Research on Child and Adolescent Mental Health

illnesses, including the processes mediating and
moderating the expression of symptoms, cannot be
understood without reference to the various
contexts in which a child lives (e.g., family, peer
group, school, community) and sociocultural
ecology. The most effective management of
childhood mental illnesses and preventive
strategies must take into account this context and
address the needs of children and their families
throughout the child’s development.
P Empirical science must underlie both
practice and policy. To provide the most effective
interventions possible for the prevention and
treatment of childhood mental illnesses, the
science base must be linked to practice and used
to direct policy, so as to reduce the disparities and
gaps in access to effective interventions.
P Interdisciplinary research is key to
advancing the understanding of children's mental
health. The rapid advances in various disciplines
of science highlight exciting opportunities for
integrating a broad knowledge base to advance
etiologic understanding of child and adolescent
mental health.
P Children’s mental disorders are often
chronic. Consequently, evidence-based treatments,
prevention programs, and services must be
positioned permanently in communities to provide
care, over time, to children and their families.
P Equity in care for children’s mental health is
essential. Compelling scientific evidence on the
critical importance of children’s mental health for
learning and development indicates the need for
the health system to address children’s mental
health in the same way that it addresses physical
health.
D. Conceptual Models
for the Report
Two broad conceptual models, shown in Figures 1
and 2, also guide the development of this report.
The first model addresses the relationship
between basic science and child mental health
services. The second model describes a
developmental framework linking neuroscience,
behavioral science, and intervention across the
life span. In this section, we describe each model
and its relevance to the themes of the report.
CYCLICAL FEEDBACK MODEL
A primary goal of this report is to describe,
illustrate, and encourage the application of a
model for the links between basic science and the
provision of mental health services to children
and adolescents. This model, depicted in Figure 1,
envisions a cyclical sequence of processes. The
sequence we envision is never expected to reach a
terminus at which all the answers are known and
all service interventions are perfected. Instead,
any report on the state of the field, at any time,
will be a snapshot of a moving target; the body of
scientific evidence and the collection of specific
“best interventions” will change continually. For
this reason, we do not attempt here to provide an
exhaustive list of the most important findings of
basic science or the best-supported interventions.
Instead, our goal—in the model and throughout
the report—is to describe a model, or strategy, for
building knowledge and building interventions by
maintaining a strong linkage between science and
practice. Implicit in the model, and throughout
this report, is our view that best practice in
mental health requires a close connection to the
state of the science and that best science requires
ongoing feedback from real-world experience.
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