Children's Mental Health and the Life Course Model: A Virtual Workshop Series Proceedings of a Workshop (2020) / Chapter Skim
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4 New Ways of Thinking about Children's Mental Health
4 New Ways of Thinking about Children's Mental Health
Pages 27-38
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From page 27... ...
This chapter's outline of these various analytic frameworks focuses on explaining the Three Horizons perspective on improving health systems and gives examples of mental health programs that have implemented this approach across the country. Finally, it concludes by explaining future opportunities and challenges in order to give direction to the Forum on Children's Well-Being and other invested stakeholders on future steps.
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The first era of health care, what we might refer to as Medical Care 1.0, focused on acute infectious disease, short time frames for care, and insurance-based financing, the main goal being to reduce the number of deaths. As the system progressed, it transitioned over the last few decades into a second era, Health Care 2.0, which increasingly focused on chronic disease, longer time frames, chronic disease management and prevention, and the extension of a disability-free life in addition to simply reducing deaths.
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Figure 4-1 Reducing risk and optimizing protective factors. SOURCE: Neal Halfon presentation, September 16, 2019.
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. Three Horizons Hoagwood introduced the Three Horizons model, saying that the search for the right framework not only aids the improvement of children's mental health, it builds our systems of knowledge, which promotes the design of better health systems.
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Figure 4-2 Influences on mental, emotional, and behavioral health. SOURCE: National Academies of Sciences, Engineering, and Medicine, 2019, Figure 2-2.
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Overall investment in children's services research hovers around 2 percent of the overall NIMH budget, but even at the state level, she said, investment in children's mental health is just absent. Horizon 2 – Disruptive Changes Horizon 2 focuses more on disruptive changes such as the digital domination of health care, which includes changing mental health models.
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Figure 4-3 Three Horizons thinking for children's mental health. SOURCE: Curry and Hodgson, 2008.
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If providers can take the evidence base that exists and put it into play at different parts of the continuum, she explained, then hopefully we can start to see better outcomes for these children and families. FUTURE OPPORTUNITIES AND CHALLENGES Following Hoagwood's presentation, participants discussed opportunities and challenges to supporting children's mental health.
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Figure 4-4 Interventions across the life course. SOURCE: The National Academies of Sciences, Engineering, and Medicine, 2019, Figure 1-4.
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One participant noted that the lack of physical exercise and unstructured play, as well as the sometimes difficult culture and climate in public schools posed challenges for children's mental health. Hoagwood suggested using the National Training and Technical Assistance Center within the Substance Abuse and Mental Health Services Administration as a resource for guidance.
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In an analogous way, prevention of mental health disorders and the promotion of optimal mental health trajectories may emerge from new ways (or third-horizon approaches) to transforming the ecosystems where children live, learn, grown, and develop.
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