APA Resolution on Children's Mental Health

Adopted by the APA Council of Representatives, October 2003


(For ease of presentation the term child is used to refer to infants, children, and adolescents.) 

Whereas psychology has been in the lead in demonstrating the importance of mental health in child development (Burns, Hoagwood, & Mrazek, 1999; Coie et al., 1993; Mrazek, & Haggerty, 1990; Marsh & Fristad, 2002; Wolchik & Sandler, 1997);

Whereas psychology is committed to providing the highest quality mental health care to children based on the best available evidence derived from ecologically valid research and evaluation of promotion, prevention, and treatment interventions (Biglan, A., Mrazek, P. J., Carnine, D., & Flay, B. R. 2003; Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., Morrissey-Kane, E., & Davino, K. 2003; Weisz, J.R., Jensen, A.L., & McLeod, B.D. in press);

Whereas there are various types of useful evidence of the effectiveness of interventions, including clinical consensus, program evaluations, research using randomized experimental and quasi-experimental designs, single-subject designs, and successful replicated demonstrations of effectiveness in real world settings (Chamberlain, P., & Smith D.K. in press; Durlak, J. A. & Wells, A. M.1997; Durlak, J.A., Wells, A.M., Cotton, J.K., & Johnson, S. 1995). For the purposes of this document, "evidence-based practice" involves the integration of best research evidence with clinical expertise and patient values (Institute of Medicine, 2001);

Whereas psychology has taken a leadership role in developing mental health promotion, prevention, and treatment interventions that meet high standards of effectiveness (Christopherson, E. R. & Mortweet, S. L. 2001; A. E. Kazdin & J. R. Weisz, Eds., 2003);

Whereas there is inadequate access to appropriate evidence-based promotion, prevention, and treatment services for children with, or at risk for, mental disorders (Paavola, 1994; Weisz, Donenberg, Han, & Weiss, 1995);

Whereas stigma regarding mental health imposes risk for children, and impedes understanding of mental health issues and access to needed mental health services (Corrigan & Lundin, 2002);

Whereas there is a disparity of access to appropriate evidence based promotion, prevention, and treatment services based on poverty, ethnicity, race, and special needs of children (Leong, 2001; Rollock & Gordon, 2000; U.S. Department of Health and Human Services, 2001);

Whereas there is inadequate financing for culturally competent, appropriate, evidence-based promotion, prevention, and treatment services (Bazelon Center for Mental Health Law, 1999; Sturm et al., 2000);

Whereas there is a need for increased research on the translation of evidence-based practices into promotion, prevention, or treatment services that are appropriate for children, families, schools, and communities in real world settings (Burns, 1999; Burns & Friedman, 1990; Burns & Hoagwood, 2002; Clarke, 1995; Kazdin & Weisz, 1998; Schoenwald & Hoagwood, 2001);

Whereas there is a need for increased research on the effectiveness of promotion, prevention, and treatment services for children, families, schools, and communities that are developed by practitioners dealing with problems and varied contexts in the community (Weisz, Donenberg, Hans, & Weiss, 1995);

Whereas there is an increased need for research on assessment and diagnosis of children's mental health problems and strengths in the context of their culture, family, school and community (Wandersman, A., & Florin, P., 2003; Kumpfer, K. L. & Alvarado, R., 2003; Wilson, D. B., Gottfredson, D. C., & Najaka, S. S., 2001; Wolchik, S. A., Sandler, I. N., Millsap, R. E., Plummer, B. A., Greene, S. M., Anderson, E. R., Dawson-McClure, S. R., Hipke, K., & Haine, R. A., 2002);

Whereas there is a shortage of trained providers to deliver culturally competent evidence-based promotion, prevention, and treatment services for children (U.S. Department of Health and Human Services, 1999; U.S. Public Health Service, 2000);

Therefore, bit resolved, that:

The American Psychological Association (APA) take a significant leadership role to support and advocate that it is every child's right to have access to culturally competent, developmentally appropriate, family oriented, evidence-based, high-quality mental health services that are in accessible settings.

