Dear Colleagues,

As pediatric providers dedicated to providing high-quality care for children and adolescents, many of us have experienced an unprecedented surge in mental health needs among our patients. The COVID-19 pandemic has exacted an enormous toll on children’s mental health: exacerbating social isolation, depression, anxiety, and trauma, and further straining our already fragile mental health care system.

The American Academy of Pediatrics and American Academy of Child and Adolescent Psychiatry jointly declared the soaring rates of child mental health conditions a national emergency and have identified pediatric providers as critical gateways for expanded access to mental health screening and care.

In my pediatric practice, many of the children and adolescents I care for are also contending with significant social needs including poverty, food and housing insecurity, exposure to violence, and racism. These experiences are often traumatic and contribute to high rates of mental and physical health disorders as well as to disparities in needed care.

My team and I have implemented universal screening for both mental health conditions and the social determinants of mental and physical health that place children at high risk for mental illness. We see universal screening for these risks as a critical step to early identification and ensuring access to and engagement in care and support.

Younger children have not been spared from this crisis—more than 20% of 5-12-year-olds report worsened mental health since the start of the pandemic. As a pediatrician, a large part of the role I play in mental health prevention and care is giving our youngest patients—and their caregivers—the language and tools needed to express their feelings and emotions.

Finding the right mental health educational tools to share with parents and younger patients can be challenging. That is why I was excited to learn of the Depression and Bipolar Support Alliance (DBSA) Mood Crew®, a program of ten emotion-based characters created to support children’s mental health and help parents, caregivers, educators, and clinicians start conversations about emotions with children ages 4 to 10. Each character comes with a biography and various activities to encourage better understanding of emotions. As the child and adult explore the interactive Mood Crew activities together, young ones will begin to build a basic emotional vocabulary that can support lifelong mental health.

We can turn the tide on the children’s mental health crisis by supplying our families with building blocks for resilience. Learning how to communicate “big” feelings is often the first step in prevention, and for children with more serious needs, to healing.

Sincerely,

Nicole Brown, MD, MPH, MHS
Chief Health Officer, Pediatrician
Strong Children Wellness Medical Group, PLLC

Nicole Brown, MD, MPH, MHS is a general pediatrician and health services researcher and is the founder and Chief Health Officer of Strong Children Wellness. Her research and professional interests center on enhancing care and service coordination for children who have experienced trauma and those with chronic mental health needs in the pediatric primary care setting.

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Everyone feels stressed from time to time. But if stress becomes a chronic or long-term problem, it can take a toll on emotional, mental, and even physical health. Learn more about stress, as well as some of the possible contributing factors. Knowing the signs and causes of stress can help you prevent and manage it.

Shot of a young woman suffering from stress.

Stress affects your body by:

Making you feel shaky, dizzy, or off-balance. Adrenaline can cause a surge of energy through your body, leaving you feeling jittery.

Raising blood pressure, which can make you feel uncomfortably hot and sweat more as a result. Chronic high blood pressure also negatively affects your heart, sometimes leading to abnormal heartbeats and chest pain.

Raising blood sugar. The hypothalamus sends signals throughout your nervous system and to your kidneys. In response, your kidneys release stress hormones, including adrenaline and cortisol which affects your blood sugar.

Hindering the immune system. Over time, chronic stress can limit the effectiveness of a person’s immune system.

Causing diarrhea, stomach upset, and excessive urination. Tension headaches are also a common symptom of stress.

Inhibiting quality sleep. Insomnia is a common effect of stress, which leads to daytime sleepiness.

Stress takes a mental toll, too

Stress can make you irritable and angry due to the cumulative effects stress responses have on your brain.

Stress can bring down your outlook on life, make you feel guilty, and increase your risk of mental health disabilities. According to the National Institute of Mental Health, anxiety and depression are the most common.

Chronic stress can lead to substance misuse. People who experience a lot of stress are more likely to smoke cigarettes and misuse drugs and alcohol. Depending on these substances for stress relief can lead to other health problems.

How to manage stress

Chronic stress can have many negative effects on your overall health, so managing and decreasing stress is worth making a priority. DBSA’s Wellness Wheel is a holistic tool that looks at your overall wellness, including stress reduction.

