 4-1: A public–private consortium should create a publicly available repository of evidence to inform and guide efforts to promote health equity at the community level. The consortium should also offer support to communities, including technical assistance.
RECOMMENDATION 6-4: Through multi-sectoral partnerships, hospitals and health care systems should focus their community benefit dollars to pursue long-term strategies (including changes in law, policies, and systems) to build healthier neighborhoods, expand access to housing, drive economic development, and advance other upstream initiatives aimed at eradicating the root causes of poor health, especially in low-income communities. Hospitals and health systems should also advocate for the expansion of efficient and effective services responding to health-related social needs for vulnerable populations and people living in poverty.
Transforming the Financing of Early Care and Education (2018)
RECOMMENDATION 10: The federal government should align its data collection requirements across all federal early care and education (ECE) funding streams to collect comprehensive information about the entire ECE sector and sustain investments in regular, national, data collection efforts from state and nationally representative samples that track changes in the ECE landscape over time to better understand the experiences of ECE programs, the ECE workforce, and the developmental outcomes of children who participate in ECE programs.
A Roadmap for Reducing Child Poverty (2019)
CONCLUSION 4-6: The Earned Income Tax Credit, the Child Tax Credit, the Supplemental Nutrition Assistance Program (SNAP), and to a lesser extent Social Security are the most important programs for reducing Supplemental Poverty Measure (SPM) based child poverty. SNAP and Social Security are the most important programs for reducing deep poverty among children. Tax credits are the most important means of keeping children above near-poverty. Health care programs account for more than one-third of total federal expenditures on children but are not properly accounted for in the SPM poverty measure.
CONCLUSION 7-3: Evidence suggests that paid family and medical leave increases parents’ ability to continue in employment and has positive impacts on children’s health, although it might also reduce employment among women potentially eligible for such leave.
RECOMMENDATION 9-4: Relevant federal departments and agencies should prioritize research and experimentation designed to find ways to mitigate the effects of contextual factors that impair the effectiveness of current programs to combat child poverty. These contextual factors include (1) detrimental neighborhood conditions, (2) racial and social discrimination, and (3) adverse consequences of the criminal justice system.
RECOMMENDATION 9-8: The Bureau of Labor Statistics and the U.S. Census Bureau should move expeditiously to evaluate a health-inclusive poverty measure of the kind illustrated in this report.
RECOMMENDATION 9-9: Federal and state executive agencies and legislatures should ensure that child anti-poverty assistance programs require and include adequate resources for regular monitoring of program operations and child outcomes, as well as for rigorous program evaluation and research on ways to improve program effectiveness.
Page 333 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda (2019)
Recommendation 1: Relevant federal agencies should lead and collaborate with agencies at the state and local levels, as well as private partners, including national and local foundations and the business community, in coordinating a highly visible national effort to make the promotion of healthy mental, emotional, and behavioral (MEB) development a national priority, such as by designating a Decade of Children and Youth. These agencies should:
  • articulate specific national goals and objectives in support of healthy MEB development throughout the life cycle, encompassing health promotion and disorder prevention;
  • develop an integrated plan for longitudinal data collection and coordination and analysis of federal surveys, administrative data, and vital statistics that provides a comprehensive approach to measuring and tracking child and adolescent MEB health; and
  • encourage and support the integration and coordination of new and existing efforts to pursue those goals and objectives at the federal, state, and local levels, using coordinating and convening capacities, pooling of resources, funding of outcomes analyses, regulatory options, and other powers and incentives.
