780 Discussion IV

In my population health proposal, I addressed young adults ages 18 to 25 with serious mental illness (SMI) in Sedgwick County, Kansas, including bipolar disorder, major depressive disorder, and schizoaffective disorder (Sedgwick County Health Department, 2022). The primary population health concern was elevated depression burden and suicide risk, supported by surveillance and national trend reporting (Garnett & Curtin, 2023; Kansas Department of Health and Environment [KDHE], 2023; Substance Abuse and Mental Health Services Administration [SAMHSA], 2023). I selected a community and systems-level gatekeeper training intervention to strengthen early recognition of warning signs and improve timely referral to appropriate crisis and treatment resources (Mojtabai et al., 2021; SAMHSA, 2023).

Social determinants of health

Social determinants of health were considered as upstream drivers of risk, particularly during young adulthood when transitions in housing, education, employment, and social support can destabilize access to consistent care (Centers for Disease Control and Prevention [CDC], 2024). In practical terms, these determinants influence whether someone can recognize symptoms, seek help early, sustain treatment, and maintain protective routines. Because those conditions shape population outcomes, the proposal emphasized building support and recognition capacity outside of traditional clinical settings, using a community-based approach that can reach individuals who are not consistently connected to specialty behavioral health services (CDC, 2024).

Gaps in care

Gaps in care were addressed as system barriers that contribute to delayed help-seeking and crisis escalation. The proposal considered gaps such as limited access points, inconsistent follow-up, and fragmentation between identification of risk and connection to services (Sedgwick County Health Department, 2022). My selected intervention was designed to reduce these gaps by increasing the number of trained community members who can identify risk earlier, respond appropriately, and connect individuals to established resources, which supports earlier intervention and continuity rather than waiting until symptoms become emergent (Mojtabai et al., 2021; SAMHSA, 2023).

Inequities in care

Inequities were considered through the lens that risk and outcomes are not evenly distributed across communities, and access to timely behavioral health care is shaped by structural factors like insurance status, transportation, stigma, and resource availability (Sedgwick County Health Department, 2022). I also used local and regional indicators that show variation in mental health burden at the county and sub-county level, reinforcing the need to target strategies where burden is highest (County Health Rankings and Roadmaps, 2025a; CDC, 2024). The gatekeeper model supports equity because it can be deployed across multiple community settings and does not depend on a person already being linked to specialty care.

Evaluation and value considerations

To evaluate whether the intervention positively impacted the identified problem, I would track both population outcomes and system performance measures over time. Outcome indicators include suicide mortality trends and population-level measures related to mental health burden (Garnett & Curtin, 2023; KDHE, 2023; County Health Rankings and Roadmaps, 2025a). Process measures include training reach and completion, changes in knowledge and confidence among trainees, referral activity to crisis and treatment resources, and evidence of improved linkage to services following identification of risk (Minnesota Department of Health, 2025; SAMHSA, 2023). Cost-benefit considerations were incorporated by selecting an intervention that is scalable, supports earlier intervention, and has the potential to reduce downstream crisis utilization such as emergency department visits and avoidable escalation, which aligns with a public health nursing approach to population-level prevention and systems impact (Minnesota Department of Health, 2025).

References

Centers for Disease Control and Prevention. (2024). PLACES: Local data for better health. https://www.cdc.gov/places/

County Health Rankings and Roadmaps. (2025a). Poor mental health days: Measure description and data vintage. https://www.countyhealthrankings.org/

Garnett, M. F., & Curtin, S. C. (2023). Suicide mortality in the United States, 2001–2021 (NCHS Data Brief No. 464). National Center for Health Statistics. https://www.cdc.gov/nchs/data/databriefs/db464.pdf

Kansas Department of Health and Environment. (2023). Suicide data. https://www.kdhe.ks.gov/1737/Suicide-Data

Minnesota Department of Health. (2025). The Intervention Wheel: Definitions, practice levels, and applications. https://www.health.state.mn.us/communities/practice/research/phncouncil/wheel.html

Mojtabai, R., et al. (2021). https://doi.org/10.1016/j.jpsychires.2021.02.015

Sedgwick County Health Department. (2022). Behavioral health needs assessment: Wichita and Sedgwick County. https://www.sedgwickcounty.org/media/69013/wichita-sedgwick-needs-assessment-final.pdf

Substance Abuse and Mental Health Services Administration. (2023). 2022 NSDUH annual national report. https://www.samhsa.gov/data/report/2022-nsduh-annual-national-report