Self care. It’s a relatively new term as far as understanding mental health is concerned when it comes to the general population, but it’s not often something people really think about in regards to their own well-being. Like in Mexico, where Deborah Loffler says people think about self care more as going to the gym to get physically fit rather than in their own minds. Or in New Zealand, where Jolie Wills says people are really starting warming up to the idea after the Christchurch earthquake. In Part 2 of this special panel on Mental Health around with World, Jill Sanchez returns with guests Deborah, Jolie, Steph Evans, and Sara Laskowski to talk about normalizing mental health care, and the kinds of barriers we tend to put up around ourselves, our homes, and our workplaces, that can get in the way.
OT Ep. 17 – Transcription.txt
00;00;00;03 – 00;00;58;14
Welcome to a special edition of OnTopic with Empathia! In observance of World Mental Health Month, we’re doing something a little different than you’ve come to expect from our podcasts. First, we have a different host – her name is Jill Sanchez. She’s an experienced mental health counselor. And part of her job is to assist individuals internationally. We asked Jill to gather thoughts about the state of mental health and mental health treatment from other professionals around the globe. Jill conducted separate interviews asking each expert their take on the cultural, medical and social impact of mental health on their local communities. She uncovered problems, solutions and thought provoking cultural differences. She interweaves their opinions in the following episode. Thank you for listening!
00;00;58;16 – 00;04;08;01
Welcome to OnTopic with Empathia! I’m your host, Jill Sanchez, for this special episode for World Mental Health Day. Imagine if you struggle with depression or anxiety and no one will acknowledge the struggle. It can be quite isolating to experience a mental health disorder and then add the extra layer of someone feeling ashamed to talk about it. Chances are, if you’re listening to this episode today, you have a loved one that’s been impacted by a diagnosis of a mental health disorder, or you’ve experienced a diagnosable depression or anxiety sometime in your lifetime. Today, we’re here to dive deeper into something that is very near and dear to my heart after working in the mental health field for 25 years and also having loved ones that have experienced mental health concerns. According to the World Health Organization, nearly a billion people around the world live with a diagnosable mental health disorder. That is about one in eight people. Depression and anxiety are the leading among mental health diagnosis globally. Globally, there are about 800,000 deaths per year from suicide. This does not include those that have contemplated or attempted suicide either. This is one of the leading causes of death in young people. These statistics are staggering. And today we’re going to have the opportunity to speak to various professionals around the world on this topic. World Mental Health Day is an important global observance aimed at raising awareness through education about mental health issues, reducing stigma and advocating for improved mental health services and support. Today, we’re going to spend some time talking about the impact of mental health across the globe. To help us discuss this important topic, we have invited a panel of guests who represent various regions of the world to talk about their experience in mental health specific to their professional experience and personal observations in their country or region. The episode is not intended to cover every region of the world and instead to provide a platform to continue to normalize talking about mental health and reaching out for help, whether you reside in the US, Asia, the Middle East, Europe, or anywhere in the world. I am delighted to share we have our panel of professionals back to discuss mental health around the world. Each of them works in the mental health field and live in a different region of the world. Please welcome back Jolie Wills, Sarah Laskowski, Steph Evans and Deborah Loffler. Our first episode we spent time discussing mental health and some of the similarities we experienced no matter where you live in the world. However, we were able to also touch on some differences that you may experience based on what region of the world you live in and how culturally mental health is discussed within your country, culture or family systems. Steph, can you tell me, is it normal to talk about self-care in terms of mental health in the UK?
00;04;08;03 – 00;04;48;23
Discussing self-care in terms of mental health has become very normal and an important topic of conversation in the UK. Over the past few years, there’s been a significant shift in attitudes towards mental health awareness and understanding, and as a result, we have far more open discussions about self-care strategies and to promote mental wellbeing and acceptance and recognition. And I just think it’s just far more normalized or I find it’s far more normalized in the environments that I know not only interact with, but also I’ve worked in myself.
00;04;48;26 – 00;05;14;29
Debra You mentioned self-care. I’m just curious like, is self-care even like, is that a term that you even use in Mexico or I mean, I just feel like in the US and in step with Syrian in the UK as well and in New Zealand that like that’s just a term used a lot. I’m just curious if that’s even- or what would be the- what would be the Spanish term that you would use?
