By Michele Calvo and Chideraa Ukeje
Health care reform, while on the whole improving people’s lives, is not without its challenges. Through our work with the Advancing Prevention Project (APP), we often hear about the difficulties that local health departments and their partners encounter while trying to navigate New York State’s complex health reform initiatives. One of these challenges is strengthening and aligning the public health, mental health, and substance abuse infrastructure to integrate physical, mental, emotional, and behavioral health services.
This movement towards integration of mental health and substances abuse services and the public health system is a relatively new one. The debates and resulting opportunities surrounding federal health care reform however brought the importance of overall wellness –beyond just physical wellness—to the forefront. Traditionally, services to promote mental health & wellbeing and prevent substance abuse have developed separately from the medical and public health systems. But, part of our wellness, is not just body but also mind.
Public health places a particular emphasis on prevention of illness before it even begins, and, despite a long history of treating only the crises associated with mental, emotional and behavioral (MEB) disorders, there is a role for prevention in MEB health. Integration of these two systems has the potential to prevent MEB conditions like substance use disorder or PTSD before they even begin, and promote the wellbeing of all New Yorkers.. Even more, for those people with MEBl disorders, integration could mean early identification and better access to care to better prevent crises and promote recovery.
New York State has recognized this with the inclusion of an action plan to “Promote Mental Health and Prevent Substance Abuse” in the Prevention Agenda, and a specific focus area to strengthen infrastructure in support of this. To help with achieving this challenging goal, APP released a toolkit with tools and resources for strengthening infrastructure across five domains organized by clinical, community/county, and regional levels.