Paz-Cedillos: When the center cannot hold

Mental health affects us all, whether we are the ones grappling with inner turmoil or witnessing a loved one’s unraveling world. We may not realize it, but we are all just one degree away from someone enduring an invisible battle. Privilege often determines whether they can access a competent medical team, stable support network or even essential resources to treat an illness that cannot be cured, only managed.

The COVID-19 pandemic laid bare the fragility of our collective mental health. According to the World Health Organization, anxiety and depression surged by 25% globally in the pandemic’s first year. Isolation, an unnatural state for humans, proved catastrophic. Loneliness doesn’t just harm — it kills.

But what about the mental illnesses most of us shy away from discussing — the ones that upend lives entirely, carry devastating prognoses and are often equated with insanity or institutionalization? I urge us to start here.

Our societal framework for addressing mental health is broken. We minimize and ignore issues that touch almost everyone at some point. When the center cannot hold, whether it’s you, your partner or your child, most of us are ill-equipped to recognize the signs, access support or advocate for what is needed. Even when help exists, it is often out of reach for those without the privilege of time, money or connections.

Privilege often determines outcomes.

I’ve lived this reality. Witnessing a loved one’s world collapse was devastating, and at times, it felt insurmountable. But we figured it out, fortified by privilege — time, money and networks. For many, these are unattainable luxuries. Yet even privilege was not enough without stabilization and resilience. And here lies the heart of the issue: What does stabilization mean?

Can we truly call someone’s condition stable if they lack permanent housing, health insurance or a livable wage? Releasing someone from care into an abyss of poverty and insecurity is not stabilization — it’s abandonment.

Treating individuals in isolation is not enough. We must address the systemic conditions that perpetuate instability. It’s time to stop framing mental health services and permanent housing as competing priorities. Both are essential and must work together to create real, sustainable change. Imagine a world where mental health care isn’t just a temporary intervention, but part of a holistic system that includes permanent housing, access to health care and a supportive community.

In East San Jose, we’re working to rewrite this narrative. Initiatives such as the Sí Se Puede Collective and partnerships between organizations like the Mexican Heritage Plaza and Gardner Health Services are building interconnected networks of care. Together, we’re creating pathways to housing, health care, behavioral health services, child care, healthy food and advocacy. It’s a starting point — a recognition that no family should face these challenges alone.

So, what happens when the center cannot hold? The solution lies in our collective efforts to rebuild piece by piece as neighbors, leaders and policymakers.

Note: This piece reflects my personal experience and the collective work in East San Jose to reimagine mental health support systems. The title is inspired by “The Center Cannot Hold,” a memoir by Elyn R. Saks, a law professor at the University of Southern California. Saks’ memoir about her journey with schizophrenia is a best-selling work that earned her a MacArthur Foundation “Genius” Award. Her book served as a beacon of hope, reminding me that even when the world feels like it’s falling apart, there is a way through.

San José Spotlight columnist Jessica Paz-Cedillos is the co-executive director at the Mexican Heritage Plaza. Her columns appear every first Monday of the month. Contact Jessica at [email protected] or follow her on LinkedIn.