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Caitlin Whyte: Welcome to Hally HealthCast, the Wellness Podcast from Halle Health. Your partner in helping you live your healthiest. Every episode on our podcast addresses a new topic important to your health and wellbeing, bringing in expert doctors, therapists, and specialists who offer advice and answer your most pressing questions. May is mental health awareness month. So today we're discussing mental health. It's impact on our day-to-day lives and relationships, the stigmas and barriers associated with diagnosis and treatment, when and where to seek help and a whole lot more. Here with us are two experts. Dr. John Beck is a psychiatrist and the medical director at Health Alliance in Champaign, Illinois.

And Devin Richardson is a licensed clinical social worker and supervisor of specialty care coordination programs for Halle Health and Champaign. Welcome to you both and thanks for being with us today. Let's begin with some basic mental health awareness. Dr. Beck, most of us are quite familiar with prioritizing our mental health on a daily basis, but many equate the idea of mental health with mental illness and put it out of mind, if you'll pardon the pun, until, or unless forced to deal with it. But there's more to it than that, isn't there? What exactly is mental health? This is a big term, and why should we be aware of it?

Dr. John Beck: I think, yeah, as, as you were saying, mental health is a tricky topic for people because it covers the range from. Stress, just the simple, normal stress of life and dealing with challenges you may face all the way to an actual maybe illness that's really interfering with a person's ability to function and talking about how or where that may happen. I mean, when you look at the prevalence of what we would call mental illness in a general community. Usually they talk in terms of 20% or so. What that means though, I mean, if you're looking at it on a family level or community level, it might be that a family has a child with ADHD.

And is causing struggles or challenges at school and meetings with teachers or things like that. Or it might be that someone has a family history of drug or alcohol abuse and maybe they're dealing with some of the ramifications of that. Maybe things they experienced growing up, or it could be coming to grips with their own use of substances and trying to understand is that, is this a problem or is this normal? You have issues with anxiety or depression. Well, a certain amount of that is normal to feel sad or feel down about something. But when it starts to go on and interfere and often the cutoff point for depression is two weeks, which is somewhat arbitrary.

But when a person is struggling and it's going on for weeks and they're not sleeping and they can't concentrate and their mood is very low and they can't enjoy things. Well, that's when it really starts to interfere. And studies have shown that when you really look at people who have developed mental illness that's really significantly interfering with their work or with relationships that it's years before they get any help. Because it takes a while for the person to recognize maybe that they need the help. And it may take them a period of time to actually get the help they need.

And so it can be a while and it and that has consequences. And so I think it's probably the rare family that doesn't have anything at all. I mean, I would periodically in my practice meet people who said they had absolutely no history of anything in their family anxiety or depression or substance use or anything, but they were pretty rare. And part of the issue is sometimes it's hard to know what has happened in a family because people don't necessarily talk about it. You go to your family reunion and everybody's gonna talk about their latest broken bone or their latest surgery, but they don't necessarily talk about their latest mental health visit.

And we know that some of the more serious mental illnesses have a genetic component to them. So the family history is very, very important in trying to understand symptoms somebody is having. I mean, when someone would come into my practice and they would were having symptoms of depression, it was very important to know, well, did they have three relatives who'd been hospitalized for depression or not? Because if they did have that strong family history, then I would look at the depression differently. I would be more wary of just saying, well, it's just a normal process.

So it's understanding the prevalence of these different illnesses out there and being aware, and I think as a family, be aware kind of what runs through your family. If we know anxiety runs through the family and we have a five year old starting kindergarten and they're anxious. Well, it kind of fits, that if that's part of the family. And it kind of helps bring, not closure, but helps families understand. Because I think people, particularly parents, often blame themselves. Well, You know, if I did this instead of that, well then maybe my child wouldn't be having these attention span problems in school or behavioral problems or anxiety problems.

But then when you talk to them, you realize, well, gee, this has gone through, you know, three generations of people with these kinds of difficulties. It helps the parents because they know, well it wasn't just something I did wrong, because I know with parents, that's often the concern that they think they caused the problems for their kids.

Caitlin Whyte: Thank you, Dr. Beck. Wonderful. In-depth explanation. So Devin, it looks like the state of our mental health can have some far-reaching implications. What kind of impact can mental health issues have on our daily lives?

