Barriers to Mental Health – Podcast

By LifeStance Health on May 19, 2020

Dwight Thompson (00:00):

Hi, welcome to Reset Your Mindset by LifeStance Health. Myself, Dwight Thompson, and my cohost Nicholette Leanza will bring you conversations with leading life stance health professionals who will help guide you on your journey to positive mental health and wellbeing. At LifeStance, We believe in the three pillars of mental health, mental flexibility, mindfulness, and resilience.

Dwight Thompson (00:27):

Hi, thank you for joining us. We’re joined today by Amy Thompson, a psychologist in our Blue Ash, Ohio Office. Today, Amy has joined myself and Nikki to discuss the barriers around mental health and the different aspects to that. So, Amy, thank you for joining us. Would you please tell us a little bit about yourself?

Amy Thompson (00:49):

Yeah, sure. So my name is Dr. Amy Thompson. I am a clinical psychologist that has been practicing in the area of mental health for almost 10 years now, most of which has been here in the state of Ohio. I see a wide variety of patients, adolescents through adults, focusing on a number of general mental health issues.

Nicholette Leanza (01:12):

Great. Good. Thank you. Amy, leet me start off by asking you, what do you think keeps people from obtaining mental health support or care?

Amy Thompson (01:24):

You know, Nicole, I think there’s a lot of different reasons. I’m feeling as though there’s a lot of education and a lot of advances that we’ve made recently. However, I do believe that there still is a large stigma that exists around mental health in general, that often seeks as a barrier.

Nicholette Leanza (01:48):

Yes, for sure. For sure.

Dwight Thompson (01:52):

Amy, you’ve been practicing for 10 years, so you certainly got quite a bit of experience. From your work, have you found that there is more of a barrier, we’ll talk about the different facets to just the overall barriers to mental health, but have you found that certain age groups or maybe certain generations that you work with have more of a barrier than others?

Amy Thompson (02:18):

You know what’s interesting, Dwight, is that what we know about mental health in general is that it does not discriminate, right? It doesn’t discriminate against age. It doesn’t discriminate against race, political affiliation, socioeconomic status. We know that one in five United States adults experience a mental health condition each year. One in six youths between six and 17. For those statistics that are given to us by organizations like National Institution of Mental Health and National Institutions of Health, we know that 50% of that mental health begins by the age of 14. So, there are lots of people out there that really need mental health support, mental health education. What we know is that people are not getting treatment.

Amy Thompson (03:10):

What we talked about before, and what we mentioned before is just, what are those barriers to treatment? Is stigma one of them? Which I believe very strongly, yes. A recent study showed that only about 50% of white adults that are needing mental health treatment are actually getting the treatment that they need. That percentage drops down to 25% to 30% for populations such as black Americans, Asian Americans, Spanish and mixed race populations. So even though all of these people are needing this treatment, there really are real barriers to them getting it, regardless of where they’re at.

Dwight Thompson (03:47):

Absolutely. Yeah, thank you for that. I think you hit the nail on the head with, it does not discriminate. I think that if you just start to view it from that realm, I think you can have a new appreciation for just the sense of urgency that there needs to be when it comes to seeking mental health care.

Nicholette Leanza (04:10):

For sure, which is a good jump in to of what to do about that. What can clinicians do? What can mental health professionals do to help educate or reduce the stigma so people can get the help?

Amy Thompson (04:23):

Yeah. I think so much of it starts with us really examining what is that stigma, right? Where does the stigma come from? What’s keeping it going? We know there’s been a long standing history of stigma around mental illness. Way back when, before any of us were born, there were things such as people [inaudible 00:04:45] that mental illness was the mark of the devil, or mental illness was a moral punishment for someone that was experiencing a mental health concern. Related to women, it was viewed as hysteria related to being a woman. We had no education around how to treat these conditions so we were doing things such as lobotomies. We were trying to damage the brain tissue in an attempt to try and get rid of these mental health symptoms. I think, to go back to your question of, what can we do? It’s really acknowledging that this is not a new problem, and yes, we’ve made advances for sure, but I think that we still have a long way to go.

