SES Policy Corner: Taking research to action: Psychology’s role in integrating the social determinants of mental health in public policy

The Health Places Act, which established an interagency working group to discuss environmental health concerns was followed by the Health Impact Assessment Act to reduce health disparities through social policy, land use, the built environment, and other public policies and projects

Krysta N. JonesBy Krysta N. Jones, Senior Legislative & Federal Affairs Officer, American Psychological Association, Washington, DC

Each day we are impacted by our environment: our work place, housing, human interactions, physical environment, and they all have an impact on our mental health. Psychology has played an important role in informing research on the social determinants of mental health, and policy makers are proposing health impact assessments to evaluate and implement policies.

As introduced in Dr. J. Sherrod Taylor’s article “Mental Health Impact Assessment and Public Policy,” federal legislation on mental health impact assessments has evolved over the last few years. In 2006, former Senator Barack Obama (D-IL) introduced the Healthy Places Act (S.2506), which would establish an interagency working group to discuss environmental health concerns. It would also provide grants to research the built environment and its influence on individual and population-based health, including mental health. Notably, the definition of “environmental health” in the bill includes “psychological” environments.

Building off the Healthy Places Act, in 2008, Senator Robert Menendez (D-NJ) went a step further and introduced the Health Impact Assessment Act (S.3571), which would conduct a study to determine the best practices for using health impact assessments to promote health and reduce health disparities through social policy, land use, the built environment, and other public policies and projects. Additionally, the bill requires the Centers for Disease Control and Prevention (CDC) to promote the health impact assessment processes, including, developing guidance for assessing the public participation and potential health effects of social policy decisions.

SES Policy CornerSpecifically, the bill awards grants to provide for expertise on health impact assessment to states, local health departments, metropolitan planning organizations and local planning departments; collect and disseminate best practices and provide technical assistance and training about the scope and uses of health impact assessments related to community planning and policy making; develop necessary data and evidence to inform health impact assessments and land use and community design and other broad policy decisions; and carry out a demonstration project to establish and implement effective processes and models for designing and administering health impact assessments.

In the 111th Congress, using many provisions of the Health Impact Assessment Act of 2008, Senator Tom Harkin (D-IA) introduced the Affordable Health Choices Act (S.1679). This comprehensive health reform package includes a wide array of topics and was introduced concurrently with the president’s health reform bill. This bill includes a section that would research the impact of built environment on health. Moreover, the term “environmental health” used in the bill specifically refers to the indirect effects, of the broad physical, psychological, social and aesthetic environment.

The bill would also establish a program at the CDC to foster advances and provide technical support in the field of health impact assessments. Psychologists would likely be qualified to help administer, collect and disseminate evidence-based practices; manage capacity building grants, technical assistance, and training on the use of health impact assessments; and provide guidance on health impact assessments.

The bill also includes the promotion of employer-based wellness programs, studies, research, evaluation and marketing campaigns and call for the development of “standardized measures that assess policy, environmental and systems changes necessary to have a positive health impact on employees’ health behaviors.”  Psychologists would be well-suited to take the lead on the evaluation of these programs and could utilize American Psychological Association (APA) Healthy Workplace materials and resources.  Furthermore, these are prime areas where APA would be well-equipped to offer amendments or regulatory text and further expand or insert language to specifically call for mental health impact assessments.