"Every chronic condition I have studied, without exception, has a mental health component to it, everything," said Richard Bullough, Summit County Health Director. "If you're not empowered to make change, and you're not mentally healthy to have that empowerment, you cannot influence any health factor. Mental health is fundamental to everything."
Bullough noted that it is easy to talk about physical and visible health conditions, such as physical activity and obesity. And people are also willing to talk about community issues such as clean drinking water and air pollution.
"It's pretty easy to increase awareness and have those be a fundamental part of the community," he said. "But mental health and substance abuse are very different. They are private. One of the challenges we face is making sure people are aware of the mental health services that may not always be the topic of conversation in the community."
Bullough said he hopes that changes, and that mental health can become a bigger part of the conversation as a county and as a health department.
"It should be a normal conversation about health. We just can't accomplish very much if people are not in a state of mental health to allow them to take action and take care of themselves," he said.
Summit County Manager Bob Jasper is hoping the county can begin to focus on treatment for the chronically mentally ill and those with chronic substance abuse problems as the county moves forward.
"We had a physician talk to us about doing more preventative stuff with kids, and it's not that we don't want to do that, but we only have so much money in our contract with Valley Mental Health, so I think we're more focused on the people that have had serious problems," he said.
Valley Mental Health is a community mental health care provider that has been contracted by Summit County for years to provide mental health services, such as therapy, substance abuse treatment, 24-hour crisis help, peer counseling, outpatient programs and autism spectrum programs.
Valley Mental Health has been taking steps to increase their presence in the community and awareness of their mental health and substance abuse services.
To that end, the county has implemented a county drug court program for people with chronic alcohol and drug abuse problems.
"So we're looking at a little more focus on that population, and then on the mentally ill," he said. "We are ultimately responsible for them so I want to target them a bit."
"We're trying to expand so we're not just in Park City, and I think that's working really well," said Victoria Delheimer, Valley Mental Health rural services director. "In the past, more was done at the clinic, but now we're also in North and South Summit elementary and middle schools."
Research shows that if elementary and middle school children are taught life skills, substance abuse and mental health disorders can be prevented, she said.
"So we've really focused on expanding our life skills training in schools," she added.
A 2011 survey showed Summit County youth alcohol, marijuana and prescription drug use was far above the state average.
"Parental attitudes towards favorable use is much higher than the state average," she said. "There is somewhat of a perception in Summit County that it is OK to use under the right circumstances. But the research says that if you can delay alcohol use until age 21, the likelihood of drug and alcohol problems decrease exponentially."
However, Summit County underage alcohol and drug use trends have been decreasing over time, which Delheimer attributes to the county and state preventative programs.
Bullough added that perception also plays a key role in decreasing underage substance abuse, as well as increasing awareness.
"Perception is important, and what the norm is is important," he said. "And I think one of the challenges moving forward is to accurately communicate what the norm is. So much of what we do is based on what we think is normal. So I think that's part of the message we have to work on changing."