By Dakota Parks for Pensacola Magazine
According to the National Institute of Mental Health, nearly one in five U.S. adults live with a mental illness. Despite how common and prevalent mental illness is in America, talking about mental health can be an uncomfortable topic for many people. A social stigmatization lingers around mental health and leads to a reluctance to talk about it and seek treatment. Navigating the mental health realm can also be confusing: where do you start, how do you pay for it, who should you see and what kind of treatment is best for you?
Now, more than ever, with the outbreak of COVID-19 and the preventative measures of social distancing, mental health is an important conversation to be having. We spoke with a licensed mental health counselor, a psychologist and a mental health advocate about how to stay mentally vigilant during crisis, navigate the mental health realm and break down the stigma around mental health.
There are several different types of providers for mental health, which may cause confusion for some people: psychiatrists, psychologists, therapists and counselors. A therapist is a broad term for professionals who are trained, and often licensed, to provide a variety of treatments and rehabilitation for people, including talk therapy. Psychiatrists are medically trained doctors that can prescribe medication for patients. Psychologists are PhD level doctors that can diagnose a mental illness and work in conjunction with a psychiatrist to treat a patient; psychologists also do important academic and clinical research.
Tamara Powell, a licensed mental health counselor with Empathic Practice, explained the importance of finding a good “fit” with a mental health provider.
“Go onto their website, read through their bios and don't just pick one at random. By doing that, you're going to start to get a flavor of our personality and how we talk because therapist/client fit, is everything. I tell my clients that in the first session: if you're not feeling it, I want to know,” Powell said. “You're going to be spending a lot of time with this person being very vulnerable, and that's not easy to do. I think it's the most sacred or intimate relationship you can have with a person. Most people tell their therapist things they don't even tell their partner or family. So, it's worth the extra 20 to 30 minutes of research.”
Empathic Practice is a multimodal treatment clinic ranging from talk therapy, to nutritional health, mindfulness, yoga, meditation and massage therapy.
“Most of my clients tend to be ones who would rather be on as little necessary traditional medication as possible. So, I always tell people that we can start out on the mindfulness tools like yoga and massage,” Powell said. “But, if it comes to the point where they’re still struggling to make it through the day with their presenting symptoms, then we're going to work with a psychiatric practitioner who is going to help with medication.”
Paying for mental health treatment is an additional stressor. According to the National Alliance on Mental Illness, in 2018 only 43.3 percent of U.S. adults with mental illness received treatment; however, 64.1 percent of U.S. adults with serious mental illness received treatment. Furthermore, 11.3 percent of U.S. adults with mental illness had no insurance coverage in 2018. Even those with insurance often have inadequate insurance or cannot find providers that accept it.
Many therapists and psychiatrists do not take insurance to avoid rushing to diagnose a patient, or to ensure patient confidentiality. As Powell explained, some insurance agencies will push for a diagnosis in the first session with a patient to limit the number of sessions the agency will pay for. Sliding scale appointments are available at most practices to help low- income patients and out-of-pocket patients pay for treatment.
Lakeview Center is a leading treatment facility for mental health that serves over 36,000 people annually in 60 programs and services across Escambia, Santa Rosa, Okaloosa and Walton counties. Their behavioral health services include inpatient and resident treatment to outpatient services such as trauma services, psychiatry, counseling, day treatment and intensive, round-the-clock outpatient services. Lakeview also offers nearly all programs on a sliding scale basis to ensure that all patients can afford treatment.
Dr. David Josephs, a psychologist and clinical director at Lakeview Center, explained some general warning signs for mental illnesses and explained that it is normal to feel “out of funk” during COVID-19 self-quarantine.
“For your loved ones, look out for changes in behavior and how they're functioning. Are they sleeping well? Are their eating patterns different? Are they drinking or using substances more? Are they on edge and angry? If people are noticing changes in their personality right now, it is probably related to the situational stress,” Dr. Josephs said. “It would be very unusual that we wouldn't be experiencing some level of anxiety or outrage in response to what's going on, because it's a very serious problem. However, it should not lead to pathology as long as we recognize changes and engage in practices that we can do at home to help adjust.”
Dr. Josephs said that people should continue eating well, exercising and getting the right amount of sleep. He said that the easiest thing to do when you’re feeling stressed, anxious, or overwhelmed is to get some good sleep and see how you feel the next day. Lakeview Center, and many other clinics in town have moved their services to online, virtual sessions, so patients can call or video chat with their therapists and doctors. Dr. Josephs also explained that talking and raising awareness about mental health is instrumental to breaking the stigma around it.
“Often, we avoid getting treatment because we are frightened as to what the outcomes might be. There is also the additional burden of potentially being judged by otahers that it was our fault that we have a mental health problem or that we have a substance-use problem,” Dr. Josephs said. “I think talking more about mental health and talking about mental health in the context of general healthcare is important. They are brain illnesses and we all have a brain—we are all vulnerable.”
Abraham Sculley is mental health advocate and speaker with Active Minds and Speak2Inspire. Sculley struggled with depression through college and now uses his own story to help encourage others to talk about mental health and end the social stigma around it. After taking a medical withdrawal from UWF, he changed his major from IT to psychology, so he could learn how to help others with their mental health.
“In our household, we never really talked about mental health. We never talked about feelings or emotions as much as other people do. When I was going through severe depression, I just thought it was a normal period of life as a college student. I chalked it up to stress that I was experiencing,” said Sculley. “I thought, ‘I just have to get over it or toughen up.’ I was afraid to tell my parents. I later found out that my mom also was diagnosed with depression a while back. Imagine if I had known about that, how much more comfortable I would have been to have that conversation with her instead of trying to hide it and kind of figure it out on my own.”
Sculley travels around to different colleges, universities, churches and non-profits to tell his story and discuss what prevents people from seeking treatment and how to overcome that.
“It's all about storytelling and education. I believe that we all have a story, and my specific story may not be the exact same experience as someone else, but by normalizing the talk about being diagnosed with a mental illness, getting on medication and the challenges of finding a therapist, I can help others. I want people to know they’re not alone,” said Sculley.