Doctors Applaud the Release of the National Prevention Strategy
WASHINGTON, DC—Today, Surgeon General Regina Benjamin and Health and Human Services Secretary Kathleen Sebelius announced the first ever National Prevention Strategy, called for under the Affordable Care Act that will keep Americans healthy and fit. Developed by the National Prevention Council, it included input from various stakeholders, the public and from the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health. Doctors for America’s Co-Founder and President, Dr. Vivek Murthy, was appointed to the Advisory Group this past January.
“The National Prevention Strategy is an important first step in shifting the focus of health care in America from sickness and disease to prevention and wellness”, said Dr. Murthy.
The National Prevention Strategy will do this by focusing on four strategic directions:
- Creating and sustaining healthy and safe community environments.
- Making clinical and community preventive services available, integrated and mutually reinforcing.
- Empowering people to make healthy choices.
- Eliminates health disparities.
“Doctors believe one of the best ways to improve health care is through prevention. Everyday, we see patients in our clinics and hospitals who could have avoided painful illnesses and costly care if only preventive services had been available”, said Dr. Murthy. “The National Prevention Strategy will not only save lives but improve the care that our patients receive.”
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Carl C. Bell, M.D.
ADVISER’S VIEWPOINT
Prevention Initiative Is a Win for Patients, Bipartisanship
Carl C. Bell, M.D.
Finally! After decades of accumulating strong scientific evidence that prevention of mental, emotional, and behavioral disorders is possible, the first U.S. National Prevention and Health Promotion Strategy stewarded by a cabinet level council has become a reality ( see “Feds Release First-Ever National Prevention Strategy,” p. 3).This strategy will be driven by evidence-based recommendations for improving health and prolonging life by implementing strategies aimed at promoting tobacco-free living; preventing drug abuse and excessive alcohol use; ensuring healthy eating, active living, and injury and violence free living; encouraging reproductive and sexual health; and pushing mental and emotional wellbeing.
Momentum for this first-ever national prevention strategy started under the Clinton administration, moved through the George W. Bush administration, and came to fruition under President Obama. This is as it should be. After all, health care should never be politicized.
Early Beginnings
My first recollection of the start of this federal prevention initiative was during the Clinton administration when Juan Ramos of the National Institute of Mental Health (NIMH) supported the commission of the 1994 Institute of Medicine (IOM) Reducing Risks for Mental Disorders report. Then, in 2000, NIMH, National Institute on Drug Abuse, the Veterans Administration, Centers for Disease Control, and the National Institute on Alcohol Abuse and Alcoholism commissioned the IOM to produce a report on suicide prevention called “Reducing Suicide – A National Imperative. That report stated that “protective factors” were what was preventing the vast majority of people who attempt suicide from completing suicide (“Proactive Approaches to Preventing Suicide,” CLINICAL PSYCHIATRY NEWS, May 2011, p. 10).
The next strong prevention report came from Clinton’s 16th surgeon general – Dr. David Satcher. His Youth Violence Report put the problem of youth violence into perspective and outlined several evidence-based prevention solutions. It was from these two reports that Dr. Satcher and I came up with the maxim: “Risk factors are not predictive factors due to protective factors.”
In 2002, during the Bush administration, Kathryn Power of the Substance Abuse and Mental Health Administration (SAMSHA) convened the New England Coalition for Health Promotion and Disease Prevention (NECON), where several evidence-based prevention strategies for mental and behavioral disorders were suggested to governmental entities in the Northeast. In addition, the New Freedom Commission also began its work aimed at transforming mental health care in America under President Bush.
Prevention was strongly highlighted in the commission’s report. However, the report was highly criticized by some Republicans because it supported government involvement in screening families for precursors for future mental illness. While the NIMH “dropped the prevention ball” (“NIMH Needs Stronger Prevention Focus,” CLINICAL PSYCHIATRY NEWS, February 2011, p. 19), Power of SAMSHA continued to lead the prevention vision.
Thus, to determine whether there was enough science to make the dream a reality, the IOM’s “Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities” report was commissioned. This report underscored the reality that preventing mental, emotional, and behavioral disorders was, in fact, possible and doable.
Finally, IOM has been able to develop tremendous traction during President Obama’s tenure. The IOM’s “Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities,” released in 2009 represented another step in the right direction. In fact, that report recommended the development of a White House cabinet level U.S. National Prevention and Health Promotion Strategy.
It has taken a long time and a lot of work from a multitude of people, but our nation has a tremendous opportunity before us. The science is very strong that we can prevent mental, emotional, and behavioral disorders. The president, secretary of Health and Human Services, surgeon general, other cabinet level officials and state governments can help this health promotion and prevention plan happen. But they will need the political will of the American people to support them.
Clearly, both Republican and Democratic leadership has been trying to lead our nation toward new science that will prevent mental, emotional, and behavioral disorders – all of which lead to unhealthy behaviors that result in chronic physical illness They understand politics should have no place in health care.
The problem with any federal policy or strategy is always implementation. Fortunately, we finally understand that it takes far too many years to turn these dreams into reality – even in the face of solid evidence-based interventions. Let’s do this!
DR. BELL is chief executive officer and president of Community Mental Health Council Inc. of Chicago. He also serves as director of the Institute of Juvenile Research at the University of Illinois at Chicago, and is director of public and community psychiatry at the university.
Dominica McBride
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