00;05;15;02 – 00;08;23;00
Autocuidado! Yeah. It’s, it’s- you hear it more with younger adults like, like it’s in vogue or it’s like in that you do exercise more like a bicycle or a running or a marathon. That’s- and that’s something that has grown a lot in Mexico, these events for marathons. And so people are participating in these events. I have seen a growth in there in the gyms, like the type of gyms now that you see it, more like it’s more our business now than before. But I think it’s as I’ve seen it more with the population who have gone to the university, for example, that they have more income. It is more like a trend to set- to talk about self-care and- and take care of yourself than people who lack economical resources. No? Also in the public health system and I have seen that there are some programs in relation to prevention about diabetes, no? But I don’t think that it’s something that is talked about daily or in the population that as you know, Mexico has a lot of a population that is poor, no? That we have a big population and that big difference between medium and people who have more money than a… disparity? I think it is a big disparity. Mm hmm. Yeah. And so I think people who do not have a as much as a economical resources, they don’t focus on that. They focus on the day by day, no? Of a working, getting to work. The transportation is- is unsafe. It is- there is a lot of traffic. It’s not a good public transportation. So it’s more those worries than worrying about going to the gym or running or healthy eating. No? That is why we decided to add in our EAP services the healthy eating support line with the nutritionist because Mexico in many years ago was one of the first countries with a obesity and obesity in children! So a lot of companies were were paying attention of providing a support to their employees and family members to have more healthy eating. No it’s their life, to like to have a that- that part. So but it’s not a day by day for them to have this concept of self-care. It’s meaning that they know in getting what they need for their own lives. And in the other side, with people who have more economical resources. And they went to the university and they are working and all that, athen they are more interested in self-care.
00;08;23;00 – 00;09;07;20
Yes, it reminds me of the Maslow’s hierarchy of needs. Like, I mean, you can’t be talking self-care if you’re just worried about how to get to work and basically social determinants of health, like, you know, those social things in life and our environment impacts how healthy we can be. And I think you raised a really important point that the disparity that you could- that someone in Mexico or in any other country really can really be greatly impacted by our economics. In the U.S., is it’s normal to talk about self-care in terms of mental health?
00;09;07;22 – 00;10;05;73
I think that self-care has gained a lot of traction and gets a lot of attention in workplaces, schools, countless settings. There’s many, many self help, self-care books, apps, guided experiences towards self-care, but of course different individuals and populations will see self-care differently, and it’s uniquely defined for each person. I think where the problem comes in is translating all of that information that’s available to us into actual behavior change.
It’s a real challenge for many people to engage in self-care intentionally, including caregivers and caregivers, can be the hardest bunch to take care of themselves. If you’re always caring for someone else. And so people’s busy lives make it difficult. But I would say that the tools are available.
00;10;05;73 – 00;10;15;21
Do you think that access to those tools may vary depending on people’s personal situations or economics?
00;10;15;21 – 00;10;56;53
I think so. Depending on your work environment, you may have a very supportive workplace. I think even the well-intentioned workplaces can have things in place like an employee assistance program, wellness programs, but the actual access to it may not be as visible or the work environment is too busy for anyone to think about taking care of themselves. We are seeing burnout people doing more with less.
And so I think for workplaces that should be a priority is highlighting those things that are available to employees.
00;10;56;53 – 00;11;07;29
So that’s where it leads me into my next question for you, Steph, is how- how do you- how do family and friends support a loved one or a coworker with mental health concerns in the UK?
00;11;08;02 – 00;12;29;04
In the UK, the NHS National Health Service is obviously some- is free health care for all in the UK. And there are provisions in terms of health care, including therapy, support, social support available for those that have carer responsibilities. So family and friends would fall under that group and there is guidance available also for individual seek in support of a loved one or coworker via the NHS. And we also have third party organizations, so charities who specialize and also support in that field. So family and friends is an important couple within our infrastructure, our health care infrastructure, and they are very well catered for. I would say there’s definitely specific services, even to the point where in our health care system, when you visit a GP or a doctor for any reason and we collect data, obviously in the UK in our health care services, you’ll quite often get asked about whether you have any carer responsibilities or anything like that. So they’re looking for those- those points to see if there’s some way that they can support.
00;12;29;07 – 00;12;51;03
So what are some resources in New Zealand that are available to support individuals that are struggling with mental health concerns? I know you mentioned earlier government, the Wellbeing initiative, the SOS. I was wondering if you could share, whether through that or organizations, through EAP’s, yknow kinds of, where would people be able to access support?
