On March 2, the Arkansas Democrat-Gazette hosted a virtual panel to discuss mental health care during the covid-19 pandemic. A transcript of that hour-long conversation with four Arkansas mental health experts and advocates is below. The full video is available at arkansasonline.com/copingcovid.
GINNY MONK (Arkansas Democrat-Gazette host):
All right. So, it's 6:03 and we’ve got about 30 people here joining us, so we'll go ahead and get started. So first, I thought we'd just kind of start with introductions. Tyler, I'll start with you. This is Tyler West. Do you want to kind of tell them what organization you're a part of?
TYLER WEST (Arkansas chapter of the American Foundation for Suicide Prevention):
Yeah, so welcome, everyone, for this evening and thank you to Ginny and the Arkansas Democrat-Gazette for putting us together at such an important time. So my name is Tyler West and I primarily serve on the board of directors for the American Foundation for Suicide Prevention. My primary focus is education program implementation throughout the state of Arkansas. Also, I serve as the public policy chair for Arkansas and help the national organization at the American Foundation for Suicide Prevention work on smart public policy for mental health and suicide prevention around the country.
MONK:
Alright, awesome. Thank you so much for being here. Tammy. Do you want to go ahead and go next?
TAMMY ALEXANDER (Arkansas Department of Human Services):
Sure, my name is Tammy Alexander, and I'm a clinical psychologist and I work for the Arkansas Department of Human Services in their Division of Aging, Adult, and Behavioral Health Services. And as a part of that, I have worked on several covid-related disaster grants. The one I'll probably talk about most today is called “Project Promoting Positive Emotions,” and it's a crisis counselor grant funded by FEMA and SAMHSA and administered through the Department of Human Services, but we have 15 providers throughout the state of Arkansas that provide services with us. So I'm excited to be here and thank you for pulling together this panel so that we can talk about this important topic.
MONK:
Yeah, I'm excited that all of you could join us. Buster, why don't you go ahead and go next?
BUSTER LACKEY: (Arkansas chapter of the National Alliance on Mental Illness)
Yeah, great. I'm Buster Lackey, and I'm a licensed professional counselor and a licensed alcoholism and drug abuse counselor here in Arkansas. And I'm the executive director for NAMI Arkansas, which across the state provides advocacy, resources and support for families and people with mental illness. And I'm looking forward to being on the panel tonight and have a personal connection to the covid arena here.
MONK:
All right. Thank you so much. Dr. John?
DR. SUFNA JOHN (University of Arkansas for Medical Sciences):
Hi. everyone. My name is Sufna John. I am a child clinical psychologist at the University of Arkansas for Medical Sciences. In addition to my own clinical work that specializes in supporting children who have been through trauma, I also co-direct the Arkansas Building Effective Services for trauma, ARBEST program, which is funded by our state legislature and focuses on improving outcomes for children and families all throughout our state who have experienced trauma through just a multitude of initiatives. And I am really honored to be part of this panel with my colleagues here.
MONK:
Yeah, well, again, thank you all so much for joining us. We're going to just kind of call on you and go around the, this is not a room, the Zoom chat. So I was hoping first you could kind of talk about what changes you've seen for mental health care needs, if there are common symptoms that lots of people are experiencing, and just kind of what you're seeing during covid-19. Tammy, why don’t we start with you this time?
ALEXANDER:
Sure. Being with the state and working on several different covid grants, we've been very familiar with a lot of the impact that covid has had on the mental health of people in Arkansas. We are seeing a lot of people who have never experienced any kind of depression or anxiety, or I mean, nothing more than just, you know, your blues, that you get over pretty quick or, you know, the mild anxiety we're seeing people now who because of constant bombardment, with all of the stressful news, many people have lost their jobs, they've either not found other jobs or have taken jobs that are not at the level that they were before facing the financial impact. Parents. We're seeing a lot of parents and school teachers who are really struggling, with kids in and out of school, the virtual, the parents trying to be the part-time teacher, the part-time worker, the part-time mom and dad. And we're seeing a lot of people pushed further into that depression and anxiety than what they have ever experienced. And so a part of what the crisis counseling, grant and things that we're doing are really trying to help people understand that the reactions that they're having right now are very normal reactions to an abnormal situation. None of us have been in this before. And so part of the message to get across is that, really there's no one who is not affected by the circumstances that we're living through right now. And so I think the primary thing that we are seeing through the state and the different grants that we are administering is the increase in anxiety and depression particularly.
