Plan Promotes Equitable Long-Term Recovery and Resilience for Vulnerable Populations

The quest already has been underway for decades: How can the mental health consumer/survivor/peer movement foster changes that will facilitate recovery, independence, and a full community life for those who experience homelessness and mental illness? Clearly, the urgency to act is growing, as New York City and the state of California institute new procedures to pick up persons from the street who are homeless and mentally ill, and then place them in forced institutional treatment.

If we are to make positive progress on this fundamental human rights issue, recent discussions suggest that action is needed at national, state, and local levels by all of us. A recent development at the national level may provide a framework for helping us to do this. The new Federal Plan for Equitable Long-Term Recovery and Resilience (hereafter, Federal Plan) sets forth an approach for federal agencies to cooperatively strengthen the vital conditions necessary for improving individual and community resilience and well-being nationwide. The goal is for all people and places to continuously thrive. 

The Federal Plan is of great interest. It uses as a framework the 7 Vital Conditions for Health and Wellbeing. These address the basic needs of people and communities for health and safety, meaningful work and wealth, humane housing, reliable transportation, lifelong learning, and a thriving natural world. Thus, the freedom to thrive depends on a person having a consistent set of vital conditions, such as clean air, fair pay, humane housing, early education, routine health and behavioral healthcare, and other basic necessities.

Stated differently, these vital conditions reflect the social and physical determinants of health that must be addressed if people and communities are to be healthy, have good wellbeing, and thrive. The failure to address them does lead to homelessness, poor health, behavioral health problems, low levels of wellbeing, and failure to thrive.

This framework has its roots in the community and is centered in a sense of belonging and a desire to participate. That’s because community engagement is essential for developing functioning communities and empowered citizens. Local, self-driven solutions are critical to addressing local needs—and ultimately to fostering indigenous community leadership to build an equitable, thriving future. 

The Federal Plan also is of interest for at least 2 other very important reasons. First, it is the product of all key federal departments, from agriculture and commerce, to defense and education, to health and human services, and other federal entities as well, such as environmental protection, small business, and the federal reserve. This suggests strongly that there is very good consensus in the federal community about the plan and its potential utility to address community problems.

Second, the expectation exists in the federal community that all departments and other federal entities will implement the Federal Plan in their future programs. It includes 78 recommendations for federal action, 5 of which focus on freedom from trauma, violence, and addiction.

Urgency exists for the consumer/survivor/peer movement to engage the Federal Plan and to bring it to local communities throughout our country. We only will be able to address the issue of homelessness and mental illness if we take steps to confront the social and physical determinants of health in our communities that foster and sustain this problem. Assessing the vital conditions for health and wellness in our individual communities represents an excellent starting point for undertaking this essential work to promote social justice.

Ron Manderscheid, PhD, is the former president and CEO of NACBHDD and NARMH, as well as an adjunct professor at the Johns Hopkins Bloomberg School of Public Health and the USC School of Social Work.

The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.