Recommendation 2: Relevant federal agencies should use their program creation, regulatory, and other policy capabilities to promote healthy mental, emotional, and behavioral (MEB) development and mitigate risks to MEB health by, for example:
  • developing and disseminating guidance for use by states and local jurisdictions in delivering effective promotion and prevention interventions—including preconception, prenatal, and postnatal care services; two-generation (including parent MEB health and parenting) interventions; preschool and school interventions; and universal screening for risk and protective factors—and in ensuring access to affordable treatment for parents and children to reduce risk;
  • developing both guidance and targeted accountability measures for use by states and local jurisdictions to identify effective ways of reducing the exposure of children and families to risks—such as lead and air particulate matter; ineffective and inequitable disciplinary practices; unsafe sex and unintended pregnancies; use of tobacco, alcohol, and other drugs; traumatic experiences; and negative living conditions, including exposure to violence, unstable housing, food insufficiency, and underemployment—that can contribute to unhealthy MEB development;
  • promoting coverage of behavioral health services for children and caregivers, especially those needed during pregnancy and the postpartum period and those offered by parenting programs, in reimbursement for private health insurance and Medicaid, encompassing both behavioral health promotion and risk prevention;
  • setting expectations for the adoption and evaluation of programs known to enhance social and emotional development in schools, in health care settings, and in communities;
  • supporting consistent polices on accreditation, certification, and licensing requirements for a multidisciplinary workforce oriented toward healthy MEB development in children and youth; and
  • supporting and collaborating with local and state initiatives that contribute to healthy MEB development.
Page 334 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Recommendation 3: Relevant federal agencies should support rapid progress in the development and dissemination of effective mental, emotional, and behavioral (MEB) interventions for delivery to large populations by providing funding and other resources to, for example:
  • support research and demonstration projects to determine the effectiveness of promising interventions for MEB health promotion, prevention of MEB disorders, and population screening at large scales, including the implementation of effective in-person and digital interventions;
  • support states and local jurisdictions in developing cross-sector partnerships among schools, employers, the health care system, community-based organizations, and others to advance the scale-up of effective promotion and prevention interventions;
  • support states and local jurisdictions in developing innovative funding mechanisms that can be sustained through changes in political leadership or funding shortfalls;
  • use economic evaluation tools and other methods to analyze such factors as costs and availability of funding, benefit/cost ratio, level of complexity, and need for supportive infrastructure; and
  • document needs and develop strategies for sustainability over time.
The Promise of Adolescence: Realizing Opportunity for All Youth (2019)
RECOMMENDATION 7-2: Improve access to comprehensive, integrated, coordinated health services for adolescents.
RECOMMENDATION 7-5: Improve federal and state data collection on adolescent health and wellbeing, and conduct adolescent-specific health services and disseminate the findings.
RECOMMENDATION 8-5: Foster greater collaboration between the child welfare, juvenile justice, education, and health systems.
Strengthening the Military Family Readiness System for a Changing American Society (2019)
RECOMMENDATION 3: The U.S. Department of Defense should more fully identify, analyze, and integrate existing data to longitudinally track population-based military child risk and adversity, while also ensuring the privacy of individual family member information.
RECOMMENDATION 10: To enhance the effectiveness and efficiency of the Military Family Readiness System, the U.S. Department of Defense should investigate innovations in big data and predictive analytics to improve the accessibility, engagement, personalization, and effectiveness of policies, programs, practices, and services for military families.
Monitoring Educational Equity (2019)
RECOMMENDATION 4: Governmental and philanthropic funders should work with researchers to develop indicators of the existence and effectiveness of systems of cross-agency integrated services that address context-related impediments to student success, such as trauma and chronic stress created by adversity. The indicators and measures should encompass screening, intervention, and supports delivered not only by school systems, but also by other child-serving agencies.
Page 335 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity (2019)
CONCLUSION 5-1: The current health care system focuses mainly on clinical goals and addresses the multiple other determinants of health in fragmented and highly variable ways. Despite high-quality clinical care, the health status of America’s children and young families is far worse than in comparable developed countries. U.S. health care provides only limited attention to integration of health care for the whole family, health care across the life course, or integration of mental and behavioral health with the rest of health care.
CONCLUSION 6-1: Increasing the economic resources families have available to meet basic needs when children are young (including prenatally) will improve children’s health and has the potential to reduce health and developmental disparities in early childhood.
RECOMMENDATION 4-2: Federal, state, local, tribal, and territorial agencies, along with private foundations and philanthropies that invest in research, should include in their portfolios research on the development of interventions that are culturally sensitive and tailored to meet the needs of subgroups of children known to be vulnerable, such as those living in chronic poverty, children from immigrant backgrounds, children in foster care, and children with incarcerated parents.
RECOMMENDATION 4-3: To strengthen and expand the impact of evidence-based home visiting programs federal, state, local, tribal, and territorial agencies overseeing program implementation should continue to strengthen programmatic coordination and policy alignment between home visiting, other early care and education programs, and medical homes.
