Posted on Leave a comment

What is the ideal model of mental health care within psych wards?

medical stethoscope and mask composed with red foiled chocolate hearts

Mental health care within psych wards, in my opinion, based on my experience and others whom I have spoken with, has a great deal of opportunity for improvement. In fact, I would personally describe the current mental health system as broken. Did you know that patients hospitalized in psych wards are 100-200x more likely to die by suicide upon discharge?

It is 2021, our eyes are open to the economic disparity more than they have ever been in the past. Yet, we still live in a world where quality mental health care is a privilege NOT a right. There is no valid reason as to why there is no minimum standard of care within psych wards on a national level that sets patients up for success rather than failure.

In the beginning of 2021, Inspiring My Generation partnered with More Than Mental Project to create a petition that addressed this. Below is an explanation of points covered in the petition.

When patients are admitted into the psych ward, many are not thoroughly evaluated.

In fact, most evaluations are a simple, standard check the box. These evaluations are commonly not personalized for the specific patient and their story or experience. This results in the professional assigned to the patient receiving only a partial understanding of the patient. Instead, imagine if the first 24-48 hours after a patient is admitted was an evaluation period where a patient is assigned a case manager who works with the 3 licensed professionals to develop the right treatment plan from the number of individual and group therapy sessions to proper medication (if prescribed), post admission treatment plan, and resources.

Patients are typically required to take a standard medication without a thorough evaluation.

As we know, medication is not a one-size-fits-all. The same medication will not work well for individuals living with different mental illnesses. The same medication will not affect every individual living with the same mental illness in the same way. For example, an antidepressant is known to cause manic episodes in individuals living with bipolar disorder. Thus, if an antidepressant is the standard medication, it can have an adverse effect on various patients. As a result, we should not prescribe medication without a formal evaluation and diagnosis. Furthermore, not everyone is comfortable with medication or cannot continue to afford medication upon discharge. Therefore, these situations should be taken into consideration prior to prescribing the medication. When a medication is started and stopped abruptly, it can create a severe adverse reaction.

Patients are not assigned an effective treatment plan during admission.

After the recommended 24–48-hour evaluation period, over the next 24 hours, the patient should work with an assigned case manager to develop a treatment plan that makes both parties comfortable. The treatment plan should comprise of options recommended by the medical team as well as be considerate of the person’s financial situation upon discharge. Thus, the treatment plan should be customized to the individual. Imagine if the treatment plan included a mix of both individual and group therapy sessions while admitted as well as resources and coping mechanisms to use upon discharge, with additional medication or therapy as recommended, prescribed, and financially reasonable. The system would be setting the individual up for success upon discharge rather than throwing them back into the fast-paced world with little to no support.

Individual therapy sessions are not typically offered, specifically not regularly during admission.

When someone is hospitalized in a psych ward, it is usually a direct result of suicidal ideation (active or passive). This is a critical time, where support is needed. Patients should receive consistent individual therapy sessions focused on exploring what led them to admission, relevant trauma from the past, and transitioning to life outside the institution / facility. Imagine if daily or every other day, patients were receiving therapy that explored their specific situation and symptoms, while creating a solid plan to transition back home.  

Group therapy sessions do not provide enough variety in a range of coping mechanisms nor are they separated by mental health disorder.

Group therapy sessions are a great opportunity to explore coping mechanisms in a safe and fun environment. However, not enough variety is provided within the coping mechanisms. In fact, patients should have the opportunity to explore a range of coping mechanisms during group therapy. Also, patients should also not be “marked off” for not attending group therapy sessions that do not feel right or comfortable for them. There should be specific groups created for specific conditions. For example, imagine if we created specific groups for individuals experiencing suicidal ideation / anxiety / depression / schizophrenia.

While admitted, psych wards should have resources that allow patients to explore various coping mechanisms.

Imagine if psych wards had a range of approved movies, books, art supplies, journals, games, etc. that are constantly available for patients to use. This would be a great way for patients to explore different coping mechanisms that may work for them and create their “coping toolbox.”

Upon discharge, patients should have a valuable resource that sets them up for success.

Psych wards should provide all patients with a completed workbook post release with the treatment plan they followed during admission, their recommended treatment plan post admission, a comprehensive list of coping mechanisms, local affordable options for therapy / counseling, crisis hotline and text line numbers, and a supportive message.

Treatment costs are extremely high. Hospitals and/or governments need to reallocate funding to allow for quality treatment.

