People’s foundation for physical and mental well-being starts with access to fresh air, clean water, and nutritious food. Meeting these basic needs allows us to be healthier today by avoiding hunger, exhaustion, disease, and injury. It also means we are more likely to thrive tomorrow by supporting our ability to withstand adversity.
What You Need to Know
These key issues are essential to understanding how we can support thriving people and places.
Basic Needs for Health & Safety: Freedom from Trauma, Violence, & Addiction
- Depression is the leading contributor to disability, with far-ranging effects on physical, social, and emotional health.
- With increasing rates of unemployment, the number of uninsured is rising even as the need for care increases.
- Without viable community treatment options, those in need often go without care, or are forced into more expensive emergency services.
- COVID-19 has highlighted vulnerabilities within our current delivery system, underscoring that care in the clinical or hospital setting is not always feasible or the most effective approach.
- The traditional mental health workforce does not have the capacity on its own to meet the demand for services. This was true prior to COVID-19 and is even more evident now.
- A large body of research on “task-shifting” demonstrates how many of the tasks of treating addiction and mental health needs—such as screening and tracking improvement, providing aspects of supportive counseling, coaching skills in self-care—can be done by trusted nonclinical health professionals.
Historical Context
THE IMPACTS OF TRAUMA, VIOLENCE, AND ADDICTION on human life are far reaching. Adverse childhood experiences and toxic environments can harm health and well-being across a lifespan and generations. Unfortunately, quality mental health and addiction care has long been difficult to access, hard to afford, and too uncoordinated, and underfunded to provide real healing.
When I’m not feeling inspired, I think about the kids I work with–and how I’m trying to change the system for them.”
Dr. Ben Miller, Well Being Trust
Current Conditions
To address our mental, emotional, and social health needs as whole persons, and particularly the loss, trauma, and substance misuse occurring in the wake of COVID-19, we must move toward ensuring everyone has access to integrated, comprehensive, multi-sector, community-based care, solidly anchored in the promotion of mental health and emotional resilience.
“Mental health and addiction issues touch every one of us—either directly or through someone we love. The consequences of trauma, violence, and exclusion threaten our well-being, and undercut our freedom to flourish. We all have healing to do, even as some of us suffer disproportionately as a result of systemic inequities borne by our race, ethnicity, gender identity, and socio-economic status. It’s time we recognize that whatever may divide us, that which connects us is greater still. Let us turn to one another and listen, learn, recover and find new ways to heal, thrive and grow our collective resilience. Our lives, families and nation depend on it.”
Tyler Norris, Well Being Trust
Pivotal Moves
A Selection of Ideas for Changing Course
PIVOTAL MOVES are decisive actions that could begin now and change the course of community life relatively quickly.
ENSURE ACCESS TO CARE, NOW
Emergency funding must be dedicated to clinicians and organizations treating individuals with mental health and substance use disorders.
A significant portion of emergency funds should be set aside for organizations serving those enrolled in Medicaid.
CHANGE DELIVERY OF MENTAL HEALTH CARE
Integrate mental health staff and universal screening into primary care, improve assessment and referral pathways, undertake outreach into communities and schools, and ensure that digital care is available.
Adopt a “no wrong door” approach that allows people to secure the appropriate level of care without imposing burdens that worsen their distress.
Distribute the workforce to reach people where they are.
TRANSFORM THE MENTAL HEALTH WORKFORCE
Implement a Community Health Service Corps that is dedicated to prevention and to meeting distinct needs with culturally sensitive approaches.
Embrace task-shifting—package clinical and cultural knowledge with methods that heal and prevent harm, led by the community.
Leverage clergy, teachers, community health workers, parents, trusted peers to change the character and expand the reach of mental health services.
Large-scale efforts to shift care into communities will require strong community leadership and a unifying infrastructure, as well as steps to ensure availability and equitable distribution.
GET THE FACTS & PUT THEM INTO ACTION
Implement real-time surveillance of critical issues like suicide, drug overdose deaths, and the incidence of mental health diagnoses in crises.
Devote additional resources to evaluating community and clinical interventions that mitigate or even prevent behavioral health conditions.
Translate findings into effective education and skill-building rooted in best practices and enhanced by technical and peer assistance.