The Role of Public Policy in Mental Health Care

1. The Role of Public Policy in Mental Health Care Joan Sykora, PhD Public Education Coordinator Children, Youth and Family Consortium University of Minnesota

2. Mental Health Policy is intertwined with many other areas of policy, including: • Adequate or better prenatal care • High quality education & early intervention • Freedom from neglect and violence • Availability of affordable housing • Employment with living wages • And many others

3. Policy Actors • Schools • Government agencies • Employers • Faith communities • Private agencies

4. Changes in Mental Health Needs Throughout the Lifespan • Just as physical health evolves, so does mental health • Children need a healthy birth, secure attachment, quality care and education, and freedom from family violence. • Adolescents need parental love and guidance, freedom from violence, strong connections with peers and adults, safe and healthy community space and opportunity to become productive citizens.

5. Mental Health Needs Throughout the Life Span (continued) • Parents need jobs that pay living wages and allow them time with their children, quality day care, supervised programs for school-age children, effective schools and opportunities to meet their own emotional, social, spiritual and physical needs. • Aging people need access to good mental and physical health care to assist them with aging, and connection with families, friends and society.

6. Whose responsibility is it? • Almost two-thirds of people with a diagnosable mental health problem do not seek treatment • Why? • Services dispersed among multiple agencies and settings • Often services are fragmented and inaccessible • Many individuals and families need help to identify mental health problems • Lack of reliable and equal health care coverage

7. Using the Public Health Model • Public health plays an important role • Advantages of being more pro-active about good mental health • Emphasis has shifted to include a range of treatment, prevention and early intervention services

8. Areas that Need Attention • Inequity exists in the availability, accessibility and quality of mental health care for adults and children • All rural MN counties have been federally designated as Mental Health Professional Shortage Areas due to a lack qualified providers

9. Key Issues in Minnesota • Role of schools and other child-serving agencies • Access and funding of services under managed care • Access to culturally competent care • Service coordination • Sharing of information across service delivery systems • Early identification of mental health problems

10. What currently exists in MN • The Minnesota Comprehensive Mental Health Act • Created in the late 1980’s • Purpose was to establish programs, services and funding for mental health needs of Minnesotans • Children’s portion of this legislation is the Children’s Mental Health Act • Unfortunately, funding was incomplete for the children’s portion of this legislation and services remain compromised

11. What We Know About Risks for Mental Health Problems • Chronic illness • Intellectual disabilities • Low birth weight • Family history of mental health problems • Living in a culture of chronic poverty • Lack of culturally appropriate services • Caregiver separation • Abuse and neglect

12. Policies with Potential • Early intervention/prevention • Programs that help to strengthen a positive relationship between children and parents as well as non-parental caregivers • Coordinated infrastructures for service delivery that reduces fragmentation of services