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7 Pillars for Transforming Mental Health and Substance Abuse Care

Written by Tom Chiodo Contributor Developing documentaries & special projects for public media.


July 18, 2023 / Forbes

For the past two decades, mental health outcomes in the United States have been on the decline. As of February 2023, more than 30% of adults report symptoms of depression and/or anxiety. Suicide is the second leading cause of death among youth ages 15-24, with nearly one out of every 15 high school students attempting suicide each year.

The Covid-19 pandemic exacerbated and accelerated a national mental health crisis. Overdose deaths surged during the first two years of the pandemic; according to early estimates from the US Centers for Disease Control and Prevention, approximately 110,000 people died from drug overdoses in the US in 2022.

In response, the chief executives from the nation’s leading mental health organizations formed the CEO Alliance for Mental Health in the early months of the pandemic to develop practical, research-based solutions to the intensifying crisis and unite the field The alliance has met weekly since 2020 to create a Unified Vision for Transforming Mental Health and Substance Use Care.

“We all share one vision,” stated Alliance member Schroeder Stribling, CEO of Mental Health America, “to effectively address the needs of people living with mental health and substance use challenges through a transformed and equitable system of care, and by emphasizing prevention and the vital conditions for well-being as a prerequisite for all mental health.” To accomplish this goal, “we worked together to produce a shared concept for how to better meet the urgent and growing needs of people of all ages across the country.”

The Unified Vision is a comprehensive strategic plan that outlines common goals and solutions to transform the mental healthcare system and address social determinants of mental health through interconnection and integration. The document is meant to offer guidance to those looking to reform mental health, including local leaders of community-based organizations, employers, policymakers at the federal, state, and local level, and more.

“While the challenges we face regarding mental health in our nation are large in scope and complex, having an agreed upon framework and set of priorities is critical for our success,” explained CEO and Executive Vice President of the American Psychological Association, Arthur Evans Jr., PhD.

The Unified Vision is divided into Seven Critical Pillars, which include:

1. Prevention and Early Identification: Prioritizing prevention is critical to reducing the number of people who experience mental health and substance use challenges. Community-based services for early identification and intervention are necessary components to change the trajectory of outcomes for people living with mental illness.

2. Emergency and Crisis Response: Crisis response and suicide/overdose prevention are indispensable elements in helping people stabilize and get on a path of recovery. The 988 Suicide & Crisis Lifeline provides a unique opportunity to fully build out a continuum of crisis care for mental health challenges, substance use disorders, and suicide prevention.

3. Equity: People of color and other marginalized and discriminated communities are more likely to experience poor mental health outcomes. Eliminating disparities, particularly through addressing social determinants of health and modifying law enforcement and justice-driven responses to mental health and substance use disorder needs, is the first step toward a transformed system.

4. Integration: Health-care providers can improve access to services and quality of care by integrating physical health, mental health, and substance use services. Care integration not only facilitates better and earlier care, it also reduces stigma and decreases barriers to accessing care early.

5. Parity: Coverage and funding drives health system behavior, so it is crucial to break down treatment limitations, barriers, and inequities that continue to marginalize mental health and substance use services.

6. Standards: To improve health outcomes and quality of life for people with mental health and substance use conditions, it is necessary to establish and hold systems accountable to implementing standards of quality care and adopting payment models that support the cost of providing effective, integrated care.

7. Workforce: To meet growing demand, the mental health delivery system of the future must expand the professional workforce, while creating support in the community for those with less intensive needs.

Collaboration is key to accomplishing the goals of the Unified Vision. “We can do so much more together than we can apart,” said Daniel H. Gillison Jr., CEO of NAMI, the National Alliance on Mental Illness. “Over the last few years, our unified messages and calls to action around 988, funding, policy initiatives, and more have been making a real impact, and we’re just getting started.”

“The convergence of the CEO Alliance for Mental Health signifies a watershed moment for a movement for a healthier future,” said Alliance member Brandon Staglin, President of One Mind. “Watch for regular updates to our Unified Vision to reflect new opportunities to help people throughout all communities build the thriving lives they deserve.”

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About the Author

Tom Chiodo

Tom Chiodo Executive producer Special Projects, National Productions at WETA, flagship PBS station in Washington D.C., developing primetime documentary films and original digital content, accompanied by national impact and engagement campaigns, for 330+ PBS stations. Recent projects include Ken Burns presents Hiding in Plain Sight: Youth Mental Illness (2022); Emmy-nominated documentary The Gene: An Intimate History (2020). More than thirty years experience in media, communications, television, and entertainment industry. Senior positions at Entertainment Industry Foundation, Rubenstein Associates, U.S. Department of Health & Human Services, and Massachusetts Department of Pubic Health.  Co-author “Home Care for Respirator Dependent Children” New England Journal of Medicine. Contributing writer  2023 judge for National Academy of Television Arts & Sciences News & Documentary Emmy Awards.

The “Hiding in Plain Sight” Blog supports the 2022 documentary series Hiding in Plain Sight: Youth Mental Illness (Now streaming on the PBS App)and the upcoming 2025 series, Hiding in Plain SightAdult Mental Illness, produced and directed by Ewers Brothers Productions, executive produced by Ken Burns, and presented by WETA, the PBS flagship station in our nation’s capital.

Related Stories is a mental health resource, not a crisis or suicide response website. If you are in crisis, or experiencing thoughts of suicide, please call or text the 988 Suicide & Crisis Lifeline at 988. The service is free and available 24 hours a day, seven days a week.