Founder of ICMA Affinity Partner organization, Cope Notes, a text-based mental health platform that provides daily support to users, Johnny Crowder presented a game changer session at the 2022 ICMA Annual Conference titled The 3 Pillars of Community Mental Health: Residents, Employees, and You. He opened by telling the local government audience that it is a nice title, but it should really be called “The three bubbles I will burst.”

Before examining the bubbles to burst, Crowder opened up about his background growing up in an abusive household rife with drug and alcohol use, and “An alphabet soup of diagnosis. Bipolar, schizophrenia, PTSD, you name it.” This led to multiple failed suicide attempts and a sense from him and his parents that it was all just too complicated to address. He said he wished someone had told his parents that they didn’t have to be the experts, they just had to be the champions. “Choose to take action. Take it to the attention of an expert.”

Crowder related this to being a local government manager, as many one-on-one conversations he has starts with the overwhelmed, “What am I supposed to do?” question. The answer is outsource it to an expert. Find someone who understands the challenge and get help.

“Don’t be binary. It’s not you versus the mental health problems of thousands of your residents. With those numbers, you’re guaranteed to lose. If you view it as you and thousands of people versus a need, you’ll win. Stand on the residents' side versus a challenge. You can’t be everything to everyone.”

Resident Mental Health

The first bubble to burst: “There is a huge disconnect between what you think you’re offering and what your residents are actually getting.” He said earmarking funds and doing public announcements about the intention to address mental health is a false sense of security.

Crowder listed barriers to care that virtually everyone has faced in any aspect of healthcare:

1. Hard to engage. Engagement is difficult even when there is a desire for it. Physical distance like having to drive a few hours to get to a provider that’s in-network”. Or a mountain of invasive, repetitive forms. Or the digital divide that prevents a significant portion of the population who can’t download an app or figure out how to use it.
    
2. Stigma. People are still not open to sharing that they are using mental health resources.
    
3. Wait times. One member of the audience said it could take up to a year to receive mental health support in her community.

The solution? Local government will never have the resources to dedicate individual help to every individual. Crowder used an analogy of owning a sandwich shop.

“The city or county manager’s job isn’t actually to make sandwiches or earmark money for it. Your job is to buy sandwiches and tell people you have them and where they can easily get them.”

Employees

The second bubble to burst: “Your EAP is not cutting it. Five percent of your employees are engaging with EAP. Forty percent of the first booked session are cancelled. For those who do start, 50 percent will quit after three. Some of that is related to cost. Some to bad experience. Some is related to their comfort, or lack of comfort level.”

Similar to a theme from keynote speaker Col. DeDe Halfhill’s presentation, Crowder said employee burnout is really code for something else.

Ninety percent of people who meet criteria for burnout meet the criteria for depression. They might not be aware of it themselves, and even if they are, how likely are they to tell their boss?!?

Crowder told a story about how after a year of great work and an outstanding performance review, he was given a raise from $8 an hour to $8.15. This token amount was devastating, despite the good intentions of his immediate supervisor. Even scaled on annual salary, a circumstance familiar to many supervisors and HR leaders in local government who don’t have the budget to reward their employees. Crowder said leveraging benefits is one way to make them feel supported.

Closing this pillar, Crowder gave three tips to “culturally normalize” mental health.

1. Ask questions about nonwork things to employees you want to open up. You have to build up to the ability to have more serious conversations.
    
2. Purposely use terms related to mental health all year round. Be first so others can follow.
    
3. Use a catalyst or scapegoat related to mental health. A shared point of reference like a book, TED talk, article, or even Crowder himself. So everyone points at the same thing, instead of pointing at people or fear they are being pointed at.

You

The third bubble to burst is something Crowder said seems obvious but local government leaders often forget in their day-to-day: “You’re not a city manager, you’re a person. If you want to serve tomorrow, that means sustainability is key.”

He said adults, like children, copy actions before words. Maintain mental health for yourself to show your residents and employees, not just tell them. Cope Notes strongly encourages, borderline makes it mandatory, to have leadership sign up first before they announce to staff or citizens the service is available.

Crowder suggested to create a mental health menu.

“Create a short list of things you know can make you feel better. Make this when you feel fine. Pull it out later when you’re not feeling fine.”

He said to start with senses. Something that feels calm like a warm shower. Something that feels calm, like a playlist not of your favorite songs, but relaxing music that will lower your heart rate. Something visual that stimulates a natural internal chemical reaction like videos of your dog.

Dramatic Conclusion

“All of this is your department. Residents, employees, you. I don’t care what your title is. Buck passing almost killed me. You can prioritize. You have authority and influence. Don’t waste it because you're uncomfortable with the conversation.”

Crowder reminded the audience, telling people to reach out for help is a mistake because we forget the challenges many people face prevent them from asking. Local government leaders have to bring the help to them and make it as easy and simple as possible.

“You have residents and employees who think you don’t care about them. You have the power to change that.”

Learn more about how Cope Notes can help your residents, employees, and you by breaking negative patterns and building new positive patterns to improve mental health.

Save the Date!

The 2023 ICMA Annual Conference will be held September 30-October 4, 2023 at the Austin Convention Center in Austin/Travis County, Texas.