Learn more about the Wellness Wheel

If stress is getting in the way of your wellbeing, talk to your doctor about ways you can help manage it.

Learn more about anxiety

Stress

Managing Stress

The trick to managing stress is to prevent it from happening in the first place. When that’s not possible, extending grace toward yourself and others can go a long way to manage stress, says Dr. John Budin, a physician who also lives with bipolar disorder.

“There are many things ‘to do’ that can be helpful in coping with stress,” Budin said. “But remember, we aren’t human doings, we are human beings. In the midst of all the ‘doing’ remember to just ‘be.’ Use the holidays as a time to reaffirm your journey toward your authentic, better self by practicing compassion and kindness, and accepting human imperfection.”

If the holiday season has taken an emotional toll on you in the past, try to:

Acknowledge your feelings. If someone close to you has recently died or you can’t be with loved ones for other reasons, understand it’s normal to feel sadness or grief. Allow yourself to cry or express your feelings.

If you’re not sure what’s bringing on your feelings of stress, try tracking your mood and identifying what the cause is. For more help on tracking your wellness, see DBSA’s Wellness Tracker resources.

Reach out. It can be difficult to put yourself out there but seek out community, religious or other social events if you feel lonely. In addition to activities in your area, DBSA’s free support groups are available online and in person.

Talking to a friend or loved one is also an option. Try sending a text or making a video call with someone you trust to lend a listening ear.

Doing something to boost your self-esteem can also help. Look into volunteer opportunities in your area that feed your passions or interests. This can be a great way to make friends and help others at the same time.

Set expectations. The holidays don’t have to be perfect. As families change and grow, holiday traditions can also look different. Hold on to holiday traditions you find meaningful, but try to find new ways to celebrate together, even if it’s only virtually.

Accept others as they are. If you often butt heads with another family member, set aside your grievances until a more appropriate time when they can be addressed. Focus on what you can control: yourself.

Stick to a budget. Part of financial wellness is creating a realistic budget and sticking to it. You can’t buy happiness with expensive gifts; try these alternatives instead:

  • Donate to a charity in someone’s name.
  • Give homemade gifts.
  • Start a family gift exchange.

For more information on financial wellness, see DBSA’s Wellness Wheel.

Plan ahead. There’s a lot to do around the holidays. Activities such as planning your menus and writing out your shopping list before you hit the stores can help prevent last-minute scrambling. If you need help with meal prep or cleanup, ask for help in advance.

Set boundaries. Saying yes when you should say no can leave you feeling resentful and overwhelmed. Friends and colleagues will understand you can’t do it all. If it’s not possible to say no to something, try to remove another item from your agenda to even things out.

Don’t abandon healthy habits. Eating healthy, as well as getting enough sleep and exercise, shouldn’t take a backseat amid the holiday rush. This includes taking time for yourself to rest and relax.

Seek professional help if nothing else works. Sometimes, despite our best efforts, we can still feel overwhelmed or unwell. If these feelings last for a while, talk to your doctor or mental health professional.

Stress affects our minds and bodies

Chronic stress can take a toll on our minds and bodies.

Learn more

Share with your peers

Share our holiday stress management tips on social media. Follow DBSA on Facebook, Twitter, Instagram, and LinkedIn.

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The full extent of the COVID-19 pandemic’s impact on mental health most likely won’t be completely understood for years, or even decades, to come. 

But here’s what we do know: The pandemic highlighted and exacerbated the global mental health crisis, irrevocably altering how we think about and address mental health as a whole. 

In a seven-country survey by the International Committee of the Red Cross, 51% of adults reported COVID-19 negatively affected their mental health. In the same survey, almost two-thirds of respondents agreed that taking care of both their mental and physical health has become more important now than before the COVID-19 crisis.

So, what’s changed? (And more importantly, how do we build on those lessons for the future?)

We’re talking about it. 

The conversation around mental health has been elevated to  a national stage since the onset of the pandemic. More people are speaking openly and honestly about their mental health symptoms and struggles.  As a result, in the long-term, we can hope to see a decrease in stigma related to mental health concerns and conditions. 

