Being deployed to a war zone can result in numerous adverse psychological health conditions. It is well documented in the literature that there are high rates of psychological disorders among military personnel serving in Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq as well as among the service members' families. For service members' families, the degree of hardship and negative consequences rises with the amount of the service members' exposure to traumatic or life-altering experiences. Adult and child members of the families of service members who experience wartime deployments have been found to be at increased risk for symptoms of psychological disorders and to be more likely to use mental health services. In an effort to provide early recognition and early intervention that meet the psychological health needs of service members and their families, DOD currently screens for many of these conditions at numerous points during the military life cycle, and it is implementing structural interventions that support the improved integration of military line personnel, non-medical caregivers, and clinicians, such as RESPECT-Mil (Re-engineering Systems of Primary Care Treatment in the Military), embedded mental health providers, and the Patient-Centered Medical Home. Preventing Psychological Disorders in Service Members and Their Families evaluates risk and protective factors in military and family populations and suggests that prevention strategies are needed at multiple levels - individual, interpersonal, institutional, community, and societal - in order to address the influence that these factors have on psychological health. This report reviews and critiques reintegration programs and prevention strategies for PTSD, depression, recovery support, and prevention of substance abuse, suicide, and interpersonal violence. Table of Contents Front Matter SUMMARY 1 INTRODUCTION 2 CONCEPTUAL FRAMEWORKS FOR REVIEWING EVIDENCE-BASED PREVENTION IN PSYCHOLOGICAL HEALTH 3 UNDERSTANDING PSYCHOLOGICAL HEALTH IN THE MILITARY 4 EVIDENCE FOR DEPARTMENT OF DEFENSE INTERVENTIONS FOR PREVENTING PSYCHOLOGICAL DISORDERS 5 MEASUREMENT OF DEPARTMENT OF DEFENSE PREVENTION INTERVENTIONS RELATED TO PSYCHOLOGICAL HEALTH 6 FINDINGS AND RECOMMENDATIONS Appendix A: SUMMARY FROM *RETURNING HOME FROM IRAQ AND AFGHANISTAN: ASSESSMENT OF READJUSTMENT NEEDS OF SERVICE MEMBERS AND THEIR FAMILIES* Appendix B: INFORMATION-GATHERING MEETING AGENDA Appendix C: SUPPLEMENTAL HEALTH SCREENING QUESTIONNAIRE Appendix D: PRE-DEPLOYMENT HEALTH ASSESSMENT QUESTIONNAIRE Appendix E: POST-DEPLOYMENT HEALTH ASSESSMENT QUESTIONNAIRE Appendix F: POST-DEPLOYMENT HEALTH RE-ASSESSMENT QUESTIONNAIRE Appendix G: PROGRAM REVIEWS FROM *SUBSTANCE USE DISORDERS IN THE U.S. ARMED FORCES* Appendix H: TABLE OF DOD PROGRAMS TO INCREASE RESILIENCE OR PREVENT PSYCHOLOGICAL HEALTH DISORDERS, AS IDENTIFIED BY RAND

Mental health and substance use disorders among children, youth, and young adults are major threats to the health and well-being of younger populations which often carryover into adulthood. The costs of treatment for mental health and addictive disorders, which create an enormous burden on the affected individuals, their families, and society, have stimulated increasing interest in prevention practices that can impede the onset or reduce the severity of the disorders. Prevention practices have emerged in a variety of settings, including programs for selected at-risk populations (such as children and youth in the child welfare system), school-based interventions, interventions in primary care settings, and community services designed to address a broad array of mental health needs and populations. Preventing Mental, Emotional, and Behavioral Disorders Among Young People updates a 1994 Institute of Medicine book, Reducing Risks for Mental Disorders, focusing special attention on the research base and program experience with younger populations that have emerged since that time. Researchers, such as those involved in prevention science, mental health, education, substance abuse, juvenile justice, health, child and youth development, as well as policy makers involved in state and local mental health, substance abuse, welfare, education, and justice will depend on this updated information on the status of research and suggested directions for the field of mental health and prevention of disorders. Table of Contents Front Matter Summary 1 Introduction Part I: Overview and Background 2 The Nature and Extent of the Problem 3 Defining the Scope of Prevention 4 Using a Developmental Framework to Guide Prevention and Promotion 5 Perspectives from Developmental Neuroscience Part II: Preventive Intervention Research 6 Family, School, and Community Interventions 7 Prevention of Specific Disorders and Promotion of Mental Health 8 Screening for Prevention 9 Benefits and Costs of Prevention 10 Advances in Prevention Methodology Part III: New Frontiers 11 Implementation and Dissemination of Prevention Programs 12 Prevention Infrastructure 13 Toward an Improved Approach to Prevention References Appendixes Appendix A: Biographical Sketches of Committee Members and Staff Appendix B: Open Session and Workshop Agenda Appendix C: Sources of Data on Prevalence of MEB Disorders of Young People (Studies Contributing to Table 2-1 and Figure 2-1) Appendix D: Preventive Intervention Meta-Analyses Appendix E: Tables of Risk Factors Appendix F: Intervention Research Portfolio One-Year Snapshot: Summary Analysis Index