Many patients leave the mental health treatment facility drowning in bills from their admission on top of any additional costs (such as ER visits and ambulance). If the costs were significantly reduced, this would help transitioning to life post admission more feasible and less stressful, while simultaneously encouraging more individuals to reach out for help.

After discharge, patients are thrown out into the world with no one checking in on them.

Every hospital should have a case manager that checks in with the patients on a routine basis. We recommend: a monthly check in for the first year, a bi-annual check in for the second year, and then annual check ins afterward. If the case manager feels the individual should be re-evaluated, they may call them in for a FREE evaluation appointment to see if treatment plans need to be adjusted. This creates a safety net for individuals who are struggling upon discharge and can help to reduce the suicide rate among patients discharged.

The federal or state government should reallocate more funding toward psych wards to help cover the costs of treatment.

We strongly encourage the Federal Government to increase spending on mental health and set a minimum per capita spending on mental health to ensure all states are allocating enough money toward making these improvements. Currently, we have the majority of states operating at around 1% of the total budget going toward mental health AND many insurance policies not efficiently covering mental health treatment and medications. Imagine if the Supreme Court passed legislation that requires insurance companies to cover a decent percentage of mental health treatment and medications to ensure it is affordable for ALL, not just the privileged. Furthermore, imagine if our State Governments enforced equal distribution of funds per capita to every hospital with behavioral health wards. Funding would be based on city population size and need, not based on wealth. 


Add your signature to the petition:

https://www.change.org/p/kamala-harris-mental-health-treatment-for-all?utm_source=share_petition&utm_medium=custom_url&recruited_by_id=5d2948a0-73df-11eb-9605-43c0b2a74b94

Take part in other Policy Change initiatives spearheaded by Inspiring My Generation: 

https://inspiringmygeneration.org/policy-change/

Posted on Leave a comment

Self-Love: Selfish or Selfless?

self care isn t selfish signage

“The greatest love of all is easy to achieve

Learning to love yourself

It is the greatest love of all.”

Whitney Houston, The Greatest Love of All

A question that has been long debated is whether or not self-love is selfish. We live in a world that repeatedly tells us how loving ourselves is the definition of selfishness. In fact, did you know that when you look up synonyms for self-love, you will find the following words?

  • Egotism
  • Selfishness
  • Egocentricity
  • Narcissism

From a young age, we are often taught that loving ourselves is putting ourselves before others. And, putting ourselves before others is bad. If you put yourself before others, you are selfish. But what if the world is not that black and white?

Let us look at self-love from a different perspective. Right now, let us define self-love as simply accepting yourself and prioritizing your own happiness and well-being. This does not mean prioritizing yourself over others by refusing to help or support someone else, but simply, working hard to achieve inner peace and happiness.

If we learn how to accept ourselves for who we are, we are able to work on cultivating that inner peace and happiness that we deserve. Within that happiness, we no longer feel the desire to prove ourselves to others. This helps us to live more authentically. When we are our authentic selves, we are able to offer more to others. Through the love and understanding we found within us, we are able to extend that same love and understand to others, in the form of empathy and compassion.

So, what if self-love meant that we did not view ourselves as better than others, but simply as important as others? What if self-love meant the following?

  • We simply see ourselves for who we are and are proud of who we are, instead of telling ourselves all of the reasons we are not enough.
  • We acknowledge and validate our thoughts, feelings, experiences, and traumas, instead of invalidating important pieces of our lives.

I will leave you with this, what do we take away from others by also loving ourselves?

Posted on Leave a comment

What factors can contribute to mental health symptoms and conditions?

time lapse photography of blue lights

What factors can contribute to mental health symptoms and / or conditions?

Mental Health Introduction

What is mental health? In my opinion, mental health is a scale that ranges from wellness to illness. Like physical health, mental health can change overtime. You may not always be experiencing symptoms, and conditions / symptoms may re-appear throughout your lifetime. Also, like physical health, certain mental health symptoms and conditions may be experienced worse than others.

Think of a common cold versus pneumonia. A common cold is still considered an illness. Although it is not as dangerous to your health as pneumonia, it is still treated to prevent the common cold from developing into a worse illness. Now, let us look at depression. When depressive symptoms first appear, one may feel extreme sadness for an extended period of time. One may even begin to feel hopeless in the early stages. However, imagine if depression is recognized and treated before the individual experiences thoughts of suicide.

Just because a mental health symptom or mental health condition does not appear to be “extremely severe” does not mean that the individual experiencing the symptom or condition does not deserve help, support, and/or treatment.

If we look at mental health in the same capacity as physical health, we will gain a new perspective that evolves into a world without the stigma. To better understand mental health, let us explore where symptoms and conditions can come from.

Biological Factors

Like certain physical illnesses, mental illness can also develop from biological factors. For example, there has been research that shows a genetic link between certain cancers and family history of the same cancer. There has also been research that shows a genetic link between Alzheimer’s and a family history of Alzheimer’s. Similarly, there have been studies done that show a link between genetic and certain mental illnesses, such as schizophrenia and bipolar disorder (evidence is not conclusive).

As we all know, every human being is biologically different, even though we share many common physical features. A person’s biological makeup may determine how one behaves and interacts within their environment. Therefore, biological factors can contribute to mental health conditions.

It is important to remember that genetics is not the only biological factor. Brain chemistry, gender, hormone levels, and nutrition also influence one’s biological makeup. Furthermore, the interaction between the various biological factors and other factors (environmental, psychological, and social) can play an important role.

Brain chemistry can be affected by factors, such as brain damage and drug and alcohol usage / abuse. Brain damage may result from physical health conditions, such as seizures. Why is brain chemistry important? Your brain releases several chemicals that impact one’s mood (serotonin, dopamine, and norepinephrine are a few examples).  

Biological gender can also impact one’s mental health, through gender-linked stress, trauma and / or reproductive cycle stages. Research shows that women are perceived to be more susceptible to mental health conditions due to how these factors affect their mood.

Hormone levels also play a role in one’s mental health. Deficiencies in hormones like progesterone, estrogen, and testosterone can influence one’s mood, energy levels, reproductive cycle symptoms, and more.

Lastly, nutrition is a key part of mental health. What we put inside of our bodies has a direct effect on our internal system. Poor nutrition can lead to vitamin deficiencies that not only affect our mood, but also energy levels.

Environmental Factors

There are some factors we have very little control over, such as genetics. However, one factor we have a lot of control over is our environment. Yet, our environment tends to be one of the biggest causes of mental health symptoms and conditions.

Our environment is made up of two key components, physical environment, and social environment. Both aspects of our environment are equally important in maintaining our mental health.

What encompasses our physical environment? Air pollution, work conditions that cause significant stress to the mind / body, weather, smoking (second-hand smoke included), loud noises, exposure to toxic chemicals (ex. household cleaning supplies), physical hazards (ex. dangerous workplace situations), household environment (ex. cleanliness, safety, chemicals, lighting, outdoor space, physical barriers), natural environment (ex. weather, plants / trees), physical barriers (especially for individuals living with a disability), school setting (ex. location, structure, stressors, hazards), workplace (ex. location, structure, stressors, hazards), and recreational facilities (ex. access, structure, location, hazards).

What encompasses our social environment? Stigma on mental health and treatment options (ex. therapy, medication), prejudice / discrimination (ex. racism, homophobia, transphobia, sexism), violence (within household or local community), abuse (physical, sexual, emotional), poverty, lack of necessities (food, shelter, water), media (ex. social media, news, television shows), technology (ex. cell phones, computers), relationships / lack of social support (ex. family, friends, self), self-esteem, and lack of physical safety.

All of these factors (and more) can influence one’s overall mental health. Think anxiety, depression, PTSD. It is also important to remember that the interaction between one’s social and physical environment can affect mental health.

Psychological Factors

Lastly, psychological factors are a key part in our mental health development. Psychological factors include our feelings, thoughts, behaviors, and attitude. Psychological factors are something we have a lot of control over, if we educate ourselves and our youth on warning signs and how to cope. Unfortunately, in today’s world, we tend to not discuss how psychological factors can play a key role in our mental health nor do we tend to provide the tools and resources needed to cultivate our mental health in regard to these factors.

Psychological factors include how we cope with life’s stressors (ex. suppressing our emotions, avoidance, healthy vs unhealthy coping mechanisms, defense mechanisms), social support (ex. invalidation, gaslighting), acceptance (from loved ones, especially parents), intrusive / negative thoughts, and personality (ex. use of humor, perfectionist).

Final Thoughts

When we discuss mental health symptoms and conditions, it is extremely important we look at the full picture. Often times, we provide ourselves with a very limited understanding of what can be the root cause of our symptoms and/or conditions. By looking at the full picture and how the various factors interact with each other, we are able to better understand where our symptoms / conditions stem from and how we can make changes to better cultivate our mental health.

Posted on Leave a comment

What age is appropriate to begin the conversation on mental health?  

family sitting on grass near building

What age is appropriate to begin the conversation on mental health?  

My answer: it is never too early to start the conversation.

