Prevention Interventions Curb Substance Abuse

Article excerpt

BALTIMORE -- Delinquency prevention programs have changed much for the better in the last 23 years, through the cooperation of a variety of health professionals, parents, schools, and neighborhoods, J. David Hawkins, Ph.D., said at the annual conference of the Association for Medical Education and Research in Substance Abuse.

Compared with just 10 prevention programs that were all found ineffective in randomized, controlled trials prior to 1980, the last 23 years have seen a well-spring of about 90 interventions for adolescent health and behavioral problems, noted Dr. Hawkins, director of the social development research group at the University of Washington in Seattle.

"In fact, we have more tested, effective programs than any single community can put in place at any point in time," he said.

One system that uses many of the effective interventions is Communities That Care (CTC), which Dr. Hawkins calls an "operating system" rather than a "program." CTC seeks to build a sense of ownership among children and adolescents within the communities and neighborhoods in which they live. CTC's long-term outlook on prevention requires the coordinated effort of many groups in the community, including physicians and other health professionals.

CTC planners identify the readiness of diverse groups in a community to prevent youth delinquency. The planners try to understand each group's perception of community problems and strengths, as well as its view of prevention. The group "must think you can prevent, not just treat" substance abuse and delinquency, said Dr. Hawkins, a consultant to the developer of CTC, the Channing Bete Co., South Deerfield, Mass. Each group's prior experience with collaborative efforts and prevention helps to show a community's readiness to begin CTC.

It will be necessary to bring a group of key community leaders together to understand the CTC process, insure its accountability and resources, and to create a vision of a healthy community. These leaders include people such as the mayor, police chief, superintendent of schools, health professionals, and other business and service leaders, Dr. Hawkins said.

Psychiatrists should recognize that they are "key leaders of their communities in helping people to understand that it is possible to prevent psychiatric disorders in advance," Dr. Hawkins told this newspaper. "Psychiatrists also understand science, so they can be articulate spokespeople for the fact that we not only have effective treatment interventions but effective preventive interventions that can reduce the need for treatment later among our young people."

For strategies that may be effective in a particular area, young people in the community must be surveyed to identify risk and protective factors and academic and behavioral outcomes for a district, city, neighborhood, or school. …