Selected Podcast
What is Mental Health?
Meghan Boaz Alvarex and Jill Bolster-White discuss mental health and the community outreach organization Transitions-Mental Health Association, or TMHA, in San Luis Obispo.
Featuring:
Partnership teams. She develops and provides clinical trainings for agency staff, including Mandatory Reporting, Suicide Risk Assessment, and Dialectical Behavioral Therapy. She also provides clinical supervision and oversight for interns and staff, and serves on the San Luis Obispo Suicide Prevention Council. She is the co-author of the Survival Outreach Team manual, which provides a comprehensive plan for launching a team of trained survivors who reach out to those bereaved by suicide. This publication has been accepted to the National Best Practice Registry for Suicide Prevention. She presented this work at the American Association of Suicidology Conference in Atlanta in April of 2015. She is a certified Applied Suicide Intervention Skills Training (ASIST) Master Trainer, Question, Persuade, and Refer (QPR) Instructor, and instructor in the Psychology Department at Cuesta College.
Jill Bolster-White, Executive Director has over thirty years of experience in non-profit operations and has served twenty-nine years as an Executive Director. Transitions-Mental Health Association is a community-based mental health services agency, and Jill is responsible for management and development of a budget in excess of $15,000,000; supervision and training of 290 staff; administration of businesses and contracts; board development; marketing; fundraising; oversight of program design;
client advocacy; and community education. Her management is characterized by effective fiscal oversight, innovative program development and strategic vision. Jill obtained her Bachelor of Arts from California Polytechnic State University in San Luis Obispo and a Masters degree in Public Administration with a nonprofit concentration from the University of San Francisco. She is a past-President of the California Association of Social Rehabilitation Agencies; past-President of the Board of San Luis Obispo
Botanical Gardens, an Advisory Board Member for KCBX Public Radio; a member of the San Luis Obispo Rotary Club, on the Governing Board for Sierra Vista Medical Center and a member of the National Alliance for the Mentally Ill.
Meghan Boaz Alvarez, MS, LMFT | Jill Bolster-White
Meghan Boaz Alvarez, M.S., LMFT began her career in mental health working in residential treatment for women and adolescent girls with eating disorders. After completing her clinical degree, she worked for Kern County Mental Health for 12 years, initially as a therapist specializing in psychosocial assessment, crisis intervention, and Dialectical Behavioral Therapy. She later became the clinical supervisor of the Kern County Crisis Stabilization Unit, providing intensive crisis intervention services. When MHSA funds became available, she implemented a 24-hour suicide and crisis hotline for the county, and successfully obtained American Association of Suicidology Accreditation and become part of the National Suicide Prevention Lifeline centers. During this time period she served as the county liaison to the state office for Suicide Prevention and worked as an instructor in the psychology master’s program for National University. She also served as the Crisis Intervention Training (CIT) Suicide Intervention instructor for Kern County’s 40-hour CIT program and has presented at the San Luis Obispo CIT academy as well. She is currently the Clinical Director for Transitions-Mental Health Association and oversees several intensive treatment teams in San Luis Obispo County, including three MHSA funded Full ServicePartnership teams. She develops and provides clinical trainings for agency staff, including Mandatory Reporting, Suicide Risk Assessment, and Dialectical Behavioral Therapy. She also provides clinical supervision and oversight for interns and staff, and serves on the San Luis Obispo Suicide Prevention Council. She is the co-author of the Survival Outreach Team manual, which provides a comprehensive plan for launching a team of trained survivors who reach out to those bereaved by suicide. This publication has been accepted to the National Best Practice Registry for Suicide Prevention. She presented this work at the American Association of Suicidology Conference in Atlanta in April of 2015. She is a certified Applied Suicide Intervention Skills Training (ASIST) Master Trainer, Question, Persuade, and Refer (QPR) Instructor, and instructor in the Psychology Department at Cuesta College.
Jill Bolster-White, Executive Director has over thirty years of experience in non-profit operations and has served twenty-nine years as an Executive Director. Transitions-Mental Health Association is a community-based mental health services agency, and Jill is responsible for management and development of a budget in excess of $15,000,000; supervision and training of 290 staff; administration of businesses and contracts; board development; marketing; fundraising; oversight of program design;
client advocacy; and community education. Her management is characterized by effective fiscal oversight, innovative program development and strategic vision. Jill obtained her Bachelor of Arts from California Polytechnic State University in San Luis Obispo and a Masters degree in Public Administration with a nonprofit concentration from the University of San Francisco. She is a past-President of the California Association of Social Rehabilitation Agencies; past-President of the Board of San Luis Obispo
Botanical Gardens, an Advisory Board Member for KCBX Public Radio; a member of the San Luis Obispo Rotary Club, on the Governing Board for Sierra Vista Medical Center and a member of the National Alliance for the Mentally Ill.
Transcription:
Prakash Chandran (Host): Mental health encompasses so much more than people realize. It affects how we think, feel and act, and also determines how we handle stress. Luckily, there is a community resource called Transitions Mental Health Association, serving San Louis Obispo and north Santa Barbara counties, which provides support in the form of community, work, housing or recovery.
We're going to learn more about it today with Jill Bolster-White, Executive Director of Transitions and Meghan Boaz Alvarez, Clinical Director of Transitions, both at Transitions Mental Health Association. This is Healthy Conversations, the podcast from Tenet Health Central Coast. My name is Prakash Chandran. So Jill and Meghan, really great to have you here today.
Really appreciate your time. Meghan, I'd love to start with you and just ask a simple question. What exactly is mental health?
Meghan Boaz Alvarez, MS, LMFT (Guest): Well, I think that's a great question. And one of the things that occurs to me when I hear you say that, is people often think of pathology when they think of mental health or think of mental illness. And I think it's much broader than that. It's helpful to think of mental health as mental wellness and really think about how we should take care of our mental health, just the way we take care of our physical health, like it's part of whole person health. And so that would include, you know, mood, how we're feeling, how we're coping with stress, how we're managing, you know, communication and relationships. All of those things, I think fall under the umbrella of mental health.
Host: Jill, I want to move over to you. You know, Meghan kind of alluded to this already, but I know that some people think of mental health as mental illness, you know, things like schizophrenia, but mental health is really much broader. So, are you able to describe maybe the various types or levels of mental health?
Jill Bolster-White (Guest): Certainly. It is a wide range. And I think Meghan well described that mental health is really a sense of wellbeing and overall sort of emotional health. So, there's a wide range of that. Our organization Transitions Mental Health Association primarily focuses intensive services on people who have a diagnosed mental health condition. And so you mentioned some, schizophrenia, bipolar disorder, clinical depression, anxiety, post-traumatic stress. Those are all diagnosable mental health conditions. And so that is a part of mental health that usually suggests that somebody is going to want to seek treatment. And so treatment can be in the form of therapy and medication, but also all the things that we all can be doing for our own mental health; taking good care of how much we're sleeping and how well we're eating and having good, healthy connections. So, that's important for everybody's mental health and wellbeing. But as I said, there is a wide range of mental health conditions and things that can impact our mental health.
Host: So Meghan, I wanted to ask, you know, people are encouraged to get an annual physical every year with their doctor. Is there some type of equivalent for an annual mental health checkup that you can recommend?
Meghan: I don't think anybody has ever asked me that before. Should you do just an annual checkup with a mental health professional? I think it's funny as a mental health professional, I think the answer is no. It might be something you could check in with your primary care physician on. But really, I think, yeah it's up to each of us or within our power to take care of our mental wellness on an ongoing basis. And I don't think we necessarily need the help of a mental health professional to do that. Not that I don't think therapy is great as a therapist, I endorse it for anyone at any time. But there are a lot of things we can do to just take care of our own mental health.
Jill mentioned some of these things, you know, eating right, making sure we get enough sleep, making sure we take care of our relationships, stay connected to those people that support us. Exercise of course is always a big one. Exercise has a big impact on our mental wellness.
Jill: And I think I'd like to add to that, that what we can do is really pay attention to how we're doing and maybe those around us. So, there may be times where we feel like maybe our relationship, a marriage or a primary relationship is undergoing some strain or a bad patch. And I think what our organization would really like to see is just elevated understanding of mental health.
And how do I identify when gosh, this would be helpful to talk to a professional. Or do what I think a lot of people do, which is to rely on good friends and family for those kinds of check-ins. Good, strong relationships can really actually contribute so much to mental health. And so sometimes it does take maybe a conversation with a primary care physician, as Meghan mentioned to bounce ideas off you know, gosh, I'm having this struggle or I'm feeling angst about my work or my relationships or how my children are doing. And so I think it's important. And I do think having been through the COVID pandemic for the past 18 months has also really elevated people's awareness of mental health. I think a lot of us have experienced anxiety and concern and depression in ways that maybe we haven't prior because of some of the unknowns or some of the impacts. So, I think Meghan's exactly right that it's not so much an annual checkup, but as a heightened awareness that we all have about checking in with our own mental health and being able to have the language, to talk to people who we care about and love if we're seeing signs in them, that maybe, they might to get some help, maybe find a support group, find a therapist or initiate that conversation with a primary care physician.
Host: Yeah, that makes so much sense to me. You know, I think one of the reasons I asked that question is because people typically it feels uncomfortable and unnatural to sit still and to check in with oneself, you know, something like an annual physical exam it's on the calendar. It's something that's recommended. It seems like as human beings, we just tend to let things fester and boil and bubble up to the point that they can become problems. So, you know, Jill, you mentioned some of the signs that potentially mental health might become an issue or even potentially harmful to oneself or others. Can you talk about some of those signs that people should really be aware of?
Jill: I think one of the most important signs and sometimes this is, you're exactly right, that it's really hard to recognize in ourselves, but I think a couple of signs or just when it is really impacting your life. So if for instance, somebody is really outgoing and normally connects with people and has friends and gets out. And that is really changing. Some, you know, a person becomes uncomfortable or you just sort of goes radio silent. That might be a sign either when that's happening to yourself, or if you see it happening to someone else that, that there may be something else going on. I think again, if I can speak personally, just a level of anxiety, feeling like gosh, I'm feeling really anxious.
It's really hard for me to focus because there's just so much unknown and that's certainly been a feeling I think a lot of us have had during COVID. It's just, I don't really know what the right thing is to do or what the safe decision is or how to protect my family or, you know, people at my workplace or myself.
So sometimes it is a sense of maybe feeling depressed, feeling overwhelmed, feeling really anxious. And when it does feel like it's affecting other elements of your life then I think that's a good moment to explore how to take the next steps, who to talk to, how to mitigate that, those feelings when they're really impacting the quality of your life or your ability to just do the things you need to do to function.
Meghan: Yes. I think those are all the right things to look for. Changes in mood, changes in behavior, eating, sleeping. We can notice that in ourselves and also notice that in friends or family and realize, you know, I think maybe I need to reach out to this person and say, hey, are you doing okay? I haven't seen you, you know, at book club or whatever the usual activities are and pulling away from those activities is often one of the first signs that somebody is not doing as well with their mental health.
Host: Yeah, absolutely. And it may sound a little cheesy, but these signs around that you see that we're in this together, is actually pretty important because we all have to support each other. And if we recognize that someone that we see on a frequent basis, if we recognized that they may be going through a hard time or their stress levels are elevated, it's almost our responsibility to check in with them and to make sure that they have the support that they need. Wouldn't you say that's true, Meghan?
Meghan: I absolutely would. I, there's a speaker that I really like who talks about mental health and also suicide. His name is Kevin Hines and he says, I am my brother and sister's keeper. And really talks about it is our responsibility to say, hey, are you doing okay, when we notice that somebody isn't and also really convey that it is okay to not be okay, it's okay to need some support. It's okay to need some extra help. It's okay to need someone to talk to you about what's weighing on us and that connection and the offer of that connection can really make all the difference.
Jill: Okay. I would absolutely echo what both of you were saying. I think to really pay attention to how people in your circle are doing. And if that gets overwhelming to sort of make sure you have somebody you can hand off to. Because like I said, I think that we've had a lot of evidence during this pandemic people trying to intentionally isolate themselves because of wanting to stay physically safe, but the impact that, that can have, that isolation and disconnection from others, is really important. So, I know encouraging everyone to reach out to someone, you know, who you just haven't heard from in a long time, or you've gotten some signs that maybe they, they are struggling or that they've sort of, just hunkered down and aren't reaching out. I know here at Transitions Mental Health Association, we've heard a lot from people who are reaching out who are saying, gosh, I really would love help finding a therapist, or we've gotten lots of calls on our hotline, the Central Coast Hotline from people reaching out. So, I think that is happening but not as frequently as we'd like to see.
Meghan: I think it's also really helpful for us to know who in our own lives are our go-to people for this, you know. Do I have that friend or family member who I can reach out to and say, hey I'm not really feeling okay. And I need to talk about it. It's really good to know who those folks are when we're doing well. And even kind of have that conversation like, hey, could I reach out to you if I was having a hard time, because it's really difficult to do when we are in those moments where we do feel more isolated and we are struggling with our mental health. It can be really hard to reach out and knowing who that person will be for each of us ahead of time can be just incredibly helpful when that moment comes.
Host: Absolutely. I couldn't agree more. And you know, sometimes this isolation that we're talking about can lead to people wanting to harm themselves or even become suicidal. And you know, one of the things that I read Meghan is that San Louis Obispo County has a higher rate of suicide than the state overall. So, I know this is a difficult question, but can you speak to why you think this is.
Meghan: Oh, I think that's a difficult question and it's not something that we fully understand. We do know that we lose older males to suicide more frequently than some other populations. And we may have a higher population of that demographic. So, that could be part of the reason, but it's definitely something that's concerning.
And it's something that we talk about I'm co-chair of the San Luis Obispo, Suicide Prevention Council, and we're really trying to look at how do we reach these individuals that we know have a higher risk that maybe we don't come into contact with our usual suicide prevention efforts, that maybe don't get the information about the Central Coast Hotline.
How do we reach out and make sure people are aware of that resource? If not for themselves, maybe for, you know, their loved ones, friends and family. How do they know how to recognize somebody might be at risk and reach out and ask them if they're okay. Transitions Mental Health Association offers trainings to the community on kind of gatekeeper suicide prevention. Just really basic, what to look for, how to know somebody might be in trouble and then what to do if we do recognize that, how do we get that person support?
