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Introduction¹

The field of health literacy has evolved from early efforts that focused on individuals to its current recognition that health literacy is a multidimensional team and system function. Health literacy includes system demands and complexities as well as individual skills and abilities. While communicating in a health-literate manner is truly important for everyone, it can be especially important for those with mental or behavioral health issues and for the systems and teams that interact with them and treat these individuals.

“Although it may be self-evident, embedding health-literate practices into systems requires practical and innovative applications and practical and innovative solutions,” said Bernard Rosof, the chief executive officer of Quality in Health Care Advisory Group, in his opening remarks to a workshop convened by the Roundtable on Health Literacy.² “Mental health issues and behavioral health are often not well understood by many primary care health care providers and those in the public health community, yet, many with chronic mental or behavioral health issues first access care

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¹ The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop was prepared by the workshop rapporteurs as a factual summary of what occurred at this workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.

² This section is based on the presentation by Bernard Rosof, the chief executive officer of the Quality in Health Care Advisory Group, and his statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.

through the primary care system.” The same is also true of specialty care, he added, though it is not often the initial portal for entry of the health care patient.

The purpose of the workshop, which was held on July 11, 2018, in Washington, DC, was to explore issues associated with effective communication with individuals with mental or behavioral health issues and to identify ways in which health literacy approaches can facilitate communication. In particular, the workshop aimed to gain a better understanding of how behavioral health and mental health concerns can adversely affect communications between providers and patients and their families (see Box 1-1 for the Statement of Task).

ORGANIZATION OF THE PROCEEDINGS

The workshop (see Appendix A for the agenda) was organized by an independent planning committee in accordance with the procedures of the Academies. This publication summarizes the discussions that took place throughout the workshop, highlighting key lessons, practical strategies, and the needs and opportunities for using the principles of health literacy to improve communication among health care providers, individuals with behavioral health and mental health challenges, and family members. Chapter 2 describes the communication challenges experienced by those who have behavioral health and mental health issues. Chapter 3 provides background information on behavioral health and mental health disorders, discusses the communication challenges that these disorders create for individuals and family members, and describes the principles of health literacy and how health literacy might address some of those communication chal-

lenges. Chapter 4 provides some examples of innovative approaches for applying health literacy principles to address communication challenges for those with behavioral health and mental health disorders as well as those patients’ families and communities, and describes how improved health literacy can reduce disparities in care and foster independence among older adults. Chapter 5 summarizes a panel discussion on future steps and Chapter 6 presents the roundtable’s reflections on the key lessons learned at this workshop.

In accordance with the policies of the National Academies, the workshop did not attempt to establish any conclusions or develop recommendations about needs and future directions, focusing instead on issues identified by the speakers and workshop participants. In addition, the planning committee’s role was limited to planning the workshop. This workshop proceedings was prepared by workshop rapporteurs Joe Alper and Alexis Wojtowicz as a factual summary of what occurred at the workshop.

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