Limitations of universal prevention
Prevention programs deemed universal prevent stigmatization and benefit most children. Unfortunately, because their impact on at risk and disorder carrying children is limited, they don’t lower the prevalence of mental disorders. They don’t cure existing conditions and their impact on risk factors is limited.
Giving every child equal access to services
Because teachers or parents have difficulty tolerating deviant behaviors, children who are taken care of are often those who are most annoying for adults. There are many other youths whose mental health problems are rarely identified because they do not create much trouble, like children and adolescents carrying internalizing disorders (depression, anxiety) that may foster suicidal behavior. Suicide is the third leading cause of death among American adolescents and the second one in Quebec. Dominic would give every child/adolescent equal access to services.
Symptom-loading and services organization
For more than 60 years we known that when mental health is concerned, the number of symptoms matches the severity of the condition. During the last 40 years the WHO and the APA (American Psychiatric Association) have promoted this methodology. The symptom-loading approach is used in most countries for research, clinical work, statistics, and by insurance companies. Services organization is the only mental health sector that does not take advantage of it.
Most of the time, available resources are allocated based on population numbers, political motives or subjective impressions, although a simple symptoms count would allow resources to target only the neediest and be devoted primarily to those most suffering, most at risk and most dangerous to themselves and/or others.
Those with fewer symptoms could benefit from collective family prevention programs (e.g., development of parental competencies) and more affordable group interventions.
This would prevent the condition from getting worse until the child’s behavior can no longer be tolerated and s/he is referred to a mental health facility.