“I think we’ve shifted from what some would call precontemplation to contemplation about mental health and mental wellbeing,” said Dr. Roger McIntyre, professor of psychiatry and pharmacology at the University of Toronto. “The first step has been a collective recognition of the importance of mental health, which certainly was apparent to some people before COVID, but I think the percentage of people having that conversation over the dinner table has considerably increased.”

Mental health is no longer an individual health issue – it’s a public one. 

“Our health is not just simply our physical health,” Dr. McIntyre said.

And many doctors agree: our mental health crisis is a public health crisis, and should be treated as such. 

This translates to the need for legislative action around achieving mental health parity, or the equal treatment of mental health conditions and substance use disorders in insurance plans on par with  physical health services. In addition, public health officials recommend bolstering the mental healthcare workforce and ensuring all people have access to affordable, culturally-competent, quality healthcare. 

The inequities in mental healthcare and beyond were put under a microscope.

The pandemic highlighted the existing inequities in our mental healthcare system for people of color, the working class, and other disadvantaged groups. 

We know that, on average, racial and ethnic minority populations report experiencing mental health problems at the same rate as whites. But barriers, including lack of access, discrimination and stigma, prevent these communities from getting the high-quality mental health care they need and deserve. This has spurred some leaders to declare racism itself a public health crisis.

To address this, legislative action is needed to increase access to care and ensure all populations see their communities represented in health care providers. 

Mental healthcare went virtual.

The COVID-19 pandemic disrupted or halted critical mental health services in 93% of countries worldwide while the demand for mental health services increased significantly, according to a survey by the World Health Organization

Clinicians rapidly worked to transition to virtual delivery methods, which in turn increased access and in some cases, the speed at which services were available. Insurers also began to cover the costs associated with telehealth visits, further legitimizing the medium.

It’s likely virtual services are here to stay, Dr. McIntyre says.  

We’ve collectively recognized the need for systemic change. 

Despite the ebb in COVID-19 cases, its mental health ramifications remain. 

In an ongoing survey from March 2020-21 done by the Kaiser Family Foundation, roughly half of all respondents said worry or stress related to coronavirus has had a negative impact on their mental health. Even as COVID cases dropped, people continued to report feelings of worry, stress and anxiety.

“Some of the positives coming out of this has been greater awareness around mental health, less stigma, improved virtual access, improved timely access, and also I think we’re going to see an attempt to  integrate mental health more into overall healthcare,” Dr. McIntyre said.

Now, the challenge is keeping up the momentum. 

“Covid is going to come to an end at some point;  it seems hard to imagine, but it will. And when it does, we need to make sure we do not allow mental health to lose its spotlight. That’s the most important takeaway.” 

The U.S. healthcare system struggles to provide adequate treatment for those suffering from mental health conditions, and the number of mental health providers does not match the ever-growing need. One in five adults in the U.S. experiences some type of mental crisis each year, and one in 25 experiences a serious mental health condition. Mental health conditions account for approximately one-third of hospitalizations for those aged 18- 44 years old, and adults living with serious mental health conditions die on average 25 years earlier than others.

A significant factor in why the personal, social, and economic impact is so enormous is the challenge of accessing care for those who need it. Barriers to access include stigma, cost, and lack of in-network providers due to systemic disparities.

Digital health is a rapidly growing industry that seeks to address these and other healthcare challenges and mental health is an important and growing segment of this market. Because of the COVID-19 pandemic, clinicians have witnessed an increase in the need for scalable mental health solutions and interest, specifically, in digital solutions.

“Mental wellbeing is not a ‘nice-to-have,’ but a ‘must-have,’” said Jennifer Bruno, Vice President, Global Health Services at Johnson & Johnson. “We all need to take care of our mental health the same way we take care of our physical health, especially during this complex and unprecedented pandemic.”

Digital technologies have the potential to revolutionize mental health treatment. Resources can be used in the privacy of a person’s home or on-the-go, and many are available all day, every day, sometimes with no waiting.

Steven Schueller, Ph.D., associate professor of psychological science and informatics at the University of California, Irvine, has worked in the digital technology space for 15 years. In addition to conducting research and teaching about digital mental health, Schueller serves as executive director of One Mind PsyberGuide, a nonprofit project that evaluates digital mental health products to help people use technology to live mentally healthier lives.