One of the biggest misconceptions surrounding wellness conversations are that you only need to have the conversation once. Like various other wellness and safety conversations, mental health conversations are not a one-time sit-down dialogue when your child reaches a certain age. These conversations should begin at birth.

What do you mean conversations should begin at birth?

Communication can occur in different ways. For example, when a baby is crying, providing support by holding the baby close to your heart, softly singing, or gently rocking them can be not only soothing but also let the baby know they are not alone. Another example would be allowing the baby to scream and cry (as recommended by doctors for the baby’s age) can also teach the baby that it is okay to express their emotions. Then, as your child continues to grow up, providing safe space to express their emotions without judgement is extremely important.

When a child is in grades K-2, these are core years in emotional health. This is when we often begin invalidating and gaslighting them. Although the problems and stressors children face may seem “small” or “insignificant” to us as adults, they are still very real and very difficult for children. By shutting down children when they begin to cry or get upset with phrases like:

  • People are dying.
  • Big girls do not cry.
  • Stop acting like a girl.
  • You are acting like a baby.
  • You are being dramatic.
  • Stop crying.

We are communicating that their feelings are not important, and thus, they should suppress them. Then, as they get older, we often build upon that same destructive message.

In grade school (3-5), we often use phrases like “You are not 5 anymore, grow up” when children express themselves. Often times, we do not pay attention to the drama or problems they are facing, because elementary school bullying builds character and thicker skin. Essentially, we teach them that it is okay for people to be mean to them and it is wrong for them to speak up for themselves.

By middle schools, when gossip and bullying are at an all time high, when children are beginning to explore or understand their sexuality, when their bodies are changing, they are extremely impressionable. This is a key age for self-esteem. However, we often invalidate their problems by saying, “Do not let it bother you. This won’t matter in 5 years.” Essentially, we are teaching them that their feelings do not matter.

Then, we get to high school, where life becomes complicated. Many kids are experiencing or have experienced first love and first heartbreak, grief and trauma of losing loved ones, extreme pressure on grades and SAT scores, stress to decide the trajectory of their life by choosing a college and a major, puberty, bullying, and the list goes on. Instead of having healthy wellness check-ins, we are piling more and more on to their plates with impossibly high expectations.

Then, we see suicide is the second leading cause of death from ages 10-35 in the United States, and we ask ourselves why.

Why is the suicide rate so high among our youth?

Here’s why: we are invalidating them, subconsciously teaching them to suppress their emotions, meanwhile refusing to engage in important conversations.

Imagine if in K-2, we taught kids that it is normal to have feelings AND that all feelings are valid. Imagine if we taught them there are different ways to express their emotions, such as through speaking, drawing, writing, or music.

Imagine if in 3-5, we taught kids what mental health is on a scale from wellness to illness. Imagine if we explained that sometimes, we may move along the scale as the day goes on, and that is normal to not always be happy.

Imagine if in 6-8, we taught kids about early symptom detection. Imagine if we gave them the tools and resources needed to explore their symptoms and emotions, while developing tools to cope with them. Imagine if by the time kids were 13 years old, they understood how to advocate for themselves and their mental health. Imagine if they knew the right questions to ask themselves and their doctors.

Imagine if in 9-12, we taught kids about suicide prevention. Imagine if we taught kids how to have supportive and validating conversations with their peers, as well as warning signs to look out for with themselves and with each other. Imagine if we educated them on various mental illnesses and resources available to them.

Imagine if by the time one graduates from high school, they have all of the tools and resources needed to maintain emotional wellness and cope with life’s stressors and traumas. Imagine if we set the next generation up for success in life, rather than throwing them into the world with no real understanding of mental health or how to maintain it.

So, when should we have the conversation? Every. Single. Day.

Posted on Leave a comment

What do we do when someone feels hopeless?

photo of people reaching each other s hands

I do not want to be here anymore.

That heartbreaking phrase is something no one wants to hear. Even more so, that is a feeling no one desires to experience. So, what do we do when someone feels hopeless? Do we engage in a conversation and provide support, or do we ignore it to protect ourselves? The answer to this simple question is a key component to suicide prevention.

Let us explore 4 scenarios.

Fran feels hopeless. Fran grew up in a world where everyone told her to “grow up”, “suck it up”, “build a bridge and get over it”, “stop being a baby”, etc. thus, Fran suppresses all of her feelings. Anytime she has reached out for support in the past, Fran felt like she was gaslighted and invalidated. As a result, Fran is afraid to feel, and even more terrified to speak up about it. Fran’s mind is now in control of her every thought. She thinks about dying all of the time, when she is walking, when she is eating, when she is driving, and when she is sleeping. Fran wants to give in to her hopeless thoughts, but she chooses to reach out for support one last time, in hopes that someone extends a hand back to her. Fran decides to open up about her hopeless thoughts. She shares with a confidant that she is profoundly struggling and having thoughts of suicide.

