This is an op-ed written by Tompkins County Public Health Director and Mental Health Commissioner Frank Kruppa. It was not written by The Ithaca Voice. To submit op-eds, send them to Matt Butler at

The Tompkins County Health and Mental Health Departments play a significant role in addressing access to mental health services and improving mental health outcomes. We offer an outpatient clinic, services supporting recovery from substance use, publish opioid statistics, provide programs for mothers and new parents, and programs for children and youth. During this year’s Mental Health Awareness Month, we are drawing attention to the mental health crisis and how we can improve outcomes for our community.

Recently there has been more public conversation about mental health, and we’re grateful that awareness is increasing and that there are calls for action. Some conversations are coming on the heels of the devastating pandemic and its impacts, while others are pointing to long-standing issues that seem to be getting worse.

Individuals have experienced trauma and loss, resulting in increased instances of anxiety, substance use, loneliness, and depression, even for those who have never experienced these mental health challenges before. This list may resonate for you or someone you care about. Support is available for those in crisis and recovery, but there is not enough of it. Mental health needs are increasing, and the availability of care is not keeping pace.  

Last October, in the U.S., practicing clinicians saw a 10 – 12% increase in anxiety, depression, substance use and related disorders, and reported that referrals for mental health doubled between 2020 and 2021. The CDC found that in 2020, 13% of Americans started or increased their substance use to cope with the stress of COVID-19.

The crisis is a local one too. So far in 2022, our local 2-1-1 information line has seen a 37% increase in calls expressing mental health, substance use, or other behavioral health needs compared to this time last year. Our Mental Health Department saw a 29% increase in referrals from 2020 to 2021 – we are on pace to exceed that referral rate this year.

When area middle and high school students were asked to self-report on their mental health in 2021, they reported more frequently feeling sad/depressed, feeling that “life isn’t worth it”, and that they are “no good” at an increased percentage as compared to past years. Our children are telling us they need help. If that does not get our attention, what will?

We also know that these issues are exacerbated even further for people who are historically discriminated against and marginalized. Every conversation on mental health outcomes must include how we improve delivery of inclusive care to People of Color, LGBTQIA+ people, and others who have experienced trauma related to systemic discrimination. Anything less than compassionate, culturally responsive and accessible care for all is unacceptable.

There is a need for more ample and diversified staffing of the systems providing care. There are many professionals in our community that have dedicated their lives to this work. They are tired and need reinforcements. Whether you’re a seasoned professional or just getting started on your path, consider our mental healthcare system – we could use caring people like you.

This year, the Tompkins County Health and Mental Health departments will complete a merger  into one department better suited to support the whole health of our community. We will provide our community with a unified approach that will work to address systemic concerns and barriers to care, to improve the well-being of all Tompkins County residents.  

Our role is to address the systems I’ve written about here, and to understand the whole health of the community. There are also meaningful things that each of us can do to support one another:

  • Consider social determinants of health (how environments affect health outcomes and risks) and what role you might play in perpetuating or addressing these social determinants. Housing, education, income, discrimination, access to food, and language and literacy are all examples of social determinants of people’s health and mental health.
  • Reach out to others in your community. Share resources and stay connected. Supporting those in need may take directly connecting someone to a service to make that first, hard step a little easier. And while checking in on the well-being of others, don’t forget to check in on yourself too and seek help if you need it.
  • If you have or work with children, consider your role as a caregiver, mentor or provider of safe spaces. Safe, stable, and nurturing relationships build resilience in individuals and communities and positively impact mental health outcomes. Read more about the benefits of relationships for youth at the local “Be the One” campaign.
  • If you are a professional provider of care, consider how you and your practice can better invite and serve marginalized groups. Consider the trainings you make available, the associations you’re a part of, and the resources you make available to your clients. Seek feedback from your clients and consider changes that better serve everyone, keeping in mind varying identities and cultures.
  • If your work includes managing people, consider the stress that your staff and colleagues might be under, think about how work could be structured to better meet the needs of people and their families, what supports you offer in your workplace, and how you check in with your colleagues. Consider a course in mental health first aid; local trainings are available.

With more attention to the systems that we’re a part of and the role we each play in the lives of others we can positively impact our community’s mental health outcomes. The smallest actions multiplied by all of us can reduce overdose deaths, the number of domestic violence incidents, emergency room visits, the number of people experiencing homelessness, and the number of people experiencing mental health crises, but we must do it together.