Health

How to Understand—and Fight—the Mental Health Care Crisis in the U.S.

Whether you're trying to navigate the system yourself or help improve it for everyone, it's important to know what you're up against.
March 9, 2021, 3:20pm
Covers of Better but Not Well, The Body Keeps the Score, Therapy for Black Girls, An American Sickness, and The Unapologetic Guide to Black Mental Health
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Because We Can is an ongoing series about making politics a practice, even when there isn’t a national election looming.

The way we talk about mental health, or our emotional and psychological well-being, has shifted in the past decade, mainly because of the work of mental health advocates. Athletes, actors, and artists now talk about mental health in a way that simply wasn't done 20 or even 10 years ago; that openness is reflected in how the American public thinks about mental health. It’s now more common to talk about how we’re feeling and doing, and to not feel ashamed about it. With nearly one in five adults living with a mental illness in the U.S., medical professionals, educators, and activists alike are working to end the stigmas and barriers to treatment surrounding mental illness

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The pandemic—which has pushed people to the brink financially and emotionally—has also helped move these conservations to the forefront, with lawmakers advocating for mental health days at schools and restaurant workers seeking better mental health care. However, talking about mental health and getting actual professional support are two different things. Institutions like hospitals, schools, and social services, which are often governed by local and federal policies, play a critical role in providing much needed care. Unfortunately, the reality is that these systems have sidelined mental health for decades, exacerbating conditions for groups who already face hurdles in accessing appropriate care.

We can still feel the effects of that deprioritization today. The hurdles of finding a provider who is in-network or is affordable creates even more isolation for those who need it most. And when folks do seek help, it’s not always a great experience; it’s difficult for LGBTQ folks to find therapists and psychiatrists who are gender affirming, for instance. And communities of color, especially Black and Indigenous people, continue to face cultural stigma for seeking help, on top of well-founded fears of being criminalized or incarcerated when seeking help. Ableism and racism in schools, too, add to the fire. Many people, even if they try to get help, often end up having a frustrating, if not dangerous experience. There’s a lot more work left to be done. 

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Like any other health condition, mental illnesses are complex and varied, and care is not one size fits all. There are different ways to advocate for mental health care, whether that means being able to point someone to good resources, or becoming a mental health activist who fights for better healthcare legislation and policies. Here are several articles, books, newsletters, and other resources on mental health to get you started, as well as some organizations to follow. 

Articles

Need something quick? These articles are a great way to dip your toes into the world of mental health.

Mental Health Policies, Insurance Coverage, and Institutional Change

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Inequities in the Mental Health System

Personal Essays

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How to Help a Friend (or Yourself)


Hotlines

Save these hotlines to your phone—you never know when you or a friend might need a professional to talk to. 

The Trevor Project
The Trevor Project’s TrevorLifeline is the leading crisis prevention hotline for LGBT people. You can call anytime at 1-866-488-7386. The organization also provides an instant messaging service via their website.

The National Suicide Prevention Lifeline
If you or a loved one is contemplating suicide, the National Suicide Prevention Lifeline can provide support and resources. The organization can also connect you to therapists in your area. You can call anytime at 1-800-273-8255. For Deaf and Hard of Hearing people, you can use your preferred relay service or dial 711 before calling the hotline.

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Trans Lifeline
Run by and for trans people, the Trans Lifeline gives culturally appropriate and affirming support. Trans Lifeline does not participate in non consensual active rescue (i.e., calling the police or 911) as doing so often disproportionately criminalizes and injures trans people and people of color. You can call at 877-565-8860.

Rape, Abuse & Incest National Network
For those who have experienced some form of sexual violence, RAINN offers victim services, public education, guidance on public policy in addition to operating the largest national hotline on sexual assualt. You can call 24/7 at 800-656-4673.

And while these national hotlines are a great start, be sure to check out local crisis intervention teams in your area that can provide trained support should you or someone you know need something more immediate/in person. (More on that here.)



Good Follows (Newsletters & Social Media Accounts)

The discussion around mental health is always changing. Get new perspectives on mental health in your feed or inbox. 

Mental Hellth
Written by freelance writer P.E. Moskowitz, Mental Hellth breaks down the myths surrounding mental health by interviewing experts and activists “who challenge our current conceptualizations of mental health.” 

