May is Mental Health Awareness Month, and we had the honor of sitting with Theresa Nguyen, the Chief Program Officer and Vice President of Research and Innovation at Mental Health America (MHA). Mental Health Awareness Month is an outreach initiative created by MHA in 1949 to emphasize the importance of treating mental health conditions before they reach crisis level. At Mooditude, we want to amplify MHA’s message and help spread awareness of your mental health.
Theresa is at the forefront of redefining a system for complete mental health care and brings over 15 years of experience in mental health to MHA. Motivated by her own experience with post-traumatic stress disorder as a child, she began working with a local chapter of MHA in California. She soon fell in love with its mission and focus on fighting for individuals who suffer from mental health conditions. Theresa was intrigued by the way MHA viewed and treated people who struggle in the mental health care system. She then joined MHA National to continue fighting for the rights of those with mental health conditions.
Read on to hear how Theresa is challenging the status quo in early intervention for mental health conditions.
Theresa: Honestly, the most important theme is to be person-centered. Our system historically has talked about “person-centeredness” and “recovery-oriented” as ideas that frame what I think is central to MHA’s mission about seeing people first. When I've worked in a clinical setting you really see how hard that is for clinicians to remain person-focused because there are so many elements in our system of care that want to overemphasize the system itself. Things like clinical billing and caseloads, which we call provider accountability measures, get institutionalized in these settings.
It makes it very hard for a clinician to just focus on where that person is. You're not here for an appointment. You're not a case to be managed. You’re a human being with real struggles.
It’s really important when you examine how a system functions because the first time a person comes into a system is a very scary time. The way that they're brought in and who they see, are elements that impact the rest of their help-seeking behavior in their lives. I don't think enough has been researched to understand how pivotal these moments in time are for people.
Unlike physical health issues, we often wait until someone is in a mental health crisis before they are treated. This means that their entry point into the mental health system is through a hospital, jail, or a run-in with Child Protective Services. These systems are terrifying.
Even going to the hospital for a physical ailment or seeing your doctor for the first time can be nerve-wracking. Initiating therapy for the first time is a very intimidating situation.
Theresa: Part of my work is to understand what brings people to this situation where they finally reach out for help for the first time. I look for how we can create a better system to help people engage initially in care and stay in care for long-term recovery to reduce human suffering in the long term.
One of the misconceptions that our data has revealed is that when someone has a mental health problem for the first time, seeking therapy, a doctor, or treatment is not necessarily the thing that they want. I think this finding goes against what you would assume if you only viewed this from a service lens. It doesn't take into account human behavior. However, if you step back and ask yourself, “The first time I went to go see a doctor for diabetes, how long did that take to figure it out?” Probably a while.
There are many factors in play when you consider depression or anxiety, and people spend a lot of time trying to understand what having an illness means for them in their life. Mental illnesses don't occur in a vacuum. They often occur with multiple challenges, like family conflict and financial barriers to care. Some individuals also struggle with their family’s beliefs on seeing someone for a mental health condition or talking openly about mental health.
So if we don't invest enough in understanding these nuances and providing the kinds of support for people in these early stages of recovery, we will miss the mark on prevention and early intervention. That's what I think is so important about some of our work.
Theresa: Digital technology offers an incredible opportunity to help people at the earliest stages of their recovery process. When we’re struggling with any new condition, we often turn to the internet to seek information, and systemic psychoeducation is probably the most under-researched and undervalued mental health support. Digital technology offers all of that.
When people search “Why am I depressed?” or “Am I stressed?” they will often find and take our MHA depression screening tool. After that, they are seeking some type of support, but it doesn’t look like therapy. They're seeking genuine storytelling from people who have struggled, and they want to hear it and consume it in that way. It looks like digital-based supports, so we are experimenting with what that means.
It's not surprising that more people turn to YouTube to get answers about their mental health problems than probably anywhere else. The combination of the ubiquity of technology, and the multimedia channels on the internet, like video, imagery, writing, and poetry provide a space to do that. More so than other traditional services.
