Mental Health Impact Assessment and public policy
Article by J. Sherrod Taylor, J.D., ISE Faculty Fellow, Adler School of Professional Psychology, Chicago, Ill.
This newsletter’s lead article titled “The Social Determinants of Mental Health,” by Guest Editor Lynn Todman, Ph.D., the Executive Director of the Institute on Social Exclusion (ISE) at the Adler School of Professional Psychology in Chicago, describes the operation of health impact assessment (HIA) within the contemporary public policy setting. It also reveals the need for a deeper appreciation of mental health within a similar context. As noted by Dr. Todman, during the next 18 months, the ISE will be exploring the subject of mental health impact assessment (MHIA) through funding provided by the Robert Wood Johnson Foundation and the W.K. Kellogg Foundation. The present article offers a brief review of the legal underpinnings of MHIA.
The capacity to determine prospectively the potential ramifications of governmental action upon the social determinants of mental health is very important. Impacts upon disadvantaged populations are of special concern to community stakeholder organizations and public officials alike. Consequently, local, state, and federal political leaders increasingly propose legislative initiatives seeking or supporting laws involving the SDOMH. Often having much in common with the National Environmental Policy Act of 1969 (NEPA), which spawned the environmental impact assessment (EIA) and created the environmental impact statement (EIS), such new legislation contemplates putting MHIA into the public policy toolkit. Although they differ (i.e., EIA mainly deals with alterations of the natural world and MHIA seeks to enhance population mental health) both certainly implicate human well-being. Thus, linkage of these two methodologies seems generally appropriate and remains commonplace.
Proposed laws that incorporate the notion of MHIA at the federal level have been springing up in recent years. Notably, President Obama, while serving as member of the United States Senate, introduced a bill S.2506 Healthy Places Act of 2006. When it was presented to the second session of the 109th Congress, however, Senator Obama’s legislation did not pass. Later in September 2008, Senator Menendez offered a similar bill (S.3571 Health Impact Assesment Act of 2008); another bill (S.1679 Affordable Helath Choices Act), was submitted by Senator Tom Harkin in the 111th Congress. It contained wording identical to that used by former Senator Obama. Summaries of these federal bills are detailed in the SES Policy Corner following this feature article.
Similar state laws that have been either proposed or enacted recognize these tools, as well. Such state legislation is collected at the UCLA Health Impact Assessment Clearinghouse Learning Information Center (HIA-CLIC) and is available on the SHARE website.
Undergirded by these proposed legal innovations, while simultaneously apprehending that much HIA practice has proceeded previously at the local level, even in the absence of direct enabling legislation, the ISE piloted a rapid MHIA in the summer of 2010 that resulted in submission of a policy letter directed toward certain proposed amendments to Chicago’s Vacant Buildings Ordinance.
In early 2011, the Institute initiated a more comprehensive MHIA designed to promote population mental health and well-being within the local environment. Expanding HIA practice beyond its usual emphasis upon physical health issues, the ISE’s MHIA will address mental health concerns that often have been left out of public policy discourse. Moreover, and perhaps more importantly, the process of constructing the new MHIA is giving voice to vulnerable people, whose interests historically have been omitted from the national conversation on mental health.