The nation’s top two mental health officials say it’s time to focus on prevention rather than rehabilitation when it comes to autism and other mental disorders.

In a commentary to be published Wednesday in the Journal of the American Medical Association, Thomas Insel, director of the National Institute of Mental Health, and Philip Wang, the agency’s deputy director, argue that the best treatments for mental disorders likely are not ones that take place after symptoms of the disorder have fully onset. Rather, they say research should focus on uncovering the genes behind such conditions and better understanding the brain circuitry involved.

“It is time to rethink mental disorders, recognizing that these are disorders of brain circuits likely caused by developmental processes shaped by a complex interplay of genetics and experience,” they write.

Insel and Wang point to two recent studies suggesting that autism, schizophrenia and bipolar disorder are hereditary in nature. And they say researchers are already seeing positive results in genetic research on fragile X syndrome, which carries important implications for understanding both autism and intellectual disability. New knowledge about the genetics behind fragile X led to quick trials of drugs which researchers say hold promise in treating the disorder.

“The behavioral and cognitive manifestations that signify these as ‘mental’ illnesses may be late stages of processes that start early in development,” they write. “If genetics and neuroscience could provide rigorous, specific, early detection years before psychosis or depression, these illnesses might be redefined in terms of a trajectory.”

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