Jill: It's an important part of our hotline training actually is to talk about assessment. And so that is really important because I think as anyone can imagine, those are really hard conversations to have. If someone brings up self-harm or feelings of suicide, that can be really stymieing. What do you say? Do you, you know, ask more questions and that can feel naturally really uncomfortable and difficult. And so I think Meghan's bringing up some really good points that having some idea about how to broach that topic and not shy away from it. And another thing, Kevin Hines, who Meghan also mentioned, is a suicide survivor. And he talks a lot about that importance of, you know, sort of not shying away from the conversation and how important those human connections are. And it's a big part of what the Central Coast Hotline tries to do is to be a resource to have people know that there's someone available 24-hours a day, seven days a week to speak to if someone is Ffeeling suicidal or feeling in crisis. So, I think that's an important resource. And as Meghan also said, it is hard to understand why our particular county's rate is higher but demographics do tell part of that story. And I think Meghan, you just mentioned a statistic about youth suicide. Would you mind repeating it about how I think it's the second leading cause if I recall.
Meghan: Yeah. That is true. Suicide is the second leading cause of death for youth age 10 to 24, which is terrifying as a parent of two teenagers. So, I think mental health is always on my radar as a professional because I am a therapist and I, I do run clinical programs, but also as a parent and as a community member. Just being very aware that we need to talk about mental health. We need to encourage people to take care of their mental health and also watch out for each other. Jill I so appreciate that you mentioned the Central Coast Hotline as a resource, it's a 24-hour resource. And the great thing about that is you don't actually have to know what to do, or even what to say.
If you just know enough to recognize somebody is not okay, and you call and ask the Central Coast Hotline, hey, I'm not sure what to do for this person who seems to be in trouble. Can I get resources for them or can they talk to you? There's help just very readily available in our community for trying to figure out what to do in this moment. So you don't have to figure it out on your own.
Host: And Meghan, I wanted to stick with you for a minute. One of the things that you mentioned was the importance for people to know the signs, right, that someone might be at that breaking point and might be suicidal. So, can you speak to some of the signs that people should be aware of?
Meghan: Oh, that's a great question. I so appreciate you asking. I would say changes, changes in mood, withdrawing from usual activities, being kind of disconnected from friends and family that they're usually in contact with, changes in school performance, changes in eating or sleeping patterns. Somebody who seems depressed is somebody that we should be worried about. Somebody who seems angry or agitated could also be at risk of suicide. And I think if we see any of these things, what's really key is to ask and just say, hey, you know, I noticed that you seem really down and I'm kind of worried. I know sometimes when people feel depressed, they start to think about suicide and I'm worried you might be thinking about that. Is that what's happening? And, you know, oftentimes if somebody is thinking about it, they'll be relieved that somebody asked and if they weren't thinking about it they're, you're not going to create a problem by asking that question, that person's going to recognize, wow, this person really cares about me, that they would take the time to ask this question and explain why they were asking. And it just creates an opportunity for conversation.
Host: So Jill in trying to de-stigmatize mental health, what are some of the preferred words or preferred language to use in the community today? Like for example, you don't want to call someone crazy, but I'm imagining that there is a body of vocabulary that is more respectful when you're addressing mental health issues.
Jill: That is, language is so important. And so I think we are sensitive to words like crazy, and then saying, especially when it's used in sort of advertising or just in general conversation. Because those are pretty stigmatizing words. The other thing I think we're careful about is labeling to say someone is a schizophrenic or is bipolar. Somebody is not their diagnosis. And so I think we try to use language that describes that as part of who they are. So, somebody who has a diagnosis of schizophrenia or someone who has a mental health diagnosis, I think we try to understand these as the genetic disorders that they are, there's a biological basis that likely had an environmental or a precipitating factor, but again, these are conditions that are through no fault of the individual. So, I think that it's important that the language reflect that, to not be blaming or shaming. And I think for me to try to think of mental health, just an important part of our human condition and our human fabric.
And instead of thinking that someone has done something wrong, that somebody is not strong or capable or intelligent, because in fact, it's absolutely the opposite. Some of the folks that we get to work with here at Transitions Mental Health Association are amazing and resilient and have gone through some very difficult and traumatic situations that in some cases have led to their mental health diagnosis.
And we certainly see that in every population. So, from people who may be homeless because they have an untreated mental illness to, you know, someone who is working and married and sort of doing all those kinds of regular things, but also is functioning with a mental health diagnosis. So I do think being really careful about you know, describing things as insane or crazy, or, or using those terms disparagingly, I think we really need to work hard at excising that because I think that prevents people from recognizing how important getting help is if there is a mental health condition or accepting that may be something that's happening to a member of their family or a friend instead of being afraid of it, which has been the history of mental illness is really fear. And backing away and to really try to step in and be supportive and understand and know that these are treatable and recoverable illnesses. I think when, you know, 50 years ago, we couldn't really imagine that someone would recover from schizophrenia, that their symptoms could be regulated and controlled and that they could live really fulfilling, wonderful lives.
Host: Yeah, absolutely. So, Meghan, you know, I kind of wanted to start closing the conversation with you. There might be someone listening to this that might be having some of the mental health issues that we discussed today. They're having a hard time. If they want to get help, what can they do or where should they go if they're having a crisis?
