The pandemic has caused trauma, grief, and stress leading to depression, anxiety, and worsening of other mental health conditions. Dr. Adam Karpati, former executive deputy commissioner for mental hygiene at the New York City Health Department and currently the Senior Vice President of Public Health Programs at Vital Strategies, talks with Dr. Josh Sharfstein about the profound mental health impact of the pandemic, in the context of prior failures to support people with mental illness. Dr. Karpati sets out a vision for a more organized, caring, and effective system of mental health care.