Dept. of Health and Human Services

Substance Abuse Prevention

Substance abuse and problematic patterns of substance use among youth can lead to problems at school, cause or aggravate physical and mental health-related issues, promote poor peer relationships, cause motor-vehicle accidents, and place stress on the family. They can also develop into lifelong issues such as substance dependence, chronic health problems, and social and financial consequences.1

Substance abuse is the harmful pattern of using substances—such as tobacco, alcohol, illicit drugs, and prescription drugs—leading to impairment or distress with one or more of the following behaviors: 

  • Recurrent substance use resulting in failure to fulfill major responsibilities at work, school, or home such as repeated absences, suspension, and expulsion
  • Recurrent substance use in situations where it is physically dangerous, such as driving while impaired
  • Recurrent substance-related legal problems, such as arrests for disorderly conduct that are substance-related
  • Continued substance use despite having persistent or recurring social or personal problems caused or worsened by substance use2

One of the most highly abused substances among youth in the U.S. is alcohol.3 Youth engage in binge drinking, a pattern of drinking that elevates the blood alcohol concentration to 0.08 percent or above, more than adults do.4 This can lead to risky and potentially harmful behaviors, and many times substance abuse (60-75 percent of youth with substance abuse problems) co-occurs with mental health disorders.

Substance use, abuse, and dependence can negatively impact every aspect of an individual’s life. Child-serving systems need to intervene early in the lives of youth to prevent or treat abuse, support young people, and provide them with the tools to choose the right path.

1 Department of Justice, 1998
2 American Psychiatric Association, 2000
3 Johnston, O’Malley, Bachman, & Schulenberg, 2012
4 For the typical adult, this pattern corresponds to consuming five or more drinks [men], or four or more drinks [women], in about 2 hours.

Homelessness and Runaway

Homelessness is a major social concern in the United States, and youth may be the age group most at risk of becoming homeless.1 The number of youth who have experienced homelessness varies depending on the age range, timeframe, and definition used, but sources estimate that between 500,000 and 2.8 million youth are homeless within the United States each year.2

Youth run away or are homeless for a range of reasons, but involvement in the juvenile justice or child welfare systems, abuse, neglect, abandonment, and severe family conflict have all been found to be associated with youth becoming homeless. These youth are vulnerable to a range of negative experiences including exploitation and victimization. Runaway and homeless youth have high rates of involvement in the juvenile justice system, are more likely to engage in substance use and delinquent behavior, be teenage parents, drop out of school, suffer from sexually transmitted diseases, and meet the criteria for mental illness.3 Experiences of unaccompanied homeless youth are different from those who experience homelessness with their families. While negative experiences persist for youth who are homeless with their families, their experiences may not vary drastically from youth living in poverty.4 Studies have also found distinct variability in outcomes experienced by homeless youth, suggesting that youth experience homelessness differently.5

Providing timely and direct interventions to homeless and runaway youth is important to protect them from the risks of living on the streets and to support positive youth development6, yet despite the risks and needs of these youth, few appear to know of, and access, support services.7 Even more critical is addressing the family/parental needs to prevent youth and/or their families from becoming homeless and addressing their behavioral health needs through comprehensive methods that involve both youth and their families. 

1 Toro, Dworsky, & Fowler, 2007
2 Cooper, 2006
3 Walsh & Donaldson, 2010; Toro, Dworsky, & Fowler, 2007
4 Samuels, Shinn, & Buckner, 2010
5 Huntington, Buckner, & Bassuk, 2008
6 Walsh & Donaldson, 2010
7 Pergamit & Ernst, 2010

 

SBIRT/YouthBuild

The Department of Labor's Employment and Training Administration (ETA) and the Department of Health and Human Services' Substance Abuse and Mental Health Services Administration (SAMHSA) partnered in a pilot program.

National Forum on Youth Violence Prevention (NFYVP)

The Forum models a new kind of federal/local collaboration, encouraging its members to change the way they do business by sharing common challenges and promising strategies, and through coordinated action.

Partnership for Results

Partnership for Results(The Partnership) is a model of local governance designed to implement a broad spectrum of evidence-based programs for the benefit of youth at risk. Operating in Cayuga County in Central New York, it has improved outcomes for children and youth and their families since its founding in 2000.

Memphis Fast Forward

The City of Memphis and Shelby County, Tennessee have developed three interwoven violence prevention initiatives—Operation: Safe Community, the Memphis Youth Violence Prevention Plan, and the Defending Childhood Initiative.

Key components that support the structure of these initiatives include

Suicide Prevention

Developmentally, the years between childhood and adulthood represent a critical period of transition and significant cognitive, mental, emotional, and social change. While adolescence is a time of tremendous growth and potential, navigating new milestones in preparation for adult roles involving education, employment, relationships, and living circumstances can be difficult. These transitions can lead to various mental health challenges that can be associated with increased risk for suicide.

Suicide is the second leading cause of death among youth age 15-24.1 Approximately one out of every 15 high school students reports attempting suicide each year.2 One out of every 53 high school students reports having made a suicide attempt that was serious enough to be treated by a doctor or a nurse.3 For each suicide death among young people, there may be as many as 100 to 200 suicide attempts.4 For some groups of youth—including those who are involved in the child welfare and juvenile justice systems; lesbian, gay, bisexual and transgender; American Indian/Alaska Native; and military service members—the incidence of suicidal behavior is even higher.5

Despite how common suicidal thoughts and attempts (as well as mental health disorders which can be associated with increased risk for suicide) are among youth, there is a great deal known about prevention as well as caring for youth and communities after an attempt or death. Parents, guardians, family members, friends, teachers, school administrators, coaches and extracurricular activity leaders, mentors, service providers, and many others can play a role in preventing suicide and supporting youth.

