World Mental Health Day

This past Tuesday, October 10th was World Mental Health Day, which focuses on raising awareness about mental health concerns around the world to ultimately mobilize efforts to support mental health. While I know I don’t have to state the obvious, we are nearly in 2018—a time in history where technology is at a forefront and medical procedures are becoming much more advanced. Regardless of the progression taking place in certain fields such as technology and medicine, mental illness is still a concept that remains stigmatized in many, if not most countries across the globe—including ours.

According to the National Alliance on Mental Illness, 1 in 5 adults in the U.S. (43.8 million, or 18.5%) suffer from a mental illness each year and approximately 450 million people around the world are currently suffering with a mental health issue (NIMH, 2015). Only 41 percent of adults with a mental health condition received help and just over half (50.6 percent) of children ages 8-15 received mental health services in the previous year (SAMHSA, 2014).

In 2010, the CDC reported that 57 percent of all adults believed that people are caring and sympathetic to persons with mental illness. However, only 25 percent of adults with mental health symptoms believed that people are caring and sympathetic to persons with mental illness. While efforts have been made to reduce and eliminate the stigma towards mental health, as a society, we are far from attaining this goal.

Time and time again, I have heard individuals say that people “should” be able to deal with “tough times” on their own. The response is simple. If you were to fall and sprain or break your leg, would you seek medical care or “should” you be expected to deal with this “tough time” on your own? Should you just walk it off until everything is better? That’s not a viable or realistic solution, and if we can understand and accept the significance that mental health plays in our daily lives, similarly to medical health, we can each work to break this stigma.

In life, we often find that the act of being vulnerable (to an extent) leads to the attainment or accomplishment of goals. Or at least, it puts us in the direction of doing so. For example, when searching for jobs, we find ourselves engaging in a state of vulnerability as we partake in job interviews—often a scary process for many. Asking somebody out on a date requires a level of vulnerability, as you cannot ensure the outcome you would like. Trying a new restaurant when you already have your top three go-to places also involves being vulnerable because you have no idea whether or not you’ll enjoy the food and dining experience.

So just what happens when we take this step into vulnerability? Well, for starters, you find out in the job interview if the company is the right fit for you, and vice versa. You have the opportunity to analyze the interview and note what went well and how you can improve for future job interviews. When you engage in vulnerability and ask somebody out, there’s the possibility that the person will say yes. Of course, there’s the possibility that the person will say no, but you may never know what their answer is unless you ask. And as for the restaurant, you may end up with a new favorite dish and/or dining spot, or you may realize you never want to go back there again. But we won’t be able to attain these answers and knowledge if we don’t at least try something new.

So when we look at mental health and discussing our own personal mental health, yes, this is another experience in which vulnerability may likely be required. It can be uncomfortable to openly discuss what has been going on in our lives and how that has been affecting us. It can be challenging to freely discuss how we are feeling when it seems as though preconceived notions on the part of others may constantly be present. And it can seem impossible to honestly discuss when we aren’t doing too well. But this is how we break the stigma. We have to start somewhere, and that somewhere is playing our part and finding the courage to be more open regarding our mental health.

Promoting a greater level of mental health starts by speaking up. We cannot expect to break a stigma that has been around for centuries if we don’t practice what we preach. While I can attest that at times, this is easier said than done, what is it that we have to lose? By confiding in a confidant, we allow ourselves the opportunity to be heard. We give ourselves a change to really explore how we are doing without censoring ourselves. And we let ourselves be supported—another act of vulnerability.

Can we overcome “tough times” on our own? Honestly, who cares? Strength can be found within each of us, and overcoming challenging life obstacles by oneself doesn’t define personal strength. Personal strength can often be found in reaching out for a helping and supporting hand. There is strength in numbers, and if we can create and foster a support system and find the courage to open up, we can begin to break the stigma of mental health, while working on and maintaining our own mental health as well.

By no means is this a clinical perspective for anyone dealing with mental health concerns. This is more along the lines of what we can do to break this stigma. Should an individual find themselves in need of help, open up to a confidant and let them know what is going on. If they don’t listen, find somebody else. And if it is an emergency, do not hesitate to call 9-1-1. Know there is a plethora of mental health professionals who are here to listen. Collaborating with a mental health professional to receive treatment and accomplish any goals one sets for themselves is always going to be an option. We just have to be vulnerable by taking the first step.

There is one designated day in the calendar set aside to focus on mental health. (Granted, I missed that day, but I guess it’s better late than never). It is up to us to ensure that we focus on mental health everyday so that being vulnerable and honestly discussing how we are doing is something people can take pride in. We will be the ones who set the standards for how future generations view mental health. But in order for any change to happen, it must start with us.

