A Letter from 2020: What I Imagine Mental Health will look like in 5 Years
When we launched 7 Cups in July 2013, we started by providing 50 supportive conversations a week with just a handful of active listeners. Now, we provide 130,000 supportive conversations a week and have over 100,000 listeners across 180 countries offering support in 140 languages.
It has been a long and hard road to get here. We learned a lot of hard lessons along the way, with many more to learn. We consulted with lawyers specializing in mental health and technology. We also spoke to leading mental health professionals like John Norcross, Ph.D., ABPP, an internationally recognized expert on behavior change.
The bulk of what we learned, however, did not come from consultation or top-down strategic planning. Rather, it came from staying close and listening to our community.
Many of the lessons learned are counterintuitive, and I want to share them, because I think they point to one possible vision or framework for understanding the future of mental health and potentially all healthcare.
That said, lets pretend its 2020, and Im writing a letter to my friend and colleague, Louis. Youre getting a glimpse into this letters excerpts, in which I made comparisons to the past, including today, 2015.
Heres what I see—and hope:
October 15, 2020
Dear Louis,
How are you? Im sure the boys are quite big now. Amazing how quickly the time goes and how much things change. I wanted to share some thoughts with you comparing 2020 to how things were back in 2015. Would welcome your feedback!
1. Free Basic Mental Health Care for All: Remember in 2015 when so many people struggled and couldnt access mental health care? It wasnt that anyone was deliberately holding back care from people that needed it; it was just that we didnt yet know that we could rearrange some pieces in the puzzle and do things differently. Fortunately, now we do know and, man, what a difference it makes.
2. Peer Support: Its still hard for me to believe that peers, or volunteers, play such a critical role now. Who would have known they would become the foundation of our field? We had some clues of it with NAMI (National Alliance on Mental Illness), AA (Alcoholics Anonymous), but really had no idea of their roles.
AA and NAMI also gave us hints of something else as well: the importance of community, the need for us to be a part of something greater than ourselves, to lean on and be leaned on when others need support. Communities strengthen people and help everyone see that really we are all on the same journey.
3. Emotional Wellness as Enjoyable: Mental health was not seen as a good time in 2015. Perhaps it was the words mental health and the stigma associated with it that made people want to avoid it so much. Or maybe it was our obsession with labels in identifying people as disorders instead of, well, uh, people? What we know now is that emotional wellness is enjoyable. People build great relationships, play therapeutic games, and know that life is comprised of ups and downs. There is a deep joy that can be found in helping another person who might be struggling.
Today, we realize challenging times are just a part of life and nothing to be ashamed of. Im so happy that our field is now seen as hopeful, positive and enriching. Lets never go back to those dark days of 2015.
4. Technology: I think everyone knew that face to face sessions were going to go by the wayside. Everyone had a phone in their pocket, so it wasnt a huge surprise for people to begin to connect with others via the Web and apps. What I remember being more surprising was how our models of support changed. We gradually came to realize that people benefit from continuous support and that the 50 minute hour was just an artifact, an old dusty idea. Man, and remember how clinicians had to struggle to see 30-35 clients in a given week? What a recipe for burnout and frustration. I guess we didnt know any better. Now, through a combination of texting therapy, video chat, and therapeutic games, therapists can track outcomes across a hundred clients a week.
5. Collaboration: Looking back on the mental health world 5 years ago, I think we were all in a sort of collective denial about the economics. Clinicians had already been getting paid less and less each year. Reimbursement rates kept falling. There was growing competition between counselors, psychologists, social workers, and psychiatrists. In retrospect, I dont think we realized that we were all fighting over a pretty small pie. Turns out when everyone gets free access to mental health care, the amount of people that need support from licensed professionals grows 10X. The pie, as they say in the business world, becomes bigger than any of us realized. Now, because demand is so high, we learned that we need to collaborate. Peers see the majority of clients with sub-clinical issues, and this frees up licensed folks to take on the more challenging cases. There also now seems to be less tension around the different roles, because we all realize that each profession plays an important part in the overall field.
5. Outcomes: Today, we have learned that regular assessments and monitoring throughout the course of treatment can allow us to make adjustments where necessary and help us get the person well faster and more efficiently. Previously, some percentage of clinicians used outcome measures regularly, but they were largely administered on paper and stuck in a file cabinet or room somewhere. NHS (National Health Service in the U.K.) was just starting some innovative work in regularly administering assessments and gathering data at scale but, unfortunately, they were still kind of wedded to the clinical hour model. I dont think any of us realized in 2015 that baking in outcome measures right into the normal flow would allow us to learn so much more about treatments that work at a much faster rate.
One last thought: How do you think things will look in 2025? I cant wait to see how things evolve and change. Things changed so much in the last 5 years. Very fun to think about!
Give my regards to Heather and the boys!
Best,
Glen
Ive been thinking about this for several months now and wanted to share it with our community. Would welcome your thoughts and feedback!
We can only hope that people treat mental health like an actual disease and not just "suck it up" and sweep it under the rug in the next 5 years.
@astuteScorpius
Lovely <3
I think this needed to be written:) this site increasing helps people every year, and if we can achieve a change, no matter how big or small, then imagine ,what the next 5 years will look like, or even the next 10 years! I really loved the letter!!