RECOMMENDATION 5-3: The U.S. Department of Health and Human Services, state, tribal, and territorial government Medicaid agencies, health systems leaders, and state and federal policy makers should adopt policies and practices that improve the organization and integration of care systems, including promoting multidisciplinary team-based care models that focus on integrating preconception, prenatal, and postpartum care with a whole-family focus, development of new practice and payment models that incentivize health creation and improve service delivery, and structures that more tangibly connect health care delivery systems to other partners outside of the health care sector.
RECOMMENDATION 8-1: Policy makers and leaders in the health care, public health, social service, criminal justice, early care and education/education, and other sectors should support and invest in cross-sector initiatives that align strategies and operate community programs and interventions that work across sectors to address the root causes of poor health outcomes. This includes addressing structural and policy barriers to data integration and cross-sector financing and other challenges to cross-sector collaboration.
Page 336 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health (2019)
Goal 1. Design health care delivery to integrate social care into healthcare.
Recommendation 1. Health care organizations should take steps to integrate social care into health care. Specific steps include
  1. Make and communicate an organizational commitment to addressing health-related social needs and health disparities at the community and individual levels.
  2. Recognize that comprehensive health care should include understanding an individual’s social context. Evidence is rapidly accumulating concerning the most effective strategies for screening and assessing for social risk factors and social needs. Such strategies should include standardized and validated questions, as available, and should use interoperable data systems to document results.
  3. Use patient-centered care models to more routinely incorporate social risk data into care decisions.
  4. Design and implement integrated care systems using approaches that engage patients, community partners, frontline staff, social care workers, and clinicians in planning and evaluation and that incorporate the preferences of patients and communities. Include social care workers as being integral to a team-based approach to designing and delivering health care.
  5. Establish linkages and communication pathways between health care and social service providers. This is important for personal care aides, home care aides, and others who provide care and support for seriously ill and disabled patients and who have extensive knowledge of patients’ social needs.
  6. Develop and finance referral relationships with selected social care providers when feasible, supported by operational integration such as co-location or patient information systems. Social care providers and health care providers should establish a formal understanding and accountability within their contracting and referral relationships.
  7. Support the development of those infrastructure components needed to meet the goal of care integration, including the redesign and refinement of workflows, technical assistance and support, staff with the ability to support the redesign, champions of the redesign, information on best practices, health information technology to enhance integration, and support for community partners and their infrastructure needs.
Goal 2. Build a workforce to integrate social care into health care delivery.
Recommendation 2a: State legislatures, licensing boards, professional associations, and federal agencies should develop, expand, and standardize the scopes of practice of social workers, community health workers, gerontologists, and other social care workers.
Recommendation 2b: Social workers and other social care workers should be considered to be providers who are eligible for reimbursement by payers. Public and private payers should create standards for the reimbursement of social care, including assessment and such treatment as chronic care management, behavioral health integration, and transitional care management. Medicare/Medicaid payment advisory commissions should evaluate models in which social workers and other social care workers are reimbursement-eligible providers of social care services.
Page 337 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Recommendation 2c: Funders of health care workforce training (e.g., the U.S. Department of Health and Human Services, the U.S. Department of Veterans Affairs, and foundations) should include the social care workforce in their education, training, and practice initiatives.
Recommendation 2d: Schools for health professions (including schools of medicine and nursing) as well as continuing education programs should incorporate competency-based curricula on social care. Curricula should include evidence on the social determinants of health, protocols for working in interprofessional teams to address social needs in health care settings, interpersonal and organizational approaches to advancing health equity and decreasing health disparities, and competencies relating to collecting, securing, and using data and technology to facilitate social and health care integration. Schools of health professions should also engage social workers in instructional roles in order to model their participation in interprofessional teams and to provide information on social risk screening and social care resources and referrals.
Recommendation 2e: Credentialing organizations for medicine, nursing, and other health professions should incorporate knowledge about the social determinants of health and the importance of addressing social needs in licensing examinations and continuing education requirements.
Recommendation 2f: Schools of social work as well as continuing education programs should use competency-based curricula on social care. In addition to educating students about the social determinants of health and health disparities, the curricula should include information about effective models that integrate social care and health care delivery, the interprofessional workforce, technology, and payment models that facilitate implementation and competencies relating to collecting, securing, and using data and technology to facilitate social and health care integration.