Key Resources

National Suicide Prevention Lifeline: 800-273-TALK (8255)
hotlineThe National Suicide Prevention Lifeline is a 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress. When you call 1-800-273-TALK (8255), you are connected to the nearest crisis center in a national network of more than 150 that provide crisis counseling and mental health referrals day and night. The Lifeline also provides informational materials, such as brochures, wallet cards, posters, and booklets. Prestamos servicios en español (1-888-628-9454). Translators speaking approximately 150 languages are available.

2012 National Strategy for Suicide Prevention: Goals and Objectives for Action (PDF, 184 pages) 
The National Strategy is a call to action from the U.S. Surgeon General and the National Action Alliance for Suicide Prevention to guide suicide prevention in the United States. The National Strategy includes 13 goals and 60 objectives that reflect advances in suicide prevention knowledge, research, and practice, as well as broader changes in society and health care delivery.

Resources and Information on Suicide from SAMHSA
The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) funds and supports the National Suicide Prevention Lifeline and the Suicide Prevention Resource Center. It manages the Garrett Lee Smith grant program, which funds State, Territorial, and Tribal programs to prevent suicide among youth. SAMHSA developed the National Registry of Evidence-based Programs and Practices (NREPP), which reviews evidence of effectiveness for prevention programs on topics related to behavioral health, including suicide. SAMHSA also sponsors prevention campaigns and provides resources.

Injury Prevention and Control: Suicide Resources from CDC
Resources, publications and articles on suicide, prevention, and risk from the Centers for Disease Control (CDC), including links to some statistical databases, including WISQARS (Web-based Injury Statistics Query and Reporting System), YRBSS (Youth Risk Behavior Surveillance System), National Violent Death Reporting System, and National Vital Statistics System.

Suicidal Thoughts and Attempts among U.S. High School Students: Trends and Associated Health-Risk Behaviors, 1991-2011
This article published in the Journal of Adolescent Health describes trends in suicidal thoughts and attempts and the types of associated health-risk behaviors among high school students.

Suicides — United States, 2005–2009
This report from the CDC provides data on suicide in the United States and differences in the characteristics of those who have died from suicide.

Suicide Information from the National Institute of Mental Health
Information on suicide prevention, treatment, and resources from the National Institute of Mental Health.

Suicide Prevention Resource Center
The Suicide Prevention Resource Center (SPRC)—funded by SAMHSA—helps strengthen suicide prevention efforts of state, tribal, community, and campus organizations and coalitions as well as organizations that serve populations with high suicide rates. It provides technical assistance, training, resource materials and a newsletter, an online library, and customized information for professionals working to prevent suicide. SPRC also co-produces the Best Practices Registry for Suicide Prevention.

Injury Control Research Center for Suicide Prevention
The Injury Control Research Center for Suicide Prevention is funded by the CDC to promote a public health approach to suicide research and prevention. It conducts research, provides technical assistance, and organizes conference calls, webinars, and an annual Research Training Institute for those engaged in suicide-related research and working in the field of suicide prevention.

1 CDC, 2011
2 Eaton et al., 2010
3 Eaton et al., 2010
4 McIntosh, 2010
5 HHS, 2012

Mental Health

It is normal for children and youth to experience various types of emotional distress as they develop and mature. For example, it is common for children to experience anxiety about school, or youth to experience short periods of depression that are transient in nature. When symptoms persist, it may be time to seek professional assistance. While most youth are healthy, physically and emotionally, one in every four to five youth in the general population meet criteria for a lifetime mental disorder and as a result may face discrimination and negative attitudes.1 As with physical health, mental health is not merely the absence of disease or a mental health disorder. It includes emotional well-being, psychological well-being, social well-being2 and involves being able to

  • navigate successfully the complexities of life,
  • develop fulfilling relationships,
  • adapt to change,
  • utilize appropriate coping mechanisms to achieve well-being without discrimination.
  • realize their potential,
  • have their needs met, and
  • develop skills that help them navigate the different environments they inhabit.3

The presence or absence of various combinations of protective and risk factors contribute to the mental health of youth and efforts can be undertaken to promote positive mental health and prevent or minimize mental health problems. Youth with mental health disorders may face challenges in their homes, school, community, and interpersonal relationships. Despite these challenges, for most youth, mental health distress is episodic, not permanent, and most can successfully navigate the challenges that come from experiencing a mental health disorder with treatment, peer and professional supports and services, and a strong family and social support network. 

1 Merikangas, He, Burstein, et al., 2010
2 Centers for Disease Control and Prevention (CDC), 2011; CDC, Health-Related Quality of Life, 2011
3 U.S. Department of Health and Human Services, 1999; National Research Council and Institute of Medicine, 2004

New Reports Highlight Human Service Needs of Lesbian, Gay, Bisexual, & Transgender Populations

Describe the human service needs of LGBT populations and discuss areas for future research.

Trafficking Prevention

Trafficking of youth is a form of modern slavery within the United States. It is a crime involving the exploitation of U.S. citizen/resident or noncitizen youth for the purpose of compelled labor or a commercial sex act through the use of force, fraud, or coercion, regardless of whether the trafficker or the victim crossed state or international borders. If a person younger than 18 is induced to perform a commercial sex act, it is a crime regardless of whether there is force, fraud, or coercion.1

Members of the youth-serving community are in a unique position to recognize children who may be on the path to becoming victimized and to report suspicions to the appropriate authorities. Once victims are identified, housing, medical and mental health, immigration, food, income, employment authorization, and legal services may be available to assist them. Federal agencies and departments are working collaboratively to raise awareness about human trafficking and the impact on victims, reduce the prevalence of human trafficking, support victims, prosecute offenders, and provide communities with the capacity to respond to the problem.

1 [U.S.C. §7102(8)]