This is Post 1 of 2 introducing the “Push Paradigm.”
More resources; worse outcomes
In an era defined by an unprecedented influx of resources, funding, and innovation into the mental health landscape, one glaring paradox remains: Despite the staggering investment of money, energy, and ingenuity, our collective mental well-being has proven impervious to improvement.
Dr. Thomas Insel, former director of the National Institute of Mental Health, has highlighted in detail, citing data from Deaths of Despair, the CDC, and Open Minds, just how we are spending more and getting so much less. In fact, on campuses across the country, according to the American Psychological Association and CDC, mental health keeps getting worse.
Many of us remain filled with worry. But the mental health reality for 15-29-year-olds is statistically even harsher. Students find themselves perpetually isolated, relentlessly anxious, chronically stressed, unremittingly depressed, and fighting suicidality at levels previously unimaginable.
And most of them, studies show, never tell anybody—including their counselor—what they’re really thinking. Many will even deny what they’re thinking and experiencing. And, again citing Insel from his book, Healing, “less than half—actually close to 40 percent—of the people identified with a mental illness in epidemiological studies are in care” (20).
Expectations are evolving
Two things have been happening simultaneously over the years:
- There has been a historic proliferation of offline and online mental health resources.
- Our individual expectations towards these resources have undergone a subtle yet profound transformation.
We expect machine algorithms will predict our needs and desires. That expectation applies to mental health, too.
Research conducted through my organization has started painting a picture of the latter, emerging reality: Unbeknownst to many, we are collectively shifting the goalposts on what we expect from our mental health support systems.
We expect that someone around us should already know how we’re feeling.
It’s a boundary-pushing insight that comes from nearly a year of research.
In a world where algorithms predict our concert preferences, streaming platforms anticipate our next binge-worthy series, and e-commerce giants intuit our cravings, the unspoken expectation—assumption even—has arisen that someone, somewhere, should intuit our struggles.
University counseling centers should know how I’m feeling. I shouldn’t have to tell them. And I certainly shouldn’t have to struggle against all the extant frictions to get the support they should know I need. (I’ll have more to say about these “frictions” in a future article.) Counselors should do something about it proactively!
You should have helped me yesterday
Hold on, Chris, you’re telling us someone should know how our students, healthcare workers, vets, and first responders are feeling?
No. What I’m saying is that we know from the “Facebook Files” and Meta whistleblower Frances Haugen that people are already aware of exactly how we—especially our teenage and young women—are feeling and which ones are feeling that way.
We need a new paradigm to put this knowledge to work for our students and others.
Teenagers and young professionals (15-29-year-olds) may not be explicitly articulating this sentiment in such clear statements. But the expectation is manifest nonetheless. As well it should be! There’s an entire branch of medicine known as “predictive medicine” (sample portfolio of research here) that predicts diseases of the body. Well, isn’t the mind a part of the body?
The Push Paradigm
To accommodate these new expectations, we need to evolve a new paradigm of mental health support delivery, one where we:
- Read people’s digital and real-life signals to anticipate a need
- Proactively activate virtual and real-life personal and professional resources before that need is acute
- Ensure the support resources are customized to meet them where they are
That paradigm is called the “Push Paradigm.” And the Push Paradigm complements the existing “Pull Paradigm” by addressing the expectations of Gen Z in ways that the Pull Paradigm simply cannot.
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