Video Transcript: What is it like? Part 3

Welcome back to mental health integration. This is week three part three. In the  last segment, we talked a lot about what mental illness feels like, what it feels  like to go through the process, what it feels like in your own brain and your own  mind space, what it feels like to get diagnosed and what it feels like to start your  journey towards getting better. We also talked a little bit about how this process  changes you some of the doubts that go through your mind, some of the new  things that you have to process. In this section, we're going to be talking about  what populations seek treatment, what that looks like, and why it should be a  little bit eye opening as to how things are going in the mental health space. So  with that said, let's jump in. So who gets treatment? 43% of adults with mental  illness get treatment that's in any given year, and 64% of adults with serious  mental illness, 51% of youth with a mental condition. And then by race, we have  these listed out as well before we get to those, though, I want to stick with these  age related pieces 43% of adults is still less than half, like we mentioned before, and 64% of adults with serious mental illness is still only two thirds of those who  have an illness serious enough that it can disable them from work. So this, these stats still aren't that great, so we need to look not just into what is available, but  we need to look into why someone wouldn't get treatment. Then we have 51%  of youth with a mental health condition that's also affected by parents and  guardians. There are all sorts of factors that play in with that. Further by race,  we have 25% of Asian adults actually seek treatment, 31% of black adults, 32%  of adults who report mixed or multiracial. 33% of Hispanics or Latinx adults, 49% of white adults, and 49% of lesbian, gay and bisexual adults. What we see is  that there is a pretty profound breakdown in which people are getting help and  which people are not getting help, and part of this is due to services accessible.  Things like insurance play a big part in mental health services. I know I live in  Denver, and if you go to the community mental health centers around Denver  that do not need insurance, sometimes wait times can be three, four or five  months before you can get an appointment. And I've heard similar things all over the US. But having insurance break down a lot of those barriers. If you can go to a private pay psychiatrist or a private pay therapist, sometimes you can find  services that are available in only a week, sometimes less, instead of waiting  months in order to get access to services. The other piece of this, though, is if  you have access to services? Are you going to see them? As we saw, 25% of  Asian Americans are receiving services, as opposed to about half of whites.  Well, 25% is that's a really low number. Is that because there's just not access  or is there something else going on? And that's what we want to talk about a  little bit more and what we'll get into more this week. So let's push in a little bit  more on some of the other things going on with mental health issues. One of the other things going on is mental health issues as a co occurring condition in 2015 and 2016 more than 2 million US adults had an opioid use disorder, and  according to the National Survey on Drug Use and Health, 62% of them had a 

co occurring mental illness and 24% a serious mental illness. However, only  24% and 29% of them, respectively reported receiving treatment for their  conditions. So what we see over and over is that there are other things going on besides just mental health issues. They don't just sit there alone. One of the  reasons may be because mental health conditions are so hard to work with, as  we talked about in the last segment, that many people choose or find  themselves in a space where drug addictions, opioid addictions, alcohol  dependencies, various other dependencies, are used as a coping mechanism in order to get through the hard points of mental illness, they at least give you a  settling. Point. Now we talked a little bit about addictions before that. Addictions  are really, really bad solution to a problem. In the case of mental health issues, it can be a coping mechanism, but it can create its own problems. So it's it's a  really bad solution. The other thing that we see is that mental illness and  addictions tend to feed off of one each other, off of one another. If you have  something like bipolar disorder, the rates of substance use are incredibly high.  Part of that might be that it's used as a coping mechanism. Part of it also might  be that once you're addicted to a substance, it is so hard to quit because you're  trying to deal with unraveling not only the substance use disorder, but also the  mental illness at the same time, and those two can trigger each other over and  over and over again, creating a reinforcing cycle that makes it really hard to get  out of. It also creates hard treatment paths for professionals. Which do we treat  first, the bipolar disorder or the addiction? Well, in the case of those two  combined, you can't treat the bipolar disorder until you begin to treat the  addiction. The drugs just won't work. You can't make you can't get someone's  mental chemistry right if they're already changing that chemistry on a very  regular basis from the outside. So in order to get medications to work, you  actually have to get someone off of their hard drugs or off of alcohol or  sometimes even caffeine dependencies, depending on what it is, in order for  those drugs to work right. Medications rather, however, if you try to deal with the  addiction first, you're also dealing with an addiction that has triggers all over  caused by the mental illness. So it's not quite as simple as it is with normal  addiction, it's even harder. And addictions are hard enough on their own, it  creates a very which came first the chicken or the egg kind of scenario. But in  this case, we know what actually needs to happen. First, we need to deal with  the addiction, then we'll deal with the mental illness, and we just know that it's  going to be extra difficult because the two are playing off each other on a very  regular basis. So now I want to go back just a little bit. Why are these rates of  getting help so low? Even with opioid use addiction, we saw that rates of  support are less than 30% why is it that that is going on all of the time? Well,  when we talk about this, we're going to have to start, start talking about, what is  it inside of us that is calling out, that is trying to get help? One of the ways that  people try to get help is with self harm, and according to mentalhealth.gov 

