A Public Health Approach to Mental Health Care:

Taking Transformation to Scale Washington State Prevention Policy

SummitMay 13, 2008

A. Kathryn Power, M.Ed.Director, Center for Mental Health Services

2

Global Burden of Disease

The top 3 leading causes of disability worldwide are behavioral disorders.

The World Health Report 2001— Mental Health: New Understanding, New Hope

0% 4% 8% 12% 16% 20% 24%

All Other Causes of DisabilityMigraineDiabetes

Cancer (Malignant neoplasms)Communicable Diseases

Digestive DiseasesInjuries (Disabling)

Sense Organ DiseasesCardiovascular

Respiratory DiseasesMusculoskeletal Diseases

Alzheimer's Disease and DementiasAlcohol and Drug Use Disorders

Mental Illnesses

Mental Health Status ContinuumMental Health Status Continuum

Mental Health Care ContinuumMental Health Care Continuum

Men

tal H

ealt

h Co

ntin

uum

Enhancing Health: Primary PreventionPrimary Prevention: Early Recognition Treatment andTreatment andPromoting optimum Addressing risk factors and Intervention: Rehabilitation:Rehabilitation: mental health, e.g., job vulnerable groups, Detecting a problem Interventions tosatisfaction, resilience, e.g., coping skills for or illness at an early reduce symptoms ofself-esteem, people who are stage and increasing an illness, diminishand social skills, improving unemployed, home visits access to effective disability, and improveaccess to income for families experiencing treatment quality of life

separation or divorce

Positive Mental Health:Positive Mental Health: Mental Health Problem:Mental Health Problem: Mental Disorder:Mental Disorder:High-level capacity of the Disruption in interactions Medically diagnosable illnessindividual, group, and between individual, group,, that results in significant environment to interact & and environment, impairment of cognitive, to promote well-being, producing a diminished affective, or relational abilitiesoptimal development, and state of positive mental healthuse of mental abilities

Source: Scanlon, K., Williams, M., & Raphael, B. (1997). Mental Health Promotion in NSW: Conceptual framework for developing initiatives. NSW Health Department, Sydney, Australia, p.9 3

4

Campaign for Mental Health Recovery

5

Ten Essential Public Health Services

• Monitor health status to identify and solve community health problems.

• Diagnose and investigate health problems and health hazards in the community.

• Inform, educate, and empower people about health issues. • Mobilize community partnerships and action to identify and solve

health problems. • Develop policies and plans that support individual and community

health efforts. • Enforce laws and regulations that protect health and ensure safety. • Link people to needed personal health services and assure the

provision of health care when otherwise unavailable. • Assure competent public and personal health care workforce. • Evaluate effectiveness, accessibility, and quality of personal and

population-based health services. • Research for new insights and innovative solutions to health

problems.

Source: Centers for Disease Control and Prevention

6

Social-Ecological Approach to Public Health

Each of these levels of influence can be addressed to promote mental health and prevent mental illness.

7

Lifecycle of Emergence

• Stage One: Networks– Discovering shared meaning and purpose

• Stage Two: Communities of Practice– Developing new practices together

• Stage Three: Systems of Influence– New practices become the norm

Source: Wheatley, M., & Frieze, D. (2006) Using Emergence to Take Social Innovations to Scale. www.berkana.org/pdf/emergence_web.pdf

8

Coming together is a beginning; keeping together is progress; working together is success.

Henry Ford