Recommendation 2g: State agencies and academic institutions, including community colleges, should develop standards for training and advancement (e.g., career ladder programs) for community health workers and other emerging social care workers.
Recommendation 2h: Foundations and other funders should commission a follow-up comprehensive report on the role of social work in health care as social care and health care integration continues to evolve.
Recommendation 2i: Foundations and other funders should fund a campaign to raise awareness among the health care professions and others about the value and contributions of social workers and other social care workers in health care.
Goal 3. Develop a digital infrastructure that is interoperable between health care and social care organizations.
Recommendation 3a: The federal government should establish a 21st-century social care digital infrastructure on a scale similar to that described in the Health Information and Technology for Economic and Clinical Health Act of 2009,2 and it should identify and deploy policies and resources to build the internal capacity necessary for social care organizations and consumers to interoperate and interact with each other and the health care system.
Page 338 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Recommendation 3b: The Office of the National Coordinator should be resourced to act on the Patient Protection and Affordable Care Act of 20103 Section 1561 recommendations, including the adoption of modern, secure, interoperable digital systems and processes that will allow all partners to share the administrative and other data necessary to enable consumers to seamlessly obtain and maintain the full range of available health care and social care services.
Recommendation 3c: The Office of the National Coordinator should support states and regions as they identify the appropriate interoperable platforms for their communities, based on open standards and a modern technical architecture that supports flexible interfaces to allow the health and social care systems and consumers to share the structured data necessary for care coordination, avoidance of error, and a reduced burden on organizations and people being served.
Recommendation 3d: The Federal Health Information Technology Coordinating Committee should facilitate data sharing at the community level across diverse domains such as health care, housing, and education so as to support social care and health care integration.
Recommendation 3e: Integrating social care and health care requires the sharing of new types of data between new partners, some of whom are covered by the privacy rule promulgated by the Health Insurance Portability and Accountability Act of 19964 and some of whom are not; therefore, the U.S. Department of Health and Human Services should work with the private sector to disseminate educational tools and guidance on the data security and privacy issues that arise when collecting and sharing personally identifiable information.
Recommendation 3f: The parts of the public and private sectors involved in developing and implementing analytic and technology resources, including cell and Internet access, should do so with an explicit focus on equity; the goal should be to avoid unintended consequences such as perpetuation or aggravation of discrimination and bias and the further marginalization of populations and to proceed with an appreciation of the impact on the existing social care system.
Goal 4. Finance the integration of health care and social care.
Recommendation 4a: The Centers for Medicare & Medicaid Services should clearly define which aspects of social care that Medicaid can pay for as covered services (e.g., in the context of providing care management, targeted case management, and home- and community-based long-term care services and supports as well as within the context of managed care).
Recommendation 4b: State Medicaid agencies should use the flexibility described by the U.S. Centers for Medicare & Medicaid Services in the social care that Medicaid pays for as a covered service and make the opportunities and limitations associated with that flexibility clear to health plans and health care and social care service providers.
Recommendation 4c: The Centers for Medicare & Medicaid Services (CMS) should accelerate learning about how the integration of health and social care can improve health and reduce health care costs by encouraging and approving waivers that support social care. Sustainable financing for effective interventions piloted in the waiver should be identified by the state and CMS as an outcome of the waiver.
Page 339 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Recommendation 4d: States should pursue policies of continuous program eligibility to, among other benefits, create stable pools of populations for which entities can be held accountable.
Recommendation 4e: The Centers for Medicare & Medicaid Services should consider additional Medicare reforms that can broaden Medicare coverage rules in a way that is consistent with lessons from Medicaid populations and the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2018 (the CHRONIC Care Act). 5 Health plans should take full advantage of the flexibility provided under the CHRONIC Care Act for supplemental benefits under Medicare.
Recommendation 4f: The Centers for Medicare & Medicaid Services and the states should coordinate the coverage and benefits administration of their Medicare and Medicaid dually eligible populations consistent with the emerging lessons of the financial alignment demonstrations. Efforts to improve alignment should be aggressively pursued over the short and long term, with an intentional focus on social care integration.