Meghan: Well, if somebody is having a crisis, calling the Central Coast Hotline is always a great place to start. And the person who answers the phone is a highly trained call handler, who can help assess the crisis and identify what types of resources might be helpful in that moment of crisis. And then also identify some ongoing resources for support. If somebody is struggling with mental health, starting with a therapist is always a great way to go. Medication can be helpful too, and people can talk with their primary care physicians about what's happening and start the conversation there and kind of explore, is it going to be a primary care issue or is a referral to a psychiatrist may be going to be necessary. But I probably have a bias as a therapist. I definitely think people benefit from therapy and that's a great place to start.
Jill: I think I would also add that even therapy used as just a boost, you know, sort of like a booster for a family, for parents, for couples can be really helpful and really important. So I think, you know, just if somebody is feeling just some general stress and that's impacting relationships; that's a great way of having an objective professional assist. And so I would also recommend looking at therapy and in that way.
Host: And Jill we've mentioned the hotline a couple of times. Are you able to share the number?
Jill: Yes, it is 800-783-0607. And as we mentioned, 24-hours a day, seven days a week, and warm, empathetic and trained person will be on the other end of the line.
Host: What a fantastic resource. Well, I really appreciate this conversation today. I have learned so much and also it has just reinforced the importance of being a supportive community, family member and friend. And so, you know, just before we close here today Jill, do you have any final thoughts that you would like to share with our audience?
Jill: I just appreciate this opportunity to talk about mental health and just remind everyone to be a resource and to know that there are resources out there. And thanks so much for this opportunity Prakash.
Host: Of course. And Megan, I'll give you the last word.
Meghan: Sure. Thank you. I would just say if if you're concerned about a friend or family member, just check in with them and say, hey, are you doing okay? Here's why I'm asking. Let's talk about what's happening. And that can open the door to the conversation.
Host: I think that's fantastic advice and the perfect place to end. Jill, Megan, thank you so much for your time.
Meghan: Thanks for having us.
Jill: It's our pleasure.
Host: That's Jill Bolster-White, Executive Director of Transitions and Megan Boaz Alvarez, Clinical Director of Transitions, both at Transitions Mental Health Association. If you'd like to call the hotline mentioned today and speak to someone you can call 800-783-0607. We really appreciate you checking out this episode of Healthy Conversations and to learn more about TMHA, which is the Transitions Mental Health Association, you can visit www.t-mha.org. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. This has been Healthy Conversations. The podcast from Tenet Health Central Coast. My name is Prakash Chandran. Thank you so much. And we'll talk next time.
Prakash Chandran (Host): Mental health encompasses so much more than people realize. It affects how we think, feel and act, and also determines how we handle stress. Luckily, there is a community resource called Transitions Mental Health Association, serving San Louis Obispo and north Santa Barbara counties, which provides support in the form of community, work, housing or recovery.
We're going to learn more about it today with Jill Bolster-White, Executive Director of Transitions and Meghan Boaz Alvarez, Clinical Director of Transitions, both at Transitions Mental Health Association. This is Healthy Conversations, the podcast from Tenet Health Central Coast. My name is Prakash Chandran. So Jill and Meghan, really great to have you here today.
Really appreciate your time. Meghan, I'd love to start with you and just ask a simple question. What exactly is mental health?
Meghan Boaz Alvarez, MS, LMFT (Guest): Well, I think that's a great question. And one of the things that occurs to me when I hear you say that, is people often think of pathology when they think of mental health or think of mental illness. And I think it's much broader than that. It's helpful to think of mental health as mental wellness and really think about how we should take care of our mental health, just the way we take care of our physical health, like it's part of whole person health. And so that would include, you know, mood, how we're feeling, how we're coping with stress, how we're managing, you know, communication and relationships. All of those things, I think fall under the umbrella of mental health.
Host: Jill, I want to move over to you. You know, Meghan kind of alluded to this already, but I know that some people think of mental health as mental illness, you know, things like schizophrenia, but mental health is really much broader. So, are you able to describe maybe the various types or levels of mental health?
Jill Bolster-White (Guest): Certainly. It is a wide range. And I think Meghan well described that mental health is really a sense of wellbeing and overall sort of emotional health. So, there's a wide range of that. Our organization Transitions Mental Health Association primarily focuses intensive services on people who have a diagnosed mental health condition. And so you mentioned some, schizophrenia, bipolar disorder, clinical depression, anxiety, post-traumatic stress. Those are all diagnosable mental health conditions. And so that is a part of mental health that usually suggests that somebody is going to want to seek treatment. And so treatment can be in the form of therapy and medication, but also all the things that we all can be doing for our own mental health; taking good care of how much we're sleeping and how well we're eating and having good, healthy connections. So, that's important for everybody's mental health and wellbeing. But as I said, there is a wide range of mental health conditions and things that can impact our mental health.
Host: So Meghan, I wanted to ask, you know, people are encouraged to get an annual physical every year with their doctor. Is there some type of equivalent for an annual mental health checkup that you can recommend?
