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Mental Health Training in Schools of Public Health: History, Current Status, and Future Opportunities

Mental disorders, which are the leading cause of disability1 and contribute to approximately 8 million deaths worldwide annually,2 are a major public health issue. People with mental disorders die 10–25 years younger than the general population.2,3 Fewer than half of people with mental disorders receive treatment for their condition,4 and often the quality of treatment is substandard.5 To address this challenge, the public health workforce must be capable of developing, implementing, and disseminating programs and policies to prevent mental disorders, increase access to and ensure quality of treatment, and improve quality of life for people with mental disorders. Mental health has been recognized as a crucial aspect of public health training since the mid-1900s, when Johns Hopkins University developed the country’s only department focused on mental health.6 In 1959, a report from a conference entitled Mental Health Teaching in Schools of Public Health acknowledged the need for integrating mental health into the curricula at schools of public health (SPHs) and defining the core knowledge of public mental health.7 In the 1970s, the majority of graduates from SPHs felt that mental health issues were important for their coursework and related to their jobs.8,9 Since the 1970s, the few studies addressing mental health training for public health professionals have focused on emergency preparedness and psychological first aid.10–12 No recent work, to our knowledge, has examined current mental health training in SPHs. This issue warrants revisiting because of recent policy changes and trends in public health. During the past 50 years, the burden and cost of illness has shifted even further from acute to chronic diseases,13 including mental disorders. Mental health is moving into the mainstream of health-care delivery, particularly with implementation of mental health parity and the Affordable Care Act. The mental health workforce is aging and there is a growing shortage of public sector leaders.14 Furthermore, the direction of public health education is evolving to ensure that graduates master the skills needed to have an impact on major public health issues.15 The Association of Schools and Programs of Public Health (ASPPH) has developed recommendations for reshaping public health programs,16–18 which are being used by the Council on Education for Public Health (CEPH) to revise the criteria for accrediting SPHs.19 Given the relevance of mental health in public health today and the prospective changes in public health education, we assessed mental health courses and programs offered by SPHs.