Mental Health Teaching in the Training of Public Health Professionals: A Thematic Analysis of Interviews with Key Stakeholders

Abstract

Background: Public health approaches to mental health, or ‘public mental health’, is an area of increasing interest in public health strategy in the UK (NHS England, 2016b), alongside growing recognition of the need for preventative mental health approaches (Public Health England, 2017a). The infrastructure around this however is limited. Developing skills and knowledge in the senior public health workforce has been cited as a key priority, but there is little clarity as to how this will be achieved. Training and teaching offer opportunities to develop the conceptual basis of public mental health and promote theoretically-rigorous practices. Aims: This study aimed to explore the coverage and content of mental health teaching available across the public health speciality training pathway, as well as barriers and facilitators to accessing mental health teaching content. Method: Interviews were conducted with 14 participants who had a professional connection to a Master of Public Health course, or placement-based component of regional speciality training programmes. A critical realist methodology was taken, and thematic analysis was used to analyse transcripts. Results: Four main themes were identified: ‘lacking a coherent conceptualisation of mental health’; ‘the relationship between concepts, workforce and service structures’; ‘conceptual frameworks informing the curriculum’; and ‘structural causes of an unsystematic and heterogeneous approach’. Conclusions: There was a widespread lack of opportunity to access mental health teaching across the Masters courses. Placement-based learning primarily took place in clinical settings rather than preventative contexts. De-prioritisation of teaching was shaped by conceptualisations of mental health and an overarching medical paradigm, as well as structural factors which marginalised public mental health. The implications include a need to review the current ad hoc approach to training, as well as a need for development of theories and concepts in the public mental health discipline. The findings resonate with current interest in population and preventative approaches in clinical psychology and indicate opportunities for collaboration with mutual disciplinary benefit.