Population Based Strategy: Food for Thought
"Population-based approaches to mental health" are nonclinical interventions aimed at improving mental health outcomes for groups defined by geography or demographics. These strategies focus on system-level changes, policies, and environmental factors, requiring a societal shift and further research to ensure effectiveness in reducing mental health disparities.
Although much has been written about the notion of population mental health and the closely related concept of public mental health, a concrete definition of “population-based approaches to mental health” does not exist. Drawing from scholarship about population mental health, as well as that related to “population health” terminology, we define population-based approaches to mental health as nonclinical interventions and activities intended to improve mental health outcomes, and the determinants of these outcomes, among a group of individuals that are defined by shared geography, sociodemographic characteristics, or source of clinical services utilization [i.e. hospital, health care system].
Population-based interventions must be nonclinical and thus exclude direct mental health services (e.g., psychotherapies and pharmacological therapies) to individual patients. [...] Health care system-level interventions that address mental health, however, can be considered population-based because the intervention is at the system, as opposed to the clinical, level. Social, economic, and environmental policies are also considered population-based interventions because they affect groups of people simultaneously, and psychiatric epidemiology studies indicate that a wide range of public policies affect mental health.
Widespread implementation of population-based approaches to mental health is likely to require a collective shift in thinking at the societal level—from a view that conceptualizes mental health as an individual issue that is exclusively within the purview of psychologists and psychiatrists to one that conceptualizes mental health as a public health issue that actors and organizations across all sectors have a responsibility to address. Structural changes related to financing, training, and accreditation are also likely needed to institutionalize population-based approaches to mental health across sectors. More research is needed to better understand the impacts of population-based approaches to mental health to ensure they are effective and reduce, not exacerbate, disparities in mental health problems between socially disadvantaged and advantaged groups.
Public policies that are not implemented with the explicit intent of addressing mental health, but reduce the incidence of traumatic events and limit exposure to psychosocial stressors, might have the greatest impacts on population mental health. The highest-quality evidence about the impacts of population-based approaches to mental health comes from natural experiments of public policies and cluster randomized-controlled trials of built environment interventions.
Excerpts from Population-Based Approaches to Mental Health. Emphasis added.
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