A: One way of looking at sustainability is to say that it's a separate technology from program development that requires a new program of research, but I think about it a little differently. I do not assume that mental health interventions should be "programs" because programs typically have owners and I am concerned at times that the goal is to advance a program rather than solve a problem.

What's the difference? Let's say I'm talking to the principal and staff at a school where the playground is out of control, or we'll say that they're very concerned that their parents are not as involved as they need to be, or their teachers are very stressed. We can address any of those problems, and I still don't have a program. I'm still not bringing them a program. I'm helping them address a problem. What I like about this distinction is that it keeps me in the setting, and it keeps me thinking about that setting.

Now if I want to bring them a program that I think might really work, I might say, "Dr. Joe Smith at Harvard has developed this terrific program for working with parents. Let's take a look at it." I think what that does is it gets us out of the bind where we need a whole new way of thinking about it. That's the way I've been approaching my work. I'm immersed in the settings, and I'm trying to think from the perspective of these settings about what we can do to make things work. In that respect, I'm not thinking about what we need to do in addition to make these programs work. I'm thinking, "Are these the right programs for this setting? And if they're not, what do we need to do to address that?" Sustainability is not part of the question ñ it is the question.

A: I think these problems that we're talking about addressing, the public health issues of children failing in school and the enormous stressors related to poverty, are way beyond any single person to address. I think that academic research has been set up to say that you have to be a lone ranger, and if you can't do it all on your own, then you're just not very good. For instance, there's only one PI on grant at the NIMH, and I've never written a grant that way in my life. There's never just been me. It's always been a team. It's not the way the kind of research I'm doing goes. I cannot do this research by myself. I need co-investigators who are helping to think about this and helping us stay smart and keeping us on our toes.

I hope that people interested in this type of research will join teams, and I hope that junior researchers get viable roles where they can develop their own independent lines of research as part of the research team. I think it's a problem when they never get the chance to develop their own ideas. That gets into mentoring and seeing that senior people can be good about giving people a chance to develop. The problems we're talking about are so complex that there is a lot of room for innovation here. I think the ideal is that these research teams work together on problems and spin off other studies that then the junior person becomes the principal investigator on those studies. Academia is admittedly not set up that way very often, but I think we need to change that. I think we need to talk about that as a field and say it is not healthy that we're only thinking of people working on their own and developing their own programs. It's not producing the kind of research that we need to produce.