In 2014, one in five American adults experienced mental illness. Four in ten Americans report knowing someone who has been addicted to prescription painkillers. Gun suicides outnumber gun homicides in this country by two-to-one.

In other words, each and every one of us has been touched by mental illness, either directly or through someone we care about. And that is true no matter where you live, or who you vote for, or how much money you make.

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But despite the vast scope of this crisis, our federal and state governments have largely ignored the importance of mental wellness, shortchanging mental health care by billions of dollars. And it is our cities that have borne the brunt of this disinvestment.

Just look at our jails. On any given day, about 40% of inmates in New York City have an identified mental health-related problem. More than half of all inmates in Oklahoma State Department of Corrections custody have a history of mental health issues, or are currently suffering from a condition.  The takeaway is clear—in the absence of alternatives, jails have become de facto—and deficient—mental health institutions. 

This is just one example of a yawning gap in mental health care that has swallowed up millions of Americans, especially our most vulnerable neighbors—those living at the intersection of homelessness, poverty, and mental health. As mayors, we have an obligation to stand up for them and demand action. We cannot ignore the problem while our citizens suffer needlessly from treatable diseases. Our state and federal leaders must do more and invest in solutions that will save lives—and ultimately, save taxpayer dollars by helping people avoid costly emergency room visits, inpatient hospital stays, and incarceration.

The good news is that we already know what works. America’s cities are blessed with a vast network of faith-based and non-profit agencies with long track records of helping people recover from mental illness. And cities are developing innovative new initiatives that could—and should—serve as models for their counterparts nationwide.

Consider ThriveNYC, New York City’s action plan to change the way people think about mental health, and the way City government delivers services. Led by First Lady Chirlane McCray, ThriveNYC includes 54 different initiatives that address mental health risk factors at every stage of life. The City will also train 250,000 New Yorkers in mental health first aid, which helps people gain a more complete understanding of mental health while teaching participants how to help people in need access appropriate treatment. Thanks to the First Lady’s leadership, New Yorkers will soon find it much easier to get effective, culturally competent mental health care.

More than 1,300 miles away, Oklahoma City is also breaking new ground and reminding the nation that health and wellness are about more than exercise and good diet—if mental health issues aren’t addressed, a person cannot be truly healthy. Their innovative Northeast Regional Health and Wellness Campus brings mental health, primary care, and public health clinical services together under one roof. Other onsite partners are able to address stressful issues ranging from domestic violence to employment and education to fresh produce and healthy foods. Mental health services are also integrated into their new Senior Health and Wellness Centers.

In order to solve the nation’s mental health crisis, we urge other cities to join the movement. Here’s the formula that has worked for us:

  • Change the Culture: For all the progress we’ve made as a society on other issues, mental illness remains in the shadows, something we talk about only in whispers, if at all. It is time to break the silence. We call on our fellow mayors to fund training for mental health first aid in their communities. Research shows that mental health first aid increases our ability to support others who may be suffering from a mental health condition, reduces biases against mental illness, and allows people to more comfortably engage with mental health issues.
    • Act Early: Social-emotional learning teaches children how to build healthy relationships and handle conflicts, which are the building blocks of lifelong mental wellness. Every community needs to make sure their kids are learning these skills. Cities can lead the way by offering professional development on these skills to educators who work with young children.
    • Partner with Communities: Before launching ThriveNYC, New York City spent ten months listening to what our citizens needed, and we are continuing that conversation as we implement the initiatives. Services provided at Oklahoma City’s Health and Wellness Campus are the culmination of several years of planning and building partnerships to meet the community’s needs. Every mayor should do the same.
    • Strengthen Government’s Ability to Lead: Cities are often the laboratories where national models are developed. We must redefine public health to include the most important part of our body—the brain. The first step is to take a close look at the mental health resources already available in your city—both public and private—and help them forge stronger connections.

In OKC and NYC, we are working hard every day to develop workable, creative solutions to a challenge others have written off as impossible—because that’s what mayors do. We invite you to help us change America’s mindset around the mind.


de Blasio is Mayor of New York City and Mick Cornett is Mayor of Oklahoma City