A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control

BMC Psychiatry, Feb 2015

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.

A PDF file should load here. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a PDF plug-in installed and enabled in your browser.

Alternatively, you can download the file locally and open with any standalone PDF reader:

http://www.biomedcentral.com/content/pdf/s12888-015-0394-0.pdf

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 - 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)


This is a preview of a remote PDF: http://www.biomedcentral.com/content/pdf/s12888-015-0394-0.pdf

Adrienne O’Neil, Felice N Jacka, Shae E Quirk, Fiona Cocker, C Taylor, Brian Oldenburg, Michael Berk. A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control, BMC Psychiatry, 2015, pp. 15, 15, DOI: 10.1186/s12888-015-0394-0