July 8, 2004

Clinical Preventive Services in Substance Abuse and Mental Health Update: from Science to Services

This article was written by Joel L. Nitzkin, MD, MPH, and Shelagh A. Smith, MPH, CHES, and published in July 2004. This report has been prepared to summarize the most promising preventive interventions of a behavioral nature intended to impact mental and substance use disorders, or in some cases, medical outcomes. This review focuses on prevention interventions that are primarily delivered by health care systems.

This report fills in the previously founded gaps in preceding articles by including all studies, regardless of outcome, and describes the optimal circumstances for implementing services and tracking costs. The descriptions may be most useful to health care organizations and providers in determining what preventive services to offer and how to implement them. Based on the rigor of the research presented here, the breadth of applicability among interventions, and their potential cost effectiveness for health plans, effective behavioral preventive interventions can be classified as basic or general, or less widely applicable but targeted to certain groups at risk or within specific conditions. The following interventions discussed here in detail have shown the greatest promise, based on the research reviewed, to diminish or prevent the development of a mental or substance use disorder.