Dwight Thompson (05:31):

Absolutely. Yeah, Amy, you bring up a good point. This is one of the facets we can start with. Tell us a little bit about what you have found when it comes to the way the female population views the importance of their mental health care for oneself, and then on the flip side, how you feel women are frequently viewed just from the general population when it comes to the seriousness, if you will, of the mental health concerns that they present.

Amy Thompson (06:06):

It’s interesting because I feel like women are often finding themselves in a double bind. Because stereotypically, we are viewed as the more sensitive and the more emotional gender. So, people might view someone who is sad, or tearful, or stressed, or overwhelmed, anxious as, oh, they’re just dramatic, just a dramatic person and not truly appreciate what that is going through. On the flip side of that, women are often seen as caregivers. So in the same light, we’re expected to be strong and keep it together to help other people. So for women, what I’ve seen in my practice, is just really the validation of what they’re going through, giving them a name, and giving them some education around what they’re experiencing has been really helpful, Dwight. Just helping educate them on what treatment can do to support them.

Dwight Thompson (07:07):

Sure, so these women, one thing I always like to remind myself is it’s important to control what you can control. So these women can not necessarily control whether it’s the way they’re viewed by a peer or just the general population. What advice would you give to someone who is looking to feel validated that their concerns are real and that they don’t need to hear it from anybody else, but what they’re going through is real and it is legit. What advice would you give to taking initiatives to align themselves with care?

Amy Thompson (07:47):

You know, one of the things that I always talk to my patients about is your story is your story. It’s exactly Dwight, like what you just said, I can’t compare that what I’m going through is more difficult or is not as severe as what somebody else is going through. So yes, to take control of what we can control is to say, this is my body, this is my mind. I know what I’m experiencing. How can I be empowered to help myself be better so that I can function better?

Nicholette Leanza (08:24):

If I might kick you back on that, is as you’re working with your clients to empower themselves and the stories they might tell themselves in general, but also looking at the connections with other people. Connecting with others to say, look, I’m showing this is my thing. Is this a thing for you too? The power of that and feeling like, hey, your story might not be exactly like my story, but some of this is familiar enough and feels similar enough that it feels like you get me and the power of that connection with other people and being able to share it. For sure.

Amy Thompson (08:56):

Oh, absolutely. Especially in today’s day and age, whether that’s person to person connection with them, [inaudible 00:09:09] able to communicate and validate with each other, whether that’s on a broader spectrum, for better or worse, this is a way that social media can be helpful. There’s a number of hashtag campaigns out there. There’s a number of different online forums. You have celebrities that are using their platforms.. I think there are some national athletic associations that are now hiring psychologists and really making mental health of their athletes a priority. You have celebrities such as Demi Lavato, Lady Gaga, coming out and talking about the struggles that they’ve been through. There truly is a power in numbers.

Nicholette Leanza (09:53):

Yes. For sure. For sure.

Dwight Thompson (09:56):

Thank you for that, Amy, That’s really insightful.

Dwight Thompson (10:04):

Okay, so Amy, you brought up a few different points that I would like to touch on. We can start with social media. You’re absolutely right. Social media is obviously frequently viewed in a negative light, but it has so many aspects to it that can certainly be spun positively. Especially in relation to the discussion that we’re having right now, breaking down some of the barriers to mental health. I have seen social media campaigns regarding suicide hotlines, whatever it may be, that people might not have seen if it weren’t for social media. In your judgment, how can social media be utilized to break down these barriers to mental health like we’ve been talking about?

Amy Thompson (10:52):

Absolutely. One of the first things that I do with my patients as we’re talking just around stigma and how stigma plays into how they experience both themselves, as well as mental health in general, is talk about social media because it is very prevalent. We talk about how they’re using social media. First and foremost, one of the things that we always talk about is, like you spoke about Dwight, is there is the negative to social media. I heard a quote one time that I think was really powerful for me that oftentimes we want to make sure that we’re not comparing our behind the scenes story to somebody [inaudible 00:11:32]. We talk about that and then we talk about, okay, so how can we use social media in a positive way?