Benefits of Digital Mental Health Resources: Scalability, Personalization, Convenience 

Schueller’s research has made clear the yawning gap between the number of people in need of mental health services and the supply of services availableWe don’t talk often enough about the challenges of not having health providers in the right places and that’s a serious issue. I want to understand how to better reach people where they are at and provide useful mental health tools,” he said.

“In rural communities, for example, what challenges might a 17-year-old gay male face when searching for a provider to help him in his struggles while appreciating his identity?”  

Studies show digital mental health interventions using web and mobile technologies have consistently demonstrated effectiveness in more than 100 randomized controlled trials conducted over two decades. Internet-cognitive behavioral therapy (I-CBT), for example, has been shown to have approximately equivalent efficacy compared to face-to-face CBT and is a safe and effective method to decrease access barriers. CBT is a scientifically backed form of psychotherapy used to treat a wide range of mental health conditions including depression and anxiety by modifying dysfunctional emotions, behaviors, and thoughts. 

“When I say digital tools are not a replacement for face-to-face treatment, that is not a bad thing or good thing. Some people need in-person care; for others, digital might be better,” said Schueller. “Ultimately, It’s better to have more tools available in the marketplace so more people can get help and people can get what they want.” 

Digital mental health tools also offer a convenience benefit that allows people to access services when they need them.  

“Digital technologies can be used more discretely, on the go, and fit better with the schedules of busy people,” Schueller said. “Having an app, something they can use on their own time and schedule, enables them to receive care in ways that feel safe, private, and workable for them.”  

A woman holding a phone

The Sky’s the Limit…Yet Challenges Remain  

Schueller bases his bullish projections for the future of digital mental health services on several key factors.  

“Necessity is always the mother of invention. It’s not a coincidence we’ve seen a huge acceleration in the use of digital services in the past 18 months during a pandemic,” he said. “Growth was also boosted by an easing of regulations and a shift in people’s perception and comfort level as they used more digital health services more often.” 

A recent survey revealed 70% of respondents aged 14-22 reported using a health app (related to stress, substance use, meditation, anxiety, etc.). The survey also showed that the more depressive symptoms a respondent exhibited the more likely they were to have used a health app. 

There has also been an enormous amount of funding in this space in the past year. Venture capital investments in mental health start-ups rose 72.6% from Q1 2020 to Q1 2021, totaling $2.4 billion in 2020 and accounting for 19% of all digital health funding. 

“It’s exciting to watch how the field is evolving to address the needs of different population groups and a wider array of mental health challenges,” said Schueller. “We’re seeing more digital mental health products to address the youth space and, digital products, such as Ginger or Headspace, developed to address the continuum of mental health care, starting with depression and anxiety and leading to more complex issues such as OCD or eating disorders.”   

Despite considerable upside, the future of digital mental health does not come without challenges. The biggest challenge is in unmet promises. Industry app developers continue to promote the benefits of greater access to mental healthcare services through their tools, yet the reality is that there is still a lack of digital resources developed by and tailored for BIPOC communities and other underserved populations.  

Digital mental health developers must also contend with what Schueller calls the engagement challenge.  

“It’s easier for people to turn off their computers and stop using their apps. There is less accountability and, therefore, less engagement with digital products. To combat that, companies are introducing digital programs such as Happify and Total Brain that also rely on professional (clinician) support because they allow the best of technology and professional care to come together.”   

The data is clear. The numbers are worrying, experts say. And the outlook is uncertain. 

Since the onset of the COVID-19 pandemic, researchers across the U.S. have been sounding the alarm on a different kind of crisis: rising rates of depression, anxiety, and poor mental health in general. 

An ongoing survey of Americans conducted earlier this year shows more people are experiencing depression, anxiety, and thoughts of suicide than ever before recorded.

The COVID States Project survey, a joint effort between researchers from Northeastern, Harvard, Northwestern, and Rutgers Universities, found 28% of people surveyed report levels of depression that would typically trigger a referral for evaluation and treatment; these numbers have diminished slightly compared to their peak of 30% in December 2020 but remain about three times those observed in the pre-COVID era, and elevated compared to the low of 25% in late June 2020.