This is a very nice letter, I hope to see the same things in 5 years 
(I can't help but notice though, isn't it supposed to be "A Letter for 2020"? Or did we go Back To The Future wayooooo xD)
in 5 years time it would be great if this site was reccomended by doctors and or people who work in mental health who reccomend this site to there clients or people who they help. cant wait to watch this site grow .
...Now that was genius
This is very nice and really hope i don't have to pay 60 dollars a session in 5 years, however I do have email access to my therapist if something comes up, but i don't believe one on one therapy will become obsolete. I'm really bad at hiding behind a computer, so one on one for me let's me be real with myself and see the expression of my therapist. Where a computer i can hide and also take everything the wrong way like i tend to do.
@purplewaves83, I took away from the letter that all of these modalities have their place and time and that the trick is to help people find and get access to the sort of help they need.
I love this, Glen!
That is inspiring to see the change in how the mental health field is changing. Yes, 50 minutes don't really cut it a week when someone is seriously struggling, does it? And the old true and tried therapeutical methods that label people and do not see the humanity in the person (I am guilty of this too when I paid homage to the Western psychiatric model, which I find has some glaring holes in its conclusions).
I hope that 7 cups continues to grow and people get the help they need irregardless of ability to pay as the mentally healthier, more connected world is a happier world indeed. Perhaps it will lead to less mass shootings in America, imagine that?
Thank you, Glen, Heather, Laura and the 7 Cups community for being an amazing safe space to be.
What a good letter. It can be empowering to get out thoughts out on paper, or rather on the computer. I agree. Rearranging pieces in the puzzle has made a world of difference.
There are not enough mental health professionals to handle the task of seeing every person who needs to be seen. It's sad that people who have mental illness can't get the time off of work, can't afford the gas to get to appointments, and some must pay for babysitters so that they can get to their appointments. Often, their mental illness prevents them from going to appointments, even if they are necessary.
I've volunteered my time as a moderator on several mental health websites. I've seen the difference that the volunteers have made. I've also felt the effects on my own mental health. In fact, the sites have made a bigger difference than almost all conventional methods of therapy.
One would think that if a profession is looking to improve upon services, they'd start with people who use the services, to see what works and what doesn't. With mental health, this doesn't seem to be the case. Many times, people with mental illness feel dismissed and seen as "crazy".
People who've suffered can be amazing. They often come up with solutions that work for them. What's even better is that because they've gone through pain, they are often careful with words and try their best to help others to find solutions.
This is where the benefit of online communities come in. If I've gone through a traumatic event, I may find solutions that have worked for me. I'll be eager to share those things, so that others may benefit, and will no longer hurting.
In international online communities, we have different values, religions, morals and practices. When we get together and communicate, we get solutions from people all over the planet. There are bound to be things that may not suit us, but the opposite may also be true. We may find a solution from another part of the world. That's a pretty powerful resource to have in one space!
One doesn't have to be a part of this community for very long before they see that we build strength here. It's very apparent. Building strength here is bound to translate into our daily lives. It's a building block.
Think of actions in this site and in our lives as though they are bricks. If we are trying to build a building, we have to put the bricks together. When our building is looking well put together, it helps others start trying to do the same.
In this site, we are attempting to fix what's wrong around us. When we start out here, we may feel very much broken. How do we fix that? Well, we look at our actions as though they are bricks.
A kind word that we share = a brick.
A piece of constructive advice that we give = a brick.
A kind, healing and gentle hug = a brick.
An ear that we lend = a brick.
A heart on a post = a brick.
Working together = a brick.
Those bricks build our house. We are putting bricks in place very quickly here.
One interesting thing that you said that caught my eye was the wording in your third paragraph. You referenced "emotional wellness". I read that several times, just absorbing the positivity in it. Often, we hear of "mental illness". I don't remember if there has EVER been a time in my life where I can say that somebody has really made an effort to model emotional wellness. It most certainly wasn't spoken of.
In this community, we know that there are bound to be tough days. We see it often. We're encouraged to help those in need. At the same time, we are also encouraged to keep taking steps to become more healthy. It's wonderful to be able to celebrate each other's successes as they embark on this journey of building a stronger community here, and their successes that come from their daily lives.
Quote time.
"There is a deep joy that can be found in helping another person who might be struggling." - Very true. :)
"Now, through a combination of texting therapy, video chat, and therapeutic games, therapists can track outcomes across a hundred clients a week." - I love this thought! :)
"Turns out when everyone gets free access to mental health care, the amount of people that need support from licensed professionals grows 10X. The pie, as they say in the business world, becomes bigger than any of us realized. Now, because demand is so high, we learned that we need to collaborate. Peers see the majority of clients with sub-clinical issues, and this frees up licensed folks to take on the more challenging cases." - The most powerful words in your entire letter, in my opinion. If I had my choice, that would be a quote in medical/psychiatric journals. Right along with it would be:
"Today, we have learned that regular assessments and monitoring throughout the course of treatment can allow us to make adjustments where necessary and help us get the person well faster and more efficiently."
I'm new here, and although you don't know me, it may now be apparent that I'm not usually very short on words. I didn't mean to take over your post, I just had a lot to respond to. It will definitely be interesting to see where this journey take us. Thank-you for sharing, even if it seems odd that I'm saying that to you, on your site. hahaha
Hey, your fault. you asked for the feedback. lol
@CompassionHelps, great reply - lots to think about!