Drexel study: Local health departments key to expanding mental health care in the U.S.

Local health departments could play a significant role in tackling mental health issues in the United States, according to a recent study conducted by faculty in Drexel’s Dornsife School of Public Health.

Standing as government entities responsible for addressing the public health needs and concerns of a specified geographic population, nearly 3,000 local health departments serve cities and counties nationwide.

Drexel’s professors found that of the 505 local health departments they studied, between 30 and 40 percent provided some form of mental health care services. Additionally, those that provided services were found to be seven times more likely to perform population-based mental illness prevention activities and almost three times as likely to be involved in policy or advocacy for activities to address mental health issues.

Jonathan Purtle, DrPH, assistant professor in the Dornsife School of Public Health’s Department of Health Policy and Management, was the lead author of the study, “Prevalence and correlates of local health department activities to address mental health in the United States,” which was published in the journal Preventive Medicine. Purtle’s co-authors in the study were Ann Klassen, PhD, Jennifer Kolker, MPH  and James Buehler, MD.

“Mental health is important for public health in two main ways,” said Purtle. “One is that mental health conditions adversely impact quality of life and are highly prevalent. Depression is among the top conditions in the world that leads to an adverse quality of life. And the second part if why mental health is important is a huge body of research tells us that mental health conditions hugely increase the risk of developing physical conditions and injury.”

Providing a more holistic sense of health, linking the mental and physical aspects, is important.

“For 100 years, people in the United States have been saying mental health is a public health issue. And people in the public health field have been saying, ‘Yes. It is,’” Purtle said. “That said, many of these organizations have been focused on physical health and mental health has been looked at as the domain of psychologists and psychotherapists, which is an individually-based view of health.”

With local health departments taking on a more holistic view of health that includes mental health services, there are opportunities to leverage that into further growth.

Under the Affordable Care Act, to retain their tax-exempt status, non-profit hospitals must conduct a community health needs assessment every three years. Local health departments could provide opportunities for partnerships with these hospitals to better address those community mental health needs, according to the Drexel research team.

The Drexel team found that roughly 25 percent of local health departments implement strategies to target the mental health service needs of under-served populations. If a local health department already had some form of mental health care services to offer, the study indicated that it was almost three times as likely to attempt to reach underserved populations.

When looking at those local health departments that implemented strategies to reach underserved populations, it was found that roughly 80 percent of them sought to access gaps in mental health care and just over 88 percent attempted to increase access to mental health services. Additionally, almost half of those local health departments were found to be involved in policy and advocacy activities addressing mental health.