January 18, 2017

Although local health department officials perceive population mental health as a growing issue that should be addressed by public health agencies, a new Drexel University study from the Dornsife School of Public Health concluded that more resources, training and education, and systems-level changes are needed to embrace population-based approaches to improve mental health in communities.

To assess factors influencing the involvement of local health departments in mental health promotion, Drexel researchers conducted twenty-one semi-structured interviews with local health department officials from a geographically diverse sample of city and county health departments that serve different size populations. The study was published this month in the American Journal of Preventive Medicine.

All of the health department officials surveyed perceived mental health as a public health issue and expressed that it has emerged as a priority through community health needs assessment processes.

One respondent noted that “The community was saying, ‘Keep the rate on the public health stuff you do, like inspect restaurants and work with vaccines, but we’re really worried about the behavioral health issues in our community.’” Some cited high profile suicides or local mass shootings as events that focused public interest on mental health.

However, the survey found that limited resources, knowledge, data, and hesitancy to infringe upon the territory of local behavioral health agencies were cited as reasons preventing substantial health department engagement.

Dornsife researchers noted that certain reforms to the structure and financing of the U.S. health system offer opportunities for local health departments to embrace population-based approaches to mental health promotion, in complement to local behavioral health agency efforts.

For example, researchers suggested, in light of an increased demand for mental health services sparked by the implementation of the Affordable Care Act, local health departments could offer mental health services to patients that local behavioral health agencies don’t have the capacity to serve. Another opportunity, researchers noted, could integrate local mental health services with other physical and social services, as incentivized through programs like Medicaid’s Section 1115 Waiver – Delivery System Reform Incentive Payment (DSRIP) Programs which aim to improve quality care and population health while reducing Medicaid costs.

In addition, researchers recommended incorporating mental health in public health training programs as well as local syndromic disease reporting systems.

The study was conducted by Dornsife School of Public Health’s Jonathan Purtle, DrPH, MPH, MSc, assistant professor of Health Management and Policy, Jennifer Kolker, MPH, associate dean for Public Health Practice and associate professor of Health Management and Policy, Ann C. Klassen, PhD, professor of Community Health and Prevention, and Health Management and Policy doctoral student Rachel Peters, MPH.

This research was supported by a public health services and systems research grant from the Robert Wood Johnson Foundation (71685) and supported in part by the Implementation Research Institute at the George Warren Brown School of Social Work, Washington University in St. Louis, through an award from the National Institute of Mental Health (R25MH050916).