The dilemma of early intervention: some problems in mental health screening and labeling

Motivated in part by a desire to identify and manage individuals considered to be at risk for serious mental disorders, early intervention programs are becoming increasingly accepted by the medical community, increasingly supported by the pharmaceutical industry, and increasingly unchallenged by the public. This article examines some of the conceptual and practical difficulties associated with early, or preventive, mental health care. Examples are drawn from contemporary research as well as historical commentaries in the fields of industrial psychology, sociology, and education. The tone of the discussion is cautionary, but the goal is to encourage mental health professionals and consumers to consider the potential harmfulness of early intervention strategies before these programs are uncritically copied, expanded, or renewed.