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Prevention is an investment in the future
Prevention programs must be accountable
Early childhood education is the key to economic development
All parents must receive support
Professional development is the key to quality prevention
Prevention must be integrated within communities
Enhance emotional health to prevent suicide
Innovation is an important element of prevention
2003/2004 Prevention Committee
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Prevention is an investment in the future
Every
$1 spent on prevention saves $5 to $10 on social problems. 13,4
Investment of tax dollars in prevention is the most cost effective approach
to addressing crime, poverty, and illness. Comprehensive community based prevention
promoting social competence, building relationships and actively involving people
in their communities decreases costs of drug and alcohol treatment, crime, and
public assistance.
Substance use in Arizona starts early. Arizona teens smoke marijuana more often than cigarettes. 2 Nearly 20% have attended school intoxicated. 2 By age 18, over 15% of people in Arizona have developed a problem with alcohol or other substances. 18 Use of illicit drugs is increasing across all age groups with Arizona's rate among the ten highest in the Nation. 18
Incarceration
is the most expensive and least effective solution. It is time to shift the
War on Drugs to the application of concepts and funding of strategies from the
well-established science of substance abuse prevention and treatment. Not only
are prevention and treatment more effective than incarceration, but they are
substantially less expensive, and more respectful of human dignity. Treatment
of substance abuse must include active involvement of families and enhancement
of natural support systems to meet individual needs.
Family support and rehabilitation services in the behavioral health system are best provided through Community Service and Behavioral Health Organizations with established, high quality prevention and health promotion services.
Treatment should be integrated into communities. Community development and mobilization is a strategy all human services providers should employ to maximize their impact on individual health and well being. Prevention of substance abuse is best accomplished through collaborative, community partnerships which identify the prevalence of precursors to substance abuse in their community, develop a comprehensive plan to enhance strengths, build supports, and monitor outcomes.
Prevention programs must be accountable
Prevention providers are ethically obligated to ensure facilities and programs protect and promote the basic safety and health of participants.
Prevention should be provided in safe, clean settings. Providers that are not associated with licensed behavioral health agencies should pursue registration as a community service agency with the Division of Behavioral Health. In this way, health and safety issues would be in state compliance.
Arizona must develop a statewide data tracking system that addresses community, state, and human service provider goals and gathers data to assess program quality, impact, cost effectiveness, and benefits. The Arizona Council of Human Service Providers supports a coordinated evaluation of performance and prevention effectiveness across state departments.
Early childhood education is the key to economic development
Participation in early childhood programs increases cognitive ability and lowers rates of being held back in school. 5
Decades of inequitable school funding has contributed to teacher shortages, high school drop out rates, and unsafe school environments.
Human service agencies can assist schools with establishing a climate for students that promotes learning, strengthens resiliency, and bridges the school with the community. Youth who feel connected to school are more likely to avoid alcohol and other drugs, engage in healthy behavior, avoid pregnancy, and productively cope with stress.
Arizona
decision makers need to ensure that funds
continue for important programs like:
All parents must receive support
Infancy and pregnancy are crucial times for children. In 2001, 743 babies in Arizona were born to mothers who used alcohol during pregnancy. 8 Prenatal exposure to alcohol and illegal drugs causes low birth weight, small head size, long term medical complications and increased incidence of Sudden Infant Death Syndrome Drug and alcohol exposed infants tend to be irritable, lethargic and difficult to console. 9 These babies can be difficult to bond with thus creating parents who are more likely to abuse or neglect their child. 16
Child abuse and neglect have serious negative effects on our children. Annually, over 6,000 Arizona children are in out of home care due to abuse or neglect perpetrated by their parents or guardians. 6
Promotion
of child health and welfare begins with providing support and education to all
parents. Parents at greater risk to abuse or neglect their child need even more
comprehensive support and education, but have been the least likely to receive
it. Parents at high risk include: parents with alcohol or other drug addiction,
parents of children with developmental disabilities, victims of domestic violence,
parents with a mental illness, and adolescent parents. 15 The behavioral health treatment and medical systems need to work harder to identify the support and education needs of parents with substance use disorders,
behavioral health disorders, young parents, and parents of children with disabilities.
Programs providing support and education to parents at high risk for abuse or neglect should be given priority for state funding.
In addition, youth removed from the care and custody of their family should be provided with specialized support via the behavioral health treatment system that addresses issues related to trauma, abandonment, abuse, and neglect.
Professional development is the key to quality prevention
Prevention is most effective when implemented by well-trained and supported individuals. Staff retention and recruitment are a major barrier to programmatic success, particularly in rural communities; low salaries contribute to this problem.
A statewide resource center for the training and development of human service professionals should be funded at capacity. Policy makers need to support program efforts to develop effective methods of recruiting and retaining quality staff. Universities in Arizona need to work harder to coordinate their education of students with the needs of Human Services Providers.
Prevention must be integrated within communities
Prevention must be relevant to the population served and targeted populations must be involved in program planning. Community needs must be understood and programs evaluated.
Legislators, decision makers and providers have a responsibility to coordinate with communities.
Tools
for understanding community needs, identifying gaps, and establishing directions
for future programming are available. Two tools are the Arizona Youth Survey
(AYS) and Youth Risk Behavior Survey (YRBS). Administered to youth throughout
Arizona in alternating years, these surveys measure behaviors contributing to
the development of behavioral health problems.
