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Why Mental Health Is a Public Health Issue

Peer-to-peer programs need to be developed to meet our mental health needs.

Key points

  • Identifying mental health as a public health issue is imperative to building healthier and more productive communities.
  • Resiliency initiatives can be be designed to bring peer-to-peer programs into communities and scaled to create community well-being.
  • The Community Resiliency Model is one model with the potential for scalability.

Identifying mental health as a public-health issue is imperative to building healthier and more productive communities. The pandemic, mass shootings, violent conflicts like the Ukraine War and the Uyghur genocide, political unrest, climate change events, and other traumas of the human condition have left an indelible imprint on the world community. Unprecedented challenges with mental health affect every aspect of life including the ability to conduct the activities of daily living.

Unrecognized and untreated mental health conditions can lead to social isolation and problems with interacting with one’s family and community. It can sometimes lead to encounters with the criminal justice system and behaviors that can compromise mind and body health.

Yet there are not enough professional mental health practitioners to address our worldwide mental health needs. Models of intervention are being developed to mitigate the impact of mental health challenges being experienced in unprecedented ways. One example is the Community Resiliency Model we have developed at the Trauma Resource Institute.

The Community Resiliency Model

The Community Resiliency Model teaches six wellness skills to restore the mind, body, and spirit to well-being. It shares psychoeducation about common reactions during and after stressful and traumatic events, including information about the stress response and the autonomic nervous system. It is biologically based, and the model has distilled the complexity of neuroscience into simple, understandable concepts. This approach helps individuals understand their emotional, spiritual, cognitive, behavioral, relational, and physical reactions through the lens of biology. The skills of the community resiliency model have already been brought to communities throughout the world.

The Community Resiliency Model's skills can be delivered in small doses through community workshops or one-on-one to individuals across the lifespan. Professional medical and mental health practitioners and the natural leaders of communities (ministers, teachers, first responders, community health workers, and more) can become teachers and guides to share the skills throughout their communities.

Natural leaders are individuals who may or may not have formal education in mental health or designated leadership roles but are looked to for guidance because of their embodied personal qualities of treating others with respect, compassion, and empathy. They share their wisdom with equanimity in a way that encourages and empowers their community.

An Unprecedented Time of Risk to Community Mental Health

The impact of traumatic experiences on individual and community health is widespread. According to the World Health Organization (WHO, 2021), “Traumatic events and loss are common in people’s lives.” Sun (2021) states that there is a need to quickly establish programs that provide timely psychological counseling and intervention to alleviate anxiety and improve general mental health. Health and community care systems led by a cadre of psychologists, psychiatric nurse practitioners, chaplains, social workers, marriage and family therapists, nurses, and physicians have brought the community resiliency model concepts and skills into medical clinics, community mental health and resiliency programs, shelters for the unhoused, and hospitals.

Widening the lens to peer-to-peer interventions leading to well-being and mental health can be part of the public health response to healing individuals, families, and communities. Peer-to-peer interventions can provide approaches that are accessible, affordable, and can be adapted to communities by integrating a cultural lens. The Community Resiliency Model holds promise as one of the interventions that can be deployed in communities with a public health lens with the potential to scale its skills and concepts.

Health Resiliency Workforce Awards and Research Cultivating Well-Being

Duva (2022) reports the effectiveness of the Community Resiliency Model for nurses and other front-line workers. De Kock (2021) reports that front-line healthcare workers are at risk of significant psychological distress due to the COVID-19 pandemic, and published studies suggest that symptoms of anxiety, depression, insomnia, distress, and OCD are found within the healthcare workforce.

Four Health Resiliency Workforce Awards were granted in 2022 by the U.S. government's Health Resources and Services Administration (HRSA) to organizations that include the Community Resiliency Model as one of the modalities they will implement and research, including Emory University; Children's Hospital, Los Angeles; the University of Alabama; and the University of New Mexico. HRSA awarded funds to be used over three years to reduce burnout and promote mental health in the health workforce. These awards, which particularly consider the needs of rural and medically underserved communities, will help health-care organizations establish a culture of wellness among the health workforce and support training efforts that build resiliency for those at the beginning of their health careers.

Community Wellness Initiatives with the Community Resiliency Model

Another example of a community wellness initiative comes from New Hanover County, North Carolina. Bo Dean, a Senior Human Resources Analyst for New Hanover County (2021), reported about the culture of resilience that was brought into their county in North Carolina. The residents of the county went into action after the devastation of Hurricane Florence in 2018. Their efforts with the Community Resiliency Model were initiated in their attempts to find a well-being approach with the potential for scalability in their county.

The team’s initial efforts blossomed into a solid preparation and prevention strategy for the entire community that is now in place for when future climate-change events and other challenges like COVID-19 occur. In 2021, New Hanover County received an Achievement Award from the National Association of Counties in the category of Training and Professional Development for their “New Hanover County Culture of Resiliency” program. They have trained over 5,000 people in the Community Resiliency Model skills. Their resilience perspectives were brought into the county systematically and could be replicated in other parts of the country and the world.

Learn more from the Trauma Resource Institute.

References

Dean, B. (2021)New Hanover County Culture of Resilience – Training and Professional Development, New Hanover County, Human Resources.

De Kock, J.H., Latham, H.A., Leslie, S.J. et al. A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health 21, 104 (2021). https://doi.org/10.1186/s12889-020-10070-3

Ingrid M. Duva, Jordan R. Murphy, and Linda Grabbe, (2022)A Nurse-Led, Well-Being Promotion Using the Community Resiliency Model, Atlanta, 2020–2021, American Journal of Public Health, 112, S271_S274,https://doi.org/10.2105/AJPH.2022.306821

Sun, P., Wang, M., Song, T., Wu, Y., Luo, J., Chen, L., & Yan, L. (2021). The Psychological Impact of COVID-19 Pandemic on Health Care Workers: A Systematic Review and Meta-Analysis. Frontiers in Psychology, 12, 626547. https://doi.org/10.3389/fpsyg.2021.626547

World Health Organization (2022), Weekly Epidemiological Update on Covid-19-8 March 2022, https://www.who.int/publications/m/item/weekly-epidemiological-update-o…

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