Abstract

Centering Mental Health in American Society: Connecting Theory to Practice to Improve Well-Being for All

Silicia Lomax, MPH¹, Cori Cafaro, MSc, MA, ², Nadha Hassen, MPH³, Clysha Whitlow, MA⁴, Kirby Magid, MA⁴, Gita Jaffe, PhD⁵ (1)Waxman Strategies, (2)DePaul University, College of Science & Health, Clinical-Community Psychology, (3)York University, (4)University of North Carolina at Charlotte, (5)Global Alliance for Behavioral Health and Social Justice

APHA 2022 Annual Meeting and Expo

Background: Having endured over two years of interruption to education, social connection, and routines, the COVID-19 pandemic illuminated America's structural inequities that have worsened population mental health and well-being. Integrating mental health into institutions, systems, and settings while recovering and rebuilding, must be at the forefront to provide a path for transformation or the mental health crisis will continue to grow. Centering mental health and well-being as a human right will improve systems and quality of life in American society.

Description: Achieving this requires learning from successful approaches and scaling up the implementation of effective strategies that promote equity by actively addressing determinants and barriers across systems that impede overall health. Reflecting and building upon policies such as the Civil Rights Act, the Fair Housing Act, and the Affordable Care Act may help lawmakers to improve mental health and access to services. In addition to policy recommendations, we outline how principles from Patient-Centered Medical Home (PCMH) and Housing First (HF) approaches can be applied to multi-sector, equity-focused community initiatives to promote mental health and well-being as a human right.

Lessons Learned: Addressing social and structural determinants of health must be considered in the innovation of centering mental health. Considering real world application, evidence-based examples driven by human rights are most effective in addressing mental health inequities. The PCMH model applies a person-centered approach within an interdisciplinary team of providers under one system of care. Findings from PCMH initiatives reflect reductions in inpatient care, prescription spending, and hospital admissions. HF approaches offer immediate, independent housing to unhoused individuals with co-occurring behavioral health conditions without the prerequisite of receiving treatment. It emphasizes client choice and is associated with public savings because enrolled clients are less likely to require emergency services.

Recommendations: Based on lessons learned, we offer three recommendations for achieving well-being as a human right. American systems should 1) Embed mental health within and across all systems and expand its definition across a continuum; 2) Prioritize prevention and health promotion through person-centered and community-driven strategies; and 3) Expand the diversification and training of the mental health workforce across sectors.