Introduction
The current teaching plan targets adolescents and young adults who struggle with mental illness and substance abuse. The proposed seminar falls under the domain of educational policies and health promotion interventions that could not only address but also prevent mental health concerns and substance abuse among the chosen demographic. Primary prevention and health promotion are now seen as the necessary pillars of any sustainable healthcare system. Today, healthcare is taking a dramatic shift from reactivity to proactivity (Rawaf, 2018). This means that merely handling the consequences of social ills and public health concerns is no longer enough. The proactive approach suggests that socially and economically, it is beneficial to stop a crisis in its tracks by taking preventive measures (Rawaf, 2018). Education is one of such measures, and the present seminar seeks to promote awareness, autonomy, and conscientiousness in adolescents and young adults. The educational initiative complies with Healthy People 2020 (HP2020) goals.
Poor mental health, especially when exacerbated by comorbidities such as substance abuse, is a complex issue that requires a comprehensive solution. For this reason, the proposed teaching plan addresses for domains: cognitive, physical, language, and behavioral. A change in cognition means taking up a more positive approach to life choices after recognizing the existing issues and identifying the need for transformation. However, thought is nothing unless it is translated into action. This is why the physical domain of this learning experience emphasizes behavioral changes such as healthier habits, clean eating, and others.
The positive effects of lifestyle changes are to be strengthened by communication skills. The linguistic domain of the current teaching plan seeks to encourage participants to be open about their experiences. The last but not least element is social integration embodied by the social-emotional domain. The employed teaching approach is based on the idea that public health is only attainable if every person is feeling connected to their community, is assigned a particular role, and able to bond with others. The latter domain is especially important given that it is the social learning theory (SLT) that constitutes the theoretical underpinnings of the proposed teaching plan. The SLT states that an individual is able to adopt healthier behaviors when given a chance to observe and imitate them. Thus, the proposed teaching plan seeks to provide young people with a positive example that they could further use for recovery and self-leadership.
Epidemiological Rationale for Topic
In the United States, declining mental health has become a major public health concern. The situation is likely to exacerbate in the light of the COVID-19 pandemic that made millions of people psychologically, socially, and economically vulnerable why exposing the many faults of the existing system. However, even before the pandemic, the situation was critical. As reported by the National Institute of Mental Health (2019), 47.6 million adult Americans suffered from some kind of mental illness at least once during their lifetime. 8% of the adult population (age > 18 years), or 17.5 million Americans, report having a severe mental health condition. What is unfortunate is that poor mental health is often accompanied by comorbidities such as drug or alcohol addiction. 4 out of 17.5 million mentally ill Americans fall under this category. The conditions fuel and exacerbate each other, effectively trapping a person in an extremely adverse situation.
As for substance use statistics, the National Institute of Mental Health (2019) states that 20.2 million adults, or every tenth American over the age of 18, were at risk or fighting a substance use disorder. What is concerning is that in many cases, the problem starts early: 4% of the adolescent population in the US aged 12 to 17 struggle with a substance use disorder. As for young adults, 5.1 million out of the demographic cohort aged 18-25 (14.8%) abuse substances such as drugs or alcohol. The problem is aggravated by the inaccessibility of prompt and comprehensive healthcare and the lack of awareness. The estimated 20.7 million people between age 12 and older required specific treatment for a substance use disorder, and only about 19% of them received the treatment.
Another factor shaping the landscape of public health in today’s America is health literacy. Presumably, healthcare workers are not omnipotent, and day-to-day management of the disease should largely be a patient’s responsibility. To be autonomous, an individual needs to have relevant information about their health status and possess knowledge about the necessary steps toward recovery. The Centers for Disease Control and Prevention (2019b) reports that around one-third of American adults (36%) have basic and below basic health literacy skills. Arguably, the numbers are more prevalent in disadvantaged communities where people do not have easy access to education and are at risk of developing mental conditions and abusing drugs or alcohol.
