Where is the state of public mental health?
PSYCHIATRIC VIEWS ON THE DAILY NEWS
As we approach our 4th of July holiday weekend, celebrating our country’s Independence Day, I associate to that famous phrase from our Declaration of Independence: “Life, liberty, and the pursuit of happiness.”
It has always struck me as an implied claim to health and mental health, especially if “life” refers to mortality statistics; “liberty” refers to freedom of the mind; and “pursuit of happiness” refers to an opportunity to pursue psychological well-being.
On Tuesday, Rochelle Walensky, MD, MPH, the outgoing director of the Centers for Disease Control and Prevention (CDC) wrote a guest essay for the New York Times titled “What I Need to Tell America Before I Leave the C.D.C.”1 In its own way, it is both a review of the current state of our public health and a warning about the need to considerably improve it for the future.
She viewed her “primary charge as bringing the country from the dark and tragic pandemic days into a more restored place.” To convey how she did so over the last 2 and a half years, she reviewed the public health challenges, which went well beyond the prominence of the COVID-19 pandemic. She emphasized how the prior underinvestment in public health led to a major shortage in public health workers and up-to-date laboratories.
However, nothing was mentioned about public mental health, despite using psychological terms like “despair” in the title. Not only have we had a concern about “deaths of despair,” but survey after survey indicated an accompanying crisis in mental health during the pandemic:
-Psychiatric symptoms and certain disorders were increasing even more drastically during the pandemic, especially for the youth and minorities, with no evidence that they are now remitting
-Conflict between groups limited cooperation with CDC recommendations
-Conspiracy theories ran amok online
-Having to stay at home brought some families together, but for others there was increased conflict and children falling behind in learning
-Increasing political tribal divisiveness
-The burnout epidemic in physicians rose once again, and that burning out spread to other workplaces and even parenting
This crisis suggests that what we need is more involvement of psychiatry and other mental health expertise involved in our public mental health. After all, we know by now that there is no health without mental health. The same goes for public health. That should include representation at the top levels of our government by adding a psychiatric assistant to the Surgeon General or a new position of Psychiatric Surgeon General.
In the meanwhile, the July 4th holiday weekend offers a bit of time to enhance our state of mind. A formal vacation out of town, airlines willing, or staycation at home can bring some mental relief. May the continuing summer in the northern hemisphere bring even more, though we will also need the cooperation of livable weather to do so.
Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times.
1. Walensky R. What I need to tell America before i leave the C.D.C. The New York Times. June 27, 2023. Accessed June 29, 2023. https://www.nytimes.com/2023/06/27/opinion/rochelle-walensky-cdc-pandemic-despair.html