Rates of anxiety also remain elevated at 25%, but down from 28% in December 2020. In addition, 23% of respondents still say they thought of suicide at least occasionally, similar to the rates observed in December. 

Of those surveyed, young adults were the hardest hit, with 42% meeting at least moderate depression severity criteria, followed by 25-44 year olds at 32% and 45-64 year olds at 20%. Respondents age 65 and older reported the least impact, on average, with 10% meeting criteria for moderate or greater depression.

“Younger adults have lives that are more dynamic than older adults,” David Lazer, professor of political science and computer sciences at Northeastern and one of the researchers who conducted the study, said in a statement. “They’re finishing school, getting a job, starting a family, all things that are more likely to be disrupted by the pandemic.”

Among those more likely to have their lives disrupted by the pandemic are children and adolescents,  a group researchers also say  is experiencing mental health concerns at an increased rate.

In a study published in April, researchers at the Children’s Hospital of Philadelphia found that while emergency department visits decreased during the pandemic, the proportion of pediatric patients coming in for mental health emergencies increased. Of the children seen in the emergency department, a higher percentage needed to be admitted to the hospital for mental health services than in pre-pandemic times.

That increase has Dr. Polina Krass worried.

“This is very concerning,” Krass, the lead author of the study and a pediatrician at the Children’s Hospital of Philadelphia, said. 

“Prior to the COVID-19 pandemic, youth mental health conditions were increasing in prevalence and severity, and there were extreme shortages in access to mental healthcare. COVID-19 may further exacerbate these trends.”

Since her study was published, more research has come out pointing to an increase in the number of emergency department visits for mental health conditions for certain age groups, especially adolescents, Krass said.

“There are also stark inequities in access to mental health care for youth from minority communities,” she noted. “We know that COVID-19 has impacted these populations disproportionately, and they might be even more at risk for mental health challenges as a result.”

Where do we go from here?

While the need for and strain on mental health services is worrisome, there is hope that people’s mental health will improve as we begin to move past the pandemic, said Susan Borja, chief of the National Institute of Mental Health’s Dimensional Traumatic Stress Research Program.

Most people who are exposed to a mass disaster or widespread traumatic event will experience some symptoms initially, but those symptoms typically diminish in the following weeks and months as part of natural recovery, Borja said.

“Increased symptoms exist along a continuum,” she said. “Many people may experience symptoms, but those symptoms may not consistently rise to the level of severity or impairment required for a diagnosis. Although natural recovery is the norm, a significant minority may continue to experience symptoms, and some may benefit from treatment to achieve full recovery.”

On an individual level, Borja says people may find it helpful to play an active role in aiding the recovery effort from a traumatic event. Actions like wearing a mask, practicing physical distancing, and getting vaccinated are all things people can do to help reduce the duration of the pandemic and give them a sense of control over their personal risk. Engaging in healthy ways to cope with  stress—such as maintaining a routine, eating healthy when you can, exercising, and getting enough sleep—can help people support their mental health over both the short and long term, she said.

In addition to personal behavior, policy changes in the works could help more people access mental healthcare, including:

  • More investment to increase mental health services through SAMHSA block grants to states, which supplement Medicaid, Medicare, and private insurance services
  • The Promoting Effective and Empowering Recovery Services in Medicare (PEERS) Act (H.R. 2767/S. 2144), which would allow patients using Medicare to receive peer support services
  • Fulfilling the Promise of 988, the National Suicide Prevention Lifeline, which includes:
    • Excellence in Mental Health and Addiction Treatment Act (H.R. 4323/S. 2069), which would expand the Medicaid certified community behavioral health clinic demonstration program and authorize funding for additional grants to certified community behavioral health clinics.

Behavioral Health Crisis Services Expansion Act (S. 1902), which would set standards for behavioral services so they are available to more people, regardless of age or ability to pay.

“If there is any silver lining to the tremendous toll the pandemic has taken in terms of lives lost and widespread illness, it is that there is increased recognition of the importance of mental health and a general awareness that mental health is a significant part of public health,” Borja said.