Devin Richardson: Great question, Caitlin. Again, we're gonna look mostly at thoughts and behavior here because our thoughts and behaviors are with us every single second of every single day. So if you are in a pretty healthy mental health space, then probably your thoughts are gonna be more appropriate, more positive, and kind of then been into more positive behaviors and better functioning. Whereas if you're really in the trenches with those more negative symptoms of a mental health diagnosis, that's when we get into unsafe thoughts and behaviors, or if not unsafe, at least negative thoughts and behaviors that can really diminish the person's ability to function just in their day-to-day lives.

Caitlin Whyte: Well, it's a lot to consider. Thank you, Devin. Dr. Beck with so much at stake with our mental health, clearly getting help when it's needed is critical, but unfortunately, there's still a great deal of social stigma associated with seeking treatment for mental and behavioral problems. How do you respond to those concerns?

Dr. John Beck: Well, I think that's a really good point, Caitlin, because certainly in my practice through the years, it's very difficult for people I guess, cross that threshold to get, decide they need help to come in and see a mental health provider of some type. I mean, and so I think you have a lot of people who aren't getting services they need. So I think there's that in the sense of people's kind of reluctance to, to go there. But then I think in addition, you. Just resources for mental health treatment have often been hard to come by, so to speak, in terms of wait list. Very often when people are contacting for mental health services, it's pretty urgent because people have generally waited until it's reached somewhat of a crisis point before they decide, okay, yeah, I need to get help.

But then if they get told they can't see a provider for four months, that's very discouraging. So I think, we as a health plan, and I know the different provider systems have been working with, well, how do you really address that? How do you get people the care they need when they need it? And I think through our health plan, as I was saying before, we have MD live where you know you can. Get virtual behavioral healthcare within a matter of couple of days, the whole spectrum of care. And I think that's been real critical because with the pandemic it's made people much more comfortable with the idea of things, doing things virtually.

And I'm talking with a provider system recently, and everything had been, or most of their care had been done virtually for a period. Couple years with the pandemic and as they were opening their offices, they found a significant number of patients and providers liked virtual work. And so even though they could drive in and see their provider, bricks and mortar, so to speak, they actually liked virtual. And I think that's, Been really helpful because I think it's opened up opportunities because behavioral health is one of the areas of care. I think that lends itself to a virtual service. And then as Devin was saying too, and can elaborate through Hally our members have that ability to access behavioral health things virtually.

So,you can research things and you can look to see which opportunities are or alternatives. And as I said before, you always have the fallback of talk to your primary care physician. And I know it's a little trickier because a lot of young people don't necessarily have a primary care physician. For people that do, I think they can be a really good resource, both in terms of helping understand, well, Gee, is what I'm experiencing, do I warrant anything , or is this just normal? So as I said, you have a number of places to access care now that even pre pandemic weren't as available. Before the pandemic virtual care was extremely limited, and hardly ever utilized, and now it's become really part of the mainstream, which I think is good.

Caitlin Whyte: Yes. Thank you Dr. Beck. It's so important to remember, especially those virtual options, that's actually how I do my own therapy sessions, and it's just so nice to be able to do it from home.

Dr. John Beck: I think just absolutely because it also addresses people. Concern for privacy. I mean, I had patients say to me that where I was working for a period of years and was by a busy main street thoroughfare and they didn't like coming into the building because. Maybe a hundred cars would drive by as they were waiting across the crosswalk and walking into the building, and they didn't want to be seen and they wanted that privacy and that was hard to give them because we didn't really have a lot of options.

But now you do. I mean, you can literally get care and never set. in maybe a designated facility that would make you uncomfortable that you want your privacy. Because certainly with behavioral health issues, people, not everybody, but for some people the privacy is exceedingly important and it really drives whether they even get care or not.

Caitlin Whyte: Absolutely. Just knowing we have all these options for services is so helpful. So Devin, in addition to the social stigma associated with mental health, there's also the frequent misconception that only certain people struggle with mental health issues, particularly people who perhaps aren't like us. But isn't it true that all types of people younger, older people from all backgrounds and life experiences struggle with mental illness issues, right?

