This guide was created to promote the early identification of children and adolescents with mental health and substance use problems as well as to provide guidance, tools, and resources for early identification--including a compendium of the most developmentally, culturally, and environmentally appropriate screening instruments. SAMHSA developed the guide using the input of the members of the Federal/National Partnership* (FNP) Early Identification Workgroup, chaired by representatives from the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA).

This inaugural Physical Activity Guidelines for Americans provides science-based guidance to help Americans aged 6 and older improve their health through appropriate physical activity.The U.S. Department of Health and Human Services (HHS) issues the Physical Activity Guidelines for Americans. - - The Guidelines are designed to provide information and guidance on the types and amounts of physical activity that provide substantial health benefits. The main ideabehind the Guidelines is that regular physical activity over months and years can produce long-term health benefits. Realizing these benefits requires physicalactivity each week. These Guidelines are necessary because of the importance of physical activity to the health of Americans, whose current inactivity puts them at unnecessary risk. Unfortunately, the latest information shows that inactivity among American adults and youth remains relatively high..-.-Key Guidelines for Children and Adolescents .Key Guidelines for Adults Key Guidelines for Older Adults Key Guidelines for Safe Physical Activity Key Guidelines for Women During Pregnancy and the Postpartum Period Key Guidelines for Adults With Disabilities Key Messages for People With Chronic Medical Conditions A Roadmap to the Physical Activity Guidelines Chapter 1: Introducing the 2008 Physical Activity Guidelines for Americans Why and How the Guidelines Were Developed The Framework for the Physical Activity Guidelines for Americans Putting the Guidelines Into Practice Chapter 2: Physical Activity Has Many Health Benefits Examining the Relationship Between Physical Activity and Health.The Health Benefits of Physical Activity Chapter 3: Active Children and Adolescents Explaining the Guidelines Meeting the Guidelines Getting and Staying Active: Real-Life Examples Chapter 4: Active Adults Explaining the Guidelines Meeting the Guidelines Special Considerations Getting and Staying Active: Real-Life Examples Chapter 5: Active Older Adults Getting and Staying Active: Real-Life Examples iv 2008 Physical Activity Guidelines for AmericansChapter 6: Safe and Active Explaining the Guidelines Gradually Increasing Physical Activity Over Time: Real-Life Examples Chapter 7: Additional Considerations for Some Adults Physical Activity for Women During Pregnancy and the Postpartum Period .Physical Activity for People With Disabilities Physical Activity for People With Chronic Medical Conditions Chapter 8: Taking Action: Increasing Physical Activity Levels of Americans What Can Adults Do To Get Enough Physical Activity?How Can We Help Children and Adolescents Get Enough Physical Activity? .What Can Communities Do To Help People Be Active? .Glossary .Appendix 1. Translating Scientific Evidence About Total Amount and Intensity of Physical Activity Into Guidelines BackgroundTwo Methods of Assessing Aerobic Intensity Developing Guidelines Based on Minutes of Moderate- and Vigorous-Intensity Activity Using Relative Intensity To Meet Guidelines Expressed in Terms of Absolute Intensity .Appendix 2. Selected Examples of Injury Prevention Strategies for CommonPhysical Activities and Sports Appendix 3. Federal Web Sites That Promote Physical Activity

Current evidence shows that medications are underused in the treatment of alcohol use disorder, including alcohol abuse and dependence.* * Within this document "alcohol abuse" and "alcohol dependence" are used when discussing medication indications or research that is based upon this terminology. For a summary of important differences between DSM-IV and DSM-5, please see the box on this page. This is of concern because of the high prevalence of alcohol problems in the general population.1,2 For example, data show that an estimated 10 percent to 20 percent of patients seen in primary care or hospital settings have a diagnosable alcohol use disorder.3,4 People who engage in risky drinking often have physical and social problems related to their alcohol use. Problems with alcohol influence the incidence, course, and treatment of many other medical and psychiatric conditions.

Implementing these practical and largely achievable suggestions will improve access to timely and targeted mental health services in primary care settings. Program and clinical experts agree that the early prevention and treatment of mental disorders will result in decreases in individual suffering, family burden, and medical costs. This project provided an important opportunity to review policy and service-delivery change mechanisms aimed at improving the reimbursement of mental health services in primary care settings. By using knowledge from a variety of individuals and settings and combining empirical research with qualitative interviews and the Expert Forum proceedings, this project identified areas where Federal agencies, states, provider organizations, and commissioner associations can clarify, collaborate, educate, and provide support to improve the reimbursement of and access to mental health services in primary care settings.

