Despite the many unequivocal successes achieved by the field, traditional victim-oriented approaches to mental health treatment have at least one obvious limitation. Even the most sophisticated after-the-fact treatment approaches are incapable of reducing the initial incidence rates of a disorder (Bloom, 1979). As Albee (1982) notes, regardless of our best efforts, no disease or mental disorder can be conquered in a solely reactive fashion by treating only those already affected. In fact, some have argued that by focusing on treatment to the exclusion of prevention, mental health professionals have sometimes labored under an illusion that social problems are being solved, when they actually are not (Heller, Jenkins, Steffen, & Swindle, 2000).

Prevention of disorders before they occur is an appealing proposition, especially when applied to children. Who would dispute the value in teaching children skills and bolstering their competencies to spare them later physical and psychological distress? Periodically over the years, the virtues of prevention have been espoused by various mental health advocates, but these sentiments have typically been overlooked by the broader treatment community (Heller, 1996).

Why has the mental health community been reluctant to embrace such an inherently attractive concept as prevention? Several factors may have contributed to prevention's apparent lack of staying power. First, as noted, the established mental health treatment community historically has concerned itself with the remediation of existing deficits in individual patients. The sheer inertia of this orientation, along with early advocates' sometimes poor articulation of the prevention concept, has made it difficult for preventionist movements to gain a strong constituency. Second, it has been suggested by Felner, Felner, and Silverman (2000) that our society seems to believe that a certain level of human suffering and loss is acceptable or even necessary. Felner et al. maintain that the adoption of a goal of zero tolerance toward human casualties is necessary for prevention as a concept to be effective and widely accepted. Finally, the movement toward prevention has periodically been slowed by critics arguing that prevention had yet to prove its worth (e.g., Lamb & Zusman, 1979; Moscowitz, 1989).

Over the past several years, however, a clear groundswell of support for the prevention of mental disorders has once again emerged. Managed care organizations have begun to tout early detection and prevention in an effort to curb rising health care costs. These organizations hope to reduce the traditional reliance on more expensive acute care delivery systems. The Institute of Medicine (IOM) and the National Institute of Mental Health (NIMH) have each released reports, authored by prominent and influential preventionists, reviewing the current state of mental health prevention and calling for a strong national prevention research agenda (Mrazek & Haggerty, 1994; NIMH, 1994). These reports provide increased acknowledgment of the merits of prevention research on the federal level. Influential psychologist and past president of the American Psychological Association Martin Seligman has also spoken widely of the need to refocus psychology on prevention and promotion of more positive human attributes (Clay, 1997). Together, these events signal that, once again, the time is ripe for prevention. No groups stand to gain more from this renewed emphasis on prevention than children and adolescents. . .

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