Theodore L. Caputi | D.A.R.E.-ing for better mental health

The Quixotic Quaker | Mental health advocates should allow research to catch up to our emotions

By Theodore L. Caputi 09/15/15 11:17pm

Last week was National Suicide Prevention Week. For Penn students, it was an emotional week, that spurred responses including reflective Facebook posts and a march down Locust Walk.

As our University and national leaders consider policy changes that support mental health and wellness, I worry that our sympathetic nature and sense of urgency surrounding this issue may hinder the impact of our efforts. Emotionally charged issues often elicit emotionally charged policy responses, which may not be ideal.

To this end, I offer a cautionary tale from a discipline I am familiar with — substance abuse prevention. Substance abuse and suicide are both mental health issues, and I hope that, when choosing which policies to endorse, suicide prevention advocates can learn from the mistakes made by early substance abuse prevention advocates.

About 40 years ago, substance abuse prevention policymakers witnessed increasing deleterious effects of drugs in their communities and made the mistake of allowing highly charged emotions to force fast policy responses. These responses were timely and seemed intuitively positive — but they had not been tested by sound research principles and turned out to be counterproductive to the field for decades to come.

The most conspicuous example of this mistake is the Drug Abuse Resistance Education program, known as D.A.R.E., a school-based substance abuse prevention program developed in the 1980s. D.A.R.E. was produced by Daryl Gates, former chief of the Los Angeles Police Department, as a solution to rising and highly-publicized substance abuse and drug-related violence among young people. Gates had seen his fair share of drug deaths through the LAPD and was undoubtedly sympathetic towards those who had lost a loved one to drugs. His intention — to reduce drug use among kids — was commendable.

But D.A.R.E. was not conceived through careful investigation and controlled experiments (Gates was a cop, not a psychologist or research expert). A research-based intervention would take too long to develop — and besides, how hard could it be to teach kids about the obvious dangers of drug use? With that sentiment, D.A.R.E. offered a “commonsense” response to an emotional outcry for something to be done. As such, it quickly became the most widely disseminated substance abuse prevention program in America, reaching 75 percent of American school districts.

The problem? D.A.R.E. didn’t work.

When researchers got around to testing D.A.R.E., they found that the students who went through D.A.R.E. were no less likely to use drugs than those who had not. Worse, some studies indicate that the D.A.R.E. students were more likely to use drugs than their control group counterparts.

It turns out, preventing substance abuse was not as easy as “just say no” or providing fatality statistics. Solutions that seemed intuitively obvious failed. Practitioners bypassed the research stage of policy-making, and they ended up spending billions of dollars on an ineffective program — not to mention the opportunity cost of not implementing effective programming.

But that’s not the worst part. D.A.R.E. wasn’t just a bad program for the time it ran — it left a legacy that continues to hinder the field of substance abuse prevention to this day. D.A.R.E. dominated the school-based “market” and became a behemoth in the substance abuse prevention field. But D.A.R.E. was also stubborn about changing, and by refusing to improve its decidedly ineffective program (until 2009), it made suboptimal prevention the norm for years, even after better prevention practices were discovered.

Many activists and those in recovery became convinced that the “just say no” mantra and scare-tactics employed by D.A.R.E. were best practices — but research shows otherwise. Critics of prevention programs often cite the failure of D.A.R.E. as proof that all substance abuse prevention is fruitless (even though it is decidedly not). D.A.R.E. didn’t just cost taxpayers money for ineffective programming — it set back the prevention discipline by several decades by preventing effective programs from being adopted. I worry that, if we act on our emotions and sense of urgency, the field of mental health may suffer a similar fate.

That said, D.A.R.E. is not truly “the bad guy” D.A.R.E. came to be becuase of an emotional need for an immediate and expedient repsponse to the pressing problem of drug abuse. I understand that suicide, like drug abuse, is a sensitive and emotionally charged issue for hundreds of thousands of affected Americans. But I urge our policy makers to be cautious in expediently adopting policies supported by emotion rather than research. Research-based solutions will take longer to develop and implement, but in the long run, the state of mental health will be better off for it.

THEODORE L. CAPUTI  is a College and Wharton junior from Washington Crossing, Pa., studying finance/statistics and mathematics. His email address is tcaputi@wharton.upenn.edu. “The Quixotic Quaker” appears every other Wednesday.

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