Public mental health
It’s a commonplace that the massive gains in life expectancy in the 1900s are in large part due to public health improvements - vaccinations, sanitary childbirth, smoking cessation, and the like. To be sure medicine improved too, but most of the value was in the low hanging fruit - “suddenly having antibiotics” and basic chemotherapy, for instance. By comparison, high-tech treatment of severe diseases such as genomic targeting of cancer have so far had relatively little quantitative effect on QALYs. Rather than health care, a lot of value seems to come from public health - preventative measures and lifestyle improvements to make people less likely to get major illnesses in the first place.
Mental health, however, seems entirely focused on the health care side of things and lacks a public health component. We have drugs and therapies to treat major depression, bipolar, psychosis, and so on, but relatively little attention to how lifestyle factors affect our subjective experience and might predispose us to eventually developing the major maladies. And so we end up with situations where half of grad students and a third of medical students demonstrate symptoms of depression, but nobody panics at the stressors and social isolation that might be causal here, the way they’d panic if they saw med students taking smoke breaks between patients.
Clearly the low-hanging fruit is simply to be personally attentive to your “mental health hygiene” and lean against the popular paths when they conflict with it. It’s not totally obvious what policy/institutional responses are realistic, particularly with the recent hullabaloo over how colleges handle acute cases of mental health problems.
Actually, quite a few things seem like “public mental health” to me:
1. The self-esteem movement, growth mindset movement, etc.
2. Everything in the category of people on Tumblr posting “Remember, you’re beautiful and wonderful and perfect the way you are!”
3. Various government efforts to remove toxins that damage brain health, for example pesticides implicated in ADHD
4. Trigger warnings.
5. Everything in the category of transgender rights could be seen as a public mental health intervention.
6. You bring up residents as an example of an untreated high-risk population, but before I started my residency I had go to to some incredibly annoying patronizing lecture where they told us how to schedule our time and gave us tips for dealing with stress and so on.
You might prefer evidence-based public mental health, but it’s really hard to get good evidence on these sorts of things - the early studies said self-esteem was great, then later more rigorous ones found that it wasn’t.
There was a big mental hygiene movement in late 19th cen. and early 20th cen. America, though it was pretty well entwined with notions of social, physical, and moral hygiene, educational reform, and the Progressive movement generally.
In terms of acting on environmental factors, slum clearance, the building of parks, and the Playground Movement could be seen as part of or allied to the mental hygiene movement.
(When I talk about entwinement consider the YMCA - it offered young transient workers an alternative site of residence and socialization to bars and taverns [social], gymnasiums and athletic facilities to encourage exercise [physical], in service of a vision of Muscular Christianity [moral] which blamed many of the faults of urbanizing society on the feminization of cultural institutions.)
Early intervention was also big component - it was held that many mental disorders such as anarchism, homosexuality, and gender deviance were the fault of mothers, particularly poor mothers from immigrant and rural-transplant communities, who were incompetent at properly acculturating their children, and urged their sidelining in childraising in favor of (usu. upper-class) professionals and (same, also female) social workers. This was also the origin of the notion of “juvenile delinquency”.
Other mental hygiene initiatives of the period included the construction of asylums, forcible institutionalization, and the sterilization of the congenitally mentally unfit, by analogy to existing public health interventions of professionalized sterile hospitals, quarantine, and vector control.