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Mental Health Care: Beyond Symptoms

11/16/2016

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​By: Hannah Heitz 

​Dr. Benjamin Druss, a Professor at Rollins School of Public Health and Rosalynn Carter Chair in Mental Health, started his career in internal medicine but quickly decided that he wanted a more focused specialty. During his residency and subsequent fellowship at Yale, he discovered that the clinical issues of patients with mental illness was only a small component of their daily concerns. During his fellowship, he researched mental health care services and looked the various systems that created barriers to care for those with mental illness. Now at Emory, his work includes issues outside the health system, such as housing, employment, and other social determinants that impact wellbeing. Those with serious mental illnesses are considered a health disparities population and often die much younger than those without serious mental illness. Unfortunately, improving access to healthcare is only one small solution within a much larger problem.
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Dr. Druss serves as a voice on this subject through is roles on the National Institute of Mental Health (NIMH) Council and the editorial boards of the Journal of the American Medical Association (JAMA) Psychiatry, the American Journal of Psychiatry, General Hospital Psychiatry, and as editor of the Psychiatric Services Integrated Care Column. With an increasingly biological perspective in the field of psychiatry, Dr. Druss believes it is essential to also consider the downstream social and psychological impacts of illness in a specific culture and that this approach, coupled with biological understanding, is the most effective means of improving health for individuals with mental illness.
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Source: Wikimedia Commons, Logo of the United States National Institute of Mental Health
​​At Emory's Rollins School of Public Health (RSPH), Dr. Druss looks at mental health as a cross-cutting issue that is relevant to all disciplines. Ten years ago, there was very little discussion of mental health within the public health world, but this is slowly changing. Along with this change in public health, Dr. Druss believes that a shift from focusing on symptoms and numbers to focusing on function in medicine is necessary. He asserts that patients care most about functioning, but often the health system rewards a focus on numbers, testing, and novel treatments.

Thus, in Dr. Druss’ work, he prioritizes function, especially in disadvantaged populations: “It is about more than just dialing down psychosis—what is meaningful to them? Are there other aspects of things we can do to help them? Housing? Employment?” He looks beyond the acute symptoms of mental illness and looks at how the symptoms have a holistic impact an individual’s life. Dr. Druss is currently conducting research in health system level interventions in order to foster integration between mental health and medical care. He wants to find unique ways to fill existing gaps in the health service system.
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Source: Flickr, Emory University Hospital
​One of his programs include a mobile personal health record to help coordinate care and engage patients in their care. The study is currently underway. Patients have been receptive and report liking the technology thus far. Although there is growing interest in the use of health technologies to facilitate improved care, many consider the face-to-face, in-person component of mental health treatment as the active ingredient necessary for successful interventions. But for those whose baseline is no access to care, using technology to improve mental health is a far better alternative. Dr. Druss believes that we can use technology to capitalize on what works. Even if technology cannot replace certain aspects of care, there is still a role it can play in improving access and augmenting care systems.

Dr. Druss has seen vast changes in the field of both medicine and public health in the past years. Through is research and various professional roles, he gets to keep learning and promoting improvements in mental healthcare access through his work at RSPH and the Carter Center. Dr. Druss found his niche at the population level with a focus on improving mental health care and believes that changes at the level of larger systems can foster improvements in patient care and functioning.  
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