approximately 1% of people self harm, a fair amount. It's not that many when  we're talking about statistics of 10, 15, 20% around mental illness, but it is a  significant number. An interesting thing about self harm, though, is self harm,  normally, is not related to someone immediately trying to kill themselves, though  people with self harm also often have higher suicide rates. It's often associated  with trying to feel with numbness, with with trying to feel alive again in some  way, shape or form, because of something else going on. So while it is  concerning, it is not as concerning as some of the other things that happen, like, for instance, a suicide attempt. And while you should take it really, really  seriously, it doesn't mean that someone is actively trying to kill themselves, but it does mean that we should get help, and that we should get help involved,  especially experts in self harm. Now we're going to get the reason that so few  people get treatment very well. The first is this, 11 the average time between  symptoms manifesting and treatment is 11 years. They can say that's a really  long time. Why on earth, if your life is this bad, would you wait 11 years to get  help? Well, in some cases, I think it's not quite as simple as we think. And before we start blaming the people who are having mental health issues and saying,  you know, you really just should have gotten to the doctor before it took you 11  years, maybe, let's figure out kind of what's going on. I want to use a couple  examples. One example is actually my wife, who has issues with depression,  and who struggled as a teenager, she dealt with suicidal ideation at times, but  she always had this thought in the back of her head. Doesn't everybody  struggle? It's because as a society, at least in the US, we've tried to normalize  things to a point where we say, yeah, everything, everything is hard. Everybody  has a hard life. That's just how it goes. Everybody gets sad, sometimes,  Everybody Hurts, sometimes. And so for her, the question was, is this bad  enough that it requires treatment? When we started my way at Cape, we initially started working just with people with bipolar disorder, and within the first six  months, we had people asking questions like, am I bipolar enough to be in your  program? At which point we said, Yeah, we're trying to get you help. We don't  care how bipolar you are, we care that you're getting help. But this can be an  often cited thing. Is this bad enough that I really need help? Or am I? The other  thing that comes up is stigma. Stigma is like the buzzword in mental health, and  has been for the last decade. Stigma is basically that reason that you don't want  to have a mental health condition, or in the case of just not mental health, the  reason you don't want to have whatever it is that's stigmatized, it's almost like  collective shame. Now, in the case of my wife, is she defective if she has  depression? Is there something wrong with her? Is there something wrong with  the way she was raised. If she has depression, is there something going on  deep inside her soul? We could say no, knowing what we do about mental  health issues, we definitely say no. We'd say, well, you're having struggles that  are not normal. If we just diagnose them and treat them. We can probably get 

back you back to normal pretty quick. We can actually do some extra work to  help you thrive, more than you ever thought you could thrive. But stigma says  no, you're going to get labeled, and that is going to make you dysfunctional.  You're not going to be good enough. There's going to be a problem and you're  going to be it. Stigma says if there's a problem like this, it may not get better.  You won't get better. You don't get to be yourself anymore. And ironically, the  things that would help you most, in this case, treatment and therapy, get pushed  off to the side, because stigma says if you do those things, you are defective. So ironically, stigma keeps you in a place of being ineffective and having a life that's not great, instead of breaking the stigma and entering a space that is really  good. When we saw the stats about what different races and what different  populations were getting treatment. A lot of those stats have to do with stigma.  We had launched a program. We were working with African American churches  in the center part of Denver, and it was amazing to see how many stigmatized  individuals and populations, there were just in those little areas who basically  said, if you have something like this, there's a different problem going on. We  often heard that mental health issues were a white people's problem, that other  populations didn't have mental health issues, or didn't have the luxury of having  mental health issues, and that if they had those mental health issues, it was  because they didn't have enough faith. They didn't have what it took to get  better. They weren't in community, they weren't doing something right. It wasn't  related to their mental health. It was related to some moral thing or some activity that they were or were not doing, and because of that, their own mental health  was stigmatized and they were pushed down, and their chances of getting better were dramatically lowered, ironically, because they weren't getting the one thing  they needed, which was a diagnosis, and then following that access to  treatment. Now, there are things that we can do about stigma, and one of the  things that we can do that helps most with stigma is stories. We talked a lot a  little bit about that in the last section that is. If you hear the story of somebody, it  changes how you perceive them. Knowing that I have bipolar disorder and that I  struggle with anxiety, you might know how well he looks fairly normal, maybe,  and he looks like he's done okay. So maybe this isn't such a bad thing, but if we  only associate bipolar disorder, with someone going crazy or anxiety, with  somebody who is having panic attacks constantly and who can't get stabilized,  we don't have a lot of empathy for those people. And because of that, our  conceptions of what mental illness are are relegated to these incredibly acute  severe cases, and when we only see acute, severe cases, we write off all of  those other cases that we see. I used to see this a lot when we started working  with churches, we'd approach a church and say, we're trying to work with mental health, and we want to see if there's anything we can do to help you. And they'd  say, yeah, there's a congregation of two or 300 people, and we have this one  person, and they really struggle with mental illness. And I would have to look at 

