News & Announcements
National Minority Mental Health Awareness Month Webinar
Posted: July 11, 2012
This celebration webinar was inspiring -- young mental health advocates shared their recovery experiences. Watch the webinar recording and download the slide handout (pdf). Read the presenters responses to unanswered questions from the webinar.
Here are other ways you can get involved:
People from diverse communities have a harder time accessing and receiving quality mental health treatment. Even though systemic barriers to treatment can make recovery harder to attain and maintain, recovery is possible for people from diverse backgrounds. This webinar explored the road to recovery for young people and focused on what it's like to be a racial minority who grapples with mental illness during two stressful phases --school and early career. Accomplished mental health advocates Jessica Gimeno from the Balanced Mind Foundation and writer and activist Melody Moezzi shared their personal experiences of recovery and provided tips and strategies others could use on their own journeys to recovery. This webinar was held on July 10, 2012.
Jessica is the Online Communications Associate at the Balanced Mind Foundation where she leads Flipswitch, the organization’s efforts dedicated to helping teens and people in their twenties understand depression and bipolar disorder. Jessica graduated cum laude from Northwestern University with a B.S. in Communications and a second major in Political Science. While at Northwestern, she developed a passion for helping students with depression and bipolar disorder get through challenging times and achieve academically. She and a best friend co-founded a depression support network. For several years, she gave talks to campus fellowship groups about de-stigmatizing depression while working with individual students to get them psychiatric help. This year Jessica won 2nd Prize in the National Council for Community Behavioral Healthcare and Eli Lily’s Reintegration and Awards of Excellence. Follow Jessica on Twitter.
Melody is an Iranian-American writer, activist, attorney and award-winning author. She is also a United Nations Global Expert with the UN Alliance of Civilizations; a member of the British Council's Our Shared Future Opinion Leaders Network, and a member of the U.S. State Department's Generation Change initiative. Her first book, War on Error: Real Stories of American Muslims, earned her a Georgia Author of the Year Award and a Gustavus Myers Center for Bigotry and Human Rights Honorable Mention. Melody is a commentator for National Public Radio’s All Things Considered and for Georgia Public Broadcasting’s Georgia Gazette. She is a blogger for The Huffington Post, Ms. Magazine and Bipolar Magazine. She has made many appearances on CNN and other TV shows. Her writings have appeared in many publications, including The Washington Post, the Guardian, The Christian Science Monitor, NPR, CNN.com, Parabola, the American Bar Association, and the Yale Journal for Humanities in Medicine. Follow Melody on Twitter.
Question: At what age can bi-polar be diagnosed?
Jessica: I believe that bipolar disorder can be diagnosed in children. There are many people who do not believe that mental illness can happen to children, which is why the organization I work for (The Balanced Mind Foundation) connects families whose children have mood disorders (depression, bipolar) to essential resources. We have an Online Resource Directory where you can type in your zip code and look for resources you need by checking in boxes (“Psychiatrist, therapist, etc) here: http://www.thebalancedmind.org/connect/find.
My earliest memory of being depressed was when I was 8 years old. I remember being happy (as I almost always was) and then suddenly feeling sad (too sad for words) for no apparent reason. I started to wonder frantically what the meaning of life was or why we did anything. However, my mom says that when I was 3 years old she took me to see my pediatrician after I just stopped talking and eating once…for three weeks. (This is something I do not remember.) My mom says I gave no reason for why I stopped talking or being involved in anything but I just stopped. She even took me to see Big Bird and the other characters from Sesame Street live, front row seats, and I sat there doing nothing the whole time so she took me home. The pediatrician said I was just temporarily upset about my grandparents moving away, which may have been true. But as we look back, it’s pretty clear that I must have been depressed. Surely other children get upset when family members move away but to stop talking or eating for almost a month is a sign that something is seriously wrong. Our organization has 28 support groups for parents whose children vary in age from very young to transition (late teens, twenties). If you are interested in being part of a support group, please email me. By being a member of our support groups, you may be able to learn more about the symptoms and solutions regarding early onset bipolar disorder.
Melody: This is a hotly debated issue that countless medical professionals can answer better than I, but of course, I do have a take. Many people (including myself) argue that bipolar is over-diagnosed in children. It’s a tricky thing diagnosing a child with a mood disorder, given children’s brains are still developing. Some psychiatrists argue that you cannot and should not diagnose bipolar in children, but this seems to be the minority opinion. Certainly, there are clear-cut cases, but given childhood and adolescence are often defined by moodiness, it can be hard to distinguish “normal” moodiness from a true mood disorder. I think it’s important to be cautious, but I also think it’s important to diagnose children who are suffering. It’s a balance. Some experts suggest that bipolar can be diagnosed as early as six or seven. Again, others disagree. I think it’s a case-by-case issue.
Question: Risk for minorities to be over-prescribed with meds? Some studies suggest psychotropics work as well as placebos.
Jessica: In my experience, I do not believe that minorities are over-prescribed. Often with a lack of resources, we don’t get a proper diagnosis or treatment. I can’t speak to placebos as I’ve never taken them. But I believe it’s important to have people who understand your culture. My psychiatrist is Mexican; I am Filipino—she understands a lot of the good and bad things about my culture as it relates to mental health. My therapist is a lovely woman who also knows a lot about my culture and she happens to be Caucasian. If you’re worried about encountering racism or a lack of understanding, it may help to find someone else who is of your race or a similar ethnic background.
Melody: Certainly there is a risk of minorities being over-prescribed meds and misdiagnosed, just as there is a risk for non-minorities. I’ve read quite a bit about the use of psychotropic drugs in foster care in the US, and there appears to be a serious problem with over-prescribing there. Likewise, there are a disproportionate number of minority children in foster care, so those demographics clearly overlap. Here’s one article on the issue, but there are many others: http://ow.ly/ck5iS.
As for psychotropics working as well as placebos, I don’t think that is necessarily the case, but it depends on the situation. And it should be noted that psychotropics used inappropriately can actually cause damage. I, for example, have been treated with anti-depressants exclusively in the past—while I was misdiagnosed with unipolar depression—and such treatment is highly dangerous and ill-advised in patients with bipolar. It led to a mania and psychosis in my case. Drugs used to treat bipolar and schizophrenia, such as mood-stabilizers and anti-psychotics are far more effective than placebo. In some instances of low-grade depression, exercise and CBT alone or in combination have been shown to be just as effective as medication alone and sometimes more so. But note, exercise and CBT are not “placebos” per se. They are interventions in their own rights—just not pharmaceutical ones. That said, as I see it, medication is the primary and most important part of treating more severe mental illnesses like bipolar I and schizophrenia.
Question: I'm curious if in both of your experiences are there differences in acceptance if your a female versus a male in terms of disclosure?
Jessica: Since I only have experience being female, I cannot speak to the differences in acceptance between being a female with bipolar vs. male with bipolar (if that is what you’re asking). However, I do notice from helping people that it’s harder for men to ask for help. But this applies to physical and mental health problems whether it’s getting an annual physical exam or seeing a psychiatrist for obvious psychological problems. What I learned from graduating cum laude from Northwestern and helping other students with mental illnesses also finish school is that self-stigma is the worst stigma. Yes I have experienced stigma from others but self stigma is the worst in my opinion because it prevents people from asking for help, from being compliant with medications, and from making changes to accommodate their illness (even if they’re changes everyone does not know about).
Melody: I can’t say because I don’t know what it’s like to be disclosing as a male. I can, however, say that there is a history of using diagnoses of mental illnesses to disregard, dismiss and disenfranchise women. The false assumption that women are more likely to be hysterical and overly emotional has been used against us for centuries. Then again, men are highly discouraged from expressing emotion or anything that could be perceived as weakness in our society, and as such, they are more likely to go undiagnosed and untreated. So there are drawbacks to both scenarios.
Question: How do you get a treatment team to center your treatment plan linguistically and culturally? To integrate language access, faith base and culturally base clinical quality treatment in the hospital?
Jessica: I’ll address faith first and language and culture afterwards. For me, as a Christian, I believe that hope lies with Christ. He is the reason I can endure immense physical pain (three physical illnesses) and have bipolar disorder everyday. So it’s essential that I see a Christian therapist—I see this person once a month and I want us to be in agreement on the most important thing in my life because it affects every aspect of my life including how I manage daily stress. For language, I think it’s important to find someone who can speak your family’s language if language is a barrier. I once helped a Korean man find help for his depressed mother and we talked about the importance of finding a Korean-speaking psychiatrist. As for culture, I believe it’s important to have people who understand your culture. My psychiatrist is Mexican; I am Filipino—she understands a lot of the good and bad things about my culture as it relates to mental health. My therapist is a lovely woman who also knows a lot about my culture and she happens to be Caucasian. If you’re worried about encountering racism or a lack of understanding, it may help to find someone else who is of your race or a similar ethnic background. To find all of these things with in-patient treatment is difficult depending on where you live. I would prioritize what I want in my treatment team and not wait too long to get a diagnosis—what’s most important to you if you can’t find everything yet? Faith? Your culture? Your language? A common error I see in people is that they don’t find the “perfect psychiatrist” or therapist and keep prolonging diagnosis and treatment until it’s too late.
Melody: I encourage you to read The Spirit Catches You and You Fall Down by Anne Fadiman. From that book, you’ll see that it’s incredibly hard to receive this kind of culturally-sensitive treatment to which I think you refer. I’ve never found an imam to come and speak to me inside of a psychiatric hospital, though I’ve asked. Still, I did accept visits from “chaplains” who were clearly Christian, but also open to speaking in broader terms and without attempting to convert me. It’s worth looking into a psychiatrist or psychologist who shares your native language and/or land of origin. That said, this is not a guarantee that said provider will be good. My best mental health providers have been neither Iranian nor Muslim. Still, most of them have been minorities in one way or another, which I think has helped them understand where I’m coming from.
Question: Minority communities are the majority underserved and under-represented, how do we center the brain to be have equal access in services in Mental Health?
Jessica: I’m not sure I understand the question as it is framed—“how do we center the brain…?” I know the minority’s perspective as it relates to mental illness-how we often have less resources, face greater stigma within our culture, or must deal with twice the hardships of both racism and mental illness stigma—are not told often enough. Most mental health advocates are white. The best way to introduce the challenges minorities face and find solutions is to have more racial minorities in this industry to present their stories.
Melody: Equal access is a huge issue, particularly in the US. Minorities are much more likely to be placed in prison when they should be placed in hospitals, and they often receive substandard care. The best way I know to address this problem is to speak up as minorities living with mental illnesses and encourage others in our community to do the same. We also need to build our own institutions if we find that existing ones don’t meet our needs.