Striving for steady progress is key to lasting change in fight for mental health equity

Striving for steady progress is key to lasting change in fight for mental health equity
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In both my political career and in my personal life, I have learned that when faced with complex challenges, what matters most is putting one foot in front of the other, steadfast and walking the path to change. There are no quick-fixes to anything, regardless of how much they are needed.

As a mental health advocate, I also know the same holds true for attempting to change the deeply-imbedded cultural and structural norms around the treatment and delivery of care for those with mental health and substance use disorders. It is not a science. Far from it.

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First and foremost, true change requires acknowledging that the status quo is not working and deciding to do something about it. Road maps to guide us toward a more integrated public health system are what we strive for — not polished “solutions” that simply look good on paper. We must meet people where they are, which requires a completely different system of care than what has historically been prioritized in this country.

 

ThriveNYC, an innovative action plan designed to support the mental health and well-being of New Yorkers, is one such program offering a different, comprehensive and humanized approach to systemic change. Based on the goal of providing more services, better services and easier access to services, this multi-agency initiative set out to correct the narrowness with which mental health and addiction treatment services were being promoted and delivered.

It facilitates long-needed collaboration between city agencies and more than 200 non-profit partners. Rather than putting a band-aid over the symptoms of a disjointed, broken system, Thrive set out to address these symptoms head on, one step at a time. And that’s exactly what it’s doing.

It is a truly groundbreaking model for how government can facilitate a comprehensive behavioral health system: Thrive is engaging teachers, faith leaders and service organizations, in addition to clinical providers.

And it prioritizes preventive care — making sure children have access to school-based mental health support, partnering with community physicians to tackle substance use at its core, promoting better data collection and targeting awareness campaigns. Thrive’s approach is all-encompassing. Services are delivered over the phone and in schools, senior centers, shelters, hospitals and health clinics across the city.

Consider that NYC Well, Thrive’s helpline, has responded to more than 500,000 calls, texts and chats since October 2016.More than 100,000 New Yorkers have benefitted from Mental Health First Aid. Hospital systems in Thrive’s Maternal Depression Learning Collaborative have completed 50,915 prenatal depression screenings and 31,768 postpartum depression screenings. Mental Health Service Corps (MHSC) members have provided more than 200,000 hours of direct clinical treatment to communities across the city and 80 percent of sites with MHSC clinicians are in federally-designated mental health shortage areas. And working with NYPD, Thrive has ensured that more than 100,000 crime victims were connected to advocacy services.

These are just a few examples that showcase Thrive’s ability to plant important seeds of awareness, support and hope.

As U.S. life expectancy continues to drop due to growing numbers of overdoses and suicides and more and more young people report feeling anxious and depressed, we must make every effort to water these seeds and give them time to grow. 

Similar approaches have dramatically improved other public health issues. For example, through a strategic combination of policy-driven smoking bans, broad public communications, increased federal, state and local excise taxes and increased access to treatment tools, New York City cut the adult smoking rate by 35 percent in about a decade. The youth rate fell even more, by 52 percent.

This success didn’t take place overnight. It required years of preparation, collaboration and determination. Any effort seeking behavioral change does. It requires constant adaptation — the ability to course-correct when needed. Embracing this reality, Thrive implemented tools to measure both its short- and long-term impact. And as its programs mature, metrics will be modified to ensure that outcomes can be measured appropriately. It may take years for data to paint a clear picture of Thrive’s impact, but the infrastructure will be solid. Without a strong foundation, change simply won’t stick.

Where Thrive really shines is its focus on human connection. Instead of pushing those with mental health and substance use disorders into pre-fabricated “solutions,” Thrive meets people where they are, providing support, tools and resources applicable to an individual’s unique circumstance.

This approach, in concert with strategic prevention efforts targeting youth, will have lasting results. We can never underestimate the impact of inclusion, compassion and collaboration. Such tactics may not fit the mold of what’s expected in today’s quick-fix, instant-gratification society. Great things rarely do.

Former Rep. Patrick J. Kennedy (D-R.I.) was the lead author of the Mental Health Parity and Addiction Equity Act of 2008. He is the founder of The Kennedy Forum and DontDenyMe.org, a site that educates consumers about their rights to mental health and addiction treatment under the Parity Act.