There has been a lot discussed and debated about our individual and collective mental health over the last 14-plus months. It has led to headlines throughout the pandemic—on the lips of parents and teachers worried about children, co-workers anxious about their frazzled colleagues, and friends concerned about their unreturned calls.

Early on, the United Nations issued a policy brief highlighting that COVID-19, while first and foremost a physical health crisis, could also morph into a mental health crisis if appropriate actions were not taken. Among their top three recommendations was ensuring “widespread availability of emergency mental health and psychosocial support”. While few would disagree that it needs to be a priority, we haven’t always stopped to consider the people resources needed for such a response and the asks we continuously make of them. We have not taken the time necessary to think about who is supporting those who help support our mental health.

A recent report by the Kaiser Family Foundation, which analyzed data from the U.S. Census Bureau’s Household Pulse Survey, noted that 4 in 10 adults have reported symptoms of anxiety or depression during the COVID-19 pandemic, compared to 1 in 10 adults in the first six months of 2019. Even more concerning, this number jumped to 56% for young adults ages 18 to 24, with increased reports of substance use and suicidal thinking. And, there has been a disproportionate impact on Black and Latinx communities, which already had difficulties pre-pandemic in accessing mental health services.

Behind each of these headlines though are the unsung heroes we haven’t talked about very much during this pandemic. When we speak of the frontline workers, the images we see are of the doctors, nurses, and other hospital staff who have been working to save countless lives or, in the final moments, hold the hands of those they cannot. They sacrificed their families, staying in hotels and not hugging their children, afraid of bringing the pandemic home. We have thanked them with free meals, window signs, car parades, Super Bowl tickets, and countless other ways. They deserve all the praise they have received and so much more.

“We have not taken the time necessary to think about who is supporting those who help support our mental health.”

–Dr. Joy Ippolito

Sometimes silent supporters

But the images you don’t see are of all the mental health professionals who have been holding us up while the world feels like it is crashing all around. They are the invisible class of frontline responders. Behind every policy brief and data report are the people who are holding teletherapy sessions at all hours of the day for overwhelmed and depressed parents struggling to get their kids in front of school Zoom sessions while meeting untenable work deadlines in a crowded 800 square foot apartment. They are the workers answering suicide hotlines, trying to convince individuals they have never met to see that there is hope and light ahead. They are the school counselors and social workers who rushed to get vaccinated because they know the children on their caseload were suffering in the digital world and needed to be seen in person. They are the case managers who already had a difficult time finding services for clients, only to experience increasing caseloads at a time when community organizations had to shut their doors. They are the data scientists and clinical teams programming AI algorithms that require sifting through messages shared by people of their very dark and real struggles in an effort to provide digital support that addresses the gap of those needing care but languishing on waiting lists.

“None of them do this for fame and glory. Certainly not for the pay. They do it because they have been called to do it. And even now, as we put all of society’s expectations for solving our mental health crisis on their shoulders, they will not ask you to recognize them.

But I will. And I’m asking you to join me.”

While I have not practiced clinically during the pandemic, I have been in their shoes in my prior careers. I have listened to individuals who wanted to end their life and helped them find the reasons to keep going. I have sat quietly for 40 minutes while a teenager cried, because after a year of not talking they finally wanted to let out the tears in the safe space that was my office. I have read crushing child abuse case histories that, while only on a screen, were somehow harder to process than anything an individual had ever disclosed verbally.

I did not talk about those moments during those careers for the same reasons you are unlikely to see the images of mental health workers during the pandemic today—the intimacy and privacy of what they do keeps them from speaking openly about the enormous strain of the work. No therapist wants their clients to hear they are burnt out, especially in a job that requires holding space for difficult emotions and circumstances. As with many stressful professions, you confide in your colleagues doing the same work. You try not to take it home. Except the pandemic blurred and changed those lines as well.

I have been fortunate over the years to teach many students who have become my colleagues, admired professionals, and friends. They work with children who are differently abled, teenagers who are homeless, college students trying to manage anxiety, veterans hoping to find stability amidst their PTSD, individuals trying to escape domestic violence, and older adults struggling with dementia. I see them trying to remain positive. I see them struggling under the weight of the expectations place upon them. I have the utmost respect and admiration for the heroic work they do. None of them do this for fame and glory. Certainly not for the pay. They do it because they have been called to do it. And even now, as we put all of society’s expectations for solving our mental health crisis on their shoulders, they will not ask you to recognize them.

But I will. And I’m asking you to join me.

May is Mental Health Awareness Month and serves as an important reminder to everyone that you are not alone during this time. There are people here to listen, offer support, and provide guidance. While it can be difficult to make that first text or call, there is someone there on the other side who genuinely wants to help you.

For those of us who do not need those supportive services right now though, my ask is that you do something to help recognize the helpers. Take a moment to thank the counselors, social workers, psychologists, psychiatrists, therapists, and other mental health workers who are keeping us going through these difficult times. While they may not be helping you directly, they are supporting our hospital workers, educators, and daycare providers who are helping you and your families. They won’t be as visible as a hospital or a school—and some may be intentionally obscured due to the sensitivity of their work and the confidentiality of the clients they serve. But they are out there, doing this work 24/7. They are your family members, community members, colleagues, and friends.

For many, an acknowledgement of the difficult work they do will be gift enough. But for those wanting to do more, consider dropping off a care package at their main office or coordinating with local officials to have a day of recognition for mental health care workers. Our hope for a positive post-pandemic future rests just as much in their hands as it does in our healthcare systems, financial markets, critical infrastructures, and policy reforms. We need to support their mental health, too. Not just because we need them, but because they are under stress and strain just like the rest of us. Let’s ensure we don’t miss the opportunity to let them know how appreciated they truly are.