Recommendation 4g: The Centers for Medicare & Medicaid Services should develop incentives for health care organizations and the managed care programs that contract with Medicaid and Medicare to collaborate with community-based social services, such as area agencies on aging and centers for independent living.
Recommendation 4h: The Centers for Medicare & Medicaid Services, state Medicaid agencies, employers, and health plans should accelerate the movement to alternative payment models. The measurements aimed at assessing value in these models should include activity-based measures for social care integration and outcome measures that reflect social risk and protective factors. These value-based payment and outcome measurement models should incorporate social risk adjustment and stratification in a way that is consistent with previous recommendations (NASEM, 2016).
Recommendation 4i: The U.S. Department of Health and Human Services, payers, and other private organizations, such as foundations and institutions with community-benefit obligations, should provide funding and technical assistance to support formal contractual relationships between community-based organizations and health care entities.
Recommendation 4j: Federal and state policy makers, health plans, health systems, and private-sector investors should consider collective financing mechanisms to spread risk and create shared returns on investments in social care so that returns do not accrue to a single investor.
Recommendation 4k: Health systems subject to community benefit regulations should comply with those regulations by considering partnering in social care.
Recommendation 4l. States should pursue opportunities to align their hospital licensing requirements and public reporting with federal regulations regarding community benefits to ensure consistent obligations for health systems and to explicitly link their community benefits to the provision of social care.
Page 340 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Goal 5. Fund, conduct, and translate research and evaluation on the effectiveness and implementation of social care practices in health care settings.
Recommendation 5a: Federal and state agencies, payers, providers, delivery systems, and foundations should contribute to advancing research on and the evaluation of the effectiveness and implementation of social care practices.
  • The National Institutes of Health (NIH), the Agency for Healthcare Research and Quality (AHRQ), the Centers for Medicare & Medicaid Services (CMS), the Patient-Centered Outcomes Research Institute, the Health Resources and Services Administration (HRSA), and other funders of research and program evaluation should encourage payers, providers, and delivery systems to incorporate a range of study designs and methods that include rapid learning cycles and experimental trials.
  • NIH, AHRQ, CMS, foundations, and other funders of research and program evaluation should cultivate and support researchers who have expertise in health services, social sciences, and cross-disciplinary research.
  • CMS should fully finance (without state contributions) independent state waiver evaluations to ensure robust evaluation of social care and health care integration pilot programs and to facilitate the dissemination of findings.
  • The U.S. Department of Health and Human Services should establish and support a clearinghouse containing information on the best and most promising practices for social care integration in order to provide “lessons learned” to health systems, community- based organizations, researchers, and others.
Recommendation 5b: Funders of health care workforce research (e.g., the Agency for Healthcare Research and Quality and foundations) should include the social care workforce in studies of the effect of the social care workforce on the health and financial outcomes of health care delivery organizations.
Recommendation 5c: The Health Resources and Services Administration and other funders should support studies of the contribution of the social care workforce, including additional workers such as gerontologists and public interest lawyers, to addressing the social determinants of health in health and community care settings.
Recommendation 5d: The Centers for Medicare & Medicaid Services, the U.S. Department of Health and Human Services, state Medicaid agencies, the National Quality Forum, and the National Committee for Quality Assurance should establish mechanisms that ensure that research on effective demonstrations informs more permanent health care reforms, including the development of accountability measures and payment models.
Recommendation 5e: To enable comparative research and evaluation, researchers, evaluators, and agencies that develop measures and standards (e.g., the National Quality Forum, the National Committee for Quality Assurance, and the Centers for Medicare & Medicaid Services) should develop a consensus on and use a common core of measures reflecting social risk and protective factors as well as key health and social outcome measures. These measures should not be limited to clinical or economic metrics, but should include patient-reported outcomes and other outcomes relevant to a range of stakeholders, including patients, families, caregivers, communities, social care organizations, health care organizations, and payers. The Agency for Healthcare Research and Quality should curate these measures in a publicly available item bank.
Page 341 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century (2020)
Recommendation 1: The U.S. Department of Health and Human Services should fund additional research aimed at identifying, measuring, and evaluating the effectiveness of specific core components of programs and interventions focused on promoting positive health behaviors and outcomes among adolescents.
