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Practical Evidence and Actions for
Rapid Results to Protect Americaā€™s
Futures



   By Dennis D. Embry, Ph.D.
   President/Senior Scientist
   PAXIS Institute

   dde@paxis.org

   Copyright Ā© 2012,
   PAXIS Institute,
   All rights reserved.
   May be reproduced
   with permission.
why
             ?




Thinking about nurturing every child in Connecticut & US
What do you wish to pack in our
      suitcases for life?
Surveying the Past Foretells Our Futures
Born NOW?
Lifetime Prevalence of Disorders in US Adolescents (N=10,123)
                                                      25 billion dollar loss
            40%
                      1-out-2 USA young adults will be afflicted with one or more of these disorders
            35%
                                                                                                      Anxiety
            30%

            25%
                                                                                                      Substance
                                                                                                      Behavior
            20%
                                                                                                      Mood
            15%

            10%

            5%
                                                                            Merikangas et al.,
            0%                                                              2010
                  4     5    6     7    8    9   10 11 12        13    14      15   16    17     18
                                                 Age in Years
Nearly 3 out of 4 of the nation's 17- to 24-year-olds are ineligible
for military service for based on national epidemiological data
                                                                                    ā€¢ Medical/physical
                                                                                       problems, 35 percent.
                                                                                    ā€¢ Illegal drug use, 18
                                                                                       percent.
                                                                                    ā€¢ Mental Category V (the
                                                                                       lowest 10 percent of the
                                                                                       population), 9 percent.
                                                                                    ā€¢ Too many dependents
                                                                                       under age 18, 6 percent.
                                                                                    ā€¢ Criminal record, 5
                                                                                       percent.
                   Army Times, Nov 5, 2009 ā€¢ www.missionreadiness.org/PAEE0609.pd
Cumulative prevalence of psychiatric disorders by young adulthood: a
prospective cohort analysis from the Great Smoky Mountains Study.

By 21 years of age, 61.1% of
participants had met criteria for a
well-specified psychiatric disorder.
An additional 21.4% had met criteria
for a ā€œnot otherwise specified
disorderā€ only, increasing the total
prevalence for any disorder to 82.5%.
The US has 75
million children
and teens.
40.4 million kids
had one
psychotropic med
in 2009


         Wall
        Street
       Journal,
      12-28-2010
How many of you
know a blue-collar,
middle-class, or
upper-class family
who is reasonably
intactā€¦
with a child, teen, or adult child with
a mental, emotional, or behavioral
disorder?
ā€¢   Business competitiveness?
What will the impact of these   ā€¢   Health care costs?
data be on Federal & State      ā€¢   Public safety & national security costs?

Governments on:                 ā€¢   Social Security?
                                ā€¢   Global Competitiveness?
So what?
Connecticut has 491,000
young people between the
ages of 10 to 19.
At least 83,000 will have a
teen depressionā€¦
With collective lost lifetime
income ofā€¦ $25 billion loss

Adolescent Depression Lowers Later-Life Earning Power by
an average of $300K
Child and
                                  adolescent
                                  depression
                                  and related
                                  disorders
                                  can be
                                  averted.




There are protective behavioral vaccinesā€¦
Think about the cost of ADHD?
Excess Healthcare costs of ADHD


                                                           $3,534
                                                            Total




These four years cost $3,534ā€”which could be used avert
ADHD and other Psychiatric Diagnoses in 75-100 children.
So what?
In 2007, 5.4 million children
4-17 years of age had ever
been diagnosed with ADHD.
If each case average
excess cost of $3,534
That alone will
costā€¦ $18.9 billion
Child and
                                  adolescent
                                  ADHD and
                                  related
                                  disorders
                                  can be
                                  averted.