Amy Thompson (11:39):

We talk about what are some of the common hashtag campaigns that are out there on Instagram? I always direct people to the NAMI site because have a number of resources on there, whether it’s handouts, whether it’s getting involved in walks. I talk to people about different websites, different community websites, that have education. We talk about how different blog posts and things are out there. We just really talk about what are the resources and how can we use them in a positive way.

Nicholette Leanza (12:15):

For sure. Definitely. Let me piggyback with looking at social media as a positive platform, which makes me think of often in the media how mental illness is portrayed in movies and things like that. I know a recent movie that’s been out is the Joker, and I don’t know if you guys seen it, but it just takes you through how his own mental health deteriorated and then how he became the Joker. But again, sometimes that can still perpetuate the stigma in our movies and different things like that. That’s hard, as we’re trying to use social media as a positive platform, we also need to get Hollywood and those other platforms to also the portray differently as well, which I see it can be a big problem, for sure.

Amy Thompson (13:03):

Oh yeah, I absolutely agree with that. I think that often segues me into things like talking with clients about, language is important. Using the word crazy, talking about someone as being crazy, talking about a “schizophrenic” versus somebody with schizophrenia. Language is really important and I’m a big believer in the compound effect. So whether it’s within our small intimate circles, or whether it’s on a broader level and the way that we’re talking on social media, even on our own pages, it’s making those small changes and languages is one of them.

Dwight Thompson (13:47):

Those that may not be familiar with the compound effect, can you allude to that just a little bit?

Amy Thompson (13:50):

Sure. The compound effect is basically the idea that it’s small things that lead up to big change. When we think about making a change, we often think about these large actions that need to happen in order for that to resolve. But what we know about the compound effect is that small changes that have her every day are what lead us to the outcomes that we’re desiring.

Dwight Thompson (14:11):

Okay, thank you.

Dwight Thompson (14:20):

Amy, I think you have done a wonderful job of shedding light on barriers that, I think we’re looking at it as a macro level, but from a micro level, you touched on this earlier, but the disparity that is just amongst different races in the nation that do receive health care juxtapose to, maybe, the white population. I know that just speaking as a of color myself, I have grown up, I have experienced the bias that lies within the African American community against seeking mental health care similarly to the way women I think are often invalidated in some of their feelings. I think amongst the African American community, amongst ourselves, we tend to steer our own peers away from seeking that the healthcare, it is something that is viewed as even weak at times.

Dwight Thompson (15:23):

I think when you look at different cultures, there is such a strong base of faith and religion, which it can certainly be a good thing, but as anybody knows that faith, not it can only get you so far, but there’s some other actions that can take place. When you were seeing patients of all sorts of different races, are you finding that you are having these kinds of conversations where there might be someone coming into your office that they’re the first person in their family that has maybe even sought out mental health care?

Amy Thompson (16:02):

Absolutely, and backing up a little bit from that, Dwight, one of the things that I always find important to think about is just the therapist match. Everybody has different approaches, different beliefs. We are humans too. I can speak to my personal approach, and absolutely I’m having these conversations, especially when I’m looking at a more marginalized group, whether it is racially, gender based, and we’re talking about that.

Amy Thompson (16:36):

I can’t tell you how many people I’ve had come in that say, oh, my family just thinks that I’m trying to get attention. Especially from an adolescent or a young adult. I had an older African American gentleman come in, who said, once we really got into what was going on and he said, Amy, he said, I can’t tell you I’ve experienced this my whole life, but was told us to suck it up. Let’s go to church. We’re going to pray about it, and we’re going to move forward. I have a lot of conversations about the intersection of, in that instance, it doesn’t have to be religion or treatment.

Dwight Thompson (17:18):

Sure, they are not mutually exclusive.

