By Mary Giliberti, Executive Vice President of Policy at Mental Health America
Over this past weekend, I participated in my first outreach event for Mental Health America at the NBC4 Telemundo 44 Health and Fitness Expo in Washington DC. Dr. Martin Luther King, who’s memory we honored this week, said that people “fear each other because they do not know each other. They do not know each other because they do not communicate with each other.” Here is what I learned at the event: it is easy to communicate with people about mental health because the topic is accessible across culture, race and age. In addition, talking about mental health is especially important to those with mental illness.
We had a spinning wheel at the event and children were particularly excited to spin the wheel, answer a question, and get a prize. One little girl ran up to the wheel and I saw her dad looking on with concern, trying to read our large poster. I walked up to him and said “We are with Mental Health America, a national non-profit dedicated to mental health. We have materials on sleeping, eating right, exercising – ways to improve your mental health.” I could see his face instantly transform and relax into a smile. “Those are important,” he said as he looked through our materials and waited for his daughter.
Over the course of the day, we had amazing diversity across race, culture and age in our booth. Everyone could relate to mental health. Some people wanted to talk about themselves. Others were more comfortable discussing family and friends. All of the participants were interested in our screening tools and we quickly ran out of materials on exercise and mental health. Children talked about how they supported friends who were struggling: “I tell them jokes,” “I give them a hug,”” I talk with them.“ They also talked about what they did when they were stressed – “I talk to my dad,” “I sit in my room quietly.” They were able to answer questions about the relationship between the brain and the body – “when I feel sad, I feel tired.”
In having conversations about mental health with people of all cultures and backgrounds, I often learned that they or someone they loved were struggling with mental illness. There was a man who asked to rest a bit in our booth who had been diagnosed with both bipolar disorder and schizophrenia; a woman who wanted to discuss the suicide of her cousin whom she had not realized was struggling.
From a policy perspective, this speaks to the need for primary, pediatric and geriatric primary care professionals to communicate with patients and their families about mental health. Sleep, exercise, social connection and diet are all important topics and screening should focus on whether the person is engaged in mentally healthy behaviors as well as whether they are experiencing symptoms of a mental health condition.
Current prevention guidelines only require depression screening for individuals 12 years of age and older. Yet as we saw clearly this weekend, children and younger tweens also are very aware of mental health and can experience mental health conditions. Youth who are over 12 years of age experience issues beyond depression. Having more conversations about mental health and screening to promote mentally healthy behaviors as well as discover mental health conditions will advance both prevention and early intervention.
I also noticed in my conversations this weekend that those with more serious mental health conditions were particularly interested in how to improve their mental health. When the man with bipolar disorder and schizophrenia spun our wheel, he landed on the question of how do you know if you are struggling with your mental health and he said – “I have problems with my sleep and my medications.” Sleep was a key component of his mental health and wellbeing. His clinician could have a richer conversation with him about his medications if it were framed as promoting mental health and wellness and included a conversation about sleep.
A woman, who had previously been homeless and struggled with a serious mental health condition, talked at length about the comfort she received from her pet and how caring for her pet had helped her when she considered suicide. Her mother had recently recommended that she develop more friendships. We talked about the importance of those social connections and the relationship to mental health.
Peer support specialists are trained to help people think about tools toward maintaining their mental health, including sleep, opportunities to socialize and connect, exercise and eat better. Clubhouses are another service that promotes connection, eating well, and mental health. These services are no different than paying for someone with diabetes to work with a nutritionist or attend nutrition education classes. We all need to eat well, but those with pre-diabetes or diabetes need to be particularly mindful of their diet and nutrition. Similarly, we all need to sleep, exercise, and connect with others, but people with serious mental illness need to be particularly mindful and connected to supports that can help them promote their mental health.
Yet peer support specialists are not covered by Medicare and private insurance and are paid very little in the Medicaid program. Clubhouses struggle to get reimbursed in our current financing system which focuses on sick care, rather than promoting mental health.
In a polarizing time, we often get caught up in divisions – whether between parties or between advocates for mental health or mental illness. Recognizing that promoting mental health is important to everyone and is even more critical to those with mental illness may be a way to bring people together and provide primary and specialized services that make us all mentally healthier