Bridging Mental Health and Public Health

A decade ago, the Surgeon General's office released its first report on mental health (1), calling for the full integration of mental health into the nation's public health system. The report synthesized the scientific literature on mental illness, concluding that mental disorders are among the most prevalent and costly conditions and that effective treatments can reduce their prevalence and decrease their adverse effect on other health conditions. The report took a broad public health approach, focusing not only on clinical diagnosis and treatment of mental illness but also on surveillance , prevention, and promotion of mental health (2). The Surgeon General's report described research developments from the 1990s, the " Decade of the Brain, " that helped establish the biological underpinnings of mental disorders and move mental health into the mainstream of research and specialty practice. The subsequent decade saw a dramatic rise in the proportion of the US population receiving mental health care (3) and a shift in the locus of treatment for mental illness away from specialty settings and toward primary care (4). During the same period, strategies for moving medical and psychiatric treatment from research into routine practice settings were developed and disseminated. In particular, research showed that integrated approaches could improve quality and outcomes of care in clinical settings on the interface of primary care and mental health (5). This research laid the groundwork for a broader strategy to integrate mental health and public health at a population level. The passage of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was a step toward this goal. As the lead government agency for the nation's public health, the Centers for Disease Control and Prevention (CDC) can play a central role in these efforts to integrate mental health and public health. Articles in this issue of Preventing Chronic Disease were developed by an expert panel convened by CDC's Division of Adult and Community Health on behalf of the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). The panel was charged with examining how mental health should fit within NCCDPHP's mission. The articles provide the background for the panel's recommendations and cover a spectrum of public health activities, including surveillance, prevention and promotion, and the system and policy context for these proposed changes. Freeman et al (6) provide a mixed report on the mental health surveillance systems available in the …