ATLANTA — During the William C. Menninger memorial convocation lecture here, Thomas Frieden, MD, MPH, director of the CDC, reaffirmed the center’s commitment to mental health issues by highlighting the many examples of where public health and mental health intersect.
“Not all diseases are curable, but effective care is possible for all diseases,” Frieden said. “In public health, we think about denominators. We think about what proportion of an entire population we’ve reached, not the proportion of patients that came into our offices, but what proportion of the entire population in need we’ve reached. In psychiatry, you have the privilege and effectiveness of going deeply to improve the health of individuals. With a reciprocal revolution we could deeply effect change on a massive scale. That’s the challenge upon us.”
In recent years, a number of approaches have been developed to address issues that fall under public health and mental health.
Assisted outpatient therapy can significantly improve engagement rates and reduce homelessness.
Collaborative care models, such as one developed by the APA and encouraged by president-elect Maria A. Oquendo, MD, utilize lay health care workers to provide comprehensive care.
“We’ve understood that by changing the environment, whether it’s through cognitive behavioral therapy or an environmental approach, we can work with people with serious mental illness like schizophrenia and increase their functionality and help reintegrate them into society,” Frieden said.
A number of CDC programs address mental health issues in addition to public health, according to Frieden. These include the National Center for Chronic Disease Prevention and Health Promotion, the National Center for Health Statistics, the National Center for Environmental Health, the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention and others, which address child maltreatment, violence, suicide, opioid use, HIV, smoking, excessive drinking and more.
“We’re failing the next generation as a society, as parents and as health providers. But we can change that,” Frieden said. “We can raise a generation free from addiction by implementing policies that reduce the availability and increase the cost of tobacco, that run targeting ads, that change the glamorization of tobacco and alcohol in society, that get to a better balance on how we prescribe opiates and other dangerous medications, that get to a better place on the role of medications, the risks and the benefit and that better understand both the potential and the perils of medications to improve health.”
Regarding public health,society can foster a healthier relationship with bacteria, viruses and parasites through vaccination and a better understanding of the microbiome, and maintain healthier weights by establishing regular habits of physical activity and healthy nutrition, according to Frieden.
“We can increase the potential of freedom from mental illness through healthy parenting and childhood experiences that have a lifelong impact. We can work together to change not only the individual policy interventions and not only the clinical interventions, but the societal context that frame so much of whether people are healthy or not,” he said. – by Amanda Oldt
Frieden T. William C. Menninger memorial convocation lecture. Presented at: American Psychiatric Association Annual Meeting; May 14-18, 2016; Atlanta.
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