Advancing a Public Health Approach to Children's

Mental Health

Topical Conference Call

February 18, 2010

Neal M. Horen, PhDJoyce Sebian MS Ed

Georgetown University Center for Child and Human DevelopmentNational TA Center for Children’s Mental Health

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New Publication: A Public Health Approach to Children’s Mental Health: A Conceptual Framework

 Authors: Searchlight Consulting LLC–Jon Miles, Ph.D.

Georgetown University Center for Child and Human Development, National TA Center for Children’s Mental Health –Rachele C Espiritu, Ph.D.–Neal M Horen, Ph.D. –Joyce Sebian, M.S. Ed.–Elizabeth Waetzig, J.D.

In partnership with SAMHSA/CMHS, Children Youth and Family Branch and Prevention Program Branch

Announcing!!!!  

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Key Components of a Public Health Approach

Integration elements: • Population Focus• Includes Promotion and Prevention• Addresses Determinants of Health• Process/Action Steps

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Using a New Intervention Model: Moving beyond

Prevention and Treatment

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Prevention and Treatment

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Prevention and Treatment (cont’d)

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An International Model Positive Health and Health Problems

Valuing Mental Health: A Framework to Support the Development of a Provincial Mental Health Policy for Newfoundland and Labrador, September 2001. http://www.gov.nl.ca/publicat/MentalHealthPolicyPaper.pdf Downloaded April 9, 2007

1) people have good mental health and no mental illness.

2) people have poor mental health but do not have a mental illness.

3) people may have mental illnesses but still have good mental health.

4) people have mental illnesses and poor mental health.

2) people have mental illnesses and poor mental health.

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Prevention and Treatment (cont’d)

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Intervention Model for Children’s Mental Health

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Four intervention categories and distinctions based on action, timing and goal

Action Timing Population Goal

Promoting

…is intervening…

to optimize positive mental health by addressing determinants* of positive mental health

before a specific mental health problem has been identified in the individual, group, or population of focus

with the ultimate goal of improving the positive mental health of the population.

Preventing

…is intervening…

to reduce mental health problems by addressing determinants* of mental health problems

before a specific mental health problem has been identified in the individual, group, or population of focus

with the ultimate goal of reducing the number of future mental health problems in the population.

Treating

…is intervening…

to diminish or end the effects of an identified mental health problem

after a specific mental health problem has been identified in the individual, group, or population of focus

with the ultimate goal of approaching as close to a problem-free state as possible in the population of focus.

Re/Claiming… is

intervening…

to optimize positive mental health while taking into consideration an identified mental health problem

after a specific mental health problem has been identified in the individual, group, or population of focus

with the ultimate goal of improving the positive mental health of the population of focus.

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A Paradigm Shift

Shifting away from a focus on children’s individual mental health problems and towards strengthening the mental health of all children requires• Working collaboratively across a broad range

of systems and sectors• Engaging the child mental health care system,

the public health system, and all the other settings and structures that impact children’s well-being

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The Public Health Approach Process

• Three core functions• Ten essential elements/services

Citation: The Future of the Public's Health in the 21st Century, Institute of Medicine, National Academy Press, 2002

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The

Process (cont’d)

• Other models emphasize a process that is focused on intervention – Using data to identify a problem and

determinant(s) to address– Developing or selecting evidence-

based interventions– Evaluating those interventions

• The approach for children’s mental health integrates these models

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5 Guiding Principles

• Population focus• Emphasis on creating supportive

environments and building skills• Balanced focus between children’s

mental health problems and positive mental health

• Cross-system and cross-sector collaboration

• Implementation driven by local context

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Integrated Values of Children’s Mental Health and Public Health

• Be driven by the fundamental value and dignity of every child

• Be child centered, youth guided, and family driven• Be community based/locally adapted• Be culturally and linguistically competent• Be equitable, providing the resources for health for

all children • Balance the rights of the individuals with the good of

the collective, recognizing that each person’s actions affect other people

• Be collaborative, with systems and sectors working together to be optimally effective

• Use scientific knowledge to drive decision making whenever possible

• Operate with accountability, respect, and integrity.

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Public Health Processes Adapted for Children’s Mental Health

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A Conceptual Framework for a Public Health Approach to Children’s Mental Health

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Examples for the Intervening Model for Children’s Mental Health