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Chirlane McCray & Linda Rosenburg, MSW

Writer, mental health advocate and First Lady of New York City & former president and CEO of the National Council for Behavioral Health, respectively

A Path Forward: Mental Health and the United States Pandemic Response

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As the U.S. transitions to a new federal administration, the COVID-19 pandemic continues to claim the lives and livelihoods of countless Americans. We have great trust in President-elect Biden and Vice President-elect Harris, whose steadfast leadership and commitment to science-based health policy are poised to bend the curve. But within the crisis of infectious disease runs an equally devastating crisis of mental health.

Our best defenses against the virus – physical distance and isolation – are primary risk factors for a range of poor mental health outcomes. Addressing the pandemic compassionately, while keeping our communities and families safe from harm, requires immediate preparation to meet the current and future mental health needs that come with COVID-19. The mental health care workforce must play a central role in the national recovery.

To inform the efforts of mental health care policymakers during the Biden-Harris transition, First Lady of New York City Chirlane McCray (@NYCFirstLady) and former National Council for Behavioral Health president and CEO Linda Rosenberg (@linda_rosenberg) have written “A Path Forward: Mental Health and the United States Pandemic Response.” This urgently needed policy and practice report presents a comprehensive plan for a national pandemic mental health recovery that neatly supplements the Biden-Harris COVID-19 transition strategy, engages all levels of government and prioritizes racial equity and social justice to meet three overarching goals:

  1. Ensure that effective mental health care is accessible for all, regardless of ability to pay, area of residence or citizenship status.
  2. Support the mental health of young people as an upstream investment in long-term prevention, since children and youth will experience the residual mental health effects of the pandemic across their lifetimes.
  3. Eliminate inequities in mental health care access and outcomes that have been exacerbated by the pandemic and use public policy and service delivery as vehicles for racial equity and social justice.

We know which mental health solutions work and many of the nation’s mental health innovations have been realized at the local and community levels. “A Path Forward” draws on the work of New York City through ThriveNYC, the nation’s largest municipal mental health policy portfolio, and the Cities Thrive Coalition, a consortium of more than 220 municipal and county governments that have pledged to prioritize population-level mental health. Additional local-level strategies from Seattle, Boston and Los Angeles are showcased as innovations in crisis response, education and mental health equity promotion. The collective work of these jurisdictions forms a national model for a critically needed pandemic mental health recovery.

Using a population-level approach to mental health policy, these strategies aim to promote healing and wellness broadly and equitably for vulnerable community members with serious mental illness, for the children and youth who are our future and for the Black, Indigenous and People of Color (BIPOC) communities that have historically experienced inequitable access to mental health care. Policymakers and advocates must swiftly present a unified front to improve mental health for all and keep our communities safe and healthy.

As the pandemic progresses, there is no time to waste. We invite readers to act on the report’s three goals as we all do our part to help one another stay safe during these harrowing times. Accessible to policymakers, practitioners and advocates, the recommendations in “A Path Forward build on the successes of the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, and they are consistent with the health policy goals of the Biden-Harris transition.

This commentary will be published in an upcoming issue of the Journal of Behavioral Health Services & Research (JBHS&R). McCray CI, Rosenberg L. A path forward: Mental health and the United States pandemic response. Journal of Behavioral Health Services & Research. 2021 48(1).