The legislation incorporates a CDC community public health approach to building mental wellness and resilience.
The American Psychiatric Association (APA) recently endorsed bipartisan legislation introduced in the fall in the House by Representatives Paul Tonko (D-NY) and Brian Fitzpatrick (R-PA) and in the Senate by Senators Ed Markey (D-MA). Jeff Merkley (D-OR) and Richard Blumenthal (D-CT). The legislation aims to reduce the current epidemic of mental health and behavioral problems and prevent future ones by using a public health approach to build mental well-being and population-level resilience to all types of toxic stress, including those created by climate emergency.
The legislation, HR 9201, the Mental Wellness and Community Resilience Act, is an urgently needed new policy that will direct the Centers for Disease Control and Prevention (CDC) to provide small planning grants and larger implementation grants to coalitions of the community to strengthen capacity for mental well-being and resilience among all adults and youth.
The need for the new policy is evident. In 2021 alone, more than 1 in 5 American adults experienced a diagnosed mental illness. Residents across the country are experiencing accelerated toxic stresses due to job, income and housing insecurity; poverty; and other fights.
Another cause of increased mental distress is that 90% of counties in the United States were affected by a major natural disaster in 2021.1 Research shows that disasters cause traumatic symptoms in 20% to 40% of those directly affected, as well as those who know someone affected or watch the events from afar.2 The combination of escalating toxic stresses and acute disasters produces trauma at the community and societal levels as well as for individuals.3
There are not enough mental health professionals to help all individuals experiencing mental health and behavioral problems today. This gap will only grow over time as the climate emergency worsens. In addition, many individuals will not engage in in-person treatment due to high costs, fear of stigma, and other reasons. Community-based initiatives that help the entire population strengthen their capacity for mental well-being and resilience will go a long way in addressing these issues.
APA Executive Director and Medical Director Saul Levin, MD, issued the following statement regarding this legislation:
“The American Psychiatric Association strongly supports the Mental Health and Community Resilience Act and appreciates Representatives Tonko and Fitzpatrick for their leadership in introducing it. This forward-thinking proposal would authorize grants focused on strategies to increase communities’ ability to cope with the mental health impacts of acute and long-term disruptions from natural disasters, as well as the other public health impacts of climate change. APA strongly supports this effort to foster resilience and mental wellness in communities across the country.”
In addition to APA, more than 115 national, state, and local organizations have endorsed HR 9201. Some of the national supporters include the American Psychological Association, National Alliance on Mental Health, National Association of Social Workers, American Public Health Association, Mental Health America , National Association of State Directors of Mental Health Programs, Children’s Environmental Health Network, Anxiety and Depression Association of America, National Council on Mental Wellness, Nurses Alliance for Healthy Environments, American Lung Association, Campaign for Policy and Practice Trauma Informed, American Association on Health and Disability, Kennedy Forum, Harmless Healthcare and many others.
State organizations ranging from the United Way of the Columbia Willamette in Oregon to the New York State Association of County Health Officials (NYSACHO), as well as numerous local organizations including Resilient Communities Utah; Community Sustainability Initiative in Walla Walla, Washington; and the Neighborhood Resilience Project in Pittsburgh, Pennsylvania, have also signed on.
Specifically, the Mental Wellbeing and Community Resilience Act will:
- Authorize CDC to establish a grant program to expand existing community-based initiatives and form new ones that use a public health approach to increase population-level capacity to prevent and treat mental health problems created by ongoing adversity and toxic stresses.
- $30,000,000 appropriated for fiscal years 2023 through 2027 to fund small planning grants of up to $15,000 to help organize community initiatives, and larger program grants of up to $4 million to support and help expand existing community wellness and sustainability initiatives. (Note: This total is likely to change when the legislation is reintroduced in 2023.)
- Aim for community-based initiatives that will involve a broad and diverse network of grassroots and neighborhood leaders, as well as non-profit, private and public organizations.
- Encourage community initiatives to develop age- and culturally-appropriate strategies to engage all adults and youth in enhancing and maintaining mental well-being and resilience, with high-risk individuals and those with pathological symptoms being addressed special attention as part of larger community efforts.
- Encourage strategies that use evidence-based, promising, and/or Indigenous practices to engage residents in strengthening existing protective factors and building new ones, and to help all individuals move away from traumatic stressors , maintain mental well-being and recover quickly. when affected by toxic stresses or disasters.
- Individual mental health treatment will support community-based wellbeing and resilience building activities and help individuals who are still unable to function or are at risk of harming themselves or others.
Representatives Tonko and Fitzpatrick and the House co-sponsors, as well as Senators Markey, Merkley and Blumenthal, will reintroduce the Mental Wellness and Community Resilience Act in the next Congress. APA members are encouraged to contact their House and Senate members to urge them to co-sponsor the legislation and push for its swift passage.
Dr. Pollack is professor emeritus of public policy at Oregon Health & Science University in Portland, Oregon. Dr. Haase is medical director of psychiatry for Carson Tahoe Regional Center and chairs climate committees for APA and the Group for the Advancement of Psychiatry. Mr. Double is the executive director of the Resource and Innovation Group (TRIG), an organization affiliated with the Center for Sustainable Communities at Willamette University, where he is also a senior fellow. He is also an adjunct faculty member in the University of Oregon’s Department of Planning, Public Policy and Management.
References
1. Costley D. Report: 90% of US counties were hit by a disaster in the last decade. AP news. November 16, 2022. Accessed November 10, 2022. https://apnews.com/article/science-united-states-emergency-management-climate-and-environment-4663b776dd05fb4114276b31e503b77c
2. Sawada Y, Bhattacharyay M, Kotera T. Aggregate impacts of natural and man-made disasters: a quantitative comparison. Int J Dev. 2019; 9 (1): 43-73.
3. Ayapong B, Shalaby R, Eboreime E, et al. Cumulative trauma from multiple natural disasters increases the mental health burden on Fort McMurray residents. Eur J Psychotraumatol. 2022; 13 (1): 2059999.
