Pathways upstream: risks and realities of early screening efforts.

The need for basic societal institutions to foster growth-enhancing and ego-strengthening experiences is highlighted. The ascendancy of Asklepios--as representative of the remedial, medical model--over Hygeia--symbolizing the preventive, public health approach--is traced from Hellenic mythology to present reality. The Hygeian merits of current early identification programs are considered, and means for moving them closer to the Hygeian ideal are suggested.