Devin Richardson: Oh, absolutely. I've had the privilege of supporting people as young as three years old and folks well into their nineties, so mental wellness issues can really impact anybody, really at any age and any background as you're mentioning. So it's definitely not a discriminatory disease in that sense. And I think that the more that. People get the message out there that everybody probably at some point or another in their life is gonna have some struggle with mental health symptoms, that can really show people what a global issue it is and hopefully help eliminate some of those misconceptions.

Caitlin Whyte: Thank you, Devin. A very, very timely reminder. Well, Dr. Beck, since mental wellness issues can affect even children as young as three, like Devin mentioned, we touched on this, but again, what should parents and guardians know when it comes to mental health?

Dr. John Beck: I think if you're talking about with your children, I think there's, as a parent, you, it's hard to necessarily be incredibly objective because you don't, you just don't have the information. So if you have a child, and maybe they're struggling with attention span, or they're struggling with behavioral issues, or they're having a lot of anxiety, it's hard to know, well, what's normal? Maybe that's your only child, or you have two children, or whatever. And I think that's where schools can be a resource too, in terms of talking with the teachers or talking with mental health services through the school and say, gee, my child is having this level of anxiety related to school.

Is that, what do you see? I would often ask teachers when I was talking to 'em about a child, I was treating well, how does this child fit? And the scheme of you've been teaching for 10 years, 20 years, and their level of symptoms or distress, how does it compare to what you normally see? And they would say, oh my gosh, it's the top 1%. Or, oh no, this is what I see. Very routine. So I think it can be really helpful to reach out, to get some idea.

Well, is what we're seeing just within the spectrum of what you would expect? Or is this something that's really starting to interfere? And I think schools can be really good resources, particularly now, I think schools increasingly develop programs really to address kids' mental health needs in a way that historically I don't think they necessarily did. And so I think schools can be really good resources and then going to your pediatrician or your family practitioner and say, let's talk about what's going on and what do you think my options are, and how concerned do you think I should be?

And I think these can all be touchpoints for families in understanding how concerned they should be, but also maybe what their options are in terms of getting services. Because as a parent you don't know what, you know if your child maybe has anxiety. , you don't have any idea how to get help for them. And that's where I think these other people can, other resources can help give you information.

Caitlin Whyte: Thank you Dr. Beck. Well worth mentioning. So Devin, what about the rest of us? When is the time right for us grownups to see a mental healthcare provider? And how often or how long do people usually need to keep seeing one? I know that's a big question, but what do you see typically?

Devin Richardson: Yeah, it is a big question and I think it's pretty individualized, but I guess back to the original question of when to see a provider, I would say if you or someone close to you notices some diminished functioning or some negative changes in your mood on a pretty consistent basis. Probably time to at least reach out to a provider to see if there's anything that can be done to help you get feeling a little bit better. So it really goes back to how you're functioning day to day. And that can be the hardest step sometimes, as Dr. Beck mentioned, there's a lot of stigma sometimes a lot of hurdles people need to jump through sometimes.

But once that happens, Folks start feeling better relatively quickly. And as far as for how long people need to keep seeing a provider for a mental health issue, it is pretty individual. But I do think that providers are really good. At becoming a team with their patients and helping them understand what their warning signs might be once they have reached a more stable place. So once you get to that stable place, as long as you're consistently touching base with your provider and you and your provider have a plan, hopefully that plan is to keep you functioning really, really well and healthy for a long time. So just keep touch and base with that provider. As you and the provider have agreed.

Caitlin Whyte: Great answer. Thank you so much, Devin. Now, Dr. Beck, maybe the toughest question of all, when seeking care results in a diagnosis, how does that impact the patient's quality of life going forward? What does it mean to live with a mental or behavioral health diagnosis today?

Dr. John Beck: That's a good point, Caitlin, because when I first started out in practice, I think there was this perception from non behavioral health providers that, gee, you're working with people that don't get better. And I was like, well, actually they do get better . They get a lot better . And I think part of it is a dovetailing on some things. Devin said, if a person is experiencing emotional symptoms that are really interfering with different aspects of their life and they get help, let's say it's on a counseling level or a therapy level, part of it's working with someone over a period of time. So you and that person understand what you need.

