“It’s Okay Not to Be Okay”: How Maryland Communities Are Navigating Mental Health Amid Uncertainty 

Across Maryland—from the semi-rural city of Hagerstown, through the bustling streets of Baltimore, to the coastal communities of Salisbury—residents are carrying an invisible weight. Rising anxiety, economic instability, job loss, growing waitlists for therapy, and daily stressors are surfacing in ways that are hard to ignore. For many, the uncertainty isn’t just personal—it’s systemic. 

Policy Shifts & Layoffs Deepen Maryland’s Mental Health Strain 

Mental health professionals across the state describe what feels like a slow-building crisis. As one therapist put it, we’re living in a “perfect storm” where policy decisions made miles away are rippling through homes and workplaces. Federal layoffs, economic instability, and questions around healthcare access have left many Marylanders asking: What happens next? 

There are 2.22M federal workers across the U.S., 144,000 are located in Maryland making it one of the highest per capita states. To date more than 121,361 federal workers from more than 30 agencies including Department of Education, HUD, Center For Disease Control, FDA, Veterans Affairs and others have been terminated. Add to that additional workforce reductions, elimination of certain agencies, cancellation of government contracts and deadline for Fork in the Road Offers and early retirement, many of these workers are living under a constant cloud of uncertainty.   

“We’re seeing the effects of policy changes made in D.C.—the job insecurities, the ‘what ifs’ of what’s going to happen or not happen. Individual families are being hit hard, especially financially,” said Matthew Cape, LMSW, Mental Health Therapist of Healthy Lives Maryland, an organization that provides mental health and substance use services—like therapy, rehab, and transitional support—to individuals across Maryland. 

“If one federal worker in a household loses their job, that stress becomes a silo—and the other partner is just trying not to fall apart under the weight of uncertainty.” 

This stress can show up as sleepless nights, strained relationships, and the quiet fear of what tomorrow might bring. For many Marylanders, the mounting pressure is finally pushing them to seek support—but even that isn’t simple. With long waitlists and limited access to care, getting help often feels just out of reach. 

Even as more people begin to seek help, the systems meant to support them are shifting—putting vital resources like teletherapy on uncertain ground. “We’re already in a situation where mental health and medical providers are backed up—add mass layoffs, and now the wait is three or four months instead of two. It’s the perfect storm.” 

Access Interrupted: The Fight to Keep Telehealth 

According to a 2022 report from KFF, a nonpartisan nonprofit focused on health policy, 30.3% of Maryland adults who reported symptoms of anxiety or depression said they needed counseling or therapy but didn’t receive it within four weeks. 

With mental health needs continuing to climb, especially in the wake of recent economic uncertainty, access to consistent therapy is more essential than ever. But for many Marylanders, access to care is at risk—not because they lack the technology or the willingness to get help, but because insurance coverage is disappearing. Major providers like Aetna are cutting telehealth benefits on certain plans, and even Medicare is expected to scale back coverage for some virtual services. 

Telehealth, which became a lifeline during the pandemic, remains a critical tool for reaching clients in both rural and urban areas. When lawmakers quietly fold restrictions into broader budget or infrastructure legislation, entire communities lose access without ever realizing what was at stake. 

“Everybody has a phone—but not everybody has an insurance provider who will continue covering telehealth.”  

For clients in underserved areas—who may lack reliable transportation, child care, or the ability to take time off work—telehealth isn’t just a convenience. It’s often their only viable option. Cutting off coverage doesn’t just mean fewer appointments; it can mean no appointments at all. 

Without it, the consequences are real: fewer people reaching out, more untreated anxiety and depression, and a widening gap between those who need help and those who can access it. 

An Evolving Definition of Community 

Before therapy was ever a calendar appointment or a co-pay, healing happened in the everyday spaces where people felt seen. It looked like Friday night dinners with a chosen family. It sounded like porch conversations after church, or venting sessions in the car outside a thrift store. And it felt like safety. 

In communities where mental health was rarely named, connection filled in the gaps. These informal networks—grandmothers who listened without interrupting, barbers who offered advice with a side of humor—helped people navigate life’s hardest seasons. There was power in knowing you weren’t alone, even if no one ever said the words “anxiety” or “depression.” 

“Whether it’s therapy or just talking with someone you trust, it’s good to talk. That’s how communities heal…That was therapy,” Cape said.  

But when COVID hit, many of those everyday spaces of comfort and connection disappeared almost overnight. The shift to remote work, virtual classrooms, and social distancing fractured the natural rhythms of community. Isolation replaced routine meetups, and for many, especially elders and single adults, the loss of face-to-face connection came with a steep emotional toll. People were grieving—not just loved ones, but rituals, support systems, and the ease of spontaneous conversation.  

The places that once offered casual, unspoken support were now screens and silence. In the vacuum left behind, the need for intentional mental health care became impossible to ignore. 

Today, as professional therapy becomes more visible and accessible, it’s important to remember that healing doesn’t have to look one way. It can start in a clinic or a text thread. What matters is intention—vulnerability, empathy, the courage to speak honestly and the willingness to listen without judgment. 

Therapy isn’t just a place. It’s an interpersonal practice. And sometimes, it begins with the people you already know and trust. 

Culture & Stigma: What Keeps People Suffering in Silence 

In many communities—especially among men and people of color—mental health isn’t just a medical issue. It’s a cultural one. The barriers aren’t always financial or logistical, but emotional and often rooted in deep, unspoken beliefs about what strength is supposed to look like. 

“I think about that man, the one sitting in his car, full of anxiety and stress. He hasn’t reached the therapist yet. He might not even know he needs to,” said Cape. For men especially, acknowledging emotional pain can feel like a violation of unwritten rules: don’t cry, don’t complain, don’t ask for help. “Man up” culture teaches people to bury pain so deeply they stop recognizing it as pain at all. 

“We get so used to carrying emotional weight that we start believing it’s normal. But it’s not.”

What often holds people back from seeking help is the fear that a therapist will know too much, judge them, or misunderstand them. But as more people begin to name their struggles out loud, those long-held stigmas are starting to shift. Slowly, cultural narratives are making room for a different definition of strength—one rooted not in silence, but in self-awareness and healing. 

Making the First Move: What Help Really Looks Like 

Seeking help doesn’t have to be dramatic. It doesn’t require a breakdown or a breaking point. In fact, the healthiest decision is often the quiet one: checking in with yourself before things boil over. 

“You don’t need to be in crisis to benefit from therapy,” Cape explained. “Start small. Ask yourself: Why am I feeling this way? When did that start? What might I need? Open therapy the same way you open a shaken can of soda—cautiously, but with the expectation that the pressure will finally start to release.” 

The idea that therapy is only for people in crisis is one of the most damaging myths in mental health. Therapy can be preventative—a tool to understand yourself better, to manage everyday stress, to navigate change, or to unpack old wounds you didn’t even know were still affecting you. 

 “We don’t want tragedies to have to be the lesson. We want to stop tragedies because we’ve already learned.” 

“It’s okay not to be okay.” 

If you don’t know where to start, you’re not alone. Begin by talking to your primary care doctor. Call 211 for local mental health resources, or 988 for crisis support. Reach out to community centers, churches, or nonprofits in your area—many now offer free or sliding-scale therapy. 

Mental health challenges don’t always announce themselves. They look like coworkers quietly struggling to stay afloat, students who smile through stress, or neighbors carrying grief in silence. The truth is, many people are walking around with invisible weights.