The Intersection of
Behavioral Health,
Mental Health, and
Health Literacy
PROCEEDINGS OF A WORKSHOP
Joe Alper and Alexis Wojtowicz, Rapporteurs
Roundtable on Health Literacy
Board on Population Health and Public Health Practice
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
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This activity was supported by contracts between the National Academy of Sciences and AbbVie Inc.; Aetna Foundation; Bristol-Myers Squibb; California Dental Association; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Media; Health Literacy Partners; Health Resources and Services Administration (HHSH25034011T); Humana; Merck Sharp & Dohme Corp.; National Library of Medicine; New York University Langone Medical Center; Northwell Health; Office of Disease Prevention and Health Promotion (HHSP23337043); Pfizer Inc.; and UnitedHealth Group. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-48530-2
International Standard Book Number-10: 0-309-48530-4
Digital Object Identifier: https://doi.org/10.17226/25278
Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2019 by the National Academy of Sciences. All rights reserved.
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2019. The intersection of behavioral health, mental health, and health literacy: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25278.
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PLANNING COMMITTEE ON THE INTERSECTION OF BEHAVIORAL HEALTH, MENTAL HEALTH, AND HEALTH LITERACY1
WILMA ALVARADO-LITTLE, Associate Commissioner, Director of the Office of Minority Health and Health Disparities Prevention, New York State Department of Health
MAY-LYNN ANDRESEN, Vice President, Quality in Health Care Advisory Group
CATINA O’LEARY, President and Chief Executive Officer, Health Literacy Media
STEVEN RUSH, Director, Health Literacy Innovations Program, UnitedHealth Group
ALAN VANBIERVLIET, Extramural Program Official, National Library of Medicine
TERESA WAGNER, Assistant Professor, University of North Texas Health Science Center, and Senior Fellow, University of North Texas Health Science Center Institute for Patient Safety
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
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ROUNDTABLE ON HEALTH LITERACY1
BERNARD M. ROSOF (Chair), Chief Executive Officer, Quality in Health Care Advisory Group, LLC; and Professor of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
ANNLOUISE R. ASSAF, Senior Director, Global Medical Impact Assessment, Pfizer Worldwide Medical and Safety; and Adjunct Professor, Brown University School of Public Health
SUZANNE BAKKEN, Alumni Professor of Nursing and Professor of Biomedical Informatics, Columbia University
AMY A. CLARK, Director, Cultivating Health Communities, Aetna Foundation
GEMIRALD P. DAUS, Public Health Analyst, Office of Health Equity, Health Resources and Services Administration
TERRY C. DAVIS, Professor of Medicine and Pediatrics, Louisiana State University Health Sciences Center
CHRISTOPHER DEZII, Director, Healthcare Quality and Performance Measures, Bristol-Myers Squibb
JENNIFER A. DILLAHA, Medical Director for Immunizations, Medical Advisor, Health Literacy and Communication, Arkansas Department of Health
JAMES DUHIG, Head, Risk Communication and Behavioral Systems, Office of Patient Safety, AbbVie Inc.
ALICIA FERNANDEZ, Professor of Medicine, Director, Latinx Center of Excellence, University of California, San Francisco; Zuckerberg San Francisco General Hospital
LISA FITZPATRICK, Senior Medical Director, DC Department of Health Care Finance; Professorial Lecturer, Milken Institute of Public Health, The George Washington University
LORI K. HALL, Director, Health Literacy, Global Medical Strategy and Operations, Eli Lilly and Company
LINDA HARRIS, Director, Division of Health Communication and eHealth Team, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services
NICOLE HOLLAND, Assistant Professor and Director of Health Communication, Education, and Promotion, Tufts University School of Dental Medicine
ELLEN M. MARKMAN, Lewis M. Terman Professor of Psychology, Stanford University
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
JOHANNA MARTINEZ, Graduate Medical Education Director of Diversity and Health Equity, Northwell Health
MICHAEL M. McKEE, Assistant Professor of Family Medicine, University of Michigan Medical School
LAURIE MYERS, Global Health Literacy Director, Merck Sharp & Dohme Corp.