APA take a leadership role in ensuring that the utilization of promotion, prevention, and treatment interventions for child mental health meet the highest standards of available evidence.

APA collaborate with other organizations, consumers, and policy makers to develop and implement a primary mental health care system for children that integrates culturally competent, evidence-based, high quality, promotion, prevention, and treatment services for children, families, schools and communities.

APA provide leadership, support, and advocacy for basic and applied research to develop culturally appropriate knowledge on the promotion of mental health and the prevention and treatment of mental health problems, to translate findings from research into effective services and to evaluate services that are developed at the community level.

APA support and advocate for developing adequate funding sources that are coordinated and efficient for supporting a primary mental health care system.

APA support, advocate, and provide leadership for education and training that builds upon culturally competent, evidence-based promotion of mental health and prevention and treatment of mental health problems for all children, and reduces economic, racial, ethnic and gender disparities.

References

Bazelon Center for Mental Health Law. (1999). Making sense of Medicaid for children with serious emotional disturbance. Washington, D.C.: Author.

Biglan, A., Mrazek, P. J., Carnine, D., & Flay, B. R. (2003). The integration of research and practice in the prevention of youth problem behaviors. American Psychologist, 58, No. 6/7, 433-440.

Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E. M., & Erkanli, A. (1995). Children's mental health service use across service sectors. Health Affairs, 14, 147-159.

Burns, B., & Friedman, R. (1990). Examining the research base for child mental health services and policy. Journal of Mental Health Administration, 17, 87-98.

Burns, B & Hoagwood, K. (Eds.). (2002). Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders. New York: Oxford University Press.

Burns, B., Hoagwood, K., & Mrazek, P. (1999). Effective treatment for mental disorders in children and adolescents. Clinical Child and Family Psychology Review, 2(4), 199-254.

Chamberlain, P., & Smith D.K. (in press). Antisocial behavior in children and adolescents: The Oregon multidimensional treatment foster care model. In A. E. Kazdin & J. R. Weisz (Eds), Evidence-based psychotherapies for children and Adolescents. New York: Guilford Press.

Christopherson, E. R. & Mortweet, S. L. (2001). Childhood therapies that help: A much needed resource. Washington, D.C: American Psychological Association.

Clarke, G. N. (1995). Improving the transition from basic efficacy research to effectiveness studies: Methodological issues and procedures. Journal of Consulting and Clinical Psychology, 63, 718-725.

Coie, J., Watt, N., West, S., Hawkins, J., Asarnow, J., Markman, J., Ramey, S., Shire, M., & Long, B. (1993). The science of prevention: A conceptual framework and some directions for a national research program. American Psychologist, 4(8), 1013-22.

Corrigan, P., & Lundin, R. (2002). Don't call me nuts: Coping with the stigma of mental illness. Chicago: University of Chicago Recovery Press.

Durlak, J. A. & Wells, A. M. (1997). Primary prevention mental health programs for children and adolescents: A meta-analytic review. American Journal of Community Psychology, 25, 115-152.

Durlak, J.A., Wells, A.M., Cotton, J.K., & Johnson, S. (1995). Analysis of selected methodological issues in child psychotherapy research. Journal of Clinical Child Psychology, 24, 141-148

Hoagwood, K. (2001). Evidence-based practice in children's mental health services: What do we know? Why aren't we putting it to use? Report on Emotional & Behavioral Disorders in Youth, 1(4), 84-88.

Institute of Medicine (U.S.) Committee on Quality of Health Care in America (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press.

Kazdin, A. E. & Weisz, J. R. (Eds), (2003). Evidence-based psychotherapies for children and adolescents. New York Guilford Press.

Kazdin, A. E., & Weisz, J. R. (1998). Identifying and developing empirically supported child and adolescent treatments. Journal of Consulting and Clinical Psychology, 66, 19-36.

