(1-10-22) Daniel H. Gillison Jr., the CEO of the National Alliance on Mental Illness, today answers the four questions that I have asked major leaders in the mental health community to answer about what their organizations accomplished during 2021, what their priorities are during the coming year, and why they got involved in mental health work. Thank you Mr. Gillison for your response.
Question One: What was NAMI’s biggest accomplishment during 2021?
As we know all too well, people with mental illness, especially people with serious mental illness, and their families often face unimaginable tragedy and trauma because of our inadequate response to mental health crises. 1 in 5 people experiencing homelessness have a serious mental illness. Since 2015, nearly 1 in 4 fatal police shootings have been of people with mental health conditions, with 1 in 3 of those being people of color.
According to the Treatment Advocacy Center, law enforcement agencies are continuing to spend 10 percent of their budget and one-fifth of staff time responding to people in psychiatric emergencies they are not equipped to handle. And people with mental illness are still overrepresented in our criminal justice system; Black individuals experiencing mental illness in jail are more likely to go into solitary confinement, more likely to become injured while incarcerated, and more likely to stay in jail longer, where mental health conditions are often left untreated.
This is unacceptable.
To create positive change and positive outcomes for people with mental illness, we must work together to make it happen.
No single organization can change this troubling cycle alone. In November, NAMI hosted REIMAGINE: A Week of Action to Reimagine our National Response to People in Crisis, to kick-off our campaign to #ReimagineCrisis across the country. We brought together 40 partner organizations from both within and outside the mental health sphere — from the Treatment Advocacy Center and the Meadows Mental Health Policy Institute to the American College of Emergency Physicians and the Major County Sheriffs of America — to discuss our current response to people in mental health crisis and how we can collectively shift to providing a mental health response to these crises.
More than 7,600 advocates, policymakers and partners registered to learn more about the important opportunity ahead of us with the launch of 988, a nationwide 3-digit number for suicide prevention and mental health crisis. The week of action was to build awareness and momentum ahead of the July 2022 nationwide launch of 988. 988 offers the promise of a new response to people in crisis — but only if states act to create a 988 crisis response system.
988 Crisis Response System: People in crisis deserve help, not handcuffs.
We need urgent investment and action from both state and federal policymakers to ensure that when 988 goes live, states have the services in place to help individuals and their families receive timely, effective care. To do that, we need 24/7 local crisis call centers staffed by trained individuals to answer the call, mobile crisis teams staffed by behavioral health professionals to respond to the call, instead of relying on law enforcement, and crisis stabilization services to provide somewhere to go, providing a transition to additional care. By building and providing this continuum of crisis services across the country, we can end the revolving door of emergency room visits, arrests, incarceration and homelessness — and ensure that every person in crisis, and their families, are treated with the dignity and respect they deserve.
The public supports this change. During the Week of Action, NAMI also released a poll conducted with Ipsos about public expectations around crisis services, which found that 4 in 5 people believe mental health professionals should be the primary first responders to a mental health crisis, not law enforcement. And during the Week of Action alone, we sent more than 50,000 letters to Congress on the need to require insurance to cover crisis services and to make investments in crisis response.
People in crisis deserve help, not handcuffs. And while our Week of Action in 2021 was a tremendous success, we are committed to ensuring it will not be a one-time effort; this is a once in a lifetime opportunity to help people experiencing a crisis, and we refuse to waste it. We will be tireless in our work with our partners to keep the momentum going, and ensure that every person, in every community, demands the crisis care we all deserve to receive, when and if we need it. We will not stop in our efforts to #ReimagineCrisis until every person struggling with a mental health crisis can truly receive a mental health response.
Question Two: What are your priorities going into 2022?
Our priorities in 2022 will continue to remain focused on our strategic goals of ensuring people get help early, people get the best possible care, and people get diverted from criminal justice system involvement. Far too often, it takes years for a person with a mental illness to get a diagnosis and it is nearly impossible to get effective and accessible mental health care – leading to the over-representation of people in mental illness in our justice system. As an organization that represents people with mental illness and their families, we are fighting every day to change this paradigm.
That means, as I mentioned, maintaining our focus on policy and legislative opportunities to improve access to care, advance research, reduce the criminalization of mental illness and ensure a robust implementation of 988 in 2022. We will also continue our fight to provide housing and social supports for people with mental illness who need it and fight against discriminatory policies like the IMD exclusion and Medicare’s 190-day lifetime limit for inpatient psychiatric care.
Additionally, we’re planning to expand our work for youth and young adults. We believe representation is critical here; we have a saying at NAMI — “nothing about us without us.” That’s why, currently, we’re in the process of selecting members of NAMI Next Gen, young leaders who have personal experience with mental health conditions who can help guide some of our work. We also have several events already lined up for 2022, including one in partnership with MTV in January.
Also in line with our goal of ensuring people get help early, we plan to maintain focus on partnerships concentrated on identifying early risk factors for serious mental illness, like the AMP Schizophrenia Project. Intentionally pursuing partnerships like this is critical to getting people the best possible care as early as possible.
In 2021, we created three task forces to really help lead the charge in helping us meet our strategic goals throughout the organization: (1) Youth & Young Adult Initiatives, (2) Decriminalization & Justice Diversion, and (3) Cross-Cultural Innovation & Connection (DEI). In 2022, we’re looking forward to really putting each of these task forces into action.
Question Three: What are the biggest challenges that you currently face?
I think that the biggest challenge we all face in the mental health space is that the demand is so much greater than the supply. Millions of people are affected by mental health conditions every year; there is just so much need we can’t outrun — and that need has only increased with the mental health impact of the pandemic. There are far too few providers available to help those of us that need mental health care, and the gap is expanding daily.
We will need a collective, collaborative effort to accomplish necessary progress in workforce development, improve mental health research and treatments, and more. It is going to take all of us thinking and doing differently to create the changes we need for a truly robust mental health system. We also need tenacity, because sometimes the speed of change can feel very slow.
I feel that pressure on a personal level too — it always feels like there are never enough hours in the day to do all of the work NAMI wants to do to help people with mental illness. Recognizing the importance of balance and attending to our own self care is important too because burnout and compassion fatigue are major challenges — challenges we also see when we look at our workforce and caregivers.
Question Four: Why did you get involved in mental health?
Unfortunately, like many other Americans, I have a personal experience with suicide in my family.
In 1986, my cousin lost her life to suicide. It’s something my family and I have never really talked about, but it’s had a huge impact on all of us. My aunt and uncle were never the same; and I frequently think about her — especially during big life milestones I wish we could be sharing together.
There is so much stigma around mental health, especially in communities of color. One study showed that 63% of Black people believe that a mental health condition is a sign of personal weakness. I want to help change that. I don’t want anyone else to ever feel as alone as my cousin did, and I don’t want any other family to have to experience such a devastating loss.
I wish my family had known about organizations like NAMI back then. But I hope now I can help other families who are struggling know that there are so many resources available to help.
ABOUT THE AUTHOR: Daniel H. Gillison is the chief executive officer of NAMI (National Alliance on Mental Illness). Prior to his work at NAMI, he served as executive director of the American Psychiatric Association Foundation (APAF) in addition to several other leadership roles at large corporations such as Xerox, Nextel, and Sprint. He is passionate about making inclusive, culturally competent mental health resources available to all people, spending time with his family, and playing tennis. You can follow him on Twitter at @DanGillison.
Next in the series: Harvey Rosenthal, New York Association of Psychiatric Rehabilitation Services. (I am posting responses based on the order that I received them. The views of the authors are their own.)
About the author:
