I grew up in a home where quiet was abundant. My parents loved me and my siblings and they worked hard to give us opportunities they never had. But there were no lively dinnertime conversations, bedtime stories, banter in the car. Our parents were devoted to us, but emotionally withdrawn, silent and chronically sad.

It wasn’t until many decades later – while taking my first Mental Health First Aid course – that I recognized that their behavior was likely undiagnosed depression. I grew up in the 1950s and ‘60s when no one talked openly about diseases like depression. Still, these diseases were common, just as they are today. In addition to my parents’ struggles, members of my extended family lived with substance misuse, bipolar disorder and schizophrenia. A close childhood friend of mine took her own life. It was impossible for me to live through these and other troubling experiences and not want to do something about it.

That’s why, as First Lady of New York City, I work every day to break the silence, end the stigma and alleviate suffering. I feel called to do this work. ThriveNYC was created in November 2015, after 11 months spent talking with clinicians, government officials, advocates and New Yorkers from all walks of life about their needs and experiences. ThriveNYC is our ambitious public health plan to transform the way New York City delivers mental health services, and change our shaming, punitive culture around mental illness to one of healing and wellness.

We are making it easier for New Yorkers to access mental health care and support in the places they live, study, work and worship.  Thrive’s dedicated 15-member outreach team works across the city to connect people to services and promote Mental Health First Aid – one of the cornerstones of our plan – in multiple languages. We want every New Yorker to be a helper and a healer.

Mental Health First Aid gives us a common vocabulary and language to have open and honest discussions. Few, if any of us, grew up talking about mental health and it’s hard to talk about a challenge without the appropriate words. So, we’re doing everything we can to spread the knowledge. In truth, that has not been as difficult as I anticipated. The forces of stigma and shame remain powerful, but there is a tremendous need and hunger for Mental Health First Aid and for ThriveNYC.

ThriveNYC is not only about delivering services and erasing stigma. It also vividly illustrates the major role government can play in supporting mental health.

Guided by six principles – change the culture, act early, close treatment gaps, partner with communities, use data better and strengthen government’s ability to lead – ThriveNYC is addressing mental health through all the City’s policies and building a behavioral health system that works for everyone.

Here are some examples of our guiding principles in action:

1. The City covers the cost of Mental Health First Aid training for every New Yorker. By the end of August, we will have trained over 70,000 New Yorkers and are well on our way to meeting our ambitious goal of training 250,000 by 2021.
2. Faith and community leaders have joined forces to fight stigma through dedicated weekends to discuss mental health. Participation in the annual weekend of action has grown from 1,000 houses of worship in 2016 to 2,500 this year, with all 50 states and every major religion represented.
3. We address the challenges that are unique to communities of color, where access to care is complicated by continuing and historic inequity and a lack of culturally competent mental health experts. In 2017 we created “Sisters Thrive” with the help of six African-American women-led service organizations. We also created “Brothers Thrive” last April with six service organizations led by black men. Both groups have pledged to engage and inform communities of color and have a goal of enrolling a total of 20,000 people in Mental Health First Aid. We also have outreach staff dedicated to Asian-American and Latino communities.
4. We screen and treat pregnant women and new mothers for depression in city-run hospitals and clinics.
5. Any New Yorker can call, text or chat with a trained counselor at 1-888-NYC-WELL, our 24/7 helpline. People can call for themselves or someone they care about. NYC Well counselors can help callers make an appointment with a therapist or psychiatrist and call them back to make sure all went well.

With the help of Mental Health First Aid, ThriveNYC is creating a movement with the potential to alleviate immense suffering. Given that one in five people lives with mental illness, there is an overwhelming urgency to this plan. The growing body of knowledge about mental health must be reflected throughout our culture. I am deeply moved by this work every single day and I am honored to be on the front lines helping us evolve as a city and as a nation.