New thinking and new solutions have been required to address the magnitude of the physical health and economic impacts of the COVID-19 pandemic. Mental health problems have also skyrocketed due to the pandemic, yet the response has been more of the same. The Biden Administration and Congress must quickly alter their thinking and adopt new ways to prevent and heal psychological, emotional, and behavioral problems, or the U.S. will see a tsunami of destructive individual and collective traumas now and long into the future.
Even before the pandemic, less than half of the tens of millions of Americans with serious mental health problems could get help. Due to the pandemic, today less than a quarter of the people needing assistance can get it.
One reason is that many people cannot access the mental health system due to high costs, insufficient insurance coverage, long wait times, and the deep-seated racial inequities embedded in the system.
In addition, many people won't engage in clinical treatment because they see it as only for the mentally impaired or weak, feel it conflicts with their religious, spiritual, or cultural beliefs, or fear being stigmatized by others if they participate.
Equally important is that it is a crisis-based system that treats one person at a time only after they exhibit symptoms of pathology. It does not build the skills, resources, and social connections that are essential to prevent widespread psychological, emotional, and behavioral problems.
Due to these and other failings, mental health and psychosocial problems will continue to soar as pandemic-related stresses linger.
Without a fundamental change, the climate crisis will make pandemic-generated psychological, emotional and behavioral problems seem trivial. Research indicates that rising temperatures will increasingly expose every American to cascading disruptions to the ecological, social and economic systems they rely on for food, water, jobs, income, health, safety, and other basic needs. In addition, each year thirty to fifty percent of the population will be impacted by more frequent, extreme, and prolonged rain, snow, and wind storms, wildfires, floods or other disasters.
Left unaddressed, the mental health and psychosocial problems generated by these impacts will mushroom to levels far beyond anything the U.S. has ever experienced. The harmful reactions will profoundly affect the health, safety, and daily functioning of every adult and child. They will also greatly increase physical health problems. And, they will significantly raise costs for families, businesses, and government.
These impacts are bad enough. Just as troubling is that, left unaddressed, a vicious cycle will be triggered whereby fear-based self-protective survival reactions by millions of Americans hinder efforts to reduce the climate crisis and other problems to manageable levels, which will circle back to amplify the distress people experience.
All the individualized clinical treatment programs in the world will never stem the rising tide of harmful mental health and psychosocial problems until an equal or greater emphasis is placed on building the skills, resources, and social connections people need in their communities to build psychological and emotional resiliency to push back against traumatic stresses.
Ample research and experience shows that a public health and prevention science approach can achieve these goals.
A public health approach addresses health and social problems by strengthening protective factors, including the capacity for psychological and emotional resilience, that counters the forces that undermine safety, health and wellness. It takes a population-level approach, not one that merely focuses on treating high-risk individuals. And it prioritizes preventing problems, not merely treating them after they appear.
Prevention science expands the public health approach by showing that mental health and psychosocial problems can be prevented by enhancing the skills, resources, and social connections that build resilience among the entire population. A growing consensus in the field finds that the most effective and efficient way to accomplish this is through community-based initiatives.
Many community-based mental wellness and resilience building initiatives exist across the U.S. They engage a broad and diverse group of residents in planning and continually implementing a variety of locally tailored actions that build and sustain the capacity for resilience among all adults and youth. Mental health and social service professionals support the local coalition, not lead it.
To prevent rampant harmful mental health problems, the existing community-based programs must be strengthened, and new ones launched in communities and regions nationwide.
The Biden Administration must recognize that their efforts to address both the pandemic and climate crisis will be seriously hampered unless they are linked with community-based initiatives that prevent and heal mental health problems. Congress must also come to grips with this reality and enact a new policy that makes the prevention of mental health problems through community-based initiatives a top national priority.
The pandemic has exposed the fatal flaws in our nation's approach to mental health. Now is the time to fix these problems by authorizing, supporting and funding community-based mental wellness and resilience building initiatives nationwide.
Bob Doppelt coordinates the International Transformational Resilience Coalition (ITRC), a network of mental health professionals working to build widespread capacity for mental wellness and resilience for the climate emergency and other disasters, emergencies and pileups of toxic stresses. His most recent book is “Transformational Resilience: How Building Human Resilience for Climate Disruption Can Safeguard Society and Increase Wellbeing.”