The Role of Public Health in Mental Health Awareness

April 11, 2017|3:48 p.m.| Anna Bartels, Claire Rudolph

May 4 is the third annual Children’s Mental Health Awareness Day. This year’s theme is “Partnering for Help and Hope.” State and territorial public health leaders are well-positioned to drive innovative partnerships with healthcare providers, community-based organizations, and government agencies, as well as to create healthy conditions for children and address mental health disparities. In preparation for this nationwide event, public health agencies and their partners ought to consider how their current portfolios of work improve and protect children’s mental health and how the agencies can raise awareness. The following examples highlight successful and promising partnerships among state health agencies, primary care, behavioral health, and others, as well as potential models of integrated care that support children’s mental health.

Addressing Children’s Mental Health is Critical to Reducing Health Disparities

Children that belong to racial and ethnic minority groups are less likely to access high-quality mental health services than their non-Latino white peers, according to the National Healthcare Quality & Disparity Reports. This can lead to disparities in overall health and wellbeing. Public health initiatives, such as Rhode Island’s Health Equity Zones (HEZ), have potential to address inequities in children’s access to mental health services. The Rhode Island HEZ initiative supports communities that recognize the importance of enhancing children’s mental health. Rhode Island HEZ facilitates collaboration among community organizations to eliminate health disparities using place-based strategies. Two Rhode Island communities that are participating in this work have been funded by the Rhode Island Department of Health to focus on children’s mental health. The North Providence health equity zone supports a “stress sub-committee” that focuses on integrating a mindfulness curriculum in schools to manage stress and anxiety for families. They also support a suicide-prevention hotline for kids, teens, and parents, which is open 24 hours a day, 365 days per year. The Washington County Health Equity Zone supports access to mental health services for children by providing training for the public on how to recognize someone in an emotional crisis and connect them to appropriate services. By partnering with and empowering community organizations and local governmental offices, state public health agencies have the potential to advance children’s mental health equity and reduce resulting disparities.

Integration and Cross-agency Collaboration

Access to behavioral health services and a skilled behavioral health workforce can improve health outcomes and health equity. In addition, several states are exploring pathways that specifically foster access to behavioral health services among pediatric populations. For example, the Massachusetts Child Psychiatry Access Program (MCPAP) is a state-led initiative that provides psychiatric consultation and behavioral health referrals to primary care providers treating children and families. MCPAP, which is funded through the Department of Mental Health and major commercial insurers in Massachusetts, has served as a model for over 30 states.

Public health also employs workforces and programs that can integrate mental and behavioral health services that reach vulnerable children and their families. Many states are exploring integrating mental health consultation with existing home visiting programs that serve maternal and child health populations, so home visitors can better identify unmet needs among infants, children, and their families and create opportunities to engage and refer behavioral health providers. This has the potential to address existing and untreated mental health issues, stresses, and substance use, as well as to prevent adverse childhood experiences, promoting healthy outcomes in the future. The Substance Abuse and Mental Health Services Administration (SAMHSA) has supported this type of enhanced home visitation through the Linking Actions for Unmet Needs in Children’s Health (LAUNCH) Project. Thirty-five states, territories, and tribal nations have explored the LAUNCH model through local pilot projects. This integrated approach presents a major opportunity for public health and primary care and pediatric providers to explore partnerships that can address these knowledge gaps and better serve the whole family and child.

In addition, Minnesota and Virginia have well-established models that blend financing, planning, and service delivery across multiple state agencies and providers, allowing states to better address physical, mental, and social needs of at-risk children. Both states have recognized that children with or at risk of emotional disturbances require a full range of services and benefit from family-centered, coordinated, and non-duplicative care. Minnesota instituted the Children’s Mental Health Integrated Fund in 1991 to support children’s mental health and family services collaboratives. Partners include public health agencies, school districts, mental health entities, juvenile corrections, community-based organizations, and parents, all of whom pool resources and design services to jointly address health, educational and developmental, and social needs of children. Through the Children’s Services Act, Virginia blends funding for the departments of social services, juvenile justice, education, and mental health, and local management teams administer the funds. Virginia has found that this model reduces fragmentation of services, which also saves the state money.

Children’s Mental Health Awareness Day

State health agencies have a unique perspective and skillset that can assist other government agencies and non-governmental partners to understand their role in creating optimal health for all – especially children. “State health officials see the whole picture of population health, including the aspects of health that fall outside of clinical walls. We’ve known for a long time that public health cannot address child health alone. Public health leaders frequently engage other partners, such as those in education, early childhood programs, social services, and the behavioral health community. When we do this work together, we can prevent adverse childhood experiences, remedy disparities in health and access to care, and create a society that protects our children,” explains Mary Ann Cooney, chief of health systems transformation at ASTHO. “This important work continues all year-round, but this year’s awareness day is a great opportunity to reflect on how well we’ve done and to re-engage and reinvigorate partnerships that will better safeguard children’s mental health.”

On May 4, SAMHSA will host a national event to discuss the importance of integrating behavioral health and primary care for children and youth with substance use or mental health disorders. Interactive panel discussions will focus on the value of integrative care, improving communication between providers, and supporting the mental health needs of children with chronic illnesses. The event will take place on May 4, 7 p.m. ET, at the George Washington University School of Media & Public Affairs in Washington, D.C., as well as online.

Children’s Mental Health Awareness Day is also a prime opportunity for state and local health agencies, community-based organizations, and other partners to highlight innovative work that is improving access to care and reducing disparities in access and health outcomes throughout the year. Over 1,100 communities and 160 federal programs and national organizations are planning to observe this important day through local awareness activities, and examples of past years’ events are available here.

Claire Rudolph, MPH, MCHES, is a director for health equity at ASTHO.

Anna Bartels, MS, is an analyst for health systems transformation at ASTHO.