Amy Thompson (17:20):

Absolutely not mutually exclusive. So how can we merge those things together? How can we have conversations with our family who’s questioning why we’re in treatment?

Dwight Thompson (17:31):

Yeah. Yeah. That makes. I think you touched on the National Alliance for Mental Illness, which is NAMI, and they do a lot of excellent research into some of the disparities and what races are more likely to seek care. I was really startled that I saw 30% of African American individuals receive treatment juxtaposed to the national average of 45%. That is just, the proof is in the pudding with that. That’s really startling.

Amy Thompson (18:02):

Absolutely. Absolutely.

Nicholette Leanza (18:10):

If I might add another little twist here of bringing it back to gender, gender identified of males who are socialized, maybe not to share feelings, where I’ll be working with gentlemen who were told all their life, you don’t talk about this, you don’t cry and how that then also keeps them from going and seeking out help from a therapist. That societal expectation that men are tough, you just suck it up and keep going and what injustice we do to our males as well.

Dwight Thompson (18:43):

That’s a great point, Nikki, that’s an excellent point. What I at least have taken away in large part is, not only is there some education that needs to be done on an individual basis, but then that individual has to know how to have the conversations with their loved ones because they might receive some pushback.

Amy Thompson (19:03):

Absolutely, and those can be scary conversations. Using some of the time in treatment to role play those and explore those and what might those look like? Because you’re absolutely, Dwight, those can be very scary conversations, especially when you’re breaking the mold of what’s been there from a generational standpoint.

Nicholette Leanza (19:22):

Right. Very true. Well, Amy, this has been great. You are definitely a wealth of knowledge. Let me just put out there some of my takeaways of what we’ve been talking about. I think number one was just acknowledging that this isn’t just a current problem, looking at the barriers to mental health and the stigma, that this has been around for a while that this isn’t a new thing now, but we’re going to continue to try to make it better for people to feel comfortable to seek mental health help. Using social media as a positive platform, as well as our media being aware of how they portray mental illness. I also agree with you when you said language is so important, and the language that we’re using to describe mental health issues and things like that. That ultimately, we still do have a long way to go, but at least we’re on the path moving forward in the right direction. For sure.

Amy Thompson (20:18):

Absolutely. No, I think all of those, very much true. Again, I think that we’ve come a long way but the education and the funding needs to continue so that we can continue to break down some of these barriers. So looking at our words, looking at what funding is coming in and how we can continue to further the understanding of mental health, also the importance of treatment and to keep improving our evidence-based treatments so that we can continue to help.

Nicholette Leanza (20:51):

Right, I think the promise of mental health is just as important as physical health. I think that’s something that needs to get out there more.

Dwight Thompson (21:00):

Absolutely. I think, Nikki, if nothing else, you look at just so many of the different sporting organizations that obviously you have athletes that make up the employees of these different organizations. Obviously they put a lot of emphasis on their bodies and their physical health. You’re seeing so much more frequently now that these athletes are putting a huge amount of investment into their mental health and finally, we can be great athletes. We can be physical specimens, but you know, without your mental health, you really are not much of anything at all. [inaudible 00:21:37] ahead of the curve, finally, and starting to make a lot of progress. Amy, we cannot thank you enough for doing this. You were truly a phenomenal guest. Very insightful. I think a lot of listeners are going to have a lot of positive takeaways.

Nicholette Leanza (21:51):

for sure. For sure.

Amy Thompson (21:54):

Wonderful. Well, thank you for having me. It was an honor.

Nicholette Leanza (21:55):

Thank you, Amy. All right.

Dwight Thompson (22:05):

Thank you for listening to another episode of Reset Your Mindset by LifeStance Health. I thought Amy did an excellent job shedding light on the progress that we have already made as a society and the progress that is still yet to be made around breaking down barriers to mental health. On our next episode, we will be talking to Melanie Falls about toxic relationships and what we can do to navigate them. Thank you for listening.

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