Population-Based Approaches to Mental Health: History, Strategies, and Evidence

Annu Rev Public Health. 2020 Apr 2:41:201-221. doi: 10.1146/annurev-publhealth-040119-094247. Epub 2020 Jan 6.


There is growing recognition in the fields of public health and mental health services research that the provision of clinical services to individuals is not a viable approach to meeting the mental health needs of a population. Despite enthusiasm for the notion of population-based approaches to mental health, concrete guidance about what such approaches entail is lacking, and evidence of their effectiveness has not been integrated. Drawing from research and scholarship across multiple disciplines, this review provides a concrete definition of population-based approaches to mental health, situates these approaches within their historical context in the United States, and summarizes the nature of these approaches and their evidence. These approaches span three domains: (a) social, economic, and environmental policy interventions that can be implemented by legislators and public agency directors, (b) public health practice interventions that can be implemented by public health department officials, and (c) health care system interventions that can be implemented by hospital and health care system leaders.

Keywords: health care system design; mental health; population health; psychiatric epidemiology; public health practice; public policy.

Publication types

  • Historical Article
  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • History, 20th Century
  • History, 21st Century
  • Humans
  • Mental Disorders / therapy*
  • Mental Health / history*
  • Mental Health / statistics & numerical data*
  • Mental Health Services / history*
  • Mental Health Services / organization & administration*
  • Mental Health Services / statistics & numerical data*
  • Patient-Centered Care / organization & administration*
  • Patient-Centered Care / statistics & numerical data
  • United States