7 Pathways to Whole Community Mental Health

By Craig Rennebohm

creator of The Companionship Model.

Distress and despair are increasing among us. Suicides have almost doubled over the last two decades. Deaths related to alcohol have more than doubled. Overdose deaths have more than tripled. “In 2023 one in every 30 youth in this country, or about one in every middle school or high school classroom, attempted to end their lives.” (Zahniser & Rennebohm, 2026, p. 12) Focusing on one part of the problem is not enough, because individuals in distress need a proactive, locally-based, whole community approach that organizes care and recovery resources. All of us are in this together. 

The following seven pathways lead to healing and wellbeing, so that no one is left out or left behind. 

Companionship is the most basic pathway to address the distress and despair arising from trauma, abusive relationships, mental illness, substance use, and non-medical drivers of well-being. We begin by creating a fabric of person-to-person sensitivity and compassion. Small groups of ordinary people form Companionship by practicing hospitality and neighboring and by sharing the journey to wellness, side by side. Companions listen and accompany another person in finding healing resources and long-term stability. 

Community Collaboration is the second pathway opening neighborhood front doors to care. Community groups and organizations work with mental health services to create welcoming spaces at the local level, such as a park bench, a drop-in center, meal programs, “night cafes,” a library. These are spaces of welcome and trustworthiness with mental health workers available on site, on call, or nearby to support people so they can begin the care journey now.

Prevention and Early Intervention is a third pathway in the whole community approach to mental health. We don’t wait. We anticipate. Education erases stigma and builds understanding of our vulnerabilities. Attention to early signs of substance use, emotional suffering and relational struggle moves care upstream to address symptoms and root causes long before people flood into emergency rooms, streets, courts, and jails. 

Integration of physical and behavioral health services at our primary care clinics is the fourth pathway to whole community mental health. Integrated care provides a one-stop space, with mental health staff part of the care team, on site and able to begin care in person. 

Certified Community Behavioral Health Centers are a fifth pathway assuring that care and resources are available to all. CCBHCs can play a unique regional role in coordinating outpatient treatment, inpatient care, crisis, emergency and forensic services, supported recovery and outreach. 

Supported Recovery, which includes education, employment and social/spiritual growth, is a sixth pathway essential to maximum wellness. 

Outreach and Engagement with those of us who are most alone and on the margins is the seventh pathway. Outreach teams do case finding and help reconnect individuals who have been lost to care. Working with people who are most difficult to serve and assist, outreach and engagement staff provide feedback on what is working and what is not meeting people’s needs. Crucial to ongoing evaluation, Outreach and engagement staff provide a real time picture of how well the system of services and care is functioning.

A book I co-authored with Dr. Jim Zahniser, Whole Community Pathways to Mental Health: Ending the Epidemic of Distress and Despair, describes these seven pathways in detail. The book is available for purchase from Springer Nature. In addition, Springer Nature offers the book in digital form to university libraries under a license that allows patrons to access to the entire book or to any of the individual 12 chapters, so that faculty and students in the fields of psychiatry and nursing, psychology and social work, community mental health and public policy, can make the book a part of coursework at the undergraduate and graduate levels.

Many people would benefit by reading the book and putting the seven pathways into practice, including students and professors studying mental health and social work, PEERs (persons experienced and engaged in recovery), family advocates, mental and physical health staff and administrators, officials in city and county government, local legislators and policy makers, faith community leaders, and people in the workplace. 

Community is a broad term. Our community may be geographic, a neighborhood, a school or workplace, an organization, or a people with common interests, such as shared history, issues, concerns, or goals. How would reading this book benefit you? Who in your community might be part of reading this book? How would you envision the book being used?