Leading prevention, promotion and population approaches to health improvement

Members and friends of the College for Behavioral Health Leadership (previously, ACMHA) gathered in a cool, cloudy, and rainy San Diego last week to consider how population health can be improved in communities.

Gone were past-year discussions of the new in the Affordable Care Act, the ubiquity of managed care, and the prospects for future carve-outs. Instead, this year’s annual summit focused on a very significant new challenge: How the field can move upstream deliberately to do both prevention and promotion, and manage improved community population health in an equitable manner. Some would call this leading the three P’s. The college’s twin goals of stimulating innovation and fostering leadership were evident throughout the entire summit.

An important first for the college was its very new partnership with the Prevention Institute. The institute brought an entirely new lens to the deliberations, as reflected by keynoter Tony Iton, senior vice president at the California Endowment.

Dr. Iton carefully developed a broader narrative showing how the social determinants of health, such as poverty and discrimination, adversely impact the length of life of Americans. As a result, ZIP code is a very good indicator of longevity. This is exactly the same narrative faced by persons with mental illness and substance use conditions. Thus, the health and behavioral health fields face common challenges in addressing the social determinants and the disparities they engender.

Live Well San Diego described its own very successful public-private partnership to improve local community population health. Later in the day, considerable time was spent in reflecting how these important developments will alter our future advocacy, clinical practice and new prevention activities.

Day 2 considered the leadership of change. Larry Cohen, executive director of the Prevention Institute, shared strategies that he has developed over time to promote community population health improvement. Lynda Frost, planning and program director at the Hogg Foundation, engaged participants in an interactive exchange to identify key characteristics of successful leadership in promoting effective community change. Later sessions were devoted to smaller discussions in which summit participants could share and hone personal leadership skills.

Day 3 headlined two innovative programs. Marv Southard, acclaimed former Los Angeles County Mental Health Director and current professor of social work at the University of Southern California, described a very innovative county initiative to foster Healthy Neighborhoods in Los Angeles. This initiative links providers, community organizations and neighborhood members in a common quest to improve neighborhood health.

Maggie Bennington-Davis, chief medical officer of Health Share Oregon, described how her regional care organization is beginning to incorporate the social determinants in care activities, particularly around prevention. Both of these initiatives are immensely interesting and important for community population health improvement and deserve to be watched closely as they mature.

What does all of this mean for behavioral health? First, we do have a very bright future. We simply are not going to wither away! Successful community population health improvement must involve behavioral health skills. Second, the time already is late to expand our own skills. Successful population health improvement also requires the use of public health approaches and tools, as well as financial and assessment skills. Third, we must develop new partnerships and engage new care environments, such as counties and neighborhoods. Within the current decade, our more traditional care settings will evolve to accommodate the sweeping changes we now are beginning to witness.

Gina Lasky, 2017 summit chair and incoming college president, summed it up very well: “We have had a great three days of wonderful sharing and getting to know each others’ identities much better. These activities are the foundation for successful innovation, partnering and leadership.”

Our hats truly are off to Gale Bataille, 2016 summit chair, Jeanette Harrison, 2016 summit facilitator, the entire 2016 summit planning committee, and to the College for another excellent summit. We all look forward with much anticipation to 2017.