Health and Wellness for Adolescent Girls and Women with Mental and Behavioral Health Conditions

Knowledge Path

This knowledge path aims to bridge the public health and mental health information needs of professionals with regard to promising, practical intervention approaches to promote optimal health and wellness among women of childbearing age who experience a mental, emotional, or behavioral health condition. The knowledge path covers topics of particular relevance to health promotion and disease prevention for all women, with content specific to those with mental and behavioral health disorders: reproductive and maternal health, intentional injury, chronic conditions, healthy behaviors, and health disparities.

This knowledge path is shaped by the literature acknowledging limited training resources and educational materials responsive to the complex health-related needs of adolescent girls and women with mental health and/or substance use disorders. A selection of current resources is presented that offer data useful for framing the issues, describing integrative approaches, and reporting on key policies and best practices aimed at improving access to health promotion and disease prevention for this segment of the MCH population. While the overall goal of this knowledge path is to advance health and health access for young women, it is also intended to serve as a resource for efforts to integrate women’s mental, emotional, and behavioral health into a life course perspective.

The audience for this knowledge path is diverse and includes health and social service professionals, program administrators, educators, policymakers, and researchers. A primary goal of this knowledge path is for public health practitioners to better understand links between physical and mental health outcomes and how to effectively intervene on behalf of adolescent girls and women with mental and behavioral health conditions. Likewise, given the high prevalence of physical health conditions among women with mental health and substance use disorders, the mental health community can benefit from a greater appreciation as to how to effectively intervene and partner in the prevention, treatment, and control of chronic conditions and injury, especially as they relate to women’s health and wellness. Finally, policymakers can help frame how a life course perspective can focus attention on the unique physical, mental, and emotional health issues and needs of women during the childbearing years. A separate brief presents resources for women and their families.

This knowledge path has been developed by the Women’s Integrated Systems for Health (WISH) Project at the University of North Carolina at Chapel Hill and MCH Library at Georgetown University, both of whom are funded by the Maternal and Child Health Bureau (MCHB). It will be updated periodically.

Resources for Professionals

Overview

The Women’s Integrated Systems for Health (WISH) initiative, was awarded a 3-year distance learning grant from the Maternal and Child Health Bureau (MCHB) in 2010 to translate knowledge to practice in the areas of gender-specific, evidence-based approaches to mental health and chronic disease prevention during the reproductive years. In approaching this project, the need for improved integration of public health and mental health systems was quickly identified, particularly in the area of workforce development. The intent of WISH was to contribute to competency-based training for applying a public health, population-based, social-ecological approach to the design of women's health policies, programs, and service delivery systems for this underserved and high-risk population. The WISH project was part of the Southeast Public Health Training Center, housed at the UNC Institute for Public Health. Collaborators included the public health school's Department of Maternal and Child Health and UNC School of Medicine's Center for Maternal and Infant Health.

A growing commitment to interdisciplinary workforce preparation is evident at the federal, state, and local levels. The need for accelerated sharing of information across the public health and mental health sectors is an essential first step. The initial issue of the Women’s Health Prevention Brief, a joint publication of the Association of Maternal and Child Health Programs (AMCHP) and CityMatCH through the Women’s Health Partnership (WHP), was dedicated to women’s mental health (See Women’s Mental Health (2009) Women’s Health Prevention Brief, Issue 1). Improving mental health prevention efforts is an AMCHP and CityMatCH priority, reflecting an area of challenge to states and communities experiencing limited resources dedicated toward the achievement of core MCH goals and functions. This brief stresses the importance of prevention as a key component of building comprehensive systems of support and service to improve the overall status of women’s health and highlights examples of promising programs and a set of recommendations at the national, state, and local levels to improve women's mental wellbeing.

In 1999, the Surgeon General issued a call for collaborative action to integrate primary prevention and treatment, health, and behavioral health, and bring together policymakers, researchers, practitioners, and communities in creating a shared vision for a comprehensive system of care that supports women’s recovery from mental illness and substance abuse (See Mental Health: A Report of the Surgeon General (1999)). Research has shown that integrated approaches can improve quality and outcomes of care in clinical settings, laying groundwork for a broader strategy to integrate mental health and public health at the population level. The passage of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was a step toward this goal. New mandates that further integrate mental health and addiction services into primary care settings also fuel this movement. In January 2010, the Centers for Disease Control and Prevention (CDC) dedicated the online journal, Preventing Chronic Disease Public Health Research, Practice, and Policy, to a collection of articles, Mental Health and Public Health at the Crossroads (Vol. 7, No. 1, January 2010). An expert panel, in examining how mental health should fit within the mission of the CDC, recommended that a spectrum of public health activities be adopted, including surveillance, prevention, and promotion, and the system and policy context for these changes to be actualized.

The Surgeon General's Workshop on Women's Mental Health in 2005 brought together experts from the consumer, academic, advocacy, health care delivery, health insurance, program planning, and policy planning communities to address critical mental health issues affecting girls and women and make recommendations for materials that could be produced by the Surgeon General to advance knowledge, understanding, and behaviors regarding women's mental health issues. Topics included biological and development factors; specific mental disorders; trauma, violence, and abuse; social stress factors and stigma; identification and intervention issues; treatment access and insurance; health system issues; and protective and resilience factors. See the workshop report, Surgeon General’s Workshop on Women’s Mental Health (2006).

Websites

Distance Learning

Reports and Other Electronic Resources

Data and Statistics

Journal Articles and Other Literature and Research

NCEMCH Guides on Related Topics

These guides contain information related to women's and girls' mental and behavioral health in specific areas.

Resources for Families

See NCEMCH family resource brief, Health and Wellness for Teen Girls and Women with Mental Health and Substance Use Disorders.



Health and Wellness for Adolescent Girls and Women with Mental and Behavioral Health Conditions: Knowledge Path. (August 2014) (Updated: March 2017).

Authors: Marcia S. Roth, M.P.H., University of North Carolina at Chapel Hill Department of Maternal and Child Health; Amanda Allman, LCSWA, M.P.H., M.S.W., Hope Services, LLC and North Carolina Institute for Public Health, Breanne C. Wilhite, B.S.
Contributors: Dorothy Cilenti, DrPH, M.P.H., M.S.W., University of North Carolina at Chapel Hill Department of Maternal and Child Health and National MCH Workforce Development Center; Sarah Verbiest, DrPH, M.P.H., M.S.W., University of North Carolina at Chapel Hill Center for Maternal and Infant Health and Every Woman Southeast; Mellanye Lackey, M.S.I., University of North Carolina at Chapel Hill Health Sciences Library; Susan Brune Lorenzo, M.L.S., NCEMCH
Reviewers: Tarsha Cavanaugh, Ph.D., Health Resources and Services Administration Office of Women's Health; Women's Integrated Systems for Health (WISH) Technical Expert Panel, including several members with lived experience with a mental, emotional, or behavioral health condition; Jolene Bertness, M.Ed., NCEMCH; Rochelle Mayer, Ed.D., National Center for Education in Maternal and Child Health; Olivia K. Pickett, M.A., M.L.S., NCEMCH.