Meghan: I don't think anybody has ever asked me that before. Should you do just an annual checkup with a mental health professional? I think it's funny as a mental health professional, I think the answer is no. It might be something you could check in with your primary care physician on. But really, I think, yeah it's up to each of us or within our power to take care of our mental wellness on an ongoing basis. And I don't think we necessarily need the help of a mental health professional to do that. Not that I don't think therapy is great as a therapist, I endorse it for anyone at any time. But there are a lot of things we can do to just take care of our own mental health.
Jill mentioned some of these things, you know, eating right, making sure we get enough sleep, making sure we take care of our relationships, stay connected to those people that support us. Exercise of course is always a big one. Exercise has a big impact on our mental wellness.
Jill: And I think I'd like to add to that, that what we can do is really pay attention to how we're doing and maybe those around us. So, there may be times where we feel like maybe our relationship, a marriage or a primary relationship is undergoing some strain or a bad patch. And I think what our organization would really like to see is just elevated understanding of mental health.
And how do I identify when gosh, this would be helpful to talk to a professional. Or do what I think a lot of people do, which is to rely on good friends and family for those kinds of check-ins. Good, strong relationships can really actually contribute so much to mental health. And so sometimes it does take maybe a conversation with a primary care physician, as Meghan mentioned to bounce ideas off you know, gosh, I'm having this struggle or I'm feeling angst about my work or my relationships or how my children are doing. And so I think it's important. And I do think having been through the COVID pandemic for the past 18 months has also really elevated people's awareness of mental health. I think a lot of us have experienced anxiety and concern and depression in ways that maybe we haven't prior because of some of the unknowns or some of the impacts. So, I think Meghan's exactly right that it's not so much an annual checkup, but as a heightened awareness that we all have about checking in with our own mental health and being able to have the language, to talk to people who we care about and love if we're seeing signs in them, that maybe, they might to get some help, maybe find a support group, find a therapist or initiate that conversation with a primary care physician.
Host: Yeah, that makes so much sense to me. You know, I think one of the reasons I asked that question is because people typically it feels uncomfortable and unnatural to sit still and to check in with oneself, you know, something like an annual physical exam it's on the calendar. It's something that's recommended. It seems like as human beings, we just tend to let things fester and boil and bubble up to the point that they can become problems. So, you know, Jill, you mentioned some of the signs that potentially mental health might become an issue or even potentially harmful to oneself or others. Can you talk about some of those signs that people should really be aware of?
Jill: I think one of the most important signs and sometimes this is, you're exactly right, that it's really hard to recognize in ourselves, but I think a couple of signs or just when it is really impacting your life. So if for instance, somebody is really outgoing and normally connects with people and has friends and gets out. And that is really changing. Some, you know, a person becomes uncomfortable or you just sort of goes radio silent. That might be a sign either when that's happening to yourself, or if you see it happening to someone else that, that there may be something else going on. I think again, if I can speak personally, just a level of anxiety, feeling like gosh, I'm feeling really anxious.
It's really hard for me to focus because there's just so much unknown and that's certainly been a feeling I think a lot of us have had during COVID. It's just, I don't really know what the right thing is to do or what the safe decision is or how to protect my family or, you know, people at my workplace or myself.
So sometimes it is a sense of maybe feeling depressed, feeling overwhelmed, feeling really anxious. And when it does feel like it's affecting other elements of your life then I think that's a good moment to explore how to take the next steps, who to talk to, how to mitigate that, those feelings when they're really impacting the quality of your life or your ability to just do the things you need to do to function.
Meghan: Yes. I think those are all the right things to look for. Changes in mood, changes in behavior, eating, sleeping. We can notice that in ourselves and also notice that in friends or family and realize, you know, I think maybe I need to reach out to this person and say, hey, are you doing okay? I haven't seen you, you know, at book club or whatever the usual activities are and pulling away from those activities is often one of the first signs that somebody is not doing as well with their mental health.
Host: Yeah, absolutely. And it may sound a little cheesy, but these signs around that you see that we're in this together, is actually pretty important because we all have to support each other. And if we recognize that someone that we see on a frequent basis, if we recognized that they may be going through a hard time or their stress levels are elevated, it's almost our responsibility to check in with them and to make sure that they have the support that they need. Wouldn't you say that's true, Meghan?
Meghan: I absolutely would. I, there's a speaker that I really like who talks about mental health and also suicide. His name is Kevin Hines and he says, I am my brother and sister's keeper. And really talks about it is our responsibility to say, hey, are you doing okay, when we notice that somebody isn't and also really convey that it is okay to not be okay, it's okay to need some support. It's okay to need some extra help. It's okay to need someone to talk to you about what's weighing on us and that connection and the offer of that connection can really make all the difference.
