It's hard to predict how to best respond to a crisis.
With enough time, it becomes easier to see which decisions were good ones, and what could have been done better. Becker's Behavioral Health spoke with leaders who highlighted what they'd do differently if given the chance to go back to January 2020.
Note: Responses have been edited lightly for clarity and brevity.
Zoe Frantz. President and CEO of Indiana Council of Community Mental Health Centers (Indianapolis)
If I could call a mulligan and go back to 2020, I would have helped start a state mental health and substance use disorder data warehouse — one that measures the outcomes and success of our community mental health system to help further advance us to the Certified Community Behavioral Health Clinic model.
Eleanor Odom-Martin. Chief of Staff at South Carolina Department of Mental Health
I would order a ton of PPE before the supply chain dried up and the prices went up. Also, given the dramatic impact of the pandemic on the direct care workforce — as well as 20/20 hindsight on the amount of federal money subsequently available — I would have developed a premium pay, or hazardous duty pay, plan for direct care staff to reassure, recruit and maintain the direct care workforce.
Leo F. Flanagan, PhD. President of The Center For Resilience (New York City)
The mental health crisis in the U.S. dates back to 2007. I don’t think we focused on the fact that it was a trend accelerated by COViD-19, not started by the pandemic. We simultaneously rushed to contain and fight the virus and address the shocking rise in mental illness. The thinking was that once the pandemic had subsided, the mental health crisis would recede. We were deeply wrong.
In fact, the mental health crisis has continued to worsen. The APA’s Stress In America Study reported that of the Top Ten sources of stress, COViD is now number nine. At the same time, 27% of adults report “Most days I am so stressed I cannot function.” According to the Harvard Kennedy School IOP Youth Survey 25% of those 18 - 29 have had thoughts of self-harm at least several times in the last two weeks.
Had we anticipated this, we would have invested more in population mental health interventions. Harnessing neuroscience, we can significantly reduce severe burnout, anxiety and depression while increasing sense of purpose in large populations of people, often with no more than three 45-minute sessions with a therapist. We would have invested in matching people who require one-on-one treatment with the therapists certified in the specific treatments for the diseases they present.
In the vast majority of cases, the organizations that corporations retain provide a slate of three to five therapists, and advise patients to pick the one they like best. Rapport is important in a therapeutic relationship, but it is second in importance to receiving the right treatment intervention.
Finally, had we understood we were dealing with a trend rather than an incident, we would have significantly invested in training and licensing qualified mental health therapists.
While I am optimistic about our ability to overcome the mental health crisis in general, I am less so about the mental illness we are creating in our children. We do know the long-term impacts of giving children access to smart phones and social media, yet we fail to act. We don’t know the long term impacts of teaching children in pre-school and kindergarten to “run, hide, fight” if confronted with an AR-15 inside their school. I think it’s safe to say this will traumatize and catalyze the development of anxiety and depressive disorders in our kids, yet we fail to act.