New 988 hotline exposes want for higher psychological healthcare infrastructure


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The national rollout of 988, the mental health crisis hotline, brought two important realities to light. First, it drew welcome attention to the need for a “last line of defense” for people experiencing serious emotional distress and suicide crises. Suicide was a top-10 leading cause of death for people ages 10-64 in 2020, and access to the 24-hour 988 hotline, the equivalent of a 911 for mental health emergencies, goes a long way to mitigating self-harm and suicide ideation.

Secondly, it focused attention on the fact that the U.S. continues to lack a more proactive and well-coordinated approach to helping people “upstream” of a crisis. The support system that prevents lower acuity mental health challenges from becoming more serious is still very poor.

Given the inextricable link between mind and body, an untreated mental illness like depression or anxiety can lead to addiction and other physical health problems, which in turn can contribute in a negative cycle of other behaviors that exacerbate mental health traumas.

Moreover, school shootings, the Ukraine invasion, pandemic disruptions, Supreme Court decisions, inflation, and other events exacerbated stress levels for millions.

Astoundingly, we still currently lack the infrastructure needed to help people navigate their mental health journey. Just 28 percent of the U.S. population lives in a county where there are sufficient mental health practitioners. More practitioners would mitigate risks associated with people suffering severe mental health challenges. Even during the initial 988 hotline rollout, some states experienced problems staffing call centers and challenges referring people to local caregivers.

For employees struggling with heightened stress, and anxiety, demand for access to mental health services through their employer is increasing. Unsurprisingly, at least one survey of HR professionals identified significant challenges companies have to provide the right mental health and wellbeing services for their employees.

Developing the mental health infrastructure needed to treat mental illnesses in a coordinated and preventive manner, reducing risks before they reach a crisis point, will require a multi-stakeholder approach that includes these pillars.

  • A “whole person care” approach that involves the entire healthcare system. Hospitals, health systems, and group practices still often take a siloed approach to primary care, treating patients’ physical conditions, and giving patients suggestions for dietary and exercise help. Some academic medical institutions have demonstrated success developing integrative medicine clinics to conduct trials of whole-person care approaches, providing patients with wellness coaches or massage therapists, and improving coordination between traditional care practitioners and specialty care providers.
  • Greater adoption of so-called nontraditional benefits by employers. About half the U.S. population, or about 158 million Americans, receive employer-sponsored healthcare coverage. Employers can act as the “tip of the spear” in preventive approaches to mental healthcare. They can even expand their traditional benefits to offer holistic care services that relieve underlying workplace stress, such as massage, yoga, dietary supplements, and acupuncture. For employees needing more help, wellness and behavioral health coaching, group therapy, a flexible work schedule, paid mental health days, meal planning assistance, and stress management and resilience training are just a handful of potential offerings that focus on employee wellbeing. These approaches can help employees reduce stress, manage chronic conditions better, and support positive lifestyle changes.
  • Continued “de-stigmatization” of mental health. While we’ve made significant strides as a society in creating safe, non-threatening ways for people to seek help, too many people don’t seek treatment because they fear personal, family, or social backlash. As business leaders, healthcare professionals, public figures, and individuals, we must collectively continue reinforcing the message that we can talk openly about mental health and how people can get better with treatment. More public campaigns like Bell, Let’s Talk will go a long way, as will a greater recognition that physical and mental health are not only equal, but connected.

Many people, unfortunately, will need to seek help through the 988 hotline and other emergency services, no matter what preventive measures we take to treat their mental illnesses, and elevating a mental health crisis to the equivalent of a 911-type of emergency is a welcome step.

However, healthcare organizations, employers, communities, advocates, and politicians must continue efforts to develop a well-coordinated mental health infrastructure. We cannot ignore the fact that for any illness, preventive care and early treatment result in healthier individuals, and longer, more productive lives.

Photo: zhaojiankang, Getty Images



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