Transcription:

Maggie McKay (Host): Welcome to Right Beside You, a Reid Health podcast. I'm Maggie McKay, and I invite you to listen as we discuss mental health in the midst of COVID-19, stigmas and what you can do to get help. We're joined today by Barbie Will, Clinical Manager for Reid Outpatient Behavioral Health, and April Coffin, Director of Outpatient and Adolescent Behavioral Health.

Welcome. And thank you so much for being here. We're so happy to talk with you about this very important topic that so many people have experienced during COVID-19. It's great to have you here.

Barbie Will: Thank you. I thank you for having us.

April Coffin: Yeah, we really appreciate it. We're really excited about this opportunity.

Maggie McKay (Host): Great. If you could please start by introducing yourselves and tell us what behavioral health is and what you do. We'll start with you, Barbie.

Barbie Will: So I'm a licensed clinical social worker. And as you said, the clinical manager for Reid Outpatient Behavioral Health.

April Coffin: And my name's April Coffin and I'm also a licensed clinical social worker the Director of Outpatient and Adolescent Behavioral Health.

Maggie McKay (Host): Barbie, what is behavioral health?

Barbie Will: So behavioral health refers to how our daily habits affect our overall wellbeing, emotions, biology, and behavior. So it's interchangeable with mental health. However, behavioral health incorporates not just our mental wellness, but also the way our thoughts play out in real life. It's a balancing of the different areas of our lives, for example, eating healthy, exercising, taking care of our physical and mental health, participating in social activities, continuing our learning and education, managing stressors and adversity and engaging in activities that bring us joy.

Maggie McKay (Host): Barbie, what do you do in behavioral health?

Barbie Will: Well in our outpatient practices, we provide psychiatric medication management. We do psychotherapy. We also do psychological evaluations and assessments for both children and adults.

April Coffin: And then at the care pavilion, we have an acute stabilization unit and residential unit for our kiddos and we take ages six to seventeen. So for our acute program, most of those kiddos are those that are a danger to self or others. And their typical stay is five to seven days. And then our residential program, youth are there for chronic behaviors. Those are the kids that usually have had multiple acute stays and are already in outpatient services. Typically, that program is about five to seven months.

Maggie McKay (Host): And tell us about Mental Health Awareness Month. Why is it so important?

April Coffin: So Mental Health Awareness Month, it's a nationally recognized movement to raise awareness about mental health in order to fight stigma and provide support and educate the public and to really advocate for those policies that support people with mental illness and their families.

Barbie Will: And so for Mental Health Awareness Month, so NAMI, which is actually the National Alliance on Mental Illness, they've designated the 2022 Mental Health Awareness Month campaign to be Together For Mental Health. And so this is part of an effort to promote advocacy to improve our mental and behavioral healthcare system. And the reason that that's so important is because we have a growing number of people experiencing mental health symptoms and we want to not only be able to increase access to services, but also promote quality of services.

Maggie McKay (Host): So, how has stigma impacted people reaching out for help?

April Coffin: That's a great question. So let's start by defining what stigma is. So according to NAMI, which is the National Alliance on Mental Illness, a stigma is when someone or even yourself views a person in a negative way, just because they have a mental health condition. And so some people describes stigma as a feeling of shame or judgment from someone else. And stigma can even come from an internal place, like confusing feeling bad with being bad. So they also mentioned that stigma impacts one in five people struggling with mental illness by keeping them from reaching out for help when they are needed

Barbie Will: And then, on top of that, so navigating through life with a mental health condition is tough already, so then you add stigma to that and it creates huge challenges to reaching out. So some of the effects of stigma include people experiencing mental health conditions. They face rejection, bullying and discrimination. This make their journey to recovery longer and more difficult. Even though people can be successfully treated, less than half of the adults in the US who needs services and treatment get the help that they need. Also, it causes a delay between the onset of symptoms and when people actually get help. And so NAMI identifies that the average delay between the onset of symptoms and intervention, so actually seeking out treatment is between eight and ten years.

Another side effect of stigma is suicide. Increased suicide rates can be ineffective stigma because people are isolated and they're ashamed of reaching out for help. And suicide is the second leading cause of death of youth ages 15 to 24 and the 10th leading cause of death for all Americans.

April Coffin: So not only does stigma impact the person that's reaching out for help, but it may impact the person that's making the judgment as it is also making them less likely to seek out help when they need it.

