Collaboration Between Public and Behavioral Health is Essential

Good community mental health and wellbeing simply are not possible without effective collaboration between community public health programs and behavioral healthcare programs. Such partnerships are essential if we are to prevent traumas due to negative social and physical life determinants in the community. They also are required to engage in effective population health management designed to prevent personal behavioral health crises.

County and city public health programs have skills in strategic interventions, as well as tools to work with populations. The community-wide intervention strategies of public health are necessary to address the negative social and physical life determinants. For example, gun violence and homelessness both require such strategies. The analytical tools of public health, such as population disaggregation, assessment, tracking, and predictive analytics, are necessary to mitigate and prevent personal behavioral health crises.

In 2020, the Public Health Center for Innovations and the de Beaumont Foundation collaborated to produce a framework for 10 Essential Public Health Services. These services are clustered into 3 broader areas: Assessment, Policy Development, and Assurance. The 2 services under assessment are directly relevant for partnerships with behavioral health: investigate, diagnose, and address health hazards and root causes (for the social and physical life determinants), and assess and monitor population health (for health management).

Today, all states and more than 1700 counties have well-developed public health programs. Further, the American Public Health Association, a membership and advocacy organization of public health professionals, has state-level public health affiliates in virtually all states, as well as more than 30 substantive sections, including a Mental Health Section and an Alcohol, Tobacco, and Other Drug Section. However, only rarely do our state, county, or city behavioral health programs undertake joint endeavors with these counterparts from public health. This represents a huge missed opportunity. 

What will it take to foster these partnerships? Here are a few recommendations. They relate to 2 specific areas: developing our relationship with public health and developing different types of partnerships.

We can take several steps to develop our relationship with public health:

1. We must come to appreciate that virtually all community public health programs address populations that include a subset of persons with behavioral health conditions.
2. We must recognize that the social and physical life determinants that are root causes for behavioral health conditions also are root causes for other health conditions already being addressed by public health programs.
3. We must be willing to interact with our public health counterparts as trusted partners.
4. We must be willing to share responsibility with our public health counterparts for those in the community population who are at risk or who actually have a behavioral health condition.

Partnerships with public health can be developed in several different ways:

Joint collaboration with other community organizations. Collaboration could be undertaken with a community school system to improve student health and wellbeing. This could include joint programming for health and behavioral health fairs, targeted workshops for teachers and students, and school events to celebrate progress.

Collaboration on special initiatives. Collaboration could be developed to address loneliness and social isolation in the community, a major problem recently identified by the US surgeon general. Or this collaboration could focus on another social or physical life determinant.

Joint advocacy and policy development. Work could be undertaken together to highlight and promote actions and policies that support improved access to health and behavioral healthcare services for community members, as well as better funding for these services.

Data sharing and analysis. Joint data work could be undertaken to identify areas of high need and to inform the development of targeted interventions.

Cross training and cross employment. Staff in each entity could be incentivized to undertake such training and a rotation program could be developed to share these staff when joint initiatives are undertaken.

Collaborative endeavors between public health and behavioral health are not just beneficial, but also essential. We cannot expect to alter the negative social and physical life determinants that cause trauma and behavioral health conditions without them. Neither can we expect to engage in effective population health management to prevent behavioral health crises without them.  

Ron Manderscheid, PhD, is principal of Manderscheid Associates, as well as the former president and CEO of NACBHDD and NARMH and an adjunct professor at the Johns Hopkins Bloomberg School of Public Health and the USC School of Social Work.

The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.

Reference

Centers for Disease Control and Prevention. 10 Essential Public Health Services. Centers for Disease Control and Prevention; 2020.