Lowering the burden of suffering from child psychiatric disorder: trade-offs among clinical, targeted, and universal interventions.
OBJECTIVE
To examine the trade-offs among clinical, targeted, and universal interventions aimed at lowering the burden of suffering from child psychiatric disorders.


METHODS
Data from clinical and research studies were organized to show the advantages and disadvantages of the three strategies.


RESULTS
Important trade-offs exist among these three approaches. The strategy to reduce the burden of suffering from child psychiatric disorder should consist of a number of concurrent steps. First, effective universal programs should be in place. Targeted programs should follow for those not helped sufficiently by the universal programs. Finally, for those unaffected by the targeted programs, clinical services should be available.


CONCLUSIONS
An optimal mix of universal, targeted, and clinical programs is needed. The nature of the combination will change as knowledge accumulates, and there will always be trade-offs among these three. Acad.
Offord
D R
DR
Centre for Studies of Children at Risk, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada.
Kraemer
H C
HC
Kazdin
A E
AE
Jensen
P S
PS
Harrington
R
R
D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000628:therapy*; D002665:Child Psychiatry / Q000379:methods; D002675:Child, Preschool; D017281:Cost of Illness; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D012189:Retrospective Studies