“Crisis care is the most basic element of mental health care, yet in many communities, it is taken for granted. Limited. An afterthought. A work-around. Even non-existent. A mental health crisis is not planned. It cannot be scheduled. It can happen to anyone… anywhere… anytime.”     
 - Crisis Now Washington Declaration, 2019 

Lack of access to the right type of mental health care at the right time compounds the crisis and increases the costs of care. Burdens fall on other systems (e.g. emergency rooms)  and communities (e.g. jails) that are not equipped or trained to effectively provide mental health care. This fragmented system often increases risk and limits recovery. Public housing residents face high levels of social disorganization, financial constraints, crime, and violence. There are causal relationships between these economic and environmental stressors and poor mental health and crisis. Community health centers are deeply aware of this social condition and the complex trauma that public housing residents face. 

The extreme weather and the pandemic have heightened these burdens on people in public housing. As we begin the RECOVERY process from the trauma of departed friends and family members, forced loneliness, and lost jobs and income, reinforcing support systems—that are guided by peers—will be imperative. The next 12 months will be critical to ensure public housing agencies and community health centers are able to set in place the infrastructure of peer counselors, referral systems, and relationships to manage this systemic change. These system will only be sustained if they are recovery focused and community driven. 

The deployment of the new “988” system for mental health triage has an important role in moving communities closer to the recovery focused vision laid out in the New Freedom Commission Report—nearly 20 years ago. The new 988 telephone number will replace the “800” numbers and suicide hotlines with a hub of connected providers, and is set for implementation in July 2022. Yet as of July 2021, 34 states had taken no steps to implement the new “988” system. A review state mental health web pages show only rudimentary promotion of the new opportunity to re-make counseling and support for the “new normal” of an anxious nation reeling from COVID and other assaults. We can and must do better.