And also, as Devin was saying, what are the warning signs? So maybe you hit a rough spot and you work with someone for a period of time, and then you're feeling a lot better. And then you stop therapy. But as Devin said, tyou may say, okay, but we know that maybe holidays are, can be a difficult time. Or there may be a time in a person's life that they start to struggle and just to know that they have that resource. So,I don't think having a mental health diagnosis somehow means that, well now you're not gonna be able to accomplish the things you want to do in life.

And I think even with people who have an illness or mental health symptoms. Symptoms of depression or anxiety that may warrant a medication. And for the most part, the people I worked with. Did whatever they wanted to do. I think the problem tends to be more if people don't take their medicine or don't really follow up the way they need to, then I think you'll see maybe they have a relapse of a depression or relapse of a substance use, which can interfere. But in my experience, if someone says, gee, I have this particular set of symptoms of depression or anxiety, or my child has ADHD.

And if they get a provider and work with them and find somebody that they trust and kind of work with them over time to see, well, what's effective, what's not effective? Your mental health symptoms really don't have to change your life in a way that you don't want it to. Where I tend to see that happen would be more if someone just wouldn't take their medicine or wouldn't follow up and it would wait till they went. Were in crisis. And then I think family members and job bosses can get frustrated if someone kind of keeps going into. Periods of time where they're not functioning very well and they're really not taking steps to help themselves.

So part of it is as I'm saying, kind of in summary find a provider you work with and follow through. And I think then you and that person can over time decide, well, what kind of, what works for you? What do you need? What level of support do you need so that this doesn't interfere with your life? Just as if you had high blood pressure or diabetes or had a seizure. You need to have a provider and you need to see them, and you need to do what you need to do to take care of it. And then so it doesn't stop you from doing the things you want to do being a parent or traveling or being successful at your job. I mean, it doesn't have to interfere.

Caitlin Whyte: Very insightful. Thank you so much, Dr. Beck. And Devin, can you tell us what resources are available out there for providing behavioral healthcare and support, particularly for members of our health?

Devin Richardson: Absolutely. So again, hally.com and the hally app are both great starting places. They have things specific to behavioral health and mental health on the app. But I do also wanna mention care coordination again because that is a resource for our health and members in partnership with the treating providers, treating you for a behavioral health issue. We can also support with care coordination if that's needed. So definitely worth checking out and our team would love to be of support whenever possible.

Caitlin Whyte: Well, thank you Devin. That is some excellent information. Now, Dr. Beck, last question. In honor of mental health awareness month, if there's one thing about mental illness that you think people ought to be aware of, what would it be?

Dr. John Beck: I guess not to be afraid of it. I think it's common for people individually to be affected by symptoms of depression, anxiety, or family members. And so I think it's to be open to it and open to ask questions or get help if you yourself are starting to struggle or if you see family members starting to struggle. Because There's a lot of help out there and there's a lot you can learn and it doesn't have to be a defining situation in your life that's gonna keep you from doing what you want to do. I mean, when I would work with kids in high school and they'd be going off to college and I would always say, whatever you don't stop what you're doing in the first semester. You need to make that transition. You need to take care of yourself. And because there's help and you can do better.

Caitlin Whyte: Well, thank you Dr. Beck. Another amazing answer. And Devin, the same final question for you. May being mental health awareness month, what would you like everybody to be aware of regarding mental health?

Devin Richardson: Well, I don't think I'm gonna top Dr. Beck's excellent answer, , but I would just add that mental health truly is healthcare and to take it just as seriously as you would any other health issue and know that there's lots of great resources out there for whatever you may be experiencing, there's always a way to find help.

Dr. John Beck: Well, you both have truly just been wonderful guests. Thank you so much, Dr. Beck and Devin for joining us today and for all you do every day at Health Alliance and Halle Health. To help so many individuals and families throughout our communities, Dr. Beck and Devin will be returning as our guests in December to talk about coping with holiday stress. Stay tuned. And that concludes today's Hally HealthCast. Tune in next time as we tackle yet another topic important for your health and wellbeing. And remember, Hally Health is your partner in helping you live your healthiest life. Visit hally.com. That's H A L L Y.com for resources, information, tips, and much. Let us help keep you and your family healthy and well. Thanks for listening. We hope you tune in again.