A Public Health Approach to Children's Mental Health: A Comprehensive Framework for Health -- Call 3 Read Comments | Post Your Own Comment Widespread, major transformation around a system’s beliefs, values, and practices is required for communities or interest groups to optimize mental health for all children. Leaders from diverse groups and at all levels—national, state, tribal, territorial and community— can participate in and facilitate the application of a public health approach to strengthening the mental health of all children. The conceptual framework for a public health approach to children’s mental health (see Figure 1) is a new way of addressing mental health for children.
Many of the ideas that make up this framework are not new; what is new is how they have been integrated to create a comprehensive and coordinated approach. The framework is a starting point that could create a major transformation across the sectors and systems that address children’s mental health. Important change often happens at the local level and is often spearheaded by a small group of individuals with a common interest and passion. Whether a community or state takes small steps (adding positive health measures to data gathering efforts) or takes a series of jumps (strategically adding promotion efforts into existing paradigms), or takes a big leap (legislating new rule sets that leverage a public health approach to mental health), each strategy is an innovation to transform to a new way of thinking and doing. Implementing a public health approach to children’s mental health involves applying the public health process that has been adapted for children’s mental health in this framework: Assessing, Intervening and Ensuring. The following offers a brief highlight of strategies to consider and is summarized in Figure 2. Data Gathering - Gaining Understanding of the Current Situation A public health approach to children’s mental health is driven by knowledge of the health and determinants of health for a population of children. Data gathering should be driven by a collaborating group and involve four parts: 1) determining what to assess, 2) identifying data sources and data collection strategies, 3) collecting the data, and 4) assessing the data to inform decisions about interventions. Several existing resources for measuring and monitoring children’s well being are provided in the Additional Resources box. Intervening – Deciding What to Do and Doing It Once data on the population’s mental health status and the social and physical environmental context have been analyzed and the collaborating group has developed its theory of change, the focus can shift to intervening to achieve optimal mental health for all children. Even in this part of the process, the initial steps of data gathering, analyzing, and developing a theory of change continue to provide knowledge that guides ongoing decisions about intervening. Similar to data gathering, intervening involves several steps: 1) conducting a comprehensive scan of interventions, 2) assessing the information to inform direction, 3) researching effective interventions across the spectrum of the four intervention categories in the model, and 4) implementing the interventions to fill in the gaps. Website resources for effective interventions are provided on this site. Ensuring – Being Effective and Accountable As the full range of children’s mental health policies, actions, activities, efforts and programs becomes organized and implemented within this framework, leaders must ensure that the interventions reach their intended audiences, that the interventions are implemented effectively by a highly competent workforce, and that the interventions are sustainable.
How to Get the Work Started Each component of the process—Assessing, Intervening, and Ensuring—requires that all parts of the processes are undertaken in a complete and comprehensive manner for optimal effectiveness. But none of the three components occur without considerable effort. They require leadership that provides an overarching vision, opportunities for ongoing local adaptation, as well as an infrastructure to support sustained effort in order to truly implement a public health approach to children’s mental health. An infrastructure and defined processes are necessary to move the work forward and to guide the implementation and ongoing efforts. Three processes are important: 1) convening the people who will make the effort happen, 2) engaging in a process of creating a guiding vision and shared goals, and 3) identifying resources groups may need to support their work. Invitation to dialogue and share resources: There are many examples from communities and states that have implemented pieces of the framework that offer effective change strategies and tools. Please share your thoughts and experiences here.
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