Recommendation 2: The Division of Adolescent and School Health of the Centers for Disease Control and Prevention should
  • update and expand the Youth Risk Behavior Survey (YRBS) to include
  • out-of-school youth (e.g., homeless, incarcerated, dropped out), and
  • survey items that reflect a more comprehensive set of sexual risk behaviors with specific definitions; and conduct further research on the ideal setting and mode for administering the YRBS with today’s adolescents.
Recommendation 5-3: The Office of the Assistant Secretary for Health within the U.S. Department of Health and Human Services should fund universal, holistic, multicomponent programs that meet all of the following criteria:
  • promote and improve the health and well-being of the whole person,
  • laying the foundation for specific, developmentally appropriate behavioral skills development;
  • begin in early childhood and are offered during critical developmental windows, from childhood throughout adolescence;
  • consider adolescent decision making, exploration, and risk taking as normative;
  • engage diverse communities, public policy makers, and societal leaders to improve modifiable social and environmental determinants
  • of health and well-being that disadvantage and stress young people and their families; and
  • are theory driven and evidence based.
Promising Approach 5-1: Programs can benefit from implementing and evaluating policies and practices that promote inclusiveness and equity so that all youth are able to thrive.
Promising Approach 5-2: Programs can benefit from including youth of diverse ages, racial/ethnic backgrounds, socioeconomic status, rurality/urbanity, sexual orientations, sexes/genders, and disability/ability status in their decision-making processes.
Mental Health, Substance Use, and Well-Being in Higher Education: Supporting the Whole Student (2021)
Recommendation 5-3: Institutions should ensure their leave of absence and reenrollment policies and practices will accommodate the needs of students experiencing mental health and substance use problems and the time needed for effective treatment and recovery.
Recommendation 5-4: Institutions of higher education and the government agencies that support them should increase the priority given to funding for campus and community mental health and substance use services.
Recommendation 5-5: Institutions of higher education should work with insurance companies and health plans and federal, state and local regulators to remove barriers to seeking reimbursement for student mental health and substance use costs for covered students.
Page 342 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Recommendation 5-10: Institutions of higher education should recognize that there is no single approach to promoting wellbeing and dealing with mental health and substance use problems that will be appropriate for all student populations.
Federal Policy to Advance Racial, Ethnic, and Tribal Health Equity (2023)
Recommendation 1: To improve health equity, the president of the United States should create a permanent and sustainable entity within the federal government that is charged with improving racial, ethnic, and tribal equity across the federal government. This should be a standing entity, sustained across administrations, with advisory, coordinating, and regulatory powers. The entity would work closely with other federal agencies to ensure equity in agency processes and outcomes.
Recommendation 2: The president of the United States should appoint a senior leader within the Office of Management and Budget (OMB) who can mobilize assets within OMB to serve as the cochair of the Equitable Long-Term Recovery and Resilience Steering Committee.
Recommendation 3: The federal government should assess if federal policies address or exacerbate health inequities by implementing an equity audit and developing an equity scorecard. Specifically,
  1. Federal agencies should engage in a retrospective review of federal policies that had a historical impact on racial and ethnic health inequities that exist today to address contemporary impacts.
  2. The Office of Management and Budget should develop, and federal agencies should conduct, an equity audit of existing federal laws. The federal laws reviewed should be identified via public input obtained by a variety of means. The equity audit should include a review of how the laws are implemented and enforced by federal agencies and state and local governments. The audit should also include criteria related to equity in process, measurement, and outcomes.
  3. Congress should develop and implement an equity scorecard that is applied to all proposed federal legislation, similar to the requirement of a Congressional Budget Office score.
  4. The process and results from the equity audit and scorecard should be transparent and made publicly available.
Recommendation 4: The federal government should prioritize community input and expertise when changing or developing federal policies to advance health equity. Specifically,
  1. The president of the United States should require federal agencies relevant to the social determinants of health to generate and sustain community representation and advisory practices that are integrated with accountability measures and enforcement mechanisms.
  2. Congress should request a Government Accountability Office report to document across federal agencies whose work impacts the social determinants of health, as well as federal statistical agencies, that
    1. Assesses how community advisory boards are positioned within their agencies, whom they are composed of, how often they meet, how they report back, and how that work influences the agencies’ policies and programs; and
    2. Identifies promising and evidence-based practices, gaps, and opportunities for community advisory boards that could be applied by other agencies.