Crisis Services are a continuum of services that are provided to individuals experiencing a psychiatric emergency. The primary goal of these services is to stabilize and improve psychological symptoms of distress and to engage individuals in an appropriate treatment service to address the problem that led to the crisis. Core crisis services include: 23-hour crisis stabilization/observation beds, short term crisis residential services and crisis stabilization, mobile crisis services, 24/7 crisis hotlines, warm lines, psychiatric advance directive statements, and peer crisis services. The research base on the effectiveness of crisis services is growing. There is evidence that crisis stabilization, community-based residential crisis care, and mobile crisis services can divert individuals from unnecessary hospitalizations and ensure the least restrictive treatment option is available to people experiencing behavioral health crises.

As a nation, we have only begun to come to terms with the reality and impact of mental illnesses on the health and well being of the American people. This groundbreaking publication makes clear that the tragic and devastating effects of mental illnesses touch people of all ages, colors, and cultures. And though Mental Health: A Report of the Surgeon General informed us that there are effective treatments available for most disorders, Americans do not share equally in the best that science has to offer. Through the process of conducting his comprehensive scientific review for this Supplement, and with recognition that mental illnesses are real, disabling conditions affecting all populations regardless of race or ethnicity, the Surgeon General has determined that disparities in mental health services exist for racial and ethnic minorities, and thus, mental illnesses exact a greater toll on their overall health and productivity.Diversity is inherent to the American way of life, and so is equal opportunity. Ensuring that all Americans have equal access to high quality health care, including mental health care, is a primary goal of the Department of Health and Human Services. By identifying the many barriers to quality care faced by racial and ethnic minorities, this Supplement provides an important road map for Federal, State, and local leaders to follow in eliminating disparities in the availability, accessibility, and utilization of mental health services.An exemplary feature of this Supplement is its consideration of the relevance of history and culture to our understanding of mental health, mental illness, and disparities in services. In particular, the national prevention agenda can be informed by understanding how the strengths of different groups' cultural and historical experiences might be drawn upon to help prevent the emergence of mental health problems or reduce the effects of mental illness when it strikes. This Supplement takes a promising first step in this direction.One of the profound responsibilities of any government is to provide for its most vulnerable citizens. It is now incumbent upon the public health community to set in motion a plan for eliminating racial and ethnic disparities in mental health. To achieve this goal, we must first better understand the roles of culture, race, and ethnicity, and overcome obstacles that would keep anyone with mental health problems from seeking or receiving effective treatment. We must also endeavor to reduce variability in diagnostic and treatment procedures by encouraging the consistent use of evidence-based, state-of-the-art medications and psychotherapies throughout the mental health system. At the same time, research must continue to aid clinicians in understanding how to appropriately tailor interventions to the needs of the individual based on factors such as age, gender, race, culture, or ethnicity.

This handbook is intended to provide the reader with a basic understanding of the Medicaid program. There is a specific emphasis on the interplay between Medicaid principles and behavioral health services. The goal is for the reader to navigate his or her state Medicaid program so that he or she can contribute meaningfully to policy conversations related to provision of behavioral health services to individuals who are eligible for Medicaid. Throughout this document, the term behavioral health encompasses both mental and substance use disorders. When a mental or substance use disorder is addressed singularly, the reference will be only to that disorder. Because each state's Medicaid program is different from all others and because Medicaid laws and policies are ever changing, this handbook cannot contemplate every permutation of program construction.

Major research advances have substantially improved our understanding of the biology of HIV and the pathogenesis (i.e., origin and development) of AIDS. The pathogenesis of AIDS is now known to result from the ability of HIV to replicate at the rate of a billion new virions (viral particles) per day and nearly 10 trillion new virions over the course of HIV infection. This, countered by the ability of the body to produce CD4+ T cell lymphocytes (a primary target cell for HIV), sets the stage for the struggle between HIV and the immune system--a struggle that lasts from the first day of HIV infection to end-stage disease and death.

American Indians and Alaska Natives have consistently experienced disparities in access to healthcare services, funding, and resources; quality and quantity of services; treatment outcomes; and health education and prevention services. Availability, accessibility, and acceptability of behavioral health services are major barriers to recovery for American Indians and Alaska Natives. Common factors that infuence engagement and participation in services include availability of transportation and child care, treatment infrastructure, level of social support, perceived provider effectiveness, cultural responsiveness of services, treatment settings, geographic locations, and tribal affliations.