This past week a wonderfully written article came out in Vox, entitled “Poor countries are developing a new paradigm of mental health care. America is taking note.” I highly recommend each of you to take five minutes and read this article. It summarizes in so many ways why we must rethink our approaches to mental health. Several of the themes echoed in this article are foundational for how we should think about mental health. From who does the work to where they do it, the article challenges our current structure of mental health delivery and demands for us to consider what different might look like.
I want to go there. I think we as a society must. To me, a guy who has committed his life to advancing mental health, this article nailed what I think many times we miss - that to advance our communities mental health and well-being - we need each other.
COVID-19 was a great example of how much we need connection. Early in the pandemic when we were unsure what was happening, many of us couldn’t process out how we were feeling because we were isolated or alone. Adding insult to injury, we were uncertain as to what was safe and so many of our natural places to congregate socially were off limits.
I spoke to a USA Today reporter during this time and shared a photo of friends on my block getting together in our “socially distanced chalk circles.” We wanted to hang out, to process all that was going on, and really didn’t know the best way to do it. Looking back, it was an awkward moment for us all but the drive to connect was still there. Those relationships? They mattered a lot and I am not sure many of use knew how much we relied on them until they were taken away.
When you look at the psychological literature you will find that a major factor in whether or not a person gets better with whatever mental health issue they are dealing with is the alliance or relationship they have with their clinician. In fact, some research shows that this alliance is more important than other factors. Sure, there are also certain skills that a person needs to possess to actual lead to the change or outcome, but without the relationship, the person seeking help may not progress in their journey as quickly or effectively. As a mentor once said to me about therapy, “It’s the relationship, stupid.”
Think of the people in your life who know you. I bet you there’s a pretty long list of people that know you that you may not initially consider. Take for example the person who cuts your hair. While admittedly I don’t have much hair to cut anymore, I always looked forward to seeing Scott at Tried and True Barbershop. Over the years he became a trusted confidant - a friend, and we shared a lot of personal things with one another in those brief 30 minute encounters.
Our relationships with people matter - they make us more likely to open up - to listen. And because of the profound need we all have to be heard, these relationships allow for an avenue to connect, even if its for only 30 minutes every other week. Let’s apply this logic back to the Vox article I mentioned above. The piece highlights the research on what happens when we equip community members with skills to address mental health. It gives examples from all over the world and asks why the United States does not embrace such a model. Critically, the author points to our huge supply of workforce, as compared to other countries, yet ironically highlights that we still have a significant need for more. Supply can’t meet demand therefore new solutions must emerge.
What would happen if every person was better equipped with the skills to address mental health? It would change the world, literally, would it not? I have shouted this out before on this platform so I won’t do it again here, but I do want to point out that this age old solution - being there for someone else - does have traction to help change the direction we are going in this country for mental health. Sometimes just showing up is the first step - and imagine now showing up with skills that could help in those moments. We have the relationships - we just need the skills.
To liberate ourselves from traditional siloed thinking about “care,” we must begin to embrace the democratization of knowledge and skills throughout all our communities.
It’s why Lorenzo Lewis trains barbers to help identify and assist their clients with mental health.
It’s why the National Institute of Health’s National Library of Medicine offers a class on the role of libraries in addressing mental health.
It’s why a group in San Francisco brought together baristas to train them on mental health.
And I could go on.
We shouldn’t expect that the future of mental health is found in a new building, clinic, or program. The future of mental health is actually one that comes from the past - relationships grounded in the context of community. Let’s take advantage of the power of relationships and use it as a platform to build out new and novel approaches to mental health. We have the science and technology to rapidly scale these solutions across the globe to all communities. For me, I can’t imagine a more exciting and possible future than one that embraces this vision.