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Behavioral health is a state of mental/emotional being and/or choices and actions that affect wellness. Substance abuse and misuse are one set of behavioral health problems. Others include (but are not limited to) serious psychological distress, suicide, and mental illness (SAMHSA, 2011).


In October 2015, Rep. Jim Cantwell (D-Marshfield) introduced legislation to establish the Special Commission on Behavioral Health Promotion and Upstream Prevention.

The bill—coauthored by Jim, his staff director, Ben Thomas , and former DPH Commissioner, Cheryl Bartlett, and edited by other experts in the field—garnered the co-sponsorship of over 110 legislators and the support of numerous prevention experts and public health, criminal justice, and behavioral health organizations.

In August 2016, Governor Baker signed the Special Commission on Behavioral Health Promotion and Upstream Prevention into law following less than a year of advocacy. 

Formally beginning its work in February 2017 and driven by the need to address the opiate epidemic and other behavioral health needs in the Commonwealth, the Promote Prevent Commission focused on aspects of the behavioral health continuum of care (i.e. promotion and prevention) that have received limited attention by other taskforces, legislation, and budgetary action. The Commission released its final report and recommendations in April 2018.

The Commission was comprised of an interdisciplinary group of leaders in behavioral health, prevention, public health, addiction, mental health, criminal justice, health policy, epidemiology, and environmental health. To learn more about the Commissioners, click here


The Special Commission on Behavioral Health Promotion and Upstream Prevention was tasked with investigating “evidence-based practices, programs and systems to prevent behavioral health disorders and promote behavioral health across the commonwealth.”

The Commission zeroed in on three overarching questions:

  1. What’s working in behavioral health promotion and upstream prevention?

    • Consider recommendations from state and national reports

    • Identify programs implemented inside or outside of the Commonwealth

    • Assess strategies to improve our system of behavioral health

  2. How can we better fund what’s working?

    • Assess strategies for funding promotion and upstream prevention

  3. What can we achieve if we fund what works?

    • Recommend achievable goals for reducing behavioral health disorders


Beyond the tragic consequences for individuals and families who suffer from disorders, behavioral health issues exact heavy costs on our healthcare, criminal justice, and social service systems.  

Fortunately, decades of practice illustrate certain programs can protect or, metaphorically speaking, vaccinate people—young and old—from developing disorders such as addiction, depression, and anxiety.  Programs include school and community-based interventions like positive social norms marketing, the Good Behavior Game, and youth mentoring.

Regrettably, we invest comparably little in upstream prevention, as dollars instead flow downstream to systems that respond after problems develop.

The Promote Prevent Commission identified barriers and innovative solutions to foster investments in proven promotion and prevention programs and system changes that will prevent behavioral health disorders in the Commonwealth.

"Prevention is the best investment we can make in behavioral health-and the time to make it is now"

-Institute of medicine perspectives

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