Page 343 Cite
Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Recommendation 5: The Office of Management and Budget (OMB) should require the Census Bureau to facilitate and support the design of sampling frames, methods, measurement, collection, and dissemination of equitable data resources on minimum OMB categories—including for American Indian or Alaska Native, Asian, Black or African American, Hispanic or Latino/a, and Native Hawaiian or Pacific Islander populations—across federal statistical agencies. The highest priority should be given to the smallest OMB categories—American Indian or Alaska Native and Native Hawaiian or Pacific Islander.
Recommendation 6: The Office of Management and Budget (OMB) should update and ensure equitable collection and reporting of detailed-origin and tribal affiliation data for all minimum OMB categories through data disaggregation by race, ethnicity, and tribal affiliation (to be done in coordination with meaningful tribal consultation), including populations who self-identify as American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Pacific Islander, and Hispanic or Latino/a.
Recommendation 7: The Centers for Disease Control and Prevention should coordinate the creation and facilitate the use of common measures on multilevel social determinants of racial and ethnic health inequities, including scientific measures of racism and other forms of discrimination, for use in analyses of national health surveys and by other federal agencies, academic researchers, and community groups in analyses examining health, social, and economic inequities among racial and ethnic groups.
Recommendation 8: Congress should increase funding for federal agencies responsible for data collection on social determinants of health measures to provide information that leads to a better understanding of the correlation between the social environment and individual health outcomes.
Recommendation 9: The president of the United States should convert the Equitable Data Working Group, currently coordinated between the Office of Management and Budget (OMB) and the Office of Science and Technology Policy, into an Office of Data Equity under OMB with representation from the Domestic Policy Council, with an emphasis on small and underrepresented populations and with a scientific and community advisory commission, to achieve data equity in a manner that is coordinated across agencies and informed by scientific and community expertise.
Recommendation 10: Congress and executive agencies should leverage the full extent of federal authority to ensure equitable implementation of federal policies and access to federal programs.
  1. Relevant federal departments and agencies should design and implement policies to improve the administration of assistance programs to facilitate access to the benefits to which individuals and families are entitled. Such activities should include implementation and delivery processes, including administrative burden, eligibility, enrollment, enforcement, and client experience; and, where applicable, the creation of performance standards in federal programs administered by other (state, local, and tribal) governments.
  2. Congress should ensure that sufficient funding is made available to conduct these activities.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Recommendation 11: The president of the United States should direct the Office of Management and Budget to review federal programs that exclude specific populations, such as immigrants and those with a criminal record and, in some cases, currently incarcerated people (e.g., Medicaid coverage), to assess the rationale and implications for equity of excluding these populations, including potential impacts on their families and communities. A report on the findings and suggested changes (when applicable) should be made publicly available.
Recommendation 12: The federal government should undertake the following actions to advance health equity for American Indian and Alaska Native communities in both urban and rural settings by raising the prominence of the agencies that have jurisdiction. Specifically,
  1. The president of the United States and Congress should raise the level of the Director of Indian Health Service (IHS) to an Assistant Secretary.
  2. Congress should authorize funding of IHS at need/parity with other health care programs. This funding should be made mandatory and include advance appropriations.
  3. The House of Representatives should re-establish an Indian Affairs Committee.
Recommendation 13: The Departments of Health and Human Services, Defense, Veterans Affairs, Homeland Security, and Justice, as federal government purchasers and direct providers of health care, should undertake strategies to achieve equitable access to health care across the life span for the individuals and families they serve in every community. These strategies should prioritize access to effective, comprehensive, affordable, accessible, timely, respectful, and culturally appropriate care that addresses equity in the navigation of health care. While these strategies have a greater chance of success when everyone has adequate health insurance, there are ways the executive branch can improve and reinforce access to care for the adequately insured, the underinsured, and the uninsured.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Suggested Citation: "Appendix E: Related Reports of the National Academies of Sciences, Engineering, and Medicine." National Academies of Sciences, Engineering, and Medicine. 2025. Blueprint for a National Prevention Infrastructure for Mental, Emotional, and Behavioral Disorders. Washington, DC: The National Academies Press. doi: 10.17226/28577.
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Page 344
Next Chapter: Appendix F: Calculations for Recommendation 6-1
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