 

Below are just a few of many available mental health resources:

https://www.nami.org/Find-Support
https://www.mentalhealth.gov/get-help/index.html
https://suicidepreventionlifeline.org
https://www.nimh.nih.gov/index.shtml
https://www.goodtherapy.org

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PASEO Program Adventure—Day 17: El Porvenir y Trujillo, Peru

This morning (Monday—yes, still behind), I completed my final observation at another school in El Porvenir. It was definitely an interesting experience because the school I observed is a Catholic school (considered more private than the others), as opposed to a national school (or public school, which is what every other school I’ve observed so far is considered). Since students from the secondary school were on a field trip to local historic sites for the day, I was only able to observe students in primary school.

Upon speaking with a local social worker, I was informed that there is a lot of crime among the students, including extortion and theft. When I spoke to the director of the school, she mentioned that a lot of the children have difficulties at home that influence their behaviors, including lack of parental support and/or parents having to work long hours, leaving their children unsupervised upon returning from school. This recurring theme seemingly continues to make its way into every school that I observe. There are so many challenges that these children face both inside and outside of school, but especially once they leave school grounds each day. The risk factors are substantial, and we have to focus on fostering more protective factors in order to provide these children with substantial support so they can have the futures they deserve.

In the afternoon, we had our weekly meeting with a group of local women and family members in El Porvenir that I briefly discussed last week. Each week, two students from the program are responsible for teaching the group members relaxation and emotional regulation techniques for them to utilize at any given moment and teach others in their community. This week, one of the other students and I were in charge of working with the group members’ children—some of whom have physical disabilities and/or difficulties with motor skills and/or verbal communication deficits. We had each child write their names and draw something that corresponds with each letter of their name. The creativity and abilities in these children are truly incredible.

After our group, we went back to Trujillo for our Psicología en Peru course. Tonight, we focused on statistics within the country, all of Latin America, as well as throughout the world. When we look at a global scale, depression happens to be the most common mental illness. However, in Latin America, only five percent of the adult population reportedly suffer from Depression. According to the NIH, “In 2015, an estimated 16.1 million adults aged 18 or older in the United States had at least one major depressive episode in the past year.” If so many people in the United States alone have experienced depression, why is the percentage so low in Latin America? It’s because so many people do not seek or receive mental health services. This number is merely what is reported.

Among so many other challenges, stigma is the biggest problem pertaining to bringing attention to mental illness in Latin America, and especially Peru due to discrimination against mental health. If you seek any type of help or treatment, you’re considered “weak” or “crazy.” You’ll likely be asked, “Are you weak? You’re not strong enough to deal with this?” Alongside stigma, shame and misconceptions about having a mental illness come into play as well.

Even if we were to put stigma aside, psychoeducation is another challenge. If someone does in fact have a mental illness, many times, they’ll go to the local clinic with the belief that it’s a physical illness as opposed to a mental illness. In a perfect world, hypothetically speaking, of course, let’s say that someone does in fact go to the hospital for an issue pertaining to their mental health. As I mentioned the other week, you would have to wait days in the hospital before getting an appointment, and when you finally do get one, your appointment would only last a few minutes, and would consist of being asked a few “yes” or “no” questions to determine if you have depression.

There isn’t enough time to converse with the patient, so the odds of someone actually getting the help he or she needs and deserves are slim to none. But first, you’d have to overcome the stigma and shame in order to even make it to this point. And you’d have to hope that your family wouldn’t abandon you due to shame as well. Now if you want to talk about services, there is about 1 psychiatrist per every 300,000 people in Peru. If we were to look at another country, let’s say Colombia for example, there, you would find 2.1 psychiatrists per ever 10,000 people. Pretty significant difference, right?

The following statistics have been taken from Según el Instituto Nacional de Salud Mental (INSM) (2014): Nearly 5 million people (11.8%) in Peru suffer from some type of mental illness. 700,000 out of 1 million Peruvians suffer from depression, while 200,000 out of 1 million Peruvians suffer from some type of anxiety disorder. Less than 4 percent of these individuals receive services in specialized centers. Why, you may still ask? Fifty percent of such individuals believe they can overcome their mental illness on their own. Thirty percent don’t believe in treatment, and thirty percent don’t know where to go to receive services. (Yes, the percentages overlap.)

This is why education is so important. We must spread the word about mental health because until we can do so, millions of people will not receive the necessary services they require.