the pastor and go, two to 300 people, you should have had 40 to 60 people in  your congregation struggling with a mental health condition in some way, shape  or form, in the last year, and there's only one who's struggling, they would say,  yeah, there's just this one. And it wasn't that, that one person was the only one  struggling with a mental health condition. It was that, because we'd seen this  incredibly severe problem, this acute thing, everything else that wasn't that was  pushed to the side that's not actually mental illness. And what was mental illness was stigmatized because it was this incapacitating so in doing so, what we saw  was that entire populations of people were ignored when they were struggling  and had real real pain and real hurt, and people who had real pain and real hurt  were isolated because their cases were severe enough that they were basically  relegated to a space of, No, you're the bad one. You are dysfunctional, and God  still loves you, but you, you are not like the rest of us. And in that, in that cutting  off of people from congregations, we saw those stigmas grow. In fact, when we  started working with different congregations, we saw those stigmas grow over  and over and over again. I remember when I was first coming to church, I didn't  become a Christian until I Christian until I was 18. I remember someone found  out that I had bipolar disorder and told me, If I prayed harder, I could get better.  And it wasn't just like the pastoral staff. I never I've never actually heard  something like that from a pastoral staff at a major church. It was this really nice, 80 year old woman who believed in the power of prayer and who was trying to  help me, and in doing so, it actually furthers what stigma is, because it says, If  you really believe, you don't have to struggle with This. Instead of saying, Well,  you have a chemical condition. And if God wants to heal you, he can, but that  doesn't guarantee that he will. It takes, as Louis talked about, a proscriptive  versus descriptive state. When, when we see things like that and take a  proscriptive stance. We say, this is what you ought to do. We read about Jesus  and the Gospels and how He healed people. This is what you ought to do. You  ought to pray and it will go away. We say this is the only way to get better. We  say also to the person who's struggling, if you're still struggling, you didn't do it  right? That grows stigma, and we don't want to have a mental health condition if  that's the case, right? We're being shunned and told you're struggling, it's your  fault, and you're in the wrong. And it also grows stigmas because it isolates but  when we share stories, we can break those things. When she hears about how I struggled with bipolar disorder for years, how I desperately wanted to be healed, how I hadn't been offered that healing, but I did find medications that worked,  and it gave me my life back. That changes how she sees things and helps her  embrace people better when she embraces people better, that breaks down  stigmas, because she's no longer stereotyping mental illness as you are, the  bad one she's meant she's stereotyping mental illness as well. It's all these.  People that I know, and a lot of them, are really functional, doing really great  things, and just because you have bipolar or depression or anxiety or any of that

myriad list that we saw earlier does not mean that you are dysfunctional. It  means that you have extra struggles in your life that you need to work through,  but that you will get stronger, and that God is with you through the process. So  when it comes to which populations are getting help and which are not getting  help, I have worked really hard to try and find places and tell stories, because  those stories break down issues in the cases of our African American churches  that we were working with when they said, these are white people problems. We went into those churches, and instead of putting white people on stage and  saying, Here, listen to these stories, we asked if there were any of their own  congregants who were African American, who had stories around anxiety or  depression, who would be willing to share all the solutions came from their  congregations to their congregations, because when they heard their brother or  sister say, This is me, and this is what it looks like, and this is what it feels like, it  changed what happened inside those doors. When we were talking to some of  our Hispanic and Latin American churches in Denver, we always asked pastors,  who was it that was struggling with a mental health condition that was in their  church that we could talk to? And then we asked if they were willing to share  their story, because when they talked, they looked just like everyone else in that  room. And suddenly, this wasn't just a white person problem. Suddenly this was  an everyone problem, because it was here and it was in this space. And when  we can start pushing into this and realizing that we're not alone, that people  have these conditions and look just like us, it changes how we process mental  illness. And so as you move forward, I hope that you can continue to get to push towards help, to push towards really great solutions, and I hope that you can  also push towards finding stories of people that look just like you, and in some  cases, help other people find stories that look just like them, so they can find the healing that they need. Thank you, and we'll find See you in the next section.