Kumpfer, K. L. & Alvarado, R. (2003). Family-strengthening approaches for the prevention of youth problem behaviors. American Psychologist, 58, No. 6/7, 457-465.

Leong, F. (Ed.). (2001). Barriers to providing effective mental health services to racial and ethnic minorities in the United States. Mental Health Services Research, 3(4). Marsh, D., & Fristad, M. (Eds.). (2002). Handbook of serious emotional disturbance in children and adolescents. New York: John Wiley and Sons.

Mrazek, P., & Haggerty, R. (Eds.). (1990). Handbook of early childhood intervention: Frontiers in preventive intervention research. Washington, D.C.: National Academy of Sciences.

Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., Morrissey-Kane, E., & Davino, K. (2003). What works in prevention. American Psychologist, 58, No. 6/7, 449-456.

Paavola, J. et al. (1994). Comprehensive and coordinated psychological services for children: A call for service integration. Washington, D.C.: American Psychological Association Task Force on Comprehensive and Coordinated Psychological Services for Children: Ages 0-10.

Roberts, R., Attkisson, C., & Rosenblatt, A. (1998). Prevalence of psychopathology among children and adolescents. American Journal of Psychiatry, 155, 715-725.

Rollock, D., & Gordon, E. (2000). Racism and mental health into the 21st century: Perspectives and parameters. American Journal of Orthopsychiatry, 70(1), 5-14.

Schoenwald, S. K., & Hoagwood, K. (2001). Effectiveness, transportability, and dissemination of interventions: What matters when? Psychiatric Services, 52, 1190-1197.

Shaffer, D., Fisher, D., Dulcan, M. K., Davies, M., Piacentini, J., Schwab Stone, M. E., Lahey, B. B., Blurdon, K., Jensen, P. S., Bird, H. R., Canino, G., & Regier, D., A. (1996). The National Institute of Mental Health (NIMH) Diagnostic Interview Schedule for Children Version 2.3: Description, acceptability, prevalence rates, and performance in the MECA Study. Methods for the Epidemiology of Child and Adolescent Mental Disorders Study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 865-877.

Sturm, R., Ringel, J., Bao, C., Stein, B., Kapur, K., Zhang, W., & Zeng, F. (2000). National estimates of mental health utilization and expenditures for children in 1998 (working Paper 205). Los Angeles, CA: Research Center on Managed Care for Psychiatric Disorders.

United States Department of Health and Human Services. (1999). Mental health: A report of the Surgeon General. Rockville, MD.

United States Department of Health and Human Services. (2001). Mental health: Culture, race and ethnicity. (A supplement to Mental Health: A report of the Surgeon General.) Rockville, MD.

United States Public Health Service. (2000). Report of the Surgeon General's conference on children's mental health: A national action agenda. Rockville, MD.

Weisz, J.R., Jensen, A.L., & McLeod, B.D. (in press). Milestones and methods in development and dissemination of child and adolescent psychotherapies: Review, commentary, and a new deployment-focused model. In E.D. Hibbs & P.S. Jensen (Eds.), Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice, 2nd edition. Washington, DC: American Psychological Association.

Weisz, J., Donenberg, G., Han, S., & Weiss, B. (1995). Bridging the gap between lab and clinic in child and adolescent psychotherapy. Journal of Consulting and Clinical Psychology, 63, 688-701.

Wilson, D. B., Gottfredson, D. C., & Najaka, S. S. (2001). School-based prevention of problem behaviors: A meta-analysis. Journal of Quantitative Criminology, 17, 247-272.

Wolchik, S. A., Sandler, I. N., Millsap, R. E., Plummer, B. A., Greene, S. M., Anderson, E. R., Dawson-McClure, S. R., Hipke, K., & Haine, R. A. (2002). Six-year follow-up of preventive interventions for children of divorce: A randomized controlled trial. Journal of the American Medical Association, 288, 1874-1881.

Wolchik, S. A., & Sandler, I. N. (1997). Handbook of children's coping with common life stressors. New York: Plenum.

October 2003