From Research to Practice: A 20-Year Retrospective Exploring the Evolution of Prevention Research and How It Will Continue to Shape National and State Policy and Program Efforts

SAMHSA's prevention mission for the last 20 years has been to provide support for prevention services that are effective in reducing drug and alcohol abuse and the consequences of drinking, and reduce mental disorders.  Over time, this mission has been expanded to include the prevention of suicide and building emotional health that will lead to improved mental and physical health for our children, our families, and our communities.  SAMHSA is the leading agency for delivering behavioral prevention services in our country, delivering nearly $400 million in state prevention grants, $90 million in state mental health grants, and $50 million in behavioral health tribal prevention grants.  In this presentation we discuss priority themes that drive SAMHSA's continuing prevention agenda and how research, which is outside of SAMHSA's direct mission, continues to shape both national and state programs and policies.  One important focus involves the integration of prevention  for substance abuse and mental disorders.  We discuss the importance of this integration in the light of changing insurance coverage;  by the beginning of 2014, we expect 32 million more Americans will be eligible to be covered by health insurance that includes both mental health and substance abuse preventive services.  Also,  many of the strengths of SAMHSA's separate programs can be leveraged by having community coalitions include non-traditional partners, so that the perspectives of mental health, substance abuse,  primary care, and insurance can be taken into account.  Secondly, we discuss the role of SAMHSA's five-point Strategic Prevention Framework (SPF) as a common unifying framework for preventing drug abuse and mental disorders.  Beginning with epidemiologic assessment of a population's needs, resources, and readiness, SPF's second phase involves capacity building, including training and technical assistance to facilitate the adoption of prevention science-based programs, practices, and policies.  The third phase involves comprehensive planning, followed by an implementation phase to carry out this plan as well as identifying and overcoming barriers.  SPF's fifth phase of evaluation is used to measure program and practice impact and need for change.  We illustrate how SAMHSA continues to integrate the work of prevention science into practice.  Achievements and challenges in applying research findings to prevention practice will be discussed.