A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control
O'Neil et al. BMC Psychiatry
A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control
Adrienne O'Neil 0 1 2
Felice N Jacka 4 5 6
Shae E Quirk 1
Fiona Cocker 3
C Barr Taylor 2
Brian Oldenburg 3
Michael Berk 1 7 8
0 School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
1 IMPACT Strategic Research Centre, Deakin University and Barwon Health , Po Box 281, Geelong, VIC 3220 , Australia
2 Department of Psychiatry and Behavioral Medicine, Stanford University , Palo Alto , USA
3 Melbourne School of Population & Global Health, University of Melbourne , Melbourne , Australia
4 Black Dog Institute , Sydney , Australia
5 Department of Psychiatry, University of Melbourne , Parkville , Australia
6 Centre for Adolescent Health, Murdoch Children's Research Institute , Melbourne , Australia
7 Florey Institute for Neuroscience and Mental Health , Melbourne , Australia
8 Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne , Melbourne , Australia
Background: Historically, the focus of Non Communicable Disease (NCD) prevention and control has been cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), cancer and chronic respiratory diseases. Collectively, these account for more deaths than any other NCDs. Despite recent calls to include the common mental disorders (CMDs) of depression and anxiety under the NCD umbrella, prevention and control of these CMDs remain largely separate and independent. Discussion: In order to address this gap, we apply a framework recently proposed by the Centers for Disease Control with three overarching objectives: (1) to obtain better scientific information through surveillance, epidemiology, and prevention research; (2) to disseminate this information to appropriate audiences through communication and education; and (3) to translate this information into action through programs, policies, and systems. We conclude that a shared framework of this type is warranted, but also identify opportunities within each objective to advance this agenda and consider the potential benefits of this approach that may exist beyond the health care system.
Non-Communicable Disease; Common mental disorders; Prevention; Depression; Anxiety; Cardiovascular disease; Type 2 diabetes mellitus; Co-morbidity
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Background
The World Health Organization (WHO) defines
NonCommunicable Diseases (NCDs) as medical conditions
that cannot be transmitted. They are primarily
characterized by chronicity of at least 3-months and their
progressive nature [1]. While this definition encapsulates a host
of medical conditions, the focus of NCD prevention and
control has largely remained on the four conditions that,
when combined, account for more deaths than any other:
cardiovascular disease (CVD), type 2 diabetes mellitus
(T2DM), cancer and chronic respiratory diseases. These
conditions are known as the Big Four. However, there
have been increasing calls to expand the NCD umbrella
to include the common mental disorders (CMDs) of
depression and anxiety [2,3]. While some have further
proposed the inclusion of severe mental disorders (e.g.
dementia, schizophrenia and bipolar; the latter two of
particular significance given evidence of their shared
risk factors, pathways and co-morbidity with NCDs and
CMDs), the focus of this paper will be confined to the
CMDs, due to their major contribution to the global
disease burden. Indeed, the WHOs Global Action Plan
(201320) to reduce the global burden of NCDs and
preventable mortality now incorporates mental disorder
prevention and control targets [4]. However, efforts to
curb mental and physical disease still remain largely
separate and independent of one another. In an attempt
to close this gap, the Centers of Disease Control and
Prevention [5] has recently released a public health action
plan that aims to integrate mental health promotion and
mental illness prevention with chronic disease prevention
(see Table 1). Briefly, this framework comprises eight
strategies with three overarching objectives: (1) to
obtain better scientific information through surveillance,
Table 1 Eight framework components of the CDC
Epidemiological research into determinants and protective
factors for mental health and their relationships to chronic
diseases
Prevention research to determine the importance of mental
illness/health as factors in public health promotion and
prevention
Communication to develop culturally, linguistically, and
developmentally appropriate educational products
Education of Health Professionals including the development
of appropriate education plans for professional audiences
Program Integration Support at various jurisdictional levels
Policy Integration that involves the development of policies
at all government levels for all audiences and stakeholders
Systems to Promote Integration such as establish systems
integration to promote pro (...truncated)