There are protective behavioral vaccinesā€¦
Our Futures dependā€¦
On ALL Our Childrenā€™s futures having few
      barriers to productive livesā€¦

         Title            stealing                          Title
                                                           ADHD
         Text                                              Text
           learning disabilities                                    aggression
                                           asthma                         depression
  unstable work history
                               obesity                cancer
 depression                                                                 bipolar/schizophrenia
                            hi-blood pressure       heart-disease
      violence exposure                                                       tobacco
                                         diabetes
                  suicide                                       alcohol
                             crime                      drugs
                                     dangerous acts



     All these disorders have almost the same
preventable causes that can be rapidly changedā€¦
Youthanasia
Here lies the future of America.
Humans are the only species with bi-directional
wealth and wellbeing transfer across generations

                   Youth return the favor as adults

                                                             Our
          Our
                                                            Adults
         Childre
                     adults and elders invest in children     &
           n
                                                            Elders
We are the first civilization to abandon what
Mother Nature, Evolution & God gifted usā€¦
                         Requiring more wealth transfer


        5-Year                                                     65-Year
         Olds            But elders voting to stop funds to kids    Olds



                                                               Who are living
         Who are less
                                                             longer though get
        and less ableā€¦
                                                           progressively sickerā€¦
We are the first civilization to abandon what
Mother Nature, Evolution & God gifted usā€¦




       5-Year                       65-Year
        Olds                         Olds
Key message about global competitionā€¦
                    s                       ie
                                      o crac
                                 dem s s to
                          r rich a cce
                     the sa l                enta
                                                  l,
                   o
            th ese         er        from m d
    y of arly uni tection relate
                         v
Man e ne                    o
   hav            an d pr oral and
      n t io n of behavi          rders
                                        .
 reve otional, ical diso                         d
p
     em               s                     of an
                 phy                e ntion rs.
                              s prev isorde
                     a  tion hese d                                 .
              U SA r n all t
      The tectio                                                  How
             pro                                           competitive will
                                                            the USA be if
                                                             75% of our
                                                                 pool of
                                                              employees
                                                           have a mental,
                                            The USA has       emotional,
                                             4.6 million    behavioral or
                                                small            related
                                             businesses         physical
                                              under 25         disorder?
                                             employees.
Practical recipe for rapid results to better our
futures
                                ā€¢   Pick 4-5 practical, proven Behavioral Vaccines that
                                    protect against many problem outcomes
                                ā€¢   Make these Universally Accessible for All Families
                                ā€¢   Adopt facilitative polices ACROSS govā€™t money silos
                                ā€¢   Form public-private partnerships to facilitate rapid
                                    action, mixed funds and sponsorships
                                ā€¢   Have public scoreboard for rapid results
                                ā€¢   Promote success & use of these tools in mass
                                    media
       PS: The current government ā€œlogic modelsā€ for prevention ARE the problem.
The IOM Report
contains most of
the behavioral
vaccines that can
be scaled up for
universal access
quickly for rapid
results to protect
all Americaā€™s
children &
families.




                     Several behavioral vaccines protect against multiple
                     Several behavioral vaccines protect against multiple
                                          disorders
                                          disorders
Substance                        Work     Obesity,
Early      Mental Illness                     Violence                                  Cancer       School
                                 Abuse                        Problems     etc
Sex                                                                                                  Failure

             Mood                                 Lo Reward     Lo Executive      Lo Behavioral
                                Inattention         Delay        Function
           Instability                                                            Competencies
            Poor                                                                   Immune-
STDā€™s       Motor                                                                   Healing           Special
            Skills          Multi-Inflammatory Brain & Body Response              Dysfunction           Ed




 Major Connected Causes of the Adverse Trends Predicting MEBs & Related Illnesses

         Reinforcement          Antecedents          Physiological             Verbal Relations
        more for anti-social    cue anti-social     influences trigger         occasion perceived
          than prosocial       acts and threats     adverse biological         threats and related
            behaviors                                  mechanisms                   reactions

  The Same Conditions Predict Multiple Disorders
Heart
                                Low                               Work                           Low
 Delayed   Mental health      Addictions
                                             Prosociality
                                                                 Success
                                                                                  Health
                                                                                                           Hi Sch.
                                                                                   etc          Cancer
  Sex                                                                                                       Grad

             Mood                               Hi Reward          Hi Executive            Hi Behavioral
                                 Attention        Delay
            Stability                                                Function              Competencies
            Good                                                                           Immune-
  Low       Motor                                                                           Healing          Higher
Injuries    Skills         Multi Anti-Inflammatory Brain & Body Response                   Efficiency          Ed




       Multiple Behavioral Vaccines Protect the Futures of ALL Children, Youth and
                                         Adults

      Reinforcement            Antecedents                    Physiological                 Verbal Relations
      more for prosocial       cue prosocial                 influences trigger             occasion perceived
         behaviors              behaviors                   protective biological               safety and
                                                                mechanisms                       affiliation