For Dr. Krass, taking mental health seriously as a society means “funding mental health research, reducing the impact of social determinants of mental health care such as community violence and structural racism, and, of course, broadening access to mental health treatment across the care continuum,” she said. 

“There is a lot of work to be done,” Krass added. “I hope we can leverage this moment to start to make constructive changes.”

The current relationship between law enforcement and the mental health community requires immediate change.

The media headlines and news feeds today seem to be constantly filled with stories of people living with a mental health condition who die, become injured or suffer emotional trauma as the result of a police interaction. Last fall, the death of Walter Wallace, Jr. spurred riots in Philadelphia.  Daniel Prude died in Rochester, New York[1] police custody earlier last year, but it was recently announced that no officers will be charged. In January, an unarmed Patrick Warren, Sr. was shot outside his Texas home during a mental health wellness check.

These deaths, though tragic on their own, are not isolated occurrences. According to a study from the U.S. Department of Health and Human Services, 22% of deaths due to the use of lethal force by law enforcement were mental health related. Much of the explanation for this stems from the fact that many law enforcement policies and training do not adequately include crisis intervention and de-escalation training.

Black Americans are at an even higher risk of being caught in the crosshairs of a potentially lethal encounter with law enforcement. The National Institutes of Health notes that Black Americans are 20% more likely than White Americans to experience serious psychological distress. That statistic, when paired with the over-policing of Black communities as a whole, which increases the likelihood of police interactions, led the Bazelon Center for Mental Health Law to note unequivocally that “Black people with mental illness are at great risk of dying at the hands of the police.” 

Although it is not a crime to exhibit symptoms of a mental health condition, police are often called involving a person in this situation. Depending on how a mental health crisis is handled, it may lead to a violation of that person’s civil rights. Unless an individual represents an immediate threat to their own safety or that of another individual or property, a police response using force is not the appropriate solution. Even when officers are called and notified that a person has a mental health condition, they often may not have the training or resources to effectively de-escalate the crisis, as was the case for Patrick Warren, Sr.

We must demand a change. Across the country at the federal, state, and local levels, we continue to underfund or shutter programs that provide access to mental health treatment and wellness. Meanwhile, the pandemic has reduced treatment options, increased joblessness, created extended isolation, and produced a secondary mental health crisis as many experience episodes of depression or anxiety for the first time.

As the number of people impacted by mental health conditions grows, our law enforcement agencies have become a catch-all resource for responding to all types of crises though some lack the understanding or tools to respond appropriately. This system continues to fail.

At the Depression and Bipolar Support Alliance, we call on all of our legislators at every level to reinstate and increase funding for mental health treatment and improve access to care.

Along with improving mental health wellness journeys, we call for law enforcement agencies to improve training in at least two areas:

  • Expand civil rights training to respect the rights of people with mental health conditions, while providing protection to the community. Living with a mental health condition, even when exhibiting symptoms of illness, does not eliminate a person’s civil liberties.
  • Require de-escalation and Crisis Intervention Training for all officers who engage with the community and appoint staff liaisons tasked with building community partnerships to aid in this effort.

There are programs proven to work. Communities across the country have shown that there are more effective solutions. Most prominently, Crisis Intervention Training (CIT) is a certification course that provides training in de-escalation, understanding of how mental health conditions can present, and promotes respect by creating opportunities for police officers to talk with community members who live with mental health conditions. The training is most effective when law enforcement officers create partnerships with local organizations: hospitals, behavioral health centers, libraries, schools, and other local resource organizations.

Illinois has launched several successful programs. In Orland Park, officers have a partnership through their CIT program with a local treatment center that will get in touch with a referral within 48 hours of officer contact. Additionally, police officers follow up after that introduction has been made to ensure that the person in crisis has access to the resources they need, and to cultivate a relationship between police and local families.

In suburban Chicago, the municipality of Park Ridge’s program has been used as a model across the country, noting within their report that “CIT training across ranks and divisions has planted the seeds for a culture in which de-escalation and compassion underlie officers’ expectations of one another in the field.”

Indianapolis, Indiana has also seen success with its Behavioral Health Services Unit. Most police districts have a behavioral health detective who partners with a mental health clinician for support during non-emergency events. Ideally, individuals with mental health conditions should decide whether they require such services.  At times, however, a family member will be called upon to make such judgments.