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My Sweet Dumb Brain
A year and a half after her husband passed away, writer Kaite Hawkins-Gaar started My Sweet Dumb Brain to help her process the emotions after his death. The newsletter has expanded since then, but still is centered on the importance of giving yourself space.

NPR’s Health Newsletter
The Health desk at NPR does great coverage on policy (which they lovingly call policy-ish), the healthcare industry, and the latest research on health in general—its newsletter is the quickest way to get up to speed on new developments.

Although social media is arguably not great for your mental health, it can be a good place to connect with others who are going through similar things, and/or to get insight and calls to action from other mental health activists.

@latinxtherapy
The Latinx Therapy Network is an organization working to destigmatize mental illness in the Latinx community, as well helping to connect people with Latinx therapists. Their Instagram is an extension of that work, highlighting upcoming workshops in both English and Spanish in addition to posting general mental health advice.

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@blkfolxtherapy
Run by Jardin Dogan, a Ph.D candidate in counseling psychology, @blkfolxtherapy breaks down mental health definitions, concepts, and research tailored for Black people.

@theshaniproject
If TikTok is more your speed, licensed clinical counselor Shani Tran’s TikTok is all about defining popular terms such as attachment styles or cultural competency, in addition to teaching folks how to find adequate resources (with a little dancing too!).

@uche_blackstock
On her Twitter account and through her organization, Advancing Health Equity, physician Uché Blackstock looks at the wider health care system and its systemic, structural problems as a whole.

Books

If you’re trying to pivot away from screens and want something that dives deeper, try out these books.

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal
Want to know how the American healthcare system got here? Former New York Times reporter Elisabeth Rosenthal breaks down how healthcare became a highly profitable industry it is now—and at what cost.

The Price We Pay: What Broke American Health Care And How To Fix It by Marty Makary
Similar to Rosenthal, Marty Makary, a medical doctor, looks into the business of medicine, and provides an insider’s perspective on its ramifications. He also provides a roadmap for how everyday people can protect themselves from the system.

Better But Not Well: Mental Health Policy in the United States since 1950 by Richard G. Frank and Sherry A. Glied
In their book, economists Richard G. Frank and Sherry A. Glied dive deep into mental health reforms from the 1950s to the early 2000s. They paint a picture of how both private health insurance and social programs helped increase access to mental health resources and offer suggestions for next steps for improvement for governmental institutions.

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The Unapologetic Guide to Black Mental Health by Rheeda Walker
Psychologist and mental health expert Rheeda Walker provides not only tips on how to spot mental illness and practice self-care, but adds context as how the mental health crisis in the Black community got to where it was. She also walks through how to advocate for yourself in a racist healthcare system.

The Body Keeps the Score by Bessel van der Kolk
Trauma expert Bessel van der Kolk has worked with survivors for more than 30 years. He shares his findings as well as new research to highlight the effects trauma has on both the body and the mind.

Resources

More often than not, getting in touch with an expert or perusing research-backed resources can be tricky. These organizations are a jumping off point for certain conditions or needs. 

The National Alliance on Mental Illness
If you’re looking to learn more about changing the mental health system, NAMI is the nation’s largest grassroots mental health organization, working to create more public awareness on mental health through advocacy, education and support. Here’s where you can see which policies NAMI supports in Congress.


The National Eating Disorder Association
Dedicated to helping people affected by eating disorders, the National Eating Disorder Association supports individuals and families as well as researches prevention and treatment. If you want to connect with other people with eating disorders and/or body dysmorphia, NEDA has volunteer opportunities as well as events (its annual NEDA Walks will be coming up in April).

The International OCD Foundation
The Foundation looks to improve health outcomes for people with Obsessive Compulsive Disorder and other related anxiety conditions through providing resources, promoting awareness and increasing access to effective treatment. Besides advocacy, the organization also spotlights academic research, if that’s your speed.

The National Queer and Trans Therapists of Color Network
Trying to get help? In addition to providing a directory of accessible QTPOC therapists, the organization also has a Mental Health Fund, where you can apply for funding up to six sessions with a psychotherapist.

Therapy for Black Girls
Run by psychologist Joy Harden Bradford, Therapy for Black Girls is both a wildly successful podcast and an organization connecting Black women with therapists who look like them. 

The Loveland Foundation
Through its Therapy Fund, the Loveland Foundation provides Black women and girls with access to culturally competent services. If you’re looking to increase equity in the mental health care space, consider donating to the fund.

Follow Izzie Ramirez on Twitter.