On March 1, 2023, APA submitted comments (PDF, 283KB)opens in new window in response to a National Institutes of Health (NIH) request for information about interventions and programs centered in social determinants of healthopens in new window that can help prevent mental disorders in populations that experience health disparities. APA’s response drew from expert members who responded to the call for information, as well as from a group of scientists working with APA Chief Science Officer Mitch Prinstein, PhD, that is drafting a research agenda to support the implementation of a primary mental health model of care. The comments support expanding the number of evidence-informed preventive programs and interventions so that fewer people develop mental health disorders and need direct treatment.
One recommendation discussed in the response is increased physical activity, which can “avoid the standard structural barriers (e.g., insurance, availability of a mental health professional, mental health setting) and attitudinal barriers (e.g., stigma, self-stigma, mental health illiteracy) that often impede delivery of mental health,” according to Alan Kadzin, PhD, of Yale University. The response also notes that “exercise consistently demonstrates its capacity to reduce the symptoms of anxiety disorders like obsessive-compulsive disorder, as well as affective disorders, eating disorders, substance use disorders, schizophrenia/psychosis, and cognitive impairment. It also improves quality of life and feelings of subjective well-being.”
The response also recommends the use of community-based interventions in mitigating mental health concerns in areas with health disparities. “Place-based initiatives, which focus on multi-sector collaboration to address concerns in a particular neighborhood or community, provide infrastructure for primary prevention of mental health concerns. They can also include strategies to improve the interface between community resources and specialty mental health services,” said Kiara Alvarez, PhD, of Johns Hopkins University, and Ellen-ge Denton, PsyD. The response notes that community-based interventions, such as community school initiatives and other drop-in, low-barrier mental health and social services access models “have been disseminated successfully in many countries and can form a model for youth-focused approach to community mental health in the U.S.” However, these models rely on community leadership and coalitions that are often not allocated enough resources.
Additionally, The NIH Office of Disease Prevention, which led the NIH call for comments, asked about interventions that address social determinants of health that operate as risk or protective factors for psychological distress and the development of mental health problems. In response to this, APA cited research by APA Board member Luz Garcini, PhD, MPH, of Rice University, that emphasized interface with the law, particularly immigration status, as a risk factor for mental health problems in U.S.-based Latinx populations.
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