Maggie McKay (Host): When reaching out for help, what challenges do people face?

Barbie Will: For one, the biggest one, which we just talked about is stigma. That's one of the biggest challenges people face whenever they're reaching out for help. And then they also run into issues of insurance coverage and affordability. There's a lack of psychiatrists. There's a lack of therapists. There is a lack of mental health nurse practitioners and psychologist. There's also a lack of specialty providers. So for example, people who need help for an eating disorder. It's really difficult to find providers who address eating disorders or sex-positive therapists or medication management providers for children, or even providers that can provide psychological evaluations and assessments

There's also issues of lack of transportation. Then you have confidentiality in these rural and smaller communities, a lack of awareness of resources. Some people aren't even aware that some of the services exist in their community. There's time conflict. So a lot of our mental health agencies, they're open the same time you're at work. And then the belief that they can not be helped or that treatment won't work.

April Coffin: Yeah, that's a great point, Barbie, that you mentioned the provider shortage and just lack of specialty providers. That is a significant, big concern in our area.

Maggie McKay (Host): With the challenges of reaching out for help, how has COVID impacted people who are looking for help?

Barbie Will: So COVID itself has brought a unique set of challenges to reaching out. One of the main things, just being availability, a lot of practices when COVID started switched over to telehealth services and a lot of our patients don't have access to that type of technology, or they would rather see somebody in person. So especially when addressing issues of trauma and with in-person appointments being limited, they were really struggling with those symptoms.

April Coffin: Yeah. People also have had concerns about being out in the community in general with COVID. I think that there are concerns about masks and whether people should wear one or not. And this has been very controversial and it's created anxiety, frustration and a lot of anger for people and it's even split families and friends apart. So I think people were just tired of the COVID pandemic, whether it's in fear of COVID or the belief COVID precautions are overrated.

Maggie McKay (Host): And how has COVID affected mental health?

Barbie Will: Well, COVID has had a lot of impacts on mental health. And I think some of them were a little shocking for some of us. So according to the CDC, we saw an increase in anxiety symptoms. So what was being reported for anxiety symptoms was three times higher than reported prior to the pandemic. We also saw an increase in depression symptoms. And so that was four times higher than was reported prior to the pandemic. We saw an increase in use of alcohol and drugs, an increase in symptoms of stress. We saw financial difficulties. We even saw an increase in suicidal ideation. And so this is where it gets a little odd because even with the increase in suicidal ideation, there was still an overall reduction in the rates of suicide. So we can't be sure if it's like due to the pandemic or if this was a continuation of their prior year's trends because, prior to COVID, we were already seeing kind of a downward trend in overall suicide rates. But I think there was some speculation that with the pandemic and people being isolated, that those suicide rates would increase.

Maggie McKay (Host): April, do you have any recommendations for people who are waiting for services or who aren't comfortable reaching out yet?

April Coffin: Definitely. So one of the main things is to first take care of your body. So focusing on your daily health practices, like getting good and adequate sleep, exercising and eating healthy, staying connected with your friends and family are very important. You can also volunteer your time. I know our local animal shelters and nursing home, and even hospitals are looking for volunteers. You could journal. Decluttering your physical space, that significantly helps reducing anxiety and even depression. Attending a service at a place of worship or engaging in some sort of activity involving spirituality. Enrolling in a class or a course for a new hobby or hobby that you want to gain more expertise in, and even just establishing a routine for yourself are great recommendations for those that are not necessarily ready to reach out or just waiting for services to start.

Maggie McKay (Host): Thank you so much, Barbie and April. This has been so eye-opening and we really appreciate you being here and your time and your expertise.

April Coffin: Well, thank you for inviting us and having us today.

Barbie Will: Definitely. Thank you. Thank you so much.

Maggie McKay (Host): That's Barbie Will, Clinical Manager for Reid Outpatient Behavioral Health, and April Coffin, Director of Outpatient and Adolescent Behavioral Health. And that concludes this episode of Right Beside You, a Reid Health podcast. If you have questions or would like to connect with someone, please call Reid Outpatient Behavioral Health at 765-983-3298 or to schedule your appointment today. And for more information, please visit reidhealth.org. Please remember to rate, review and subscribe to this podcast and all the other Reid Health podcasts. I'm Maggie McKay. Thanks for listening and be well.