   The Same Conditions Protect and Prevent
ā€¢   Rapidly decreases disturbing, disruptive
 Behavioral Vaccine               behavior
 Example:
 PAX Good Behavior
                              ā€¢   Increases reading test scores, high
                                  school graduation & college entry
 Game in just FIRST Grade
                              ā€¢   Prevents every form of addiction
                                  (tobacco,alcohol, drugs)

                              ā€¢   Prevents violent crime and prison use

                              ā€¢   Prevents multiple major mental illnesses
                                  (ADHD, conduct disorders, anti-social
                                  personality disorder, depression)

                              ā€¢   Prevents suicide

                              ā€¢   Prevents early vaginal sex



Costs less to deliver universally than mosts childhood medical vaccine, butā€¦
How much might this
                     Cost Savings
                                                                   behavioral vaccine save
                                                                   for Americaā€™s future?
                                                                    PAX GBG pays back $4,637 to individuals,
                                                                    taxpayers, and others per student exposed
                                                                    in First Grade over 15 years.
                                                                    Assuming 4,000,000 First Graders
                                                                    each year in the US, that saves $18
                                                                    billion every First Grade cohort by
                                                                    age 21.


Source: Aos, S., Lee, S., Drake, E., Pennucci, A., Klima, T., Miller, M., et al. (2011). Return on Investment: Evidence-Based
    Options to Improve Statewide Outcomes. (July), 8. Retrieved from http://www.wsipp.wa.gov/rptfiles/11-07-1201.pdf
What if we provided parenting supports for every family?
Substantiated Child Maltreatment
                                    Control
                                    Counties


                              Triple P Counties


Pre                    Post
                  Two Years Later
                                Prinz et al., 2009, Prevention Science
Child Abuse Hospital Injuries

                         Control Counties


                              Trip
                                  l   eP
                                            Co
                                              un
                                                ties
                       Post
Pre
                  Two Years Later

                                 Prinz et al., 2009, Prevention Science
Child Out-of-Home Placements
                      Control Counties

                         Triple
                                    P Co
                                        untie
                                             s


                     Post
Pre
                Two Years Later

                              Prinz et al., 2009, Prevention Science
What do these results mean fiscally?
ey message by showing dollar benefits

     Use personalized
   business models to
  communicate to cost-
 efficiency and benefits.




   Show short-term
      benefits




 Allow decision makers
    and advocates to
 adjust cost savings to
      their location.
Yes, there is a
logic model for
guiding local,
state and federal
policy makers to
achieve
population-level
prevention.
Yes, there are
even innovative
funding models
to achieve
population-level
prevention.
Our Futures

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Connecticut Presentation for Major Change

