Model Core Program Paper: Mental Health Promotion and ...

1 Model Core Program Paper: Mental Health Promotion and Mental disorders prevention BC Health Authorities BC Ministry of Healthy Living and Sport February 2009 This Model Core Program Paper was prepared by a working group consisting of representatives of the BC Ministry of Healthy Living and Sport and BC s Health authorities. This paper is based upon a review of evidence and best practice, and as such may include practices that are not currently implemented throughout the public Health system in BC. This is to be expected, as the purpose of the Core Public Health Functions process consistent with the quality improvement approach widely adopted in private and public sector organizations across Canada is to put in place a performance improvement process to move the public Health system in BC towards evidence-based best practice.

2 Where warranted, Health authorities will develop public performance improvement plans with feasible performance targets and will develop and implement performance improvement strategies that move them towards best practice in the Program component areas identified in this Model Program Paper. This Model Program Paper should be read in conjunction with the accompanying review of evidence and best practice. Model Core Program Paper approved by: Core Functions Steering Committee (February 2009) BC Ministry of Healthy Living and Sport (February 2009) BC Ministry of Healthy Living and Sport, 2009 Core Public Health Functions for BC: Model Core Program Paper Mental Health Promotion and Mental disorders prevention TABLE OF CONTENTS Executive Summary.

3 I Overview/Setting the 1 An Introduction to This 2 Introduction to Mental Health Promotion and Mental disorders 2 Determinants of Mental Health and Mental Illness .. 4 Linkages With Other Health 5 Scope And Authority for Programs for Mental Health Promotion and Mental disorders prevention .. 6 National Roles and Responsibilities .. 6 Provincial Roles and 6 Ministry of Healthy Living and Sport Roles and Responsibilities .. 6 Other Provincial Ministries Roles and Responsibilities .. 7 Provincial Health Services Authority Roles and Responsibilities.

4 8 Other Provincial Agencies Roles and 10 Health Authorities Roles and Responsibilities .. 10 Local Roles and Responsibilities .. 10 Aboriginal Communities Roles and Responsibilities .. 11 Legislation and Policy Direction .. 11 Goals and Objectives .. 12 Key Foundations .. 13 A Focus on Protective and Risk Factors .. 14 Support Across the 15 Multi-Sectoral Collaboration, Partnerships and Program Integration .. 16 Universal and Selected/Targeted Initiatives .. 17 Selected/Targeted 17 Gender 18 Aboriginal People .. 19 Diverse Cultural and Ethnic Groups.

5 19 Gay, Lesbian, Bisexual and Transgendered 20 People Who Use Substances .. 20 People Who Experience Violence and Trauma .. 20 People With Disabilities .. 21 People With Chronic Illness .. 21 Main Components and Supporting Evidence .. 22 22 Mental Health Promotion (For All Ages) .. 22 Summary of Supporting Evidence .. 24 Mental Health Promotion / Mental disorders prevention Across the Lifespan .. 25 Reproductive Health .. 25 Early Childhood Mental Health .. 27 Middle to Late Childhood .. 28 Youth/Young Adult Mental Health .. 30 Adult Mental Health .

6 33 Core Public Health Functions for BC: Model Core Program Paper Mental Health Promotion and Mental disorders prevention Mental Health of Older Adults .. 34 Reduction of Discrimination and 36 Summary of Supporting Evidence .. 37 Surveillance, Monitoring and Program Evaluation .. 37 Summary of Supporting Evidence .. 37 Best Practices .. 39 Indicators, Benchmarks and Performance Targets .. 41 41 Indicators for the Program on Mental Health Promotion and Mental disorders prevention .. 42 External Capacity and Support Requirements .. 43 Key Success Factors/System 43 Information Management for the Program on Mental Health Promotion and Mental disorders prevention .

7 43 References .. 44 Glossary .. 51 List of Tables Table 1: Summary of Risk and Protective Factors That Influence Mental disorders .. 15 Appendices Appendix 1: The Evidence Base for a Model Core Program for Mental Health 71 Appendix 2: The Evidence Base for a Model Core Program for Mental disorders prevention .. 72 Appendix 3: Mental Health Promotion Logic Model .. 75 Appendix 4: prevention of Mental disorders Logic Model .. 76 Appendix 5: Indicators for Mental Health Promotion Outcomes .. 77 Appendix 6: Indicators Associated with Outcomes for prevention of Mental 79 Core Public Health Functions for BC: Model Core Program Paper Mental Health Promotion and Mental disorders prevention Ministry of Healthy Living and Sport Page i EXECUTIVE SUMMARY This paper identifies the core elements that are provided by British Columbia Health authorities to support Mental Health Promotion and the prevention of Mental disorders .

8 It is intended, as part of the BC Core Functions in Public Health , to reflect evidence-based practice and support continuous performance improvement. A Working Group of representatives from the Ministry of Healthy Living and Sport, Provincial Health Services Authority and the Health authorities worked together in the development of this paper. They noted that a clear conceptual distinction between Mental Health Promotion and Mental disorder prevention is necessary to ensure effective planning and Program delivery, as Mental disorders and positive Mental Health are overlapping and interrelated components of a single concept of Mental Health prevention and Promotion elements are often present within the same Mental Health programs and strategies, involving similar activities and producing different but complementary outcomes (Detels, McEwan, & Beaglehole, 2004; Saxena, Jane-Llopis, & Hosman, 2006).

9 Mental Health Promotion aims to promote positive Mental Health by increasing psychological well-being, competence and resilience, and by creating supportive living conditions and environments. Mental disorder prevention has as its target the reduction of symptoms and ultimately of Mental disorders . The Working Group agreed that the goal of the Mental Health Promotion component of the Program is to improve the Mental Health and psychological well-being of British Columbians throughout their lifespan/lifecourse, while the goal of the Mental disorders prevention component is to decrease the prevalence of Mental disorders among vulnerable groups and individuals.

10 Taken together, specific Program objectives are to Enhance protective factors that contribute to positive Mental Health in individuals, families, workplaces and communities. Prevent and/or reduce the social, environmental and individual risk factors that influence the occurrence of Mental disorders . Reduce the incidence, prevalence and recurrence of Mental disorders as well as the severity and impact of the illness on individuals, families and society. A number of key foundations, based on the literature and experience of experts in the field are considered necessary for achieving progress and successful outcomes.