Verified by 
Key points
- Regardless of age, class, gender, race, or ethnicity, millions of Americans today are stressed or traumatized.
- Our epidemic of mental health problems is worsened by the climate-ecosystem-biodiversity catastrophe.
- To break the cycle, the U.S. must become a trauma-informed, resilience-enhancing, wellness-focused society.
Throughout the U.S. today, millions of people are significantly stressed or experience psychological and emotional traumas. An epidemic of mental health problems has resulted. To complicate these already formidable problems, many systems in the U.S. today amplify the toxic stresses and traumas.
Because of this, I argue that we have become what is called a “trauma-organized” nation. A system becomes trauma-organized when, rather than helping people prevent and recover from adversities, it compounds their struggles. A vicious cycle of repetitive traumatic stresses results.
To reverse this harmful cycle, I believe we must deliberately choose to become a trauma-informed, resilience-enhancing, wellness-focused society.
The Mental Health Crisis in the U.S.
The U.S. now has one of the highest rates of diagnosed mental health problems of all high-income countries in the world. The number of undiagnosed but significant emotional distresses is undoubtedly even higher. The CDC has reported that mental health among adolescents, especially teen girls, is at a crisis level. Drug-related deaths are also at an all-time high.
These problems are not limited to urban areas, as some believe. Research found that rural Americans have a much higher rate of depression and 64 to 68 percent higher rates of suicide compared to urban areas. They also experience higher per capita rates of drug and alcohol-related mortality compared to urban areas.
The record heatwaves, droughts, storms, wildfires, and other ecological and weather-related disasters seen nationwide driven by the climate-ecosystem-biodiversity (C-E-B) catastrophe are aggravating many of the existing mental health issues, and generating new ones. The U.S. experienced 28 major disasters last year, surpassing the previous record of 22 in 2020. The number of people who experience a disaster-generated mental health issue, including but not limited to anxiety, depression, and PTSD, often outweighs those with physical injuries by 40 to 1.
Why Have Things Come to This Point?
The principles of a public health approach to mental health and prevention science can help us understand the causes of today’s mental health epidemic, and how to address it. Epidemiology is the foundation of a public health approach. It examines how ailments occur and why. The starting point is therefore to ask what is stimulating today’s mental health epidemic.
The accelerating scale of the problems quickly dismisses the possibility that genetic or other individual factors are the primary cause. On the contrary, it is evident that today’s heightened mental health struggles are produced by structural forces that are beyond the control of the individual.
These systemic influences are incessant, not sporadic, but are difficult for many people to see because they appear to result from other causes. But the reality, I argue, is that most mental health struggles seen today are symptoms and outcomes of trauma-organized systems.
This can be seen in many institutions today. Many social service and physical health organizations, for example, often aggravate the traumatic stresses experienced by the people they serve. Overworked, under constant financial pressure, and lacking a common framework for how to assist clients when they are stressed themselves, staff become demoralized and retreat into a self-protective survival mode. Rather than developing the safe and supportive conditions their clients need to heal, staff resort to quick diagnosis and use of medications, or rigid and punitive responses that reinforce the inadequacy many clients already feel.
Our criminal justice system offers another example. It frequently responds to crime and violence with police brutality, mass incarceration, and in some states, execution, even though overwhelming research shows these legalized forms of violence typically only increase rather than deter injurious behaviors.
Many public policies are also producing and worsening toxic stress. For instance, economic policies designed to eliminate jobs and impede the provision of living wages spread stress by putting many people, especially lower and middle-class blue-collar workers, in precarious financial conditions. The feelings of shame and humiliation commonly contribute to mental health issues. Rural communities have been particularly hard hit by these economic forces, which is one of the reasons they are experiencing heightened mental health issues.
Energy policies that promote the use of fossil fuels are also contributing to significant mental health issues, not only in the U.S. but globally as well because they lead to the generation of huge amounts of greenhouse gasses and ecological damage that are major contributors to the C-E-B catastrophe. The disruptions to the systems people rely on for food, water, jobs, shelter, health, and other basic needs generated by the catastrophe, combined with the increasing disasters, are contributing to pervasive anxiety, depression, PTSD, hopelessness, and more worldwide.
How Can We Change Direction?
A public health and prevention science perspective clarifies that, while they will remain very important, today’s epidemic of mental health issues cannot be cured with more individualized mental health services. Systems change is required.
One important action would be to make the U.S. a trauma-informed nation. This would involve teaching government officials, business, and community leaders how trauma and stress can adversely affect the human body, mind, and emotions, and activate behaviors that harm the self, others, or the natural environment. Armed with this knowledge, they then would alter policies and programs to ensure that they build well-being and resilience rather than create more toxic stresses and traumas.
Fortunately, the wheels of change are already turning. Last month, Hawaii Governor Josh Green declared Hawaii a trauma-informed state. He directed all state departments to integrate trauma-informed care principles, such as safety, transparency, and peer support, into workplaces and services.
All levels of government in the U.S. could follow Hawaii’s lead and become trauma-informed. Non-profit and private-sector organizations could do the same.
Another essential action would be to transform our economy from a trauma-organized system into one that enhances wellness and resilience. One step in this direction could be for national leaders to join Scotland, Iceland, New Zealand, Wales, Finland, and Canada in actively sharing expertise and policies that help them build economies that enhance well-being and restore the environment.
A third vital action would be to support the formation of Resilience Coordinating Networks in neighborhoods and communities nationwide. These multi-sector coalitions use a public health approach to empower residents to use their existing strengths and resources, and form additional ones, to prevent and heal mental health problems and turn adversities into opportunities for to pursue innovative solutions.
A number of communities across the country are finding significant success with this approach. Forming local resilience networks will be especially important as the C-E-B catastrophe accelerates.
The positive initiatives underway in the U.S. and elsewhere demonstrate that we can become a trauma-informed, resilience-enhancing, wellness-focused nation. What is needed is the political will to make it happen.
