Behaving, becoming, and being healthy: The 2015 ACMHA Annual Summit

The 2015 ACMHA Summit more than fulfilled its very high expectations. The case was presented, debated, and affirmed:  Personal and community health literacy and activation are essential if one is to achieve and maintain good health. Clearly, no more important message exists for a person who suffers from a major mental or substance use condition, and whose life expectancy can be shortened by as much as 25-35 years as a result of health problems and poor quality care. Joe Parks, Professor, University of Missouri, and Director, MO HealthNet, emphasized this very important message in his pre-Summit remarks.

Over the past decade, the entire cultural context of healthcare has changed from a unitary focus upon disease treatment to a much more encompassing effort to address the social and physical determinants of health, to promote positive health, and to prevent disease. Healthy People 2020 set this framework in place in 2008, the Affordable Care Act legitimized it in 2010, and the National Prevention Strategy operationalized it in 2011. Now, we must incorporate these landmark changes into behavioral health.

Kick-off plenary presentations by Paolo Delvecchio, Director of CMHS, and Ray Fabius, President of HealthNEXT, both affirmed that the public and private sectors are fully engaged in promoting and developing the “culture of health.”  SAMHSA is developing key tools for the behavioral health field, and major corporations are developing health improvement plans for employees and their family members. Both speakers emphasized that implementing a culture of health makes both personal and business sense.

Paolo Delvecchio said, “We need to flip the script…Too many lack these new skills to succeed. “  Ray Fabius extended our vision, “Our next important step will be to move from the ‘culture of health’ to the ‘culture of wellbeing.’“

Behaving, becoming, and being healthy is not simply a solitary personal task that one undertakes alone. We also have learned that our communities play a central role in our health. For example, if one lives in a community characterized by poverty, this context will lead to personal trauma and hardship that adversely affect personal health. Hence, we must learn how to activate our local communities as well.

Jei Africa, Executive from California’s San Mateo County Behavioral Health, and Arthur Evans, Executive from Pennsylvania’s Philadelphia Behavioral Health, both made the case for well-planned and culturally competent interventions to improve community health literacy, activation, and self-care, and reduce disparities. 

Carole Siegel, of Nathan Klein Institute in New York, described the importance of consumer “cultural activation” in order to become health activated.  Lenora Reid-Rose, of Coordinated Care Services, Inc., and Sandra Mitchell, of National Action Network, showed these concepts in action. Onaje Muid, of Reality House, Inc., summarized the point, “We should not ‘invisibilize’ people.”

Patrick Hendry, Consumer Advocacy, MHA, and others from the ACMHA Peer Leader Interest Group, highlighted the essential role that peer support actually plays in promoting better self-care and personal health. They also pointed to huge new opportunities for peer support in emerging integrated care settings, as well as in our jails and courts.

A highlight of the Summit, as well as a Summit first, was a presentation by a sitting judge, Judge Ginger Lerner-Wren, Criminal Division, Florida’s Broward County, who is seeking to extend health literacy and activation into the criminal justice system.  Judge Wren said, “As a former disability lawyer, I understood quickly the importance of seeking support from peers to help me identify appropriate care and supports for consumers.”

The balance of the Summit was devoted to identification of useful strategies and tools for promoting personal and community health literacy and activation. The new approaches include positive psychology; the new tools, online interventions and phone apps.  Another first for the Summit was the development of an ACMHA e-book on Health Literacy and Activation. Prepared in advance of the Summit, this e-book will be updated post-Summit, thus making available a very important ACMHA tool for use broadly by our field. Plans already are being developed to test this e-book in the field.

In total, the Summit was outstanding: exceptionally timely, fully on point, and eminently practical for the ACA era. Our hats are off to Sue Bergeson, Vice President, Consumer Affairs, Optum, and Chair of the Summit Planning Committee, the entire Committee, as well as the ACMHA Officers and Board for exceptional innovation and exceptional leadership around health literacy and activation. Bravo!