00;12;51;06 – 00;14;01;13
In some ways it would be similar in other ways, it’s different. I mean, we have a publicly funded health system, so people have free access to mental health support for clinicians, cancers through, they go to the general practitioner, their doctor, and it’s accessible that way. That said, there is a horrific backlog, right? So you can say it’s- it’s accessible, but it’s hard to access at the moment given the demand on the system. EAP is definitely, you know, available to most people and organizations in New Zealand. So having access through their workplace is a really important way to access support. We have the Mental Health Foundation in New Zealand, a charity that really supports organizations with ways to support their people and a whole lot of resources, including, I think I mentioned the five ways to wellbeing that came out of the UK, which made that a lot of population wide support to help encourage wellbeing, but also to link people with more access and more support if they need it in terms of access to services. So there’s a lot of resources and a lot of backlog and lot of strain and demand on those resources. I would say at the minute.
00;14;01;20 – 00;14;07;22
Seems to be a consistent thing that we’re seeing across the world with demand, really since COVID.
00;14;07;29 – 00;15;40;25
Yeah, I mean, there’s legal protections, there’s best practice guidance, and there’s statutory support on offer in the UK to support people, to support someone, and that’s on offer. And we have a kind of our National Health Service that’s effectively in charge of the health of the nation for us. So they have a kind of obligation to kind of offer support, but in general supporting others with emotional, physical needs, practical concerns and access to resources and services are highly utilized in the UK. Carer’s status is a core data collection. I think I mentioned that, that if you are supporting someone or you are a formal carer for someone in the family or that’s kind of a data point that’s collected. If you’re speaking to anyone in sort of the health care profession, but mainly your GP, they are kind of looking at ways that they can actually provide that support if it’s needed. It’s a kind of national metric for us as well. So the NHS collects national healthcare metrics and it’s actually a metric that is an important metric for them to collect nationally. So they proactively looking for people that might be in that position that they can then provide these resources to or support to or help to.
00;15;40;27 – 00;15;51;03
Well Steph, that actually leads me to another really important question, actually. What do you see as the biggest barriers to access to mental health in the UK?
00;15;51;05 – 00;16;26;10
I think supply and demand actually is one of the biggest barriers. So I mean, there’s a range of barriers that you could see the mental health support. There’s issues with social economic groups, geography, you know, even as a small island, there’s different parts of the country where there is more affluence than others. So geography can have a can be a barrier that education, understanding, racial and cultural factors, all of those things have to be considered. There’s still a barrier to do with shame and stigma. And also there can be something around the lack of like, cultural sensitivity around services, right? So when you have a central service like the NHS, they are super sensitive to the different backgrounds and needs of the patients they support. But there’s also a difference in cultures to when and how they would get help. There’s also barriers there where culturally it may not be the thing to go and talk to somebody about their mental health issues, but I would say that probably the biggest challenge for the NHS is supply and demand. I would say the needs outstrip in the the supply, actually.
00;17;12;00 – 00;17;17;04
Sarah can probably speak to that in the US as well.
00;17;17;04 – 00;18;31;59
I think that depending on what resources are available to you, there can be barriers. For example, not everyone has health insurance and even if you do have health insurance, there may be a huge deductible or co-pay. And so to even go for one session could cost over $100 for an individual. They may not be able to afford it. And so if you’re not able to afford something like that, you’re not likely to pursue it. Also, the different types of insurance coverage and what kind of providers accept that kind of coverage if you’re in a lower income and eligible for something like Medicaid, it’s nearly impossible to find a psychiatrist who sees children through Medicaid. And so while the insurance carrier may offer the benefit, you also have to find a provider who accepts it. And these days, providers can choose more what kind of populations they want to serve. And what kind of pay structure they’re willing to accept as well.
00;18;31;59 – 00;18;55;05
When you mention organizations, in New Zealand, I mean, have you seen a change in even- obviously employee assistance programs have been available in New Zealand for a long time. That’s a very established market. But I was curious if you’ve seen a difference even in the last- well could be since COVID, but even before, like do organizations also really support that initiative as well?
00;18;55;05 – 00;21;14;13
Absolutely. And I think it’s been driven by a few things. I mean, having a government leading the way to say, look our financial budget for the country is going to be constructed around the different types of wellbeing for communities. And how we operate as a country drives the fact that, you know, even businesses are really thinking about wellbeing as an important part of how they operate. They can see the connection between that and productivity. And so I think wellbeing initiatives that work beyond the physical and being really common in New Zealand for a while. Our health and safety system, you know how you have- I’m not sure what we call it here in the US, but in New Zealand around, you know that the laws that encourage or really enforce methods for keeping people safe at work also include mental health, you know, psychosocial hazards and how we manage not just physical safety, but also psychological safety as well. So it’s very much embedded in how organizations operate in New Zealand and wellbeing initiatives and a focus is really included. And most organizations in New Zealand are very conscious of, I mean, we are founded on a treaty which takes into account Indigenous people in their approach to the world and their needs. And so mainstream across organizations, most organizations are looking at a model of wellbeing and health that is holistic beyond the physical based on a modern model of health that originated decades ago. But still is in operation because it is such a- it’s got such a sound basis and it’s called Te Whare Tapa Whā. Basically, it means the four walls of a house and the idea being that we need to- any one wall of the house, if it’s not strong, then your whole structural integrity is at risk. So in terms of your well being and your health. So it looks at physical wellbeing, spiritual wellbeing, social wellbeing and mental wellbeing and mental health. So, you know, most initiatives within organizations that New Zealand around wellbeing are based around that model. So the four walls of your house that we need to nurture and look after for us to obey, to be well and functioning. And you know, there’s things that we need.
00;21;14;15 – 00;21;18;11
That’s also just so beautiful. I got goosebumps again.
00;21;18;14 – 00;21;35;03
And even for people who are- I don’t know, I’m married to an engineer, right? So, you know, we can talk about structural integrity when it comes to looking at an analogy that works. So in terms of how we operate and how we do and how we are.
00;21;35;03 – 00;21;54;37
Sarah! So some of our guests talked about how mental health is delivered through national health care in their countries. And so obviously in the US we don’t have that. But I was curious if you could share what are some resources that people would access mental health support within the US?
00;21;54;37 – 00;23;12;78
Well I think now we in addition to insurance based services, which individuals may or may not have access to, whether or not they have insurance, there are options for EAP’s, there’s a lot of self pay options now available online like online platforms for virtual counseling. There’s virtual apps, and a lot of that is good in terms of convenience. There’s also eCBT programs which really focus on a self guided kind of journey towards improving overall wellness and mental health. And a lot of those programs really are targeting what they call the silent sufferers, you know, people who may not reach out for help, but they’re going to go online and try to find resources that way. There’s a lot of peer support options in the United States. And I also think holistic options are gaining traction as well. People looking for different approaches to improve their wellbeing through nutrition or things like, you know, acupuncture, yoga are nontraditional purchased too.
00;23;12;78 – 00;24;40;16
I think you highlighted a number of different things actually we haven’t mentioned today and with Steph, Deborah and Jolie, which doesn’t mean that they’re not available in those countries, but just even talking about like acupuncture, kind of nontraditional ways to get help for mental health as well, it really is an exciting time when you think about- because not everyone’s going to maybe access a traditional counseling way. And so having other ways to reach people is so critical. And your comment reminded me of something – So I’ve been with the Empathia for 25 years, and I remember about 25 years ago our president of the company, CEO said, Just wait! Some day we’re going to have to be doing counseling on video. And I remember thinking that that seemed crazy that we would actually be doing counseling virtually. I mean, that was before I had an iPhhone, you know, before you’d facetime people. So it’s just kind of amazing to think about the ability to to reach people that way now. And even this- even today, having this panel that we can do a video call and have people from around the world, like it’s that technology piece is a positive thing for sure. Jolie, could you share with us if there’s been a change in New Zealand in terms of access with technology?
00;24;40;19 – 00;26;19;14
Yeah, I think the telehealth thing is means that access has been easier definitely for a lot of people in terms of accessing mental health services, counseling and support. And there’s also been a real rise in thinking about young people in particular, but also proportional are all parts, especially that the working population around mental health. So a lot of technology trying to encourage wellbeing and preventative kind of approaches that the real like is the rise of the app has been really big. So for example, there was an app that was available in the workplace for organizations to sign up their people for to help support their wellbeing that the government through COVID funded for every person in New Zealand. So there’s definitely been, you know, more of a rise of looking at different ways to deliver messaging and services. And I’m kind of of two minds. I think they’re a really important part of the puzzle where I think it does give people more access and it’s another really important methods of another channel, which I think is really important. But for me, I think too often apps are only open once and they can be the channel of the way in which stress normally, you know, technology, that’s where our stress from work comes from, you know. So I think it’s keeping it all in balance, that it’s one really important part of the puzzle. But we have some people who cannot access technology in that way. And just again, how do we keep a range of options available for people so that they can they can opt into what will work for them?
00;26;19;16 – 00;27;16;49
But I definitely think the overall coverage can be a barrier. And again, the provider availability at times. And while the virtual options have been tremendous in terms of access for many people, for a lot of people that may be doing the opposite because they may not have access to the technology needed for telehealth appointments or they’re not comfortable with telehealth appointments and we are now seeing a little bit of a shift back towards wanting that traditional face to face. Many providers are back to or still offering some kind of face to face action, but it may be more limited than it was in the past because they may be reserving part of their week for virtual appointments and the other part of their week for face to face and so that- that starts to limit the access now for people who are desiring that again,
00;27;16;49 – 00;26;55;03
Sarah, you were just sharing with us just about access within work and just how people like working people and how, you know, different work cultures might have access or promote EAP or promote even mental health. You see every single day people reaching out for help because of mental health concerns. I mean, hundreds of people call a day our organization to get that kind of help. And I’m curious just if you have any thoughts on the power of reaching out.