In scenario 1, when Fran opens up, desperately hoping for empathy and support, Fran’s loved one reacts out of fear. Instead of listening and holding a safe space, the loved one immediately says, “Do not say that! Do you know what that would do to me?” Fran immediately shuts down and feels like no one understands her. Fran interprets the response as the loved one does not care about Fran but only about themselves. As a result, Fran decides suicide is the only answer, because no one truly cares about her to provide the support she was begging for.

In scenario 2, when Fran opens up, desperately hoping for empathy and support, Fran’s loved one reacts by blowing her off. Instead of listening and holding a safe space, the loved one immediately says, “You are being dramatic, stop trying to get attention.” Fran interprets the gaslighting as confirmation that suicide is the only answer because in the moment she needed it most, no one cared to truly listen and understand, instead they chose to belittle her feelings.

In scenario 3, when Fran opens up, desperately hoping for empathy and support, Fran’s loved one reacts by listening and providing a shoulder to cry on. For the first time, Fran feels like maybe her life is worth living, maybe she is loved and needed more than she realized, maybe she is not the burden she felt like she was. Fran appreciates the support and views it as a sign to keep going. However, when the loved one does not follow up again, Fran starts to question if she has a support system, and the thoughts begin to worsen.

In scenario 4, when Fran opens up, desperately hoping for empathy and support, Fran’s loved one reacts by actively listening, repeating validating statements, asking non-judgmental open-ended questions when appropriate, and providing support. The loved one even offers to help Fran find resources that are available, if Fran is comfortable with the hands-on support. A few days after the conversation, Fran’s loved one follows up by checking in and reassuring Fran that they are there if and when she needs support, someone to talk to, or help in finding resources. Fran feels loved, safe, and not alone for the first time in a long time.

Let’s Review.

I understand it can be extremely difficult to engage in conversations about suicidal ideation (suicidal thoughts); however, as these 4 scenarios show, our reaction when someone reaches out is an essential part of prevention. I understand that in the moment, it can be hard to know the proper way to react and respond. I understand that no one may have educated you on mental health conditions, depression, or suicidal ideation so you are uncomfortable around the topic. I understand that it can be terrifying to hear a loved one feels hopeless, and you did not know. I understand that there is a stigma on all thing’s mental health, and you were never provided the tools and resources you needed to learn the right way to approach the conversation. However, we have to start doing better.

That heartbreaking phrase that no one wants to hear is something many people around you are thinking and feeling daily. In fact, there are people who are so close to the edge that they can only think about how much they do not want to be here. If they reach out, if they find the strength and courage within themselves to speak up, I ask of you, please do not gaslight them and please do not invalidate them. Take them seriously at their word, actively listen to them, show them you care, and support them in a way that makes you both feel comfortable and safe. You do not have to act as their therapist, but you can connect them to a Crisis Hotline or to a therapist. You do not have to sit with them all day everyday to “watch” them, but you can sit with them now and follow up. You do not have to “save” them, but you can assure them that they are not alone in this.

You cannot save someone, they can only save themselves, BUT you can let them know that they ae not in this alone. You can be a source of love and comfort. You can be a reminder that everything eventually will be okay. Even in scenario 4, you cannot save Fran, but because you offered the support she needed, you made her feel like there was a reason to keep going. The thoughts did not suddenly disappear, and Fran was not healed immediately, which is why scenario 3 did not work. Following up is a key part of prevention and support.

So, what do we do when someone feels hopeless? We listen. We validate. We support. We show empathy. We follow up. We provide a safe space. We let them know that although they have every single right to feel what they are feeling, they are seen, they are heard, they are loved, they are worthy of this life, and they are more than enough. Even more than that, we make sure they know that they are not alone. When someone’s life is hanging on by a thread, our response can save their life or push them over the edge.

And remember, not everyone will feel comfortable opening up and reaching out for support, especially if they were gaslighted and invalidated in the past. Do not be scared to reach out and check in with your loved ones frequently. Be a consistent reminder in their life that they are not alone, and that you are there for them.

I will leave you with this, when someone is drowning and they reach their hand out for support, are you going to push them down, ignore them as they drown, throw a life raft and walk away, or reach out your hand and pull them back into safety?