Indianapolis has also led the way with its internal police peer support and mentoring program, designed to reduce stigma and employment penalties, while addressing mental health concerns early for officers.

It cannot be overstated how effective these training programs can be when also complemented by adequate resources provided for those living with mental health conditions. After the 2018 police shooting of Marcus-David Peters in Virginia, Richmond’s police chief commented, “I look at what it would take to become a psychologist, psychiatrist, mental-health counselor — five to eight years of training. Our police department gives our officers 40 hours. Five to eight years, and we get 40 hours.” The Bazelon Center notes that “while increasing police training can improve police responses to people with mental illness, the Richmond police chief’s main point must not be ignored: the fundamental problem is having police, rather than mental health personnel, address the situation.”

At the Depression and Bipolar Support Alliance, we call on all our legislators at every level to increase funding for mental health treatment and improve access to care, and to invest more funding to ensure every law enforcement agency offers adequate training related to civil rights and crisis intervention.

[1] An early version of this document stated that Daniel Prude was in the custody of the New York Police Department instead of the Rochester, New York City Police Department. – 4.27.2021 Source: https://www.nytimes.com/article/what-happened-daniel-prude.html

Young Adult Council members understand how challenging it can be to choose a career that is a good match for you. YAC member Christine provides a list of questions to ask yourself, and other YAC members weigh in on how those questions impacted them personally. 

Remember that your career choice isn’t set in stone. You don’t have to retire from the first company that hires you. If you start a job and find out that it isn’t a great fit for you, it is okay to step back, assess what does and does not work, and make a change. 

Here are some areas to consider.

Fulfillment

  • Is your job meaningful to you? 
  • Is it enjoyable? A job can include “important” work but not personally fulfilling.
  • Do you want a job that gives you emotional fulfillment or just one that pays the bills?

YAC Member Lauren: Fulfillment has been incredibly important to me in finding a career, so I knew that I wanted to work in healthcare to heal and care for others. It took me time after college to figure out, but eventually I settled on pursuing my doctorate to become a clinical psychologist. Although I am still in training, the work has been so enriching, and I am always learning something new. It has been a privilege to be introduced to the intimate parts of people’s lives, as well as their struggles. Of course, this comes with its challenges, so self-care has been essential for me to continue to provide quality treatment. Knowing my limitations is also part of the job, so I try to be mindful of this and establish boundaries where I can. What keeps me motivated, and ultimately fulfilled, is how inspiring it is to see how therapy improves the quality of someone’s life and empowering others to realize their worth.

Personality

  • Are you easygoing or more ambitious? 
  • Do you prefer to work alone or in a group? 
  • Are you more hands-on or theoretical? 
  • Are you introverted or extroverted? 
  • Do you have a soft touch or a firm hand?

YAC Member Mason: I am definitely more ambitious than easygoing, but whether that’s me or the GAD (generalized anxiety disorder) is hard to tell. Unlike most people, I prefer to work alone, and then share, and then revise, rather than work collaboratively. When I work independently, I have to motivate myself to do it because there is nobody there to do it for me. I can be both hands-on and theoretical, depending on the task. As far as extraversion goes, my Meyers Briggs suggests that I am 51% introvert – so I guess that clears that up. I can definitely have both a soft touch and a firm hand depending on the scenario and how much confidence I have. I have been working on myself, trying to become a little more confident and independent. My primary occupation is as a sound designer for live theatre. I am often the head, if not the only member of my department, so learning to be more decisive and fostering personal growth are very important. Additionally, I try to keep a sense of humor because in these hard times, everybody needs a laugh. 

Personal Strengths

  • What are you good at? 
  • What skill sets, training, or hobbies do you have that may be useful in finding a job? 
  • What is your past job experience?

