Large increases in treatment of Common Mental Disorders (CMD) have failed to reduce population prevalence and global burden. Preventive strategies are needed to lower CMD prevalence and burden. Giving prevention a real chance to prove its promise will require: (a) full embedment in social institutions; (b) long‐term structural funding; (c) targeting major CMD determinants early in life combining population‐level and individual‐level strategies; and, (d) integrated evaluation of short‐term and long‐term effects to guide implementation. Targeting life skills and resilience of children and parenting skills of their parents has the potential for long‐term benefits for multiple outcomes including well‐being, social, economic, and financial domains as well as mental health outcomes. However, the large investments may not occur without compelling proof of effectiveness, but evaluation of effectiveness cannot occur without long‐term, structural investments. Overcoming this impasse requires a paradigm shift. Randomized controlled trials of initial efficacy need to be supplemented by evaluation strategies for long‐term surveillance of community‐based programs that guide implementation while assessing long‐term effectiveness.

中文翻译：

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辩论：让预防有机会证明其在降低常见精神障碍患病率方面的价值：需要多长时间？

常见精神疾病 (CMD) 治疗的大幅增加未能降低人口患病率和全球负担。需要采取预防策略来降低 CMD 的患病率和负担。为预防提供证明其承诺的真正机会将需要：(a) 完全融入社会机构；(b) 长期结构性供资；(c) 结合群体层面和个人层面的策略，在生命早期针对主要的 CMD 决定因素；(d) 综合评估短期和长期影响以指导实施。针对儿童的生活技能和适应力以及父母的养育技能有可能为多种结果带来长期利益，包括福祉、社会、经济和财务领域以及心理健康结果。然而，如果没有令人信服的有效性证明，就不可能进行大规模投资，但如果没有长期的结构性投资，就不可能进行有效性评估。克服这种僵局需要进行范式转变。初始疗效的随机对照试验需要补充以社区为基础的计划的长期监测评估策略，以指导实施，同时评估长期有效性。