Seeking better health through our communities and our families: The Inaugural ACMHA DC Policy Forum

Our experiences of warmth, inclusion, and acceptance by our family and friends are particularly accentuated during the rapidly approaching Holiday Season. Why mention this here? Finally, we are beginning to appreciate that our family and our community support systems do play an essential role in promoting our good health and our sense of well-being.

As we implement the Affordable Care Act (ACA), we will devote much more attention to policies and interventions that promote positive health and well-being. This effort arises from the recognition that health and disease are two separate dimensions, and that effective health promotion can prevent, delay, and mitigate disease. Our work will include improving the positive social determinants of health—such as community and family self-actualization, which can enhance the nurturing environments and life chances needed to improve and maintain good health. In fact, by 2020, fully 30 percent of our health care dollars will be spent on promoting positive health, rather than on treating disease. Because continued good health can actually prevent or delay the onset of chronic diseases, many disease care dollars can be saved if we are successful in this work. 

To underscore the viral implications of this dramatic change in our thinking about health and disease, ACMHA: The College for Behavioral Health Leadership conducted its inaugural DC Policy Forum this week on Harnessing Community Support for Health and Well-being. On December 4, at a gala reception and dinner event, more than 100 participants explored how community and family factors can improve or harm health. On December 5, Senator Sheldon Whitehouse (D-RI) hosted a Congressional Briefing for more than 150 participants to explore the role that communities and families ought to play as we seek to implement national policies that emphasize health promotion and disease prevention. (Also on December 5, Senator Whitehouse had an Op-Ed in Politico that addressed the subject of his comments: https://www.politico.com/story/2012/12/health-care-savings-without-medicare-cuts-84579.html).

Speakers included the noted physician, Dr. Vincent Felitti, former Medical Director of Kaiser Permanente and the principal author of the famed study of adverse childhood experiences, which demonstrated the potent effects of adverse events in harming subsequent health status. Dr. Felitti was joined by Dr. Carolyn Jenkins, a senior investigator at the Center of Excellence in the Elimination of Diabetes and Disparities, who has demonstrated how effective community and family self-actualization and support can reduce the adverse health consequences of diabetes in elderly minority populations.

Dr. Arthur Evans, Commissioner of the Philadelphia Department of Behavioral Health and Intellectual Disability Services, introduced a community mural preparation initiative in downtown Philadelphia to foster community self-actualization around health and well-being. Dr. Thom Bornemann, Director of the Carter Center Mental Health Program, observed that the time has come to recognize the potency of these social determinants of health in our public policies.

The message of the panel was highlighted by Tonier Cain, of the National Center for Trauma Informed Care, who shared her personal childhood and adult perspectives as a person in recovery, a trauma survivor and as a mother, and by Paolo Delvecchio, Director of the Center for Mental Health Services, also a consumer-advocate, who emphasized what we can learn from recovery communities and from trauma informed care as we undertake this work.

Some major points of consensus were reached by participants through these discussions: a need exists to educate national and state legislators and policymakers about the paradigm shift taking place in our approach to health; greater flexibility will be needed in program funding to accommodate a broader range of activities, including family and community initiatives; this flexibility will need to extend to breaking down traditional bureaucratic barriers among governmental agencies; new partners, especially public health and faith-based organizations, will need to be brought to the table. The timeline for undertaking this work is short, so that opportunities are not missed under the Affordable Care Act. Finally, we, ourselves, will not be able to effect this transformation unless we are able to first transform our own thinking.

In preparation for the event, Forum planners also prepared an Issue Brief that underscores the importance of promoting good health to achieve economic and social progress. It summarizes the evidence that supports the key role that communities and social support actually play in this endeavor. The Issue Brief is available at https://www.acmha.org/content/current_events/DC_Policy_Forum_Issue_Brief.pdf.

ACMHA has initiated the DC Policy Forum to inform both the public policy and health advocacy communities about innovative approaches and practices that can reduce the burden and cost of disease, and promote better health. The College anticipates hosting similar events in the future.   

ACMHA is recognized as the premier forum for the development of leaders and the exchange of innovations that impact the health and wellness of people with mental health and substance use conditions. Its membership consists of nationally recognized behavioral health leaders sponsoring programs to inform policy, increase awareness, and shape innovative solutions in the behavioral health field. For further information about ACMHA, please visit www.acmha.org.  

Our hats are off to Dick Dougherty, President of Dougherty Management Associates, who did a stellar job as chair of the DC Policy Forum Committee, and the other ACMHA members who provided expert advice on the Committee. These include Jennifer Andrashko, Bill Emmet, Sandy Forquer, Eric Goplerud, Eunice Hartman, Renata Henry, Steve Hornberger, Ryan Springer, and Ken Thompson. Two other ACMHA members, Katie Bess and Phyllis Vine, structured the social media for the event.