  • 1. Practical Evidence and Actions for Rapid Results to Protect Americaā€™s Futures By Dennis D. Embry, Ph.D. President/Senior Scientist PAXIS Institute dde@paxis.org Copyright Ā© 2012, PAXIS Institute, All rights reserved. May be reproduced with permission.
  • 2. why ? Thinking about nurturing every child in Connecticut & US
  • 3. What do you wish to pack in our suitcases for life?
  • 4. Surveying the Past Foretells Our Futures
  • 6. Lifetime Prevalence of Disorders in US Adolescents (N=10,123) 25 billion dollar loss 40% 1-out-2 USA young adults will be afflicted with one or more of these disorders 35% Anxiety 30% 25% Substance Behavior 20% Mood 15% 10% 5% Merikangas et al., 0% 2010 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Age in Years
  • 7. Nearly 3 out of 4 of the nation's 17- to 24-year-olds are ineligible for military service for based on national epidemiological data ā€¢ Medical/physical problems, 35 percent. ā€¢ Illegal drug use, 18 percent. ā€¢ Mental Category V (the lowest 10 percent of the population), 9 percent. ā€¢ Too many dependents under age 18, 6 percent. ā€¢ Criminal record, 5 percent. Army Times, Nov 5, 2009 ā€¢ www.missionreadiness.org/PAEE0609.pd
  • 8. Cumulative prevalence of psychiatric disorders by young adulthood: a prospective cohort analysis from the Great Smoky Mountains Study. By 21 years of age, 61.1% of participants had met criteria for a well-specified psychiatric disorder. An additional 21.4% had met criteria for a ā€œnot otherwise specified disorderā€ only, increasing the total prevalence for any disorder to 82.5%.
  • 9. The US has 75 million children and teens. 40.4 million kids had one psychotropic med in 2009 Wall Street Journal, 12-28-2010
  • 10. How many of you know a blue-collar, middle-class, or upper-class family who is reasonably intactā€¦ with a child, teen, or adult child with a mental, emotional, or behavioral disorder?
  • 11. ā€¢ Business competitiveness? What will the impact of these ā€¢ Health care costs? data be on Federal & State ā€¢ Public safety & national security costs? Governments on: ā€¢ Social Security? ā€¢ Global Competitiveness?
  • 12. So what? Connecticut has 491,000 young people between the ages of 10 to 19. At least 83,000 will have a teen depressionā€¦ With collective lost lifetime income ofā€¦ $25 billion loss Adolescent Depression Lowers Later-Life Earning Power by an average of $300K
  • 13. Child and adolescent depression and related disorders can be averted. There are protective behavioral vaccinesā€¦
  • 14. Think about the cost of ADHD?
  • 15. Excess Healthcare costs of ADHD $3,534 Total These four years cost $3,534ā€”which could be used avert ADHD and other Psychiatric Diagnoses in 75-100 children.
  • 16. So what? In 2007, 5.4 million children 4-17 years of age had ever been diagnosed with ADHD. If each case average excess cost of $3,534 That alone will costā€¦ $18.9 billion
  • 17. Child and adolescent ADHD and related disorders can be averted. There are protective behavioral vaccinesā€¦
  • 19. On ALL Our Childrenā€™s futures having few barriers to productive livesā€¦ Title stealing Title ADHD Text Text learning disabilities aggression asthma depression unstable work history obesity cancer depression bipolar/schizophrenia hi-blood pressure heart-disease violence exposure tobacco diabetes suicide alcohol crime drugs dangerous acts All these disorders have almost the same preventable causes that can be rapidly changedā€¦
  • 20. Youthanasia Here lies the future of America.
  • 21. Humans are the only species with bi-directional wealth and wellbeing transfer across generations Youth return the favor as adults Our Our Adults Childre adults and elders invest in children & n Elders
  • 22. We are the first civilization to abandon what Mother Nature, Evolution & God gifted usā€¦ Requiring more wealth transfer 5-Year 65-Year Olds But elders voting to stop funds to kids Olds Who are living Who are less longer though get and less ableā€¦ progressively sickerā€¦
  • 23. We are the first civilization to abandon what Mother Nature, Evolution & God gifted usā€¦ 5-Year 65-Year Olds Olds
  • 24. Key message about global competitionā€¦ s ie o crac dem s s to r rich a cce the sa l enta l, o th ese er from m d y of arly uni tection relate v Man e ne o hav an d pr oral and n t io n of behavi rders . reve otional, ical diso d p em s of an phy e ntion rs. s prev isorde a tion hese d . U SA r n all t The tectio How pro competitive will the USA be if 75% of our pool of employees have a mental, The USA has emotional, 4.6 million behavioral or small related businesses physical under 25 disorder? employees.
  • 25. Practical recipe for rapid results to better our futures ā€¢ Pick 4-5 practical, proven Behavioral Vaccines that protect against many problem outcomes ā€¢ Make these Universally Accessible for All Families ā€¢ Adopt facilitative polices ACROSS govā€™t money silos ā€¢ Form public-private partnerships to facilitate rapid action, mixed funds and sponsorships ā€¢ Have public scoreboard for rapid results ā€¢ Promote success & use of these tools in mass media PS: The current government ā€œlogic modelsā€ for prevention ARE the problem.
