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Table 1 Promotion and preventive strategies in youth mental health

From: Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care?

 Identified key target areasAreas for further improvement and future objectives
PromotionPromotion-prevention continuumAddress entire community
Nutrition and health careIntegrated and multidisciplinary actions
Housing and homelessnessHealthcare-community collaborations
Child abuse 
Negative consequences of parents’ divorce 
Family support 
Education and school-related problematic behavior 
Addictive substance use/dependence 
Personal skill development/management of stressful life events 
Primary preventionLife-span continuum (Early stage-intensification of risk continuum) 
UniversalBrain development and anti-inflammatory neuroprotection (Phosphatidylcholine and N-acetylcysteine supplementation)Pathophysiological mechanisms during early development
Neuroinflammation, oxidative stress, and microbiota dysbiosis (Omega-3 fatty acid, vitamin, sulforaphane, and prebiotic supplementation) 
Bullying and peer rejection (School-based behavioral interventions) 
Substance abuse 
Brain plasticity, structure, connectivity, and cognitive functioning (Lifetime exercise training) 
SelectiveParental mental illnessPoor validity of boundaries between diagnostic categories
Paternal ageLack of evidence-based selective interventions
Maternal and obstetric complications of pregnancyYouth with family history of severe mental illness (genetic risk)
Season of birth 
Ethnic minority 
Immigration status 
Urban environment 
Infections 
Childhood adversities, socio-financial disadvantage, maladaptive behavior (Nursing home visits, school-based interventions, home teaching) 
Vitamin D deficiency and malnutrition 
Low premorbid intelligence quotient 
Traumatic brain injury 
Heavy tobacco and cannabis use 
IndicatedPsychosis-risk stateLimited psychosis detection rate
Service engagement and liaison with secondary intervention servicesPluripotent and trans-diagnostic risk state
Duration of untreated illnessMulti-component symptom intervention
Control of symptoms and self-control of emotion and behavior (Cognitive behavioral, relaxation, mindfulness, and meditation strategies) 
Poor social problem solving and low quality of social support (Social skill training) 
Interpersonal conflict (Interpersonal psychotherapy, forgiveness programs) 
Loneliness and social difficulties in general (Resilience training) 
Secondary preventionCollaborative carePrimary care-specialist mental health care collaborations
Recovery 
Duration of untreated illness 
Poor treatment response/treatment resistance 
Poor psycho-social well-being and functioning 
Comorbid substance use 
Burden on families 
Tertiary preventionRecoveryDisease progression
Poor treatment response/treatment resistanceInterventions to prevent multiple relapses
Poor psycho-social well-being and functioning 
Comorbid substance use 
Burden on families