“An ounce of prevention is worth a pound of cure” goes the adage. The concept of primary prevention in psychiatry has been under-recognized until recently. In 1994, David F. Duncan, DrPH, described in an ironic manner the barriers that have kept primary prevention of mental illness from realizing its potential. Congress passed the Community Mental Health Centers Act in 1963 in response to an address by President John F. Kennedy calling for better mental health care and emphasizing the possibility of preventing psychiatric illness. However,
community mental health centers (CMHCs) were mandated to provide only negligible preventive efforts such as consultation and education. More than a decade later, primary prevention occupied <5% of CMHC staff time nationally.