CATINA O’LEARY, President and Chief Executive Officer, Health Literacy Media
MICHAEL K. PAASCHE-ORLOW, Professor of Medicine, Boston University School of Medicine
TERRI ANN PARNELL, Principal and Founder, Health Literacy Partners
LINDSEY A. ROBINSON, California Dental Association
STEVEN RUSH, Director, Health Literacy Innovations Program, UnitedHealth Group
OLAYINKA SHIYANBOLA, Assistant Professor, Division of Social and Administrative Sciences, University of Wisconsin–Madison School of Pharmacy
VANESSA SIMONDS, Assistant Professor, Community Health, Montana State University
CHRIS TRUDEAU, Associate Professor of Medical Humanities, University of Arkansas for Medical Sciences; Associate Professor of Law, Bowen School of Law, University of Arkansas at Little Rock
EARNESTINE WILLIS, Kellner Professor in Pediatrics, Medical College of Wisconsin
AMANDA J. WILSON, Head, National Network Coordinating Office, National Library of Medicine
MICHAEL S. WOLF, Professor, Medicine and Learning Sciences, Associate Division Chief, Research Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University
WINSTON F. WONG, Medical Director, Disparities Improvement and Quality Initiatives, Kaiser Permanente
Health and Medicine Division Staff
LYLA M. HERNANDEZ, Senior Program Officer
MELISSA G. FRENCH, Program Officer
ALEXIS WOJTOWICZ, Senior Program Assistant
ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice
Consultant
LAWRENCE SMITH, Dean, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell; Executive Vice President and Physician-in-Chief, Northwell Health
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by HUGH H. TILSON, University of North Carolina Gillings School of Global Public Health. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.
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Acknowledgments
The sponsors of the Roundtable on Health Literacy made it possible to plan and conduct The Intersection of Behavioral Health, Mental Health, and Health Literacy: A Workshop, which this publication summarizes. Federal sponsors from the U.S. Department of Health and Human Services are the Health Resources and Services Administration; the National Library of Medicine; and the Office of Disease Prevention and Health Promotion. Nonfederal sponsorship was provided by AbbVie Inc.; Aetna Foundation; Bristol-Myers Squibb; California Dental Association; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Media; Health Literacy Partners; Humana; Merck Sharpe & Dohme Corp.; New York University Langone Medical Center; Northwell Health; Pfizer Inc.; and UnitedHealth Group.
The workshop presentations were interesting and stimulated much discussion, and the Roundtable on Health Literacy would like to thank each of the speakers and moderators for their time and effort. Speakers and moderators were Wilma Alvarado-Little, Zarita Araújo-Lane, Jessica Black, Wilson Compton, Linda B. Cottler, Kate Farinholt, Lisa Morgan, Joanne Nicholson, Catina O’Leary, Helen Osborne, Michael Paasche-Orlow, Albert Park, Brandon Pate, Bernard Rosof, Steve Rush, David Steffens, Teresa Wagner, and Michael S. Wolf.
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Contents
Organization of the Proceedings
A Personal Perspective on Effective Communication
What People Affected by Mental and Behavioral Conditions Want You to Know
Defining Mental Health and Behavioral Health: What Is the Difference?
How Cognitive Burden Affects Communication
Health Literacy, Cognitive Burden, and Health Care
Health Literacy Principles in Mental and Behavioral Health
4 EXPLORING INNOVATIVE APPROACHES
Web-Based Resource for Individuals with Serious Mental Illness
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Acronyms and Abbreviations
| AHRQ | Agency for Healthcare Research and Quality |
| ASD | autism spectrum disorder |
| CMS | Centers for Medicare & Medicaid Services |
| DSM-5 | Diagnostic and Statistical Manual of Mental Disorders, 5th Edition |
| EHR | electronic health record |
| IMPACT | Improving Mood-Promoting Access to Collaborative Treatment |
| NAM | National Academy of Medicine |
| NAMI | National Alliance on Mental Illness |
| NIDA | National Institute on Drug Abuse |
| NIH | National Institutes of Health |
| NYS DOH | New York State Department of Health |
| SAMHSA | Substance Abuse and Mental Health Services Administration |
| VHA | Veterans Health Administration |
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