With so many resources, why does the mental health crisis continue?

Three reasons and our proposed solution

In a recent post, James E. Hill does an excellent job of conveying the urgent need for mental healthcare in Nashville. This week I would like to continue the conversation by asking why.

Nashville is actually one of the most well-resourced cities in terms of numbers: there are over 1,000 therapists practicing in the greater Metropolitan Nashville area, as well as more than 200 nonprofits in the mental health sector. Belmont, Lipscomb, Trevecca Nazarene, Tennessee State, and Vanderbilt Universities (among others) all have programs to train master’s- and doctoral-level clinicians. Unlike our rural neighbors in some parts of Tennessee, where patients may struggle even to find a therapist they can meet with in person, we have a plethora of options available.

So if the problem isn’t a lack of resources, why do Davidson County residents report an average of 5.3 poor mental health days every month?

I think there are at least three major reasons.

1 - There are structural, systemic, and sociocultural factors affecting everyone’s mental health, not just in Nashville. A Spring 2025 Johns Hopkins study revealed that 1 in 10 Americans report experiencing a mental health crisis in the past year, with the highest rate (15.1%) occurring in young adults ages 18-29.

Climate change, political tensions, loneliness, financial uncertainty, increasing family estrangements, the constant bombardment of “bad” news, and the nonstop pace of living in the Information & AI Age all contribute to rising levels of anxiety and depression. Because these factors stem from dysfunction in our very society, there is only so much that even the best therapists and most motivated clients can do to alleviate mental health struggles when their suffering is not just due to individual situations (life crises, genetic vulnerability, etc.).

2 - The economy of the “healthcare” industry works against effective healing and care. As I’ve written before, the unfortunate reality is that the U.S. medical model has become more about money than either “health” or “care.” While the law requiring insurance to provide mental health coverage on par with physical health coverage was an important step in the right direction, it can only go so far when most insurance companies pay mental health providers unsustainably low reimbursement rates (this also varies, somewhat arbitrarily, according to their type of license). Most therapists I know are not in-network with insurance because making a living that way would require seeing so many clients that we would quickly burn out altogether.

So, when we need therapy—and most of us do!—usually we end up having to pay out-of-pocket, which is not an affordable option for many people. And that’s just individual psychotherapy: if a person finds themselves needing to be hospitalized or receive intensive outpatient treatment, there are limited options that are affordable outside of really top-notch insurance coverage.

3 - Finally, I think the mental crisis continues because a key trait of 50% of people seeking therapy (i.e., SPS/HSP) is mostly being ignored. If research showed that half of all cardiology patients exhibited a particular factor, I’d like to think that the medical community would pay attention and adjust their treatment strategies accordingly. Yet about half of all therapy clients are Highly Sensitive Persons—arguably the world’s most common form of neurodivergence—and while many individual therapists know about HSPs and work to serve them skillfully, I have found zero mental health centers consciously and intentionally specializing in this trait.

This is where CATHARSIS comes in. We seek to provide “highly sensitive healing,” by HSPs and for HSPs, with the keen attention to environment, beauty and creativity, gentle approaches, continuity of care, integrated somatic and spiritual modalities, and access to nature that HSPs especially need (but from which most any patient would benefit!). And, with the help of generous community support, we aim to make it available to clients of any socioeconomic status.

While most of the factors contributing to mental health distress are far beyond what any one organization or approach can address, this significant gap—the lack of HSP-oriented care—is in our wheelhouse. We’d love to have you join us in this journey of bringing Clients And Therapist-Healers Activating Relational Synergy In Sanctuary (CATHARSIS) into being!