Running head; POPULATION HEALTH IN TRAUMA AND MENTAL HEALTH

Population Health in Trauma and Mental Health

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POPULATION HEALTH IN TRAUMA AND MENTAL HEALTH

Population Health in Trauma and Mental Health

Population health, a term widely applied in healthcare, involves maintaining the patient

population's health using all means necessary while reducing the need for costly emergency

hospital procedures, hospitalizations, and visits (Tebes et al., 2019). Population health enhances

treatment outcomes in specific patient groups within the community. Healthcare providers can

overcome healthcare barriers such as the disparity between clinical practice and technology, thus

improving patient satisfaction and reducing healthcare costs (Tebes et al., 2019). Previous

studies on population health have indicated that almost every individual in a community

experiences one or more traumatic incidences in their lives, especially during childhood years

(Sweeney et al., 2018). Trauma, in this case, refers to a particular event or series of incidences

experienced as life-threatening or harmful and carries constant negative effects on the spiritual

well-being, mental, emotional, social, and physical functioning of an individual (Kantor et al.,

2017).

Traumatic events can comprise serious illness, sudden loss, disasters, violence,

confrontation with war, and other disturbing and overwhelming occurrences. An individual's

ability to cope effectively with various life challenges is overwhelmed (Sweeney and Taggart,

2018). Trauma in population health remains a pervasive problem that can damage an individual's

and generational health (Sweeney and Taggart, 2018). Mental health refers to an individual's

social, psychological, and emotional well-being. Mental health influences how an individual

acts, feels, and thinks. Besides, it affects how an individual responds to stress and their

relationship with others (Barry et al., 2019). It is crucial to incorporate a population health

framework addressing trauma and mental health into a community's health care system. In

mental health and trauma, a population health framework will promote health across this patient

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population, including populations at risk of or experiencing trauma or mental illness (Sampson

and Galea, 2018).

Unrecognized trauma can lead to strained relationships among the affected individuals.

These individuals may react with anger out of proportion to events, depression and anxiety

problems, and low self-esteem (Sweeney and Taggart, 2018). Untreated or unrecognized mental

illness may lead to increased health care costs and increased patient suffering. Besides, if

unrecognized, mental illness and trauma symptoms may worsen, which sometimes can drive

individuals to self-medicate, such as substance and alcohol abuse. Substance and alcohol abuse is

temporarily effective and could exacerbate mental illness (Satcher and Rachel, 2017). This essay

will focus on population health across trauma and mental health patients, identify risk factors,

describe a Healthy People 2020 goal related to trauma and mental health, and describe an

evidence-based intervention to address the Healthy People 2020 goal and a measurable objective

that can address the healthy people 2020 goal.

Race, gender and sexuality, socioeconomic status, and intellectual and developmental

disabilities are significant risk factors for exposure to trauma among individuals. Besides,

comprehending the social determinants for trauma needs attention to cultural, geographic,

political, economic, social, behavioral, and biological considerations at various socio-ecological

levels to minimize risk and enhance health (Alegria et al., 2018). Previous studies have shown

that minimizing health inequalities promotes the general health of a population (Satcher and

Rachel, 2017). Childhood trauma predisposes an individual to depression, other morbidities such

as obesity, heart disease, cancer, and substance abuse, adversely affecting an individual's mental

health. Lower socioeconomic status exposes individuals to financial challenges, poverty,

violence, and living in an unsafe neighborhood, which negatively affects an individual's mental

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health (Alegria et al., 2018). Higher intellectual and developmental ability levels are consistently

associated with lower risks for trauma, whereas intellectual and developmental disabilities are

associated with higher risks for trauma (Alegria et al., 2018).

Individuals with higher intellectual levels are associated with greater cognitive capacity,

thus a lower risk for trauma (Sweeney and Taggart, 2018). Adverse childhood experiences, prior

trauma, pre-trauma life stress, and psychopathology also significantly contribute to mental illness

since they decrease individuals' capacity to cope with traumatic stress (Alegria et al, 2018).