Evaluation of Teaching Experience
Community-based education is not an immediate process: it takes time for participants to process information, make conclusions, and decide to take action. Therefore, the teaching experience can only be fully evaluated at the two-three month mark since the start of the intervention. So far, it has been possible to observe and describe the following signs of improvement among the chosen demographic as a result of the teaching initiative:
- The cognitive domain. Participants are well-aware of the benefits of sobriety and recovery from mental illnesses. The majority of them express a clear intention to change their ways and become better versions of themselves. After some skepticism at the beginning of the teaching intervention, participants recognized the role of educational sessions in improving public health and change their lives. Young adults were interested in facts and statistics as well as hard science explanations as to what substances and untreated illnesses do to the human body and psyche.
- The physical domain. Translating thought into action turned out to be the most challenging task for participants. While rationally, those young adults understood that they needed to undergo a transformation in order to put their lives back on track, they struggled to actually change their habits. Only a small portion of students reported eating healthier or taking up simple but beneficial physical activities such as hiking and preferring walking over using public transportation.
- The language domain. Participants have shown a great deal of progress with regard to their communication skills. While in the beginning, they were more likely to hold back, with the encouragement and compelling prompts from the educators, they were able to open up. Today, participants can recognize their feelings and emotions, which helps them to avoid triggers and abstain from substances.
- The social-emotional domain. Young adults admitted that their lifestyle was preventing them from integrating into a larger community. They experienced detachment and isolation, which only aggravated their existing issues. The teaching intervention helped them make new friends and find out about volunteering and leisure opportunities in their communities.
Community Response to Teaching
At first, the community response was mixed: individuals tormented by disease and substance use were rather skeptical about educational sessions and the benefits they could present for their everyday life. Therefore, in the beginning, it was difficult to motivate young adults to show up and willingly commit to the intervention. Apparently, many participants were tired of being “lectured” – they did not want someone to tell them what to do without taking into account the complexity of their situation. What these underprivileged community residents needed is a deeper understanding of their issues and addressing them from various angles. Participants warmed up when they realized that the teaching intervention was more than a series of lectures. They were happy about meeting new people, especially those going through the same hardships as they are. Hopefully, the sentiment will persist, and participants will remain positive about their experience.
Areas of Strengths and Areas of Improvement
Probably, the main strength of the current initiative is its comprehensive approach to addressing public health issues. All four domains – physical, cognitive, language, and socio-emotional – bear equal weight in changing the community. The initiative was able to keep a balance and allocate equal attention and resources to each of the domains. For instance, it would be impossible to expect a change in habits from a person who feels isolated from his or her peers and does not have a single positive example. Similarly, an individual is unlikely to come to a rational realization of what his or her situation has come to be if they are unable to verbalize their feelings appropriately. Addressing all the problematic aspects of the public health concern will allow for a sustainable model yielding long-term benefits.
Another area of strength worth mentioning is the creation of a safe space for vulnerable young adults. Many people suffering from mental illness or substance use do not find acceptance in conventional communities. The teaching intervention became a platform for amplifying the voices of those who are often overlooked by the healthcare and social welfare systems. Besides, meeting people facing the same hardships as they were seemed to be soothing for a lot of participants.
The tentative teaching intervention has shown promising prospects but was not without faults. The development of the physical domain ran into administrative and financial boundaries. For many individuals, changing their lifestyle meant financial investment, be it a gym membership of healthier eating. Besides, referring some people to additional services also meant unplanned expenses. Indeed, the lack of resources is a factor that holds many participants back on their way to recovery. Thus, it is important to promote more accessible therapy by engaging the stakeholders in charity events. In the future, it would be beneficial to collaborate with other initiatives that offer free sports classes and other healthy activities to recommend them to participants.
References
Centers for Disease Control and Prevention. (2019). Understanding literacy & numeracy.
National Institute of Mental Health. (2019). Mental illness.
Rawaf S. (2018). A proactive general practice: Integrating public health into primary care. London journal of primary care, 10(2), 17–18.