Jill: Okay. I would absolutely echo what both of you were saying. I think to really pay attention to how people in your circle are doing. And if that gets overwhelming to sort of make sure you have somebody you can hand off to. Because like I said, I think that we've had a lot of evidence during this pandemic people trying to intentionally isolate themselves because of wanting to stay physically safe, but the impact that, that can have, that isolation and disconnection from others, is really important. So, I know encouraging everyone to reach out to someone, you know, who you just haven't heard from in a long time, or you've gotten some signs that maybe they, they are struggling or that they've sort of, just hunkered down and aren't reaching out. I know here at Transitions Mental Health Association, we've heard a lot from people who are reaching out who are saying, gosh, I really would love help finding a therapist, or we've gotten lots of calls on our hotline, the Central Coast Hotline from people reaching out. So, I think that is happening but not as frequently as we'd like to see.
Meghan: I think it's also really helpful for us to know who in our own lives are our go-to people for this, you know. Do I have that friend or family member who I can reach out to and say, hey I'm not really feeling okay. And I need to talk about it. It's really good to know who those folks are when we're doing well. And even kind of have that conversation like, hey, could I reach out to you if I was having a hard time, because it's really difficult to do when we are in those moments where we do feel more isolated and we are struggling with our mental health. It can be really hard to reach out and knowing who that person will be for each of us ahead of time can be just incredibly helpful when that moment comes.
Host: Absolutely. I couldn't agree more. And you know, sometimes this isolation that we're talking about can lead to people wanting to harm themselves or even become suicidal. And you know, one of the things that I read Meghan is that San Louis Obispo County has a higher rate of suicide than the state overall. So, I know this is a difficult question, but can you speak to why you think this is.
Meghan: Oh, I think that's a difficult question and it's not something that we fully understand. We do know that we lose older males to suicide more frequently than some other populations. And we may have a higher population of that demographic. So, that could be part of the reason, but it's definitely something that's concerning.
And it's something that we talk about I'm co-chair of the San Luis Obispo, Suicide Prevention Council, and we're really trying to look at how do we reach these individuals that we know have a higher risk that maybe we don't come into contact with our usual suicide prevention efforts, that maybe don't get the information about the Central Coast Hotline.
How do we reach out and make sure people are aware of that resource? If not for themselves, maybe for, you know, their loved ones, friends and family. How do they know how to recognize somebody might be at risk and reach out and ask them if they're okay. Transitions Mental Health Association offers trainings to the community on kind of gatekeeper suicide prevention. Just really basic, what to look for, how to know somebody might be in trouble and then what to do if we do recognize that, how do we get that person support?
Jill: It's an important part of our hotline training actually is to talk about assessment. And so that is really important because I think as anyone can imagine, those are really hard conversations to have. If someone brings up self-harm or feelings of suicide, that can be really stymieing. What do you say? Do you, you know, ask more questions and that can feel naturally really uncomfortable and difficult. And so I think Meghan's bringing up some really good points that having some idea about how to broach that topic and not shy away from it. And another thing, Kevin Hines, who Meghan also mentioned, is a suicide survivor. And he talks a lot about that importance of, you know, sort of not shying away from the conversation and how important those human connections are. And it's a big part of what the Central Coast Hotline tries to do is to be a resource to have people know that there's someone available 24-hours a day, seven days a week to speak to if someone is Ffeeling suicidal or feeling in crisis. So, I think that's an important resource. And as Meghan also said, it is hard to understand why our particular county's rate is higher but demographics do tell part of that story. And I think Meghan, you just mentioned a statistic about youth suicide. Would you mind repeating it about how I think it's the second leading cause if I recall.
Meghan: Yeah. That is true. Suicide is the second leading cause of death for youth age 10 to 24, which is terrifying as a parent of two teenagers. So, I think mental health is always on my radar as a professional because I am a therapist and I, I do run clinical programs, but also as a parent and as a community member. Just being very aware that we need to talk about mental health. We need to encourage people to take care of their mental health and also watch out for each other. Jill I so appreciate that you mentioned the Central Coast Hotline as a resource, it's a 24-hour resource. And the great thing about that is you don't actually have to know what to do, or even what to say.
If you just know enough to recognize somebody is not okay, and you call and ask the Central Coast Hotline, hey, I'm not sure what to do for this person who seems to be in trouble. Can I get resources for them or can they talk to you? There's help just very readily available in our community for trying to figure out what to do in this moment. So you don't have to figure it out on your own.
Host: And Meghan, I wanted to stick with you for a minute. One of the things that you mentioned was the importance for people to know the signs, right, that someone might be at that breaking point and might be suicidal. So, can you speak to some of the signs that people should be aware of?
Meghan: Oh, that's a great question. I so appreciate you asking. I would say changes, changes in mood, withdrawing from usual activities, being kind of disconnected from friends and family that they're usually in contact with, changes in school performance, changes in eating or sleeping patterns. Somebody who seems depressed is somebody that we should be worried about. Somebody who seems angry or agitated could also be at risk of suicide. And I think if we see any of these things, what's really key is to ask and just say, hey, you know, I noticed that you seem really down and I'm kind of worried. I know sometimes when people feel depressed, they start to think about suicide and I'm worried you might be thinking about that. Is that what's happening? And, you know, oftentimes if somebody is thinking about it, they'll be relieved that somebody asked and if they weren't thinking about it they're, you're not going to create a problem by asking that question, that person's going to recognize, wow, this person really cares about me, that they would take the time to ask this question and explain why they were asking. And it just creates an opportunity for conversation.