How do people want to consume digital support online, and what kind of support do they want to consume? To me, I equate this to 20 years ago when someone struggling with mental health conditions for the first time might go to Barnes and Noble or the library and browse around the book section and pick up a bunch of self-help books. I think what we’re creating today is the digital version of that. How do we do that in a compelling and engaging way?
There's a lot of opportunities. We’re only just beginning to explore.
Theresa: There's so much that's missing. Our mental health infrastructure is not sufficiently built out. We have chronically underinvested money in creating an equal system across states. I could be in Alabama and receive some kind of service, cross the line into another state, and have a totally different experience. We need to invest more, period. But given the year that we just went through, I think everybody understands that the most important thing we have constantly neglected and need to continue to invest in, is looking at racial inequities in our system. That looks like investing and putting mental health infrastructure in black communities. We also need to train black therapists who understand and use a racial inequity framework to serve black communities.
Most people understand that culturally responsive care requires having culturally responsive therapists. That can include training. Allied therapists should become better at treating racial trauma, but are they better therapists when addressing racial trauma? The best approach is to build up a culturally and ethnically diverse workforce. I think that's going to be what's really important if we ever want to address historical trauma related to racism. It’s absolutely our responsibility as an organization.
Theresa: MHA is evaluating how to support employers across three major spaces. Our workplace research is an annual survey that asks everyday Americans to tell us what creates a psychologically healthy workplace for them.
Some of the examples that we've seen are the importance of company culture, the relationship between an employee and their supervisor, and how information is communicated to them at a company level about the importance of mental health. A lot of this research feeds the resources we provide to employers and create for employees. It also informs our Bell Seal for Workplace Mental Health. The Bell Seal is a mental health employer certification program that breaks down metrics for a company about what kinds of actions they can take to build a mentally healthy workplace.
When companies go through the certification process, they talk to us about what benefits they have implemented. We then help them identify where gaps might exist in their mental health benefit structure. Next, we’ll share information about best practices in the country or even suggest surveying their employee resource groups to understand whether or not the culture they've created has a meaningful impact on the mental health of their employees.
Companies come in at different starting points. Some want a checklist to get started and evaluate things. Others will get more consultation and we’ll help them link up to resources. I think it’s interesting because we are working with large, middle, and small-sized companies. So the approach you take changes depending on the type of company you're working for. We look at both the size of the company and level of risk. Through our research, we have identified certain populations, like construction and manufacturing, that have a higher risk. So when this data comes in, we look for the right partners who can help us unpack the implications of the results and what we can do for these communities.
Theresa: Absolutely! A partner, for example, that we really appreciate is the CDCs National Institute for Occupational Safety and Health (NIOSH). The CDC is really thinking about safety in the workplace and partnering with them adds the lens of what psychological safety looks like at the workplace.
Theresa: Individuals can use MHA screening, if they’re struggling with a mental health condition and they just want to explore questions related to depression, PTSD, psychosis, and what this means for them. The resources are designed for users who are in the earliest stages of the recovery journey. I think that we also have the most amazing public education materials. I love them and I think we've done such a good job creating our mental health month toolkits. Our current toolkit is called Tools 2 Thrive. It is the same theme as last year because I think everybody agrees that 2020 and 2021 have just blended together. You can also access all the past toolkits on the webpage.
For organizations like schools, nonprofits, and businesses, they can also use our tools to create a screening program. We can consult with them and also provide support. Our Work Health Survey is helpful for organizations to understand their employees' sentiments toward their treatment of mental health.
To support MHA in its mission to promote mental health wellness, make a donation and join the effort to get people screened before a crisis. Easily connect to MHA by reaching out to your local MHA affiliate. Theresa shared that the local affiliates are “incredibly strong and the most amazing advocates I've worked with my whole life.” MHA is also interested in large scale partnerships. Reach out to MHA at firstname.lastname@example.org if you would like to speak about something more specific.