Depression is one of the more recognized forms of mental illness.

It’s difficult these days to walk the streets in Los Angeles county and not see someone who is seemingly distressed and in need of help.They may be out of work. They may be homeless. And — even harder — they could be suffering from a mental illness.

Then add in trying to navigate through the COVID-19 pandemic this year which — when not making people sick with the coronavirus — has kept much of the public isolated or socially distant for months, further compounding stress and anxiety. 

Jessica Cruz, CEO of NAMI California (National Alliance of Mental Illness), says that while the numbers of persons with behavioral and mental illnesses is growing the housing and health care for those needing support and services remains in short supply. 

“For the behavior health and mental health communities, we’ve been talking a lot about the ‘tsunami’ that is 2020,” said Cruz, whose state nonprofit advocacy organization on Tuesday, Oct. 13, concluded a two-day virtual conference with speakers and workshops addressing these topics.

“The (coronavirus) pandemic was that first wave. But usually with a tsunami, it’s the second and third waves that create the most damage. And [mental health advocates] have been talking about how this second wave could be about the behavioral and mental health aspect.”

Cruz said along with the pandemic, statewide protests and rallies against deadly police confrontations — a study by the Treatment Advocacy Center says people with untreated severe mental illnesses are 16 times more likely to be killed by police, and that the mentally ill make up nearly half of all fatal police shootings —  and the trauma for those in the path of this season’s wildfires have helped spike the numbers of those with mental health issues.

“We’ve seen an increase of 44 percent just since July of individuals who have self-disclosed that they are dealing with some sort of anxiety or depression,” she said. “And those are individuals who have never experienced or been diagnosed with any sort of mental health condition.”

Which can make the shortages of available health care providers feel more acute.

The California Health Care Foundation has reported that an estimated 11,226,111 people in California live in an area that has a shortage of primary care providers. And approximately 150,675 people are experiencing homelessness and in need of housing, health, and social services.

In Los Angeles county, those figures are 58,936 that are considered homeless and 3,702,746 who live in an area with a shortage of primary care providers and/or services.

NAMI California adds to this another sobering informative fact from its own website: 50 percent of mental illness can begin by age 14, and 75 percent by age 24.

“From the very beginning of someone’s early signs and symptoms there’s an eight-to-10 year gap from which they actually seek and receive services,” Cruz said. “Between 18-24 is usually when people will have their first psychotic break. We have to reduce that treatment gap so people have a place to go. [But] right now there’s such a shortage of mental health professionals that it’s been a struggle.”

And the housing situation is not simply a matter of finding shelter, Cruz said.

“We advocate for ‘supportive housing,’ specifically for our population of individuals living with serious mental illness,” she said. “Housing is important. But for people living with serious mental illness, housing must have supportive services that address their mental behavioral house in addition to the physical house.

“It’s one thing to have housing available. To have it and sustain it is a totally different topic. When we talk about housing and what it looks like in California, we have to remember that for people living with [severe] mental health issues that need housing, it looks very different than just having a room to be in.”

NAMI San Fernando Valley has spent much of this year training 300 volunteers to help with suicide prevention, thanks in part to a grant from Dignity Health. They currently have six ongoing family-to-family support classes for people with family members with a mental illness, “which is way more than we normally have,” said Beth Boyd, chapter secretary.

The chapter has also trained volunteers in a program called “Mental Health First Aid,” to help people notice when individuals may be showing signs of an illness or disorder such as anxiety, depression and panic attacks, and try to get those individuals help early.

“Our classes are evidence-based and they’re all free,” Boyd said. Everything we have to offer is free.

“It’s been a year like no other. And I hope it’s only a year. But there will probably be more [need],” Boyd said.

If there is a silver lining from all the chaos in 2020, Cruz said, it’s that the year “has brought to our attention the need for more mental health services.” But she remains concerned about how unprepared society is to handle more impact caused by COVID-19, and the shortage of health professionals and facilities.

“If we’re not prepared for this second wave of the tsunami, it’s gonna wash over us,” Cruz said. “It needs to be about [having] crisis services and in-patient/outpatient services for those who are mild to moderate to severe. And if we are not ready, it’s going to be a disaster, to be honest.”

Gov. Gavin Newsom recently signed into law four separate bills aimed at increasing access to mental health and substance use disorder services, including one requiring commercial health plans and insurers outside of Medi-Cal (which is regulated by different standards) to provide full coverage for treatment of all mental health conditions and substance use disorders, and another that would authorize counties to use Mental Health Services Act funds — often limited to mental health services — to treat Californians with co-occurring mental health and substance use disorders.

But more support and resources are needed, and that is a goal of NAMI and its various chapters for the remainder of this year.

“We will also work with our 58 local affiliates we have throughout California to help their local advocacy, train individuals and continue to provide support and services for families,” she said.

And there are also steps individuals and the public can take.

“I think if you’re an individual who might be troubled, reaching out is always the best way to find support and services. Have that conversation with friends and family, and find your local NAMI because they are individuals and volunteers who have been there and done it,” Cruz said.

“The more we can normalize the conversation, and get the services to you or someone who needs them…we’re all willing to help and have that conversation. We have to keep moving and talking about it, and normalize this conversation.”

If you would like to contact NAMI San Fernando Valley for assistance and services, call their helpline at (818) 994-6747. Phone calls are often returned within a day.