This issue of The Bell features steps we are taking on a number of important areas—health reform implementation, shared decision making, and a new initiative on psychiatric advance directives.

The key focus area of our work over the past several years has been the prevention of mental illness and substance use disorders. We know that behavioral health disorders exact a significant personal, social, and financial toll on our society. And given the growing body of research demonstrating the effectiveness of strategies that promote and enhance social and emotional well-being and prevent and reduce behavioral health problems, it makes sense to elevate the importance of prevention within our public health system.

We are seeing significant progress on prevention through the work of government agencies and new policy initiatives. The Substance Abuse and Mental Health Services Administration (SAMHSA), the government's lead agency in the area, has recognized the importance of prevention in improving the nation's health. In "Leading Change: A Plan for SAMHSA's Roles and Actions 2011-2014," it identifies promotion of emotional well-being and the prevention of substance abuse and mental illness as its first strategic initiative. The new health reform law also emphasizes the importance and value of prevention, and calls for coverage of various prevention practices. And a National Prevention Strategy crafted as a result of the law identifies the promotion of mental and emotional well-being and the prevention of substance use (including drugs, alcohol, and tobacco) as two of its seven priority areas.

There should be no argument about spending money on these programs; they are cost effective. Each dollar invested returns from $2 to $10 savings in health costs, criminal and juvenile justice costs, educational costs, and lost productivity.

At Mental Health America, we are moving on a number of levels to ensure effective strategies and programs are more widely implemented and sustained. If we are serious about creating a healthier future for all Americans, prevention must be our first priority. ::