00;27;44;09 – 00;29;44;17
I think there’s tremendous power in reaching out because when you pick up that phone, what we’re seeing is the client is in their moment there. They are having a moment where they have decided right now that it’s time, you know, it’s time to get help. It’s time to get support. It’s time to explore what resources are out there, whatever that call may be. And it’s different than walking into provider’s office that’s scheduled. We are- we are literally seeing clients in their moment. And so providing that immediate support, being a welcoming and nonjudgmental person on the other end of that line, to listen and to help problem solve and support and educate is very powerful. Sometimes we have the unique experience of getting feedback long after those calls, and so that can be very validating as well to see the impact that that counselor interaction may have had on that particular person. I came across some feedback recently where a mother was complimenting one of the counselors that she spoke with and said that the counselor helped her calm down so that she was able to help her son, who was unable to calm down. And so that’s a huge thing to happen in that particular moment that she needed us. I have also seen feedback where a client had said that this counselor literally saved her life like she was at the end of all hope. And she made that phone call and she changed her mind that day about wanting to die. And so those are some of the powerful stories that we may have the opportunity to see later.
00;29;44;19 – 00;30;44:47
That’s so powerful to think that just a simple phone call may save someone’s life. And so we might have listeners that don’t have an EAP, but I’d like to say there’s always a way to reach out somewhere. But I know there’s probably people that don’t feel that there is. But, you know, whether it’s like turning to a loved one, a neighbor, a local community resource or an EAP, you know, there’s always a way or, you know, a way to connect and get just to be heard! Like and I think that’s what you’re describing, is that like that in the moment, support from a counselor, but maybe it’s a loved one sometimes where you’re just feel heard and understood can literally change the trajectory of what may have happened.
00;30;44:47 – 00;31;11;19
Yes, we do get many calls from people who just want to know how to support or help their loved ones. They may not be having their or being identified as having their own mental health issue, but someone that they love is struggling. And so we can support that person as well by helping them learn how to educate themselves, listen, support that person, but also establish boundaries for themselves so that they’re not taking on all of their loved one’s pain.
00;31;11;21 – 00;31;39;23
You know, I think today was really interesting as we reflected back and thought about kind of episode one and episode two in terms of mental health. And we’re really hoping, I think the- the five of us, our goal today is really to hopefully normalize speaking about mental health and I wanted to share this story because it reminded me that- this reminded me of, I guess, mental health in a way. But I was telling Sarah yesterday that I went on this pilgrimage and basically a walking retreat for 40 miles. And while I was on this retreat, everyone had shared kind of what was on their heart while they were there. And while no one- I’m not, it’s not like anyone said, well, I’m depressed, I’m anxious. But people shared their stories that maybe lead to mental health concerns or worries, you know, normal things that we all experience. And what was really powerful to me was while we were walking, we walked in silence and it was powerful to see how every single person, 50 women were walking with something they carried on their heart. And we were all walking in solidarity. And, you know, this was a faith-driven thing, but it reminds me of us all being together. You know, five women coming together. We all have our stories personally, professionally, and we all hear stories around the world. You know, whether or not you’re in Mexico or you’re in the US or New Zealand or the UK, we’ve all been witness to people’s stories. I think it’s just I guess my hope is that people feel connected to this in a way that maybe it makes it okay for them to reach out for help.
00;33;00;22 – 00;33;36;20
Absolutely. That’s really powerful, Jill, your experience with the pilgrimage and I share that same hope that, you know, those are the kinds of stories that we see more experiences of that, that there are more opportunities for- for people. And I think that as humans, we desire that type of connection. Everybody does. And the phone call on the other end may be desiring that connection in that moment. And so that’s something powerful that we can provide right now.
00;33;36;20 – 00;34;15;05
Exactly. That human connection. It doesn’t matter who you are, what country you’re from, what- what language you speak, we all want to be connected. Sarah, Jolie, Steph and Debra, thank you so much for joining us today. You will find more information about overcoming challenges on all our podcasts. To hear more episodes of OnTopic with Empathia, visit our website, www.empathia.com. Follow us on social media @empathia, and subscribe to OnTopic with Empathia to hear new episodes as soon as they go live. I’m Jill Sanchez. Thanks for listening to OnTopic with Empathia!