Multiple pieces of research have identified geographic location, sexual orientation, income, and

educational level, age, gender, ethnicity, and race as significant determinants for mental health.

Other factors such as work and school environment, employment opportunities, social support,

housing quality, community, family, and interpersonal dynamics can positively or negatively

impact mental health risks and outcomes (Alegria et al., 2018). For instance, when individuals

interact in safe shared places such as churches and parks, it can positively impact the mental

health of a population. Thus, where social determinants for trauma and mental health, their

relationship, and their effect are well understood, they greatly enhance and maintain that

population's mental health besides protecting them from trauma (Sweeney and Taggart, 2018).

One of the Healthy People 2020 goals aims to improve the mental health of individuals

by preventing and ensuring individuals' access to appropriate and quality mental health services.

The Healthy People 2020 goal recognizes mental health and protection from trauma as essential

in enhancing the mental functionality of an individual, which results in quality interpersonal

relationships, productive activities, and the ability to cope and change with challenges (Kiragu,

2020). Mental health is essential in family and interpersonal relationships, personal well-being,

and the ability to positively contribute to society. An individual with a mental disorder

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demonstrates alterations in behavior, mood, and thinking, resulting in distress and impaired

functioning (Satcher and Rachel, 2017).

Furthermore, mental disorders and trauma are associated with a host of problems such as

disability, pain, or even death. In the United States, mental illness and trauma significantly

contributes to disability and is associated with one of the highest disease burdens among all

diseases (Kiragu, 2020). Mental health and trauma are closely related. Individuals who have

undergone trauma are at a higher risk of developing mental illnesses such as depression, anxiety

disorders, and post-traumatic stress disorder. Besides, an individual's mental health can

significantly affect their physical health (Sweeney and Taggart, 2018). Mental health disorders

such as depression are associated with serious chronic illnesses such as heart disease, cancer,

hypertension, and diabetes. Therefore, improve the mental health of a population is significant in

enhancing their overall health (Barry et al., 2019).

One evidence-based intervention that can be utilized to address the Healthy People 2020

goal of preventing and promoting individuals' access to appropriate and quality mental health

care includes the recommendation by the Community Preventive Services Task Force (CPSTF).

CPSTF proposes collaborative care when managing individuals with depressive disorders.

Studies have shown that collaborative care improves features of depression, enhances treatment

adherence and response to therapy, and improves recovery and remission from melancholy

(Guide to Community Prevention Services, 2010). Besides, previous studies that evaluated the

costs and advantages of collaborative management found out that integrative management

models promote improved economic measures (Guide to Community Prevention Services,

2010). Integrated management for individuals with depressing conditions should utilize a

multidisciplinary approach implemented at the healthcare system level. Case managers should be

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utilized as a link between the patient, their primary care providers, and mental health specialist

(Guide to Community Prevention Services, 2010).

Collaborative care in mental health disorders aims at enhancing the routine diagnosis and

screening of depressing conditions. Enhance community and healthcare assistance during active

treatment of a patient during setting of management goals and promoting patient self-

management. Besides, promote the utilization of evidence-based practices by healthcare

providers when actively managing diagnosed depressive disorders (Guide to Community

Prevention Services, 2010). Case managers are essential in supporting roles of the primary care

provider, such as educating the patient, tracking treatment outcomes and adherence to treatment,

and re-evaluating and adjusting care programs for individuals who are non-responsive to

treatment. Primary care physicians are essential in initiating treatment for depression, routine

screening, and diagnosis, and whenever necessary, referring individuals to psychiatrists and

psychologists. Psychologists and psychiatrists are essential in providing clinical advice and

supporting the decisions of case managers and primary healthcare providers. Technology-led

assets such as telephone numbers and electronic media records play a significant role in

coordinating such processes (Guide to Community Prevention Services, 2010).