  • 26. The IOM Report contains most of the behavioral vaccines that can be scaled up for universal access quickly for rapid results to protect all Americaā€™s children & families. Several behavioral vaccines protect against multiple Several behavioral vaccines protect against multiple disorders disorders
  • 27. Substance Work Obesity, Early Mental Illness Violence Cancer School Abuse Problems etc Sex Failure Mood Lo Reward Lo Executive Lo Behavioral Inattention Delay Function Instability Competencies Poor Immune- STDā€™s Motor Healing Special Skills Multi-Inflammatory Brain & Body Response Dysfunction Ed Major Connected Causes of the Adverse Trends Predicting MEBs & Related Illnesses Reinforcement Antecedents Physiological Verbal Relations more for anti-social cue anti-social influences trigger occasion perceived than prosocial acts and threats adverse biological threats and related behaviors mechanisms reactions The Same Conditions Predict Multiple Disorders
  • 28. Heart Low Work Low Delayed Mental health Addictions Prosociality Success Health Hi Sch. etc Cancer Sex Grad Mood Hi Reward Hi Executive Hi Behavioral Attention Delay Stability Function Competencies Good Immune- Low Motor Healing Higher Injuries Skills Multi Anti-Inflammatory Brain & Body Response Efficiency Ed Multiple Behavioral Vaccines Protect the Futures of ALL Children, Youth and Adults Reinforcement Antecedents Physiological Verbal Relations more for prosocial cue prosocial influences trigger occasion perceived behaviors behaviors protective biological safety and mechanisms affiliation The Same Conditions Protect and Prevent
  • 29. ā€¢ Rapidly decreases disturbing, disruptive Behavioral Vaccine behavior Example: PAX Good Behavior ā€¢ Increases reading test scores, high school graduation & college entry Game in just FIRST Grade ā€¢ Prevents every form of addiction (tobacco,alcohol, drugs) ā€¢ Prevents violent crime and prison use ā€¢ Prevents multiple major mental illnesses (ADHD, conduct disorders, anti-social personality disorder, depression) ā€¢ Prevents suicide ā€¢ Prevents early vaginal sex Costs less to deliver universally than mosts childhood medical vaccine, butā€¦
  • 30. How much might this Cost Savings behavioral vaccine save for Americaā€™s future? PAX GBG pays back $4,637 to individuals, taxpayers, and others per student exposed in First Grade over 15 years. Assuming 4,000,000 First Graders each year in the US, that saves $18 billion every First Grade cohort by age 21. Source: Aos, S., Lee, S., Drake, E., Pennucci, A., Klima, T., Miller, M., et al. (2011). Return on Investment: Evidence-Based Options to Improve Statewide Outcomes. (July), 8. Retrieved from http://www.wsipp.wa.gov/rptfiles/11-07-1201.pdf
  • 31. What if we provided parenting supports for every family?
  • 32. Substantiated Child Maltreatment Control Counties Triple P Counties Pre Post Two Years Later Prinz et al., 2009, Prevention Science
  • 33. Child Abuse Hospital Injuries Control Counties Trip l eP Co un ties Post Pre Two Years Later Prinz et al., 2009, Prevention Science
  • 34. Child Out-of-Home Placements Control Counties Triple P Co untie s Post Pre Two Years Later Prinz et al., 2009, Prevention Science
  • 35. What do these results mean fiscally?
  • 36. ey message by showing dollar benefits Use personalized business models to communicate to cost- efficiency and benefits. Show short-term benefits Allow decision makers and advocates to adjust cost savings to their location.
  • 37. Yes, there is a logic model for guiding local, state and federal policy makers to achieve population-level prevention.
  • 38. Yes, there are even innovative funding models to achieve population-level prevention.

Editor's Notes

  1. MISSION: READINESSIn a study being released Thursday Nov 5, 2009 in Washington, Education Secretary Arne Duncan and a group of retired military officers led by former Army Gen. Wesley Clark will sound the alarm bells and call young Americans ā€™ relative lack of overall fitness for military duty a national security threat. The group, Mission: Readiness, will release a report that draws on Pentagon data showing that 75 percent of the nation ā€™ s 17- to 24-year-olds are ineligible for service for a variety of reasons. Put another way, only 4.7 million of the 31.2 million 17- to 24-year-olds in a 2007 survey are eligible to enlist, according to a periodic survey commissioned by the Pentagon. This group includes those who have scored in the top four categories on the Armed Forces Qualification Test, or AQFT; eligible college graduates; and qualified college students. According to the Pentagon, the ineligible population breaks down this way: ā€¢ Medical/physical problems, 35 percent.ā€¢Illegal drug use, 18 percent.ā€¢Mental Category V (the lowest 10 percent of the population), 9 percent.ā€¢Too many dependents under age 18, 6 percent.ā€¢Criminal record, 5 percent.