Responding to the Sandy Hook tragedy, in January 2013, President Barack Obama directed Secretary Kathleen Sebelius of the US Department of Health and Human Services (HHS) and Secretary Arne Duncan of the US Department of Education to launch a national dialogue on mental health. Secretary Sebelius recognized that mental illness affects nearly every family, yet there is a continued struggle to have an open and honest conversation around the issue. Misperceptions, discrimination, fears of social consequences, and the discomfort associated with talking about such illnesses all tend to keep people silent; but with early intervention, many people with mental illnesses can and do lead productive and full lives.
The challenge facing the administration was how to convene a national participation process that would help Americans to learn more about mental health issues, assess how mental health problems affect their communities and younger populations, and decide what actions to take to improve mental health in their families, schools, and communities.
Officials from the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency within HHS, understood the need to collaborate with the field of deliberative democracy in order to design a process that integrated multiple levels of collaboration. Dr. Carolyn Lukensmeyer of the National Institute for Civil Discourse called together the leaders of five other deliberative democracy organizations to spearhead Creating Community Solutions (CCS). Under the umbrella of CCS, 230 community conversations on mental health have occurred to date.
CCS formed a steering committee composed of deliberative democracy experts with a mission of scaling public participation in the conversation about mental health nationwide. Because three-quarters of all mental health problems present themselves before the age of 24, young people were an especially important target audience for participation, and the committee was tasked with finding effective ways to reach them. While CCS experienced success getting young people to attend the community dialogues, more innovative methods were needed to reach much larger numbers.
Relying on research that indicated young people prefer connecting and seeking support via texting than any other mode of communication, CCS created the Text, Talk, Act program, where small groups of three to five people text into a number to receive a series of text messages that guides their group through a conversation on mental health. By integrating social media, participants can see other young people that have joined the nationwide conversation on mental health. Responses from the discussion and polling questions are posted to a live website, so participants can see other responses from other groups.
This program has engaged an estimated 35,000 participants, an ethnically and geographically diverse group of teenagers and young adults in all 50 states. Over 90 percent of respondents to follow-up surveys in both rounds report an increase in understanding (about mental health during rounds 1 & 2 and about how to help a friend in need during round 3). Over 65 percent of respondents in both surveys report an increase in their level of comfort in talking about mental health.