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CDC plan sees positive mental health as aid to disease prevention

September 2, 2011
by Dennis Grantham, Editor-in-Chief
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Policy shift to expand role of mental health and wellness promotion in community public health

A new,four-year action plan from the nation’s top public health organization, the Centers for Disease Control (CDC), marks a strategic shift in the nation’s approach to community public health and disease prevention policy, a shift sure to cheer mental health and health reform advocates alike.
It contains eight strategies, backed by specific actions, to promote the importance of positive mental health as a critical factor in healthy lifestyles, as well as in the prevention and treatment of mental illness and chronic disease.

An advance copy of the plan, titled “Public Health Action Plan to Integrate Mental Health Promotion and Mental Illness Prevention with Chronic Disease Prevention, 2011-2015” was made available to Behavioral Healthcare, pending the official CDC release, which is expected at any time.

The plan’s release moves the mental health field one step closer to full integration in the nation’s public health system, a goal first envisioned in a 1999 Surgeon General report. The content on which the plan is based was guided by a Mental Health/Mental Illness expert workgroup convened by the DACH in 2008.

Among the mental health advocates thrilled by the release of the report is Ron Manderscheid, a former mental and public health researcher who now serves as executive director of the National Association of Behavioral Health and Developmental Disabilities Directors (NACBHDD, Washington, D.C.) and is an editorial board member.

According to Manderscheid, “the action plan finally recognizes the importance of community-based public health approaches that examine and promote the role of positive mental health as a means of encouraging healthy behaviors and preventing chronic disease, including mental illness. Amazingly,” he says, “[public health efforts] have never before examined this impact.”
The new plan, developed under the leadership of Dr. Wayne Giles and Dr. Letitia Presley Cantrell, calls for a series of actions involving surveillance, epidemiology, communication, training, intervention, and policy.

Manderscheid says that the plan’s surveillance activities will involve measuring positive mental health, mental illness, and physical disease factors, while its epidemiological activities will examine and compare the social determinants, risk factors, and protective factors for those with positive mental health versus mental illness, then explore how these factors factors predict the likelihood of physical illness.

“The plan signifies a huge change in policy,” asserts Manderscheid. “Community public health policy is moving beyond a focus on treating mental illness and instead, it’s addressing the question, ‘what role does positive mental health play in treating disease, preventing disease, and promoting overall health?’”

For the first time, the CDC plan also acknowledges that mental health means a lot more than the absence of diagnosed mental illness. The plan’s text contrasts positive mental health and well being, which are “characterized by the presence of positive affect (e.g., optimism, cheerfulness, interest) … and satisfaction with life” with mental illnesses “characterized by alterations in thinking, mood, or behavior associated with distress or impaired functioning.”

The potential value of this important shift in public-health policy is also explained in the plan, which notes that “the interconnections between chronic disease, injury, and mental illness (MI) are striking.” Among those with mental illness, the plan’s introduction asserts that tobacco usage rates are twice as high and injury rates are 26 times higher than those of the general population.
The report also cites extensive evidence linking mental illness with higher rates of chronic disease, a factor that likely accounts for a known reduction of more than 25 years in the life expectancy of those with serious mental illness.

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