The National Performance of 988 mental health crisis hotline, brought to light two important realities. First, it drew much-needed attention to the need for a “last line of defense” for people experiencing severe emotional distress and suicidal crises. Suicide was a Top 10 leading causes of death for people aged 10-64 in 2020and access to the 24-hour 988 hotline, the equivalent of 911 for mental health emergencies, goes a long way to mitigating self-harm and suicidal thoughts.
Second, it focuses attention on the fact that the US continues to lack a more proactive and well-coordinated approach to helping people “upstream” of the crisis. The support system that prevents more serious, lower-acuity mental health problems is still very poor.
Given the inextricable connection between mind and body, an untreated mental illness such as depression or anxiety can lead to addiction and other physical health problems, which in turn can contribute to a negative cycle of other behaviors that exacerbate mental health trauma.
In addition, school shootings, the invasion of Ukraine, pandemic disruptions, Supreme Court decisions, inflation and other events have worsened stress levels for millions.
Amazingly, we currently still lack the necessary infrastructure to help people navigate their mental health journey. Just 28 percent of the US population lives in a county that has enough mental health doctors. More practitioners would mitigate the risks associated with people suffering from serious mental health problems. Even during the initial launch of hotline 988 some countries experienced problems call center staff and challenges in referring people to local carers.
For employees struggling with increased stress and anxiety, the demand for access to mental health services through their employer is increasing. Not surprisingly, at least one survey of HR professionals identified significant challenges facing companies in providing the right mental health and wellbeing services to their employees.
Developing the mental health infrastructure needed to treat mental illness in a coordinated and preventative manner, reducing risks before they reach crisis point, will require a multi-stakeholder approach that incorporates these pillars.
- A “whole person” approach that includes the entire health system. Hospitals, health systems, and group practices still often take a siled approach to primary care, treating patients’ physical conditions and giving patients suggestions for dietary and physical support. Some academic medical institutions have demonstrated success in developing integrative medicine clinics to conduct trials of whole-person care approaches, provide patients with wellness coaches or massage therapists, and improve coordination between traditional care practitioners and specialty care providers.
- Greater adoption of so-called non-traditional benefits by employers. regarding half of the US population, or about 158 million Americans, receive employer-sponsored health coverage. Employers can act as the ‘tip of the spear’ in preventive approaches to mental health. They can even expand on their traditional benefits to offer holistic care services that relieve the underlying stress of the workplace, such as massage, yoga, nutritional supplements and acupuncture. For employees who need more help, wellness and behavioral health training, group therapy, flexible work schedules, paid mental health days, help with meal planning, and stress management and resilience training are just a few of the potential offerings , which focus on employee well-being. These approaches can help employees reduce stress, better manage chronic conditions, and support positive lifestyle changes.
- Continued ‘destigmatisation’ of mental health. Although we have made significant strides as a society in creating safe, non-threatening ways for people to seek help, too many people do not seek treatment because they fear personal, family or social backlash. As business leaders, healthcare professionals, public figures and individuals, we must collectively continue to strengthen the message that we can talk openly about mental health and how people can improve with treatment. More public campaigns like Bell, let’s talk will go a long way, as will greater recognition that physical and mental health are not only equal, but related.
Many people, unfortunately, will have to seek help through 988 and other emergency services no matter what preventative measures we take to treat their mental illnesses, elevating a mental health crisis to the equivalent of a 911 emergency is a welcome step.
However, healthcare organizations, employers, communities, advocates and policymakers must continue their efforts to develop a well-coordinated mental health infrastructure. We cannot ignore the fact that for any disease, preventive care and early treatment lead to healthier people and longer, more productive lives.
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