Transformational Times for Mental Health “Care” in Cities


  • Sue Polis
  • Stephanie Martinez-Ruckman
May 9, 2022 - (4 min read)

The latest findings from Mental Health America show that 50 million Americans – nearly 20 percent – struggle with mental illness. Recent years have seen greater recognition of the overall toll and burden from behavioral health challenges, but not much has changed to transform how we treat people who suffer with these conditions. Despite the bravery and openness of celebrities like Simone Biles, Naomi Osaka, and Bruce Springsteen, accepting mental health as a health condition like heart disease or cancer is still elusive. The enormous courage it takes to seek treatment and support is often met by pity, further isolation, and distance. “Care” is defined as the provision of what is necessary for the health, welfare, maintenance, and protection of someone or something. How can we transform mental health into mental health “care”?

Transformative Times

Despite the daunting statistics, we are living through a time when transformation is possible. From the new 988 hotline to opioids settlements, and the nearly unprecedented federal funding to support behavioral health efforts, more resources are available. Additionally, many cities are working to develop and expand cross-sector approaches to crisis response and emergency stabilization and pair behavioral health specialists with first responders to support better outcomes for people experiencing mental health crises. At the same time, new workforce programs are being brought to bear to ensure greater access to specialists.  Furthermore – a new effort by the Well Being Trust, seeks to spur a new model of Community Initiated Care.

With all of these new efforts in play, the vital component to true transformation is leadership. Leaders who are willing to lead by example to tackle the complex systems and social structures that hold uphold cycles of crisis, trauma and untimely deaths of despair. Thus, it is essential to take on the stigma and failed systems that anchor the status quo.

What Can City Leaders Do?

1. Start at home

A non-judgmental environment and example for your children, families, and friends can set the tone for how to begin to de-stigmatize mental health conditions. Whether spurred by genetics, trauma, medical conditions, violence, or peer pressure, among other drivers – everyone has a different experience, and providing an open, supportive dialogue is the first step. No blame, no shame.

2. Encourage Employers to offer Workplace Mental Health

The National League of Cities is partnering with the American Psychological Association (APA), the American Public Health Association (APHA), the International City/County Management Association (ICMA) and the YMCA of the USA (Y-USA) to urge American business and non-profit leaders to transform workplace culture to better address mental health.

3. Move Upstream

Often, the default outcomes for vulnerable individuals with behavioral health challenges are hospital emergency rooms and prisons – and usually a cycle between the two. City leaders can look upstream and consider prevention programs including those that are school-based and provide early detection and intervention.

4. Initiate and Support Systems-Based Approaches

Systems-based approaches can be thought of as ‘connecting the dots.’ Who is the individual struggling, and how can they be supported? For students, it generally takes a village between mental health providers, school counselors, peer and family support, and employer well-being efforts, among others. For vulnerable adults, there are often intersecting challenges that include treatment, meeting basic needs (housing, food, transportation, etc.), with workforce training, and employment, among others. Grappling with the needs of your community can happen with a needs assessment to identify and map all of the current efforts and identify areas for alignment.


About the Authors

Sue Polis

About the Authors

Sue Polis is the Director of Health and Wellness within the Institute for Youth, Education, and Families at the National League of Cities.

Stephanie Martinez-Ruckman

Stephanie Martinez-Ruckman is the Legislative Director of Human Development at the National League of Cities.