YAC Chair MJ: I started freelancing as a designer after college, and I learned early on that it relies on some traits that I don’t have. I’m a good multitasker and a clear communicator, but I’m also a fairly introverted person, and setting firm boundaries with my clients proved to be difficult for me – nt to mention maintaining the stamina it takes to be constantly searching for new leads and partnerships. I burnt myself out pretty quickly, but then I found a job that plays to my strengths in a way that freelancing doesn’t. I had to know the Adobe Creative Suite inside and out, which I had learned in school and further developed in my freelance work. I had to clearly express design and technical issues to coworkers who aren’t familiar with the work, and my communication skills helped with that. The benefit of my current position is that the work is brought to me, and I don’t have to seek it out. There’s more design work than socializing involved with the role, which plays better to my introversion; plus, when I talk to my coworkers and clients the communication is mostly written, and I’ve found that it doesn’t drain my energy in the same way that phone calls with my freelance clients did. It was a very slight shift in terms of the work I’m doing, but it’s made all the difference in my mental health and work/life balance!

Balance/Flexibility

  • How many hours a week do people normally work at this job? 
  • Will your employer be flexible with hours and/or sick days? 
  • Do those you know in the field have time for personal obligations, and is their work flexible if they need to take a sick day or go on maternity leave? 
  • What kind of life do you want outside of work, and will you be able to achieve this with the job you’re thinking about pursuing?

YAC Secretary Olivia: This is something I wish I had taken into more consideration before choosing my career. I work as a television news producer. Television news is a 24 hour affair; there is always a producer in the newsroom. I anticipated taking the least desirable shift as a new hire; I figured it was only fair that the new person would get the “worst” shift. However, I didn’t fully consider how the hours I work would impact my family and social life. I work nights and weekends, which makes it difficult to maintain a sense of social wellness. I’m able to cope with the situation for the time being, because I know I will be moved to a “better” shift eventually. However, I have definitely thought about how much easier it would be to maintain healthy relationships if I had chosen a career where everyone works 9-5. 

Difficulty of Path

  • How much training is required for this job, and what might it cost? 
  • Will the journey to this career be high stress and/or physically taxing? 

YAC Member Christine: I am in my last year of medical school, training to become a physician. The cost, both emotionally and financially, of this chosen path has been high, but after careful consideration I decided it was worth it for the fulfillment that my job brings me. I think that it’s okay to choose a high stress path, as long as you are sure you want it and you go in with your eyes wide open. Make sure you do your research, so you have an idea of what obstacles you may face, and make sure you have a great support system and set of coping skills for when things get rough. The items in this list are things to consider when searching for occupational success and wellness, but no job is perfect, and you have to decide for yourself which factors are most important!

Financial Security

  • Are you looking for an hourly job or a salaried job? 
  • Will you be making enough money to cover living expenses or, if you want one, a future family? 
  • Does the industry have a high turnover rate?
  • Is the degree you are pursuing versatile? 

YAC Chair MJ: After I graduated college, I moved to New York City with a friend. We didn’t have jobs or anywhere to live yet, but we knew we wanted to be in New York. For a while, I just worked freelance design for nonprofit organizations, and found other ways to make extra cash when the freelance work was slow. At times, I was a bartender, server, paid television audience, and a dogsitter. I quickly got exhausted from always hustling different jobs and trying to plan where I’d be able to make money next, and realized that I’d prefer a full time position with a single company in the design industry. New York is expensive, though, and I wouldn’t be able to make rent as an in-house designer for nonprofits, so I turned to the tech industry. I found a low-intensity design job at a large software company, and it provided me with the financial security I wanted, a singular source of income, which I preferred, and in my industry of study. I make enough now to save a little money for the future, too!

Physical and Emotional Limitations

  • Are there physical or mental health conditions that may limit the type of work you can do? 
  • Is a high stress job or a night shift job right for you and your mental health? 
  • Is it important that your bosses are supportive? 
  • Will you have insurance and paid time off benefits? 

YAC Secretary Olivia: For a short time in college, I thought I might want to become a licensed counselor or social worker. I wanted to use my personal experience to help others living with mood disorders. After I added psychology as a second major, one of my close friends experienced a mental health crisis. I’m glad I was able to help my friend and direct them to treatment, but I realized that I couldn’t commit to doing that on a regular basis; it was simply too taxing on my own mental health to feel responsible for others in crisis. I reevaluated my career options and decided to pursue television news. Now in my career, I can help share the stories of others living with mood disorders and help educate the public without putting my own mental health at risk.