This editorial by William Narrow on the Great Smoky Mountain Study (Copeland, et al.) discusses at length the effectiveness of childhood mental health services in preventing mental health disorders in adulthood.
Contrary to expectations, the findings indicate that utilizing mental health services during childhood does not prevent the occurrence of mental health disorders later in life. Furthermore, there is evidence suggesting that these services might have iatrogenic effects, especially in increasing the risk of substance use disorders among children with behavioral disorders.
The editorial highlights the gap between the ideal of primary prevention in mental health and the reality of incomplete understanding and ineffective modification of risk factors. It underscores the lack of consensus on the real-world effectiveness of mental health treatments for children, citing studies with mixed outcomes. Despite these challenges, the importance of treating mental health disorders in children and adolescents for symptom alleviation and disability prevention is acknowledged, with a call for adherence to evidence-based treatments and guidelines.