Mental Health Care Providers

Concerns

• There are not enough mental health service providers in the region, particularly in Prince George’s County, Maryland. Services are limited and difficult to access. It is also difficult to find and maintain a qualified mental health workforce.
• Mental health services are oriented toward crisis management and substance misuse. This creates a cycle where the crisis is dealt with but not the underlying issues. Nuances are lost in this approach.
• The stigma associated with participating in mental health services still prevents some people from engaging in services. The crisis model perpetuates stigma.
• Police still handle many mental health or substance misuse situations, leading to the criminalization of people because of unmet mental health needs.
• There is an incomplete understanding of how upstream factors such as discrimination, lack of housing, poverty, racism, and unemployment affect mental health.
• Clients do not always feel respected by their providers. Treatment plans are often made without input from clients. Some clients feel that providers are using them to meet funding requirements. Mental health providers do not reflect the population they serve.
• Keeping clients engaged can be a challenge, especially with youths. Attendance of mental health groups is often inconsistent.
• Mental health services are often siloed, rather than integrated. It is difficult to get a client’s medical history and care information when they transition care.
  

Strengths

• Despite capacity issues, many community-based organizations are beloved by their clients, and most service providers are passionate and dedicated to the field.
• Early intervention services help unpack client needs.
• Transportation services have been helpful where they exist.
• The ability to provide and bill for telemedicine helps vulnerable populations.
• Some providers are starting to integrate behavioral health into primary care.
• Advocacy is happening to change the systems in place.
• There has been a positive response to the availability of telehealth during the COVID-19 pandemic. Telehealth has removed transportation barriers, created flexibility for appointment times, and opened opportunities to engage with marginalized communities or to re-engage with people who have fallen out of care. Some clients miss the in-person contact and “safe space” feeling of office visits.
  

Solutions

What can DC Health do to support individuals with mental health needs?

• Focus on youths, especially youths of color living with HIV and/or substance misuse issues. School-based expansion of mental health and wellness would help connect youths with services early on and destigmatize mental health. For example, public school teachers could     incorporate meditation into the school day in public schools or start the school day with a “moment of quiet.”
• Destigmatize mental health by changing the language used. Instead of focusing on disorders, frame mental health with concepts such as purpose, meaning, self-direction, empathy, and intimacy to make interventions feel approachable and inclusive.
• Use socialization as a pathway to improving a person’s mental health. Relationships can be interventions, and social events can be used to introduce people to wellness activities and services.
• Incorporate wellness approaches, such as meditation, into all services.
• Customize services to fit the individual.
• Use peers or life coaches, where appropriate, and refer to mental health professionals if client issues become critical.
• Use retreats to get people out of their environments and into nature, and provide wellness activities (such as cooking, meditation, mindfulness exercises, and yoga).
• Expand provider capacity through programs for recent graduates of mental health programs who need clinical hours and supervision.
• Maintain existing capacity by providing support and training to clinicians.