One of the objectives aimed at addressing the Health People 2020 goal includes screening

and diagnosis of depression among the general adult population in the United States. Both the

American Academy of Family Physicians and the U.S Preventive Services Task Force

recommend routine screening and diagnosis of depression among the general adult population

(Maurer et al., 2018). The U.S Preventive Services Task Forces propose a pragmatic approach

for screening all adults previously not screened for diabetes. Moreover, it's essential to apply

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clinical judgment, consider risk factors, life events, and comorbidities to assess if high-risk

individuals require additional screening (Maurer et al., 2018).

However, for ease of implementation, all adults should be screened for depression during

their routine health visits. Besides, the U.S Preventive Services Task Force proposes children

aged twelve to eighteen years old to be screened for major depressive disorder (Maurer et al.,

2018). The screening should maximize all the resources in place to ensure that the diagnoses are

accurate, the treatment initiated is effective, and appropriate follow-up (Maurer et al., 2018).

Women, especially in the post-partum period, should also be screened for depression as

recommended jointly by the U.S Preventive Services Task Force, American College of

Obstetricians and Gynecologists, and the American Academy of Family Physicians. Post-partum

women should be screened for depression at least once during pregnancy and four to eight weeks

post-partum (Maurer et al., 2018).

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References

Alegría, M., NeMoyer, A., Bagué, I. F., Wang, Y., & Alvarez, K. (2018). Social determinants of

mental health: where we are and where we need to go. Current psychiatry

reports, 20(11), 1-13. https://link.springer.com/article/10.1007/s11920-018-0969-9

Barry, M. M., Clarke, A. M., Petersen, I., & Jenkins, R. (Eds.). (2019). Implementing mental

health promotion. Springer Nature. https://link.springer.com/book/10.1007%2F978-3-

030-23455-3

Guide to Community Preventive Services. (2010). Mental Health: Collaborative Care for the

Management of Depressive Disorders. Retrieved from

https://www.thecommunityguide.org/findings/mental-health-collaborative-care-

management-depressive-disorders

Kantor, V., Knefel, M., & Lueger-Schuster, B. (2017). Perceived barriers and facilitators of

mental health service utilization in adult trauma survivors: A systematic review. Clinical

Psychology Review, 52, 52-68.

https://www.sciencedirect.com/science/article/pii/S0272735816303373

Kiragu, V. (2020). Healthy People 2020 Leading Health Indicators: A Comparison of Health

Access Between Students in the United States and Kenya.

https://digital.library.txstate.edu/handle/10877/9860

Maurer, D. M., Raymond, T. J., & Davis, B. N. (2018). Depression: screening and diagnosis.

American family physician, 98(8), 508-515.

https://www.aafp.org/afp/2018/1015/p508.html

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POPULATION HEALTH IN TRAUMA AND MENTAL HEALTH

Sampson, L., & Galea, S. (2018). An argument for the foundations of population mental health.

Frontiers in psychiatry, 9, 600.

https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00600/full

Satcher, D., & Rachel, S. A. (2017). Promoting mental health equity: the role of integrated care.

Journal of clinical psychology in medical settings, 24(3), 182-186.

https://link.springer.com/article/10.1007/s10880-016-9465-8

Sweeney, A., & Taggart, D. (2018). (Mis) understanding trauma-informed approaches in mental

health. https://www.tandfonline.com/doi/full/10.1080/09638237.2018.1520973

Sweeney, A., Filson, B., Kennedy, A., Collinson, L., & Gillard, S. (2018). A paradigm shift:

relationships in trauma-informed mental health services. BJPsych advances, 24(5), 319-

333. https://www.cambridge.org/core/journals/bjpsych-advances/article/paradigm-shift-

relationships-in-traumainformed-mental-health-

services/B364B885715D321AF76C932F6B9D7BD0

Tebes, J. K., Champine, R. B., Matlin, S. L., & Strambler, M. J. (2019). Population health and

trauma‐informed practice: implications for programs, systems, and policies. American

journal of community psychology, 64(3-4), 494-508.

https://onlinelibrary.wiley.com/doi/full/10.1002/ajcp.12382