A third tool is the Arizona Prevention Resource Center Program Inventory, which provides a snapshot of services available.
Financial support for the collection of data and implementation of the two school based prevention surveys must continue. Problems can only be addressed when they are clearly understood. Prevention funders need to work together from a common framework to address prevention and establish a common vocabulary and framework for prevention.
Enhance emotional health to prevent suicide
Death from suicide among young adults and teens is prevalent among Native American men, Hispanic men, gay, lesbian, bisexual, and transgender populations, alcoholics, gamblers, and White males over age 65. 17,10
Suicide is the third leading cause of death for young people ages 15-24 years in Arizona. 23% of Arizona's female students and 12% of male students have seriously contemplated attempting suicide. 3 90% of suicide victims have a diagnosable behavioral health disorder. 1
Successful suicide prevention efforts focus on resiliency building and primary prevention of substance abuse and depression among high risk groups. Effective suicide prevention programs build on individual strengths, enhance social competence, build relationships and provide opportunities for meaningful involvement within their community.
Cooperation around suicide prevention is crucial to the successful growth and development of individuals.
Innovation is an important element of prevention
The Center for Substance Abuse Treatment has designated fifty five model prevention programs. This honor is granted when a program has been rigorously evaluated and the results have been published in a peer reviewed journal. While the Arizona Council of Human Service Providers recognizes the merit of using effective prevention strategies, the Council does not endorse the exclusive use of “model programs.” Successful programs are relevant to the population served. Culture is thoughtfully considered in their development and implementation. Many model curricula are prohibitively expensive, irrelevant to Arizona populations and/or not comprehensive enough to make a substantial dent in the reduction of social problems.
Arizona is home to a variety of research grounded, innovate prevention programs. Innovation and adaptation are important to appropriately meet the needs of Arizona’s diverse population and unique issues. Policy makers need to support and encourage innovation grounded in research based strategies, while maintaining support for the best practices.
2003/2004
Prevention Committee Michele R. Brown, MC
EMPACT-SPC and UMOM New Day Centers
Ilene Dode, Ph.D.
EMPACT-SPC
Aimee Graves, MA
CODAC Behavioral Health
Barbara Lamere
Youth Evaluation and Treatment Center
Ed McClelland
Southwest Behavioral Health Services
David F. Miller, CEO
Arizona Council of Human Service Providers
Sandra Ovalle
Presbyterian Service Agency
David Phelan
Scottsdale Links Collaborative
Laura Reith
Office of Prevention & Family Support, DES/DCYF
| 1. | American Association of Suicidology web site—www.suicidology.org. |
| 2. | Arizona Criminal Justice Commission (2002). State of Arizona Youth Survey. Phoenix, AZ: Arizona Criminal Justice Commission. |
| 3. | Arizona Department of Education (2003) Youth Risk Behavior Survey Brochure. |
| 4. | Caulkins, J., Pacula, R., Paddock, S., Chiesa, J. (2002). School-Based Drug Prevention: What Kind of Drug Use Does It Prevent? Rand’s Drug Policy Research Center. |
| 5. | Children’s Action Alliance. Measuring School Readiness: How do we know when we’re on track? |
| 6. | Child Welfare League of America, (2003). Arizona’s Children 2003, Washington DC. |
| 7. | Fishbein, D. (2000). The Importance of Neurobiological Research to the Prevention of Psychopathology. Prevention Science (1). P. 89. |
| 8. | Mrela, C., Coe, T. (2001). Arizona Health and Vital Statistics. Phoenix, Arizona: Arizona Department of Health Services. |
| 9. | National Clearinghouse on Child Abuse and Neglect. (2001). IN FOCUS: Understanding the Effects of Maltreatment on Early Brain Development. US Department of Health and Human Services. |
| 10. | Overholser, J, Freiheit, S. R., Di Filippo. J. (1997). Emotional Distress and Substance Abuse as Risk Factors for Suicide Attempts. Canadian Journal of Psychiatry, 42, p. 402-408. |
| 11. | Pentz, M. (2003) Preventing Drug Abuse Through the Community: Multi-component Programs Make the Difference. Presentation to the National Conference on Drug Abuse Prevention Research. |
| 12. | Rolnick, A. (2003) Federal Reserve Bank of Minnesota. |
| 13. | Scott, S., Knapp, M., Henderson, J., Maughan, B., (2001). Financial cost of social exclusion: follow up study of antisocial children into adulthood. British Medical Journal. |
| 14. | St. Luke’s Health Initiatives (2003). Counting Counts: Building Resilience Indices. Arizona Health Futures. P. 17. |
| 15. | Thomas, D. Leicht, C. Hughs, C. Madigan, A and Dowell, K. (2003). Emerging Practices in the Prevention of Child Abuse and Neglect (DHHS Publication). |
| 16. | U. S. Department of Health and Human Services, Administration for Children and Families. The Risk and Prevention of Maltreatment of Children with Disabilities. National Clearinghouse on Child Abuse and Neglect Information. |
| 17. | Wandersman, A. Intentional Self Harm (Suicide). Injury Mortality Among Arizona Residents 1990-2000. Arizona Department of Health Services. |
| 18. | Wright, D. (2003). State Estimates of Substance Use from the 2001 National Household Survey on Drug Abuse: Volume 1. Findings (DHHS Publication No. SMA 03-3775NHSDA Series H-19). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies. |