Outside the boxes

A strategy for stopping widespread depression in developing countries should be as obvious as one for combatting epidemics. A new strategy aims to downshift jobs to local workers to act as peer therapists.

There is a mental-health capacity crisis gripping Washington state. The area’s response approach, crafted over two decades, centers on a set of intensive outpatient and early-intervention programs aimed at preventing hospitalizations.

Different programs in various nations are training ordinary people and creating community groups to effectively satisfy the mental health needs of their communities. In many of these regions, "treatment gaps" – where there are little to no mental health treatment plans or resources – exist, but this new informal infrastructure helps to fill that.

Assertive community treatment teams working through outreach-centered programs in Maricopa County have become an industry standard for treating those with persistent and severe mental illnesses who have recently been incarcerated. They provide a long-term approach, aiming to halt a cycle of incarceration and hospitalization by focusing on underlying issues such as what caused the police interaction and incarceration.

Veterans who suffer from post traumatic stress disorder number about one-fourth of military personnel returning from Iraq and Afghanistan conflicts, roughly 500,000 veterans so far. Inmates in prisons nationwide train dogs as companions for these war veterans, providing a sense of healing for all.

In Houston, TX, many individuals with mental illnesses cycled in and out of emergency care while arrested or incarcerated. Houston’s police department has decreased the number of incarcerated who have mental illness by opening a division to mental health called the Chronic Consumer Stabilization Unit. Now Milwaukee seeks to replicate Houston’s results.

Milwaukee County’s mental health system put more resources in expensive emergency care rather than invest in programs that offer continual care. As a result, Milwaukee County identifies nine solutions from other cities that have had success in repairing mental health systems. Solutions include the ending of reliance on emergency care, expand community support programs, change laws, and supportive housing.

Across the country, jails hold 10 times as many people with serious mental illness as state hospitals do, according to a recent report from the Treatment Advocacy Center. To deal with the problem, San Antonio and Bexar County have transformed their mental health system into a program considered a model for the rest of the nation - the effort has focused on an idea called "smart justice" — basically, diverting people with serious mental illness out of jail and into treatment instead.

Turnaround for Children, an organization founded to address mental health issues and their repercussions in the classroom, focuses on preparing teachers and schools to structure classroom environments in a constructive way. They create opportunities for learning in rigorous ways with high expectations so that children thrive and are well cared for, helping them to thrive both academically and emotionally.

Despite strong evidence that school-based physical activity improves children’s cognitive skills, concentration, and behavior, schools under pressure to produce quantitative results and decrease bullying have drastically cut back on recess in recent years. An Oakland-based nonprofit organization called Playworks is working to make healthy play accessible for more children and show schools how productive recess can be to the whole academic world.