Chirlane McCray is passionate about mental health. The first lady of New York City openly discusses how mental illness has affected her own family, including diseases like bipolar disorder and schizophrenia, PTSD and a relative who died by suicide. She brought that passion to her Oct. 19 lunchtime keynote at AHCJ’s Urban Health Journalism Workshop.
McCray founded ThriveNYC, a broad-based mental health initiative designed to reach deep into communities throughout the five boroughs and connect people with the counseling and services they need. But first, she told the room of journalists, you have to be able to push past the stigma and talk about it.
“We have to stop thinking about mental health in a silo, as a subset of physical health,” she said. Too many families still don’t know where to turn, and keep their problems hidden, as they try to protect the people they care about from judgment and shame.
The program launched in January 2015, the result of 11 months of input from expert advisers, evidence-based review of other programs worldwide, and community engagement. It aims to overcome the challenges of identifying, treating, and supporting New Yorkers with mental health or mental health and substance abuse, who often face almost insurmountable obstacles from a disconnected, disjointed health system, racial, cultural and socioeconomic barriers, and simple lack of information about mental health.
One in five people in the U.S., or about 43.8 million people, suffer from mental health challenges in any given year, McCray said. Many more go undiagnosed or uneducated. Families don’t feel comfortable talking, or maybe don’t recognize the signs and symptoms of mental illness, and government response has been “woefully inadequate.”
ThriveNYC partners with local community organizations, faith leaders, health workers, and everyday New Yorkers to teach them to recognize signs of mental health problems and help connect people to counseling and treatment. McCray said taking a public health approach to mental health means understanding and addressing wellbeing on many levels.
While the stigma is slowly lifting thanks to frank discussions by celebrities like Kendrick Lamar, communities of color are still vastly underserved by mental health professionals. “Because of structural racism, discrimination and gender inequities in our health system, some communities and some populations have always carried more than their fair share of the burden,” McCray pointed out.
Although black and brown New Yorkers tend to experience higher rates of mental illness compared to white residents, it’s incredibly difficult to find appropriate providers. In Manhattan, McCray said there is one psychiatrist for about every 1,300 people. In the Bronx, where 50 percent of the population speaks Spanish, there is one psychiatrist for every 13,000 people.
“We want more people to understand the signs and symptoms of mental illness and substance use disorders. We want more people to have a shared language and be able to talk about these treatable diseases and to know how and when to connect those who want or need services,” she said.
ThriveNYC is based on six core principles, which can be adapted to any city or community. Importantly, it addresses the often-fragmented nature of services and support. The idea is to make every New Yorker part of the solution.
- Change the culture — The first step is getting people to talk about the problem, so it can be solved. That starts with Mental Health First Aid training, or what McCray described as “CPR for mental health.” An intensive eight-hour course certifies participants to become non-clinical responders. It increases their comfort level and knowledge of mental health and boosts confidence in engaging with friends and families about the issue so they can make a difference, she explained. Any interested resident over 17 can apply for and take free Mental Health First Aid Training. About 75,000 New Yorkers have been trained to date.
- Act early — Early intervention can help stem the diseases that affect people — from teaching Pre-K students acceptable coping and self-care skills to connecting at-risk adolescents with professional support. According to McCray, half of all mental health disorders present by the age of 14 and 75 percent by age 24. So early identification and intervention is critical. The program also provides healthy relationship training to all New York City teens in foster care, with interactive workshops on dating violence and cyber abuse as well as offering onsite mental health services are at all community schools.
- Close the treatment gaps — Address disparities in access, effectiveness, cultural and linguistic competency. This includes screening and providing treatment for issues like depression, PTSD and crisis counseling among pregnant women and new mothers, runaway and homeless youth, and veterans.
- Partner with communities — That might mean talking with a locally trained member of the clergy, after-school youth counselor, a worker at the local food pantry, or a respected older resident who can lend an ear and steer someone in need to New York City’s mental health helpline or other services. For example, Connections to Care (C2C) integrates mental health services into programs already serving low-income communities, where people may not know they need help, or are reluctant to access it. Additionally, trained counselors are available in many of the city’s largest senior centers and volunteers are out in the community to reach out to many of the city’s isolated older adults, who often suffer from depression.
- Use data better — there is a renewed push to collect reliable citywide data on mental health, such as the emotional wellness of children to coordinate and improve services.
- Strengthen the government’s ability to lead – “Government can’t do it alone,” said McCray. But it needs to step up and actually lead the effort. A good example of this is NYC Well, a 24/7 comprehensive entry point to many of the City’s behavioral health services. The program logged more than 400,000 interactions during its first two years. Additionally, more than 200 mayors, county officials and thought leaders have joined the Cities Thrive coalition to share best practices with each other and advocate for federal support for their communities.
McCray encouraged journalists in the room to take care of their own mental health needs, especially in the current stressful environment. She also asked us to think about the mental health lens as we cover stories like the after-effects of disasters, homelessness, incarceration, housing and other topics. “Everything is connected to mental health in some way.”
- The Carter Center offers this guidebook to help journalists more sensitively cover behavioral health topics.
- This tip sheet from Katti Gray on mental health needs of aging prisoners can help frame coverage of the issue.
- Tip sheet: How ACA repeal could impact mental health care
- Finding purpose in mental health coverage
- This GAO report on the mental health of children in the wake of Hurricane Katrina is a good foundation for reporting on other disasters.
- The CDC has multiple resources and tools to aid your reporting on mental health issues
- For those reporting on global mental health issues, the WHO offers these resources