Host: So Jill in trying to de-stigmatize mental health, what are some of the preferred words or preferred language to use in the community today? Like for example, you don't want to call someone crazy, but I'm imagining that there is a body of vocabulary that is more respectful when you're addressing mental health issues.
Jill: That is, language is so important. And so I think we are sensitive to words like crazy, and then saying, especially when it's used in sort of advertising or just in general conversation. Because those are pretty stigmatizing words. The other thing I think we're careful about is labeling to say someone is a schizophrenic or is bipolar. Somebody is not their diagnosis. And so I think we try to use language that describes that as part of who they are. So, somebody who has a diagnosis of schizophrenia or someone who has a mental health diagnosis, I think we try to understand these as the genetic disorders that they are, there's a biological basis that likely had an environmental or a precipitating factor, but again, these are conditions that are through no fault of the individual. So, I think that it's important that the language reflect that, to not be blaming or shaming. And I think for me to try to think of mental health, just an important part of our human condition and our human fabric.
And instead of thinking that someone has done something wrong, that somebody is not strong or capable or intelligent, because in fact, it's absolutely the opposite. Some of the folks that we get to work with here at Transitions Mental Health Association are amazing and resilient and have gone through some very difficult and traumatic situations that in some cases have led to their mental health diagnosis.
And we certainly see that in every population. So, from people who may be homeless because they have an untreated mental illness to, you know, someone who is working and married and sort of doing all those kinds of regular things, but also is functioning with a mental health diagnosis. So I do think being really careful about you know, describing things as insane or crazy, or, or using those terms disparagingly, I think we really need to work hard at excising that because I think that prevents people from recognizing how important getting help is if there is a mental health condition or accepting that may be something that's happening to a member of their family or a friend instead of being afraid of it, which has been the history of mental illness is really fear. And backing away and to really try to step in and be supportive and understand and know that these are treatable and recoverable illnesses. I think when, you know, 50 years ago, we couldn't really imagine that someone would recover from schizophrenia, that their symptoms could be regulated and controlled and that they could live really fulfilling, wonderful lives.
Host: Yeah, absolutely. So, Meghan, you know, I kind of wanted to start closing the conversation with you. There might be someone listening to this that might be having some of the mental health issues that we discussed today. They're having a hard time. If they want to get help, what can they do or where should they go if they're having a crisis?
Meghan: Well, if somebody is having a crisis, calling the Central Coast Hotline is always a great place to start. And the person who answers the phone is a highly trained call handler, who can help assess the crisis and identify what types of resources might be helpful in that moment of crisis. And then also identify some ongoing resources for support. If somebody is struggling with mental health, starting with a therapist is always a great way to go. Medication can be helpful too, and people can talk with their primary care physicians about what's happening and start the conversation there and kind of explore, is it going to be a primary care issue or is a referral to a psychiatrist may be going to be necessary. But I probably have a bias as a therapist. I definitely think people benefit from therapy and that's a great place to start.
Jill: I think I would also add that even therapy used as just a boost, you know, sort of like a booster for a family, for parents, for couples can be really helpful and really important. So I think, you know, just if somebody is feeling just some general stress and that's impacting relationships; that's a great way of having an objective professional assist. And so I would also recommend looking at therapy and in that way.
Host: And Jill we've mentioned the hotline a couple of times. Are you able to share the number?
Jill: Yes, it is 800-783-0607. And as we mentioned, 24-hours a day, seven days a week, and warm, empathetic and trained person will be on the other end of the line.
Host: What a fantastic resource. Well, I really appreciate this conversation today. I have learned so much and also it has just reinforced the importance of being a supportive community, family member and friend. And so, you know, just before we close here today Jill, do you have any final thoughts that you would like to share with our audience?
Jill: I just appreciate this opportunity to talk about mental health and just remind everyone to be a resource and to know that there are resources out there. And thanks so much for this opportunity Prakash.
Host: Of course. And Megan, I'll give you the last word.
Meghan: Sure. Thank you. I would just say if if you're concerned about a friend or family member, just check in with them and say, hey, are you doing okay? Here's why I'm asking. Let's talk about what's happening. And that can open the door to the conversation.
Host: I think that's fantastic advice and the perfect place to end. Jill, Megan, thank you so much for your time.
Meghan: Thanks for having us.
Jill: It's our pleasure.
Host: That's Jill Bolster-White, Executive Director of Transitions and Megan Boaz Alvarez, Clinical Director of Transitions, both at Transitions Mental Health Association. If you'd like to call the hotline mentioned today and speak to someone you can call 800-783-0607. We really appreciate you checking out this episode of Healthy Conversations and to learn more about TMHA, which is the Transitions Mental Health Association, you can visit www.t-mha.org. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. This has been Healthy Conversations. The podcast from Tenet Health Central Coast. My name is Prakash Chandran. Thank you so much. And we'll talk next time.