MONK:
All right. Thank you so much. Buster, How about you?
LACKEY:
Well I think you know, for us at NAMI, we've seen a number of calls coming in with families, See, before the pandemic, you could have the “fight-or-flight” in place, you know, everybody they left in the morning for school, for work, they came in back home in the afternoons, and they kind of got back together. So it wasn't all around the table, you know? And now we're getting, mom's at one end of the table trying to do a Zoom call for work, dad at the other end of table doing a Zoom call, kids are trying to do their Zoom school and different things, and the “flight” is gone, so now all they can do is fight. I do some consulting work with local police departments, and the domestic violence cases are up tremendously. Child abuse cases are increasing across the nation, and it's because of this, because we've never dealt with this. You know, the last pandemic was in 1914. It's over 100 years ago. You know, none of us on this panel, probably half our audience tonight, we weren't here then, so we don't know how it was handled. Depression is something that we're getting a lot of calls about on the one line that we offer. And, of course, that is, now they're turned into suicidal thoughts and things with, and we're having to really be able to provide resources for these folks so that they don't just isolate themselves. I told Congressman French Hill a couple of weeks back on a call we did was that we kind of missed the mark and we told everyone “social distance.” What we really meant is “physical distance,” not “social distance.” You know, social, we’re being social tonight. We're still interacting, we're still having things going on, even though I'm not sitting in your house or your office, whatever. So there's a lot of things that is changed in the last nine months that we've never thought. But the good news is we will come out of this. We always do. We’ve got great resources and things in place. And the panel tonight, I mean, there's just a collective group here that has a lot of resources that people may not know about.
MONK:
Yeah, thank you so much. And I think kind of speaking of depression and getting calls about suicidal ideation. Tyler, can you kind of tell us what the Foundation for Suicide Prevention is seeing in your work? I think you might be muted.
TYLER WEST:
I even have my own sign. Can you guys hear me now? Okay, so I think the question originally is what's the difference during covid and what have we seen, behavioral changes. I think one of the biggest misconceptions that, or at least preconceptions that people are saying, or that we're all hearing is that suicide rates are going up. There is no evidence for that. As a result of the pandemic, there is no evidence that we see an increase in suicide rates. It's too early to have that data. Data lags. What we do know is that people are asking for help more frequently and more often. We, the National Suicide Prevention Lifeline, is a strong partner with both NAMI and AFSP and many other organizations, and what they have seen is that, yes, more people are reaching out for help. But what I can tell you, over the last three years in Arkansas, we have seen a decline in suicides. Now it's been a small decline, and in no way is that a trend. But at least we're going in the right direction. Now, we don't have 2021 data now, but what the 2021 data we do have is Arkansans are reaching out for help when they need it, and that's a good sign. That's a good sign. The other thing that that I can talk about with the American Foundation for Suicide Prevention and our local on the ground, you know, we're a grassroots organization, so we have, we've got partners across the state. We're seeing organizations step up. We're seeing small towns come and reach out to us and say “Hey, we need some help right now.” So we're offering these virtual trainings to communities, to faith leaders to churches. So we're not only seeing the individuals step up and ask for help, we're seeing communities step up and ask for help to handle, to try to be better equipped to handle what they're seeing in their communities. And I think that, I think we have to take the wins where we can get them. And that's definitely a win for Arkansans.
MONK:
That's great to hear that there is some positive things that you all are seeing people asking for help. Dr. John, what kind of trends are you seeing with children and teens?
JOHN:
Yeah, you know, one of my colleagues brought up a really important point that I think is, you know, it's absolutely true that none of us have been through this before, and that covid is a storm that we are all going through and it's important to remember that we're in the same storm, but that doesn't mean we're in the same boat. Like there are a lot of people who bring a lot of vulnerabilities to the table. And so Tammy, did I thought, a really nice job of talking about people who are experiencing mental health difficulties for the first time. Actually in childhood and in the trauma arena in particular, we're actually dealing with people who have had a multitude of traumatic stressors before this, and covid just represents one more trauma that they're having to cope with and deal with in their lives. And parents are, you know, having a front row seat to their children's mental health functioning throughout the day in a way that they weren't having before when their kids go to school. And so what we've seen in our clinic here at the UAMS Child Study Center is certainly an increase in mental health referrals, but particularly, I think, for families who unfortunately already represent marginalized populations that have worse outcomes, worse access to health care. And so I think this conversation, in addition to talking about everyone's needs, it's important to also focus on who is vulnerable in our state, who is most vulnerable and most potentially in need of connection to mental health care.
MONK:
Yeah. So for this next one, we're gonna go with some, we got a lot of reader-submitted questions before the panel started about how to help loved ones who are struggling with symptoms of mental illness or mental illness, particularly folks who don't want to seek professional help. Dr. John, I'm gonna start with you on this one, since you were last for the last one.
JOHN:
Sure. You know, the first thing I think of is, as a family member, you can play such an important role in normalizing the importance of taking care of your mental wellness. When you asked that question, it was interesting to me because my first question was, “Why don't they want to go seek mental health services?” I think there's a lot of stigma around mental health, but as a family member, you can say, “you know, if you were worried about diabetes or that you broke your arm, you would go to the doctor to check it out.” And our mental health is the same. There's nothing special or unique about mental health compared to physical health. And also that just don't deprive yourself of the opportunity to get better. So mental health has come a long way in our ability to really successfully treat a whole range of mental health difficulties that people have. And so I think as loved ones, not only can we recognize when our family members are maybe having more symptoms or behaving in a way that's unusual for them, but also that we can be real cheerleaders to normalize taking care of mental health as something that our family thinks is important, that our community thinks is important and that I would encourage you to do.
WEST:
Yeah, I want to follow up on that, because I've been making notes as Dr. John was talking. And I think, I think a key point is to give each other grace through this and give ourselves grace through this.
MONK:
Can you kind of expand on what you mean by that?
WEST:
You know, I think as our environment and the inputs to our life and as communities change, we tend to hold the same expectations of ourselves and the people that are in our communities And I think it's important to understand that we're all human and I can have a bad day and it's okay, or my loved one, my colleague could have a bad day and it's okay. All that means is, I just need to talk to myself a little bit that day and say, “Hey, we're going to get out of this. This is temporary. It's also okay to talk to somebody that I love. It's also okay to talk to my spouse, my kids and say, ‘You know what? You had a bad day. It's okay, we're gonna get through this together.’”
ALEXANDER:
And Ginny, if I could add to something that Sufna said, too. You know, talking about stigma. I mean, it's a challenge that we have dealt with in the mental health field for many, many years, and as she brings up, you know, you wouldn't think twice about going to the doctor if you have an ear infection or if you have a broken arm. But when you're suffering from a mental health issue, people are still reluctant to go seek treatment when there are such effective treatments available. But one of the things that I am hopeful for, and I think this is happening some and I'd like to hear what my colleagues think, too. But I almost feel like one of the positive things that has come from this past year of stressful quarantine and covid and complete stress is that we have almost all of us have felt some sense of mental health distress. And I'm very hopeful that this past year is going to help us to break down some of that stigma for seeking treatment and for understanding and recognizing. So I mean that is one thing, I don't know if you all are seeing that, but, you know, but I'm really hopeful that that's going to be something that comes from this this tough year.
MONK:
Yeah, Buster, I know particularly helping loved ones kind of talking to their family members is something that NAMI has worked on. Can you kind of talk about this question and what NAMI has to offer for people who might have questions about mental illness?
LACKEY:
So you know, NAMI, we don't call it a “hotline,” we call it a “warmline”, and our office lines are answered 24/7 by a live person. So that way someone can get immediate help or immediate connection, but, you know, across the state, we offer, our affiliates offer different support groups for both people with mental illness and people who have caregivers or don’t have time to figure this out. We get a lot of calls saying, “Hey, you know, my son or daughter has just been diagnosed with this illness, and we have no clue what it is,” whether it be bipolar or depression or whatever. So our team, we've got a couple of peer-support specialists. We've got a lot of people that’ve got the lived experience of mental illness and different things on our staff. So they're able to not only just help them find the connections and find the resources, but they really get to talk to them from a first-person, “you know, I've been there. I was the person that you're talking about” or whatever. So, NAMI as a whole is, you know, we want to advocate and we want to provide the resources and the support for those family members, and we've got to end the stigma. I know there's been a common thing we're talking about and why in 2021 are we still dealing with mental health stigma is beyond my comprehension. But every day we deal with it, we deal in the communities. We deal with it in the workplace, we deal with their home and, you know, someone told me the other day “Well, you know, back in the day when, you know, my aunt was, we now know she had schizophrenia and everybody just say, ‘Oh, well, that's Aunt Virginia. So, you know, just overlook her.’” And what she was saying was, just ignore it. Well, that's what we've done for so long, and now we've got to bring it back to the forefront and deal with it, because there are so many techniques and therapies and medications that are out there that are created for us. And I think one of the colleagues said you know, if you had diabetes or you had a heart problem, you would go to see a specialist for that. This is no different. You have to go see a specialist and you get it taken care of. And many of these things are you can't overcome and you can control it by therapy and medicine and things. So NAMI wants to be there for these people and make sure they get connected to the right place. No matter where you live in the state, we're gonna help you find the local, either local community health center or local private therapist or whatever it is you're looking for. We want to be able to help you, and that's what we do. We have five staff that that's what they do every day and every night.
MONK:
Yeah. Thank you so much. I'm gonna go ahead and interject here and say that if any of our participants have questions for the panelists, you can submit those in the chat. We want to try to spend as much time as possible on the questions that you have. But I will go ahead and ask if you have particular tips for people who are needing care, seeking care, especially for people who are uninsured or their insurance doesn't cover therapy. Tammy, we'll start with you on this one.
ALEXANDER:
Sure. Actually, there are quite a few resources for people who do not have health insurance coverage for mental health or whose coverage is lacking. There's some coverages that just won't pay for enough and you need some extra help. So, the community mental health centers which are located in, there is a site of a community health center in all 75 counties in Arkansas, and they are partially funded through state monies and through some federal mental health block grant monies and substance abuse block grant monies, so they have sliding scales. They also have different programs that a person could sign up at these community mental health centers and receive services paid for through those grant funds, so that's an excellent resource for individuals who need those services. The grant that I was talking about the Stay Positive, the project promoting positive emotions, Project PPE, we've also, it also has the name “Stay Positive Arkansas,” and that's the website for that grant and that has crisis counseling for any Arkansan regardless of ability to pay. The type of grant that this is, it's funded through FEMA [Federal Emergency Management Agency] and SAMHSA, the Substance Abuse and Mental Health Services Administration, and it allows for free crisis counseling, resources referral, if needed. And in this grant, a lot of federal grants need to be the payer of last resort. And so, if you have insurance that needs to be billed and then, the grant can cover it, if your insurance doesn't. With this crisis counseling grant, the “Stay Positive Arkansas,” we don't even ask for any kind of insurance information. It can be the payer of first resort, So that's kind of a different thing and nice. Now, it is for shorter-term crisis counseling and if someone needs longer term treatment or more intensive treatment then they would be referred, usually to a community health center or some type of private behavioral health agency in their area. One of the things, if I can go on with this for just a second, one of the things that we have seen is that people are searching for materials, too. They’re searching for self-help things during this pandemic. And so part of what we've done with this grant is we have a wonderful staff who have developed a lot of resources, printable resources that you can go on the Stay Positive Arkansas website and print them out for yourselves. There are things like a pandemic parenting chart, and I mean, my daughters who are grown and have kids have it on their refrigerator to remind them of things. And it's like, “Have you hugged your child today?” “I played a game with my child today.” I remembered to take calming breaths.” “I helped my child clean up today.” “I did something silly and laughed with my child today.” And so you put it on the refrigerator and mark it off for Sunday, Monday, Tuesday, Wednesday, Thursday. It's kind of a reminder that don't be all “doom and gloom.” Do those normal things, you know, find joy in the everyday things. So, we have a whole lot of printable resources on that website, and it's www.staypositiveArkansas.com. And there's also a pandemic self-care for health care workers. You know, we've tried to target some of the people who are impacted significantly by covid. So, you know, just some reminders for those health care workers who are working shift after shift with very little time off. But, so there are a lot of resources, and I think sometimes, sometimes people just need that little bit of information and that little push of “Here go in this direction.” and that's all they need. And then other people might need a little bit more, they might need to talk to somebody, talk to a professional or be referred for a little bit longer-term counseling. So, you know, we try to help people understand what it is they need. And those types of services.
MONK:
Thank you. That time I was muted. Tyler, could you talk a little bit about how people can get access to the trainings that you were referencing?
WEST:
Yes. So, the American Foundation for Suicide Prevention here in Arkansas has funds set aside for the next year to and we're, I think we're calling it something like “build a recovering resiliency post-covid in Arkansas.” And what we're doing is we're going to towns all across Arkansas. You can go to afsp.org, Brianna [Kwasnik, Arkansas Democrat-Gazette reporter], if you could post this, afsp.org/Arkansas to see some of the programs as they begin to roll out, we're going from corner to corner of the state, small communities, big communities, we're bringing these trainings in about what it looks like post- pandemic, how to reconnect. A bit of a personal story: I was on my first flight in a year, and I had a moment of anxiety. It was uncomfortable. And I think we're all going to have those moments, whether it be in an airport, whether it be in our churches, whether it be in our local gas stations, whether it be going back to school. We're all going to have those moments where we're a little bit uncomfortable because it's not what we've experienced for the last year. And so what AFSP, what The American Foundation for Suicide Prevention is going to start doing and communities across the state, is implement these programs where we talk about “what does it look like to build resilient families, faith-based communities, communities, schools across the state?” And you know the specifics obviously, it's pretty early to figure out how and when and where we can implement these. But I do encourage you to follow this, to follow that website. You can also sign up for email alerts. We will, we’ll keep you up to speed on, as these programs roll out across the state how you can get involved.
MONK:
All right. Thank you so much, Dr. John, can you tell us about what UAMS has to offer for people looking for help?
JOHN:
Sure. And this it’s actually like Elissa from our audience segued right into that and asking “Is there anything being done for front line workers?” So UAMS has a program called “AR-Connect” that provides kind of immediate 24/7 support that's free for anyone in the public and Arkansas. It provides short, brief-term help and also connection to longer-term mental health care, if that's what's important and needed in that kind of case. But we've actually been seeing a lot of influx of health care providers, nurses, frontline staff as well as other types of frontline personnel like, people who are stocking our grocery store shelves and working in restaurants and teaching our children. And so I absolutely agree with a lot of my panelists, there's a lot of good resources out there and want to make a plug for the fact that, like a lot of this, can be done virtually now. And so some of the other barriers that people might have had related to transportation, I don't have enough time to get off of work and get to a clinic and get back to work, some of those barriers are actually improved with our ability to provide more services via telemedicine than we've ever been able to in our state, thanks to emergency orders that have been upheld by our governor. And so, I would just really strongly urge people to one, make sure you actually don't have insurance coverage or are not eligible for insurance coverage, because a lot of people could get on ARkids and Medicaid, and they may not realize that they're eligible for that type of coverage. So DHS can be a really good resource for people. But ARconnect is available. And then finally, there's an app for that. There's lots of mental health apps that actually have some pretty strong research to help people cope with a variety of different types of stuff. UCSF has a really nice collection of these apps, and what I'll do is just put that web link in the chat just so everybody has it just to make sure you're consuming those types of apps that are shown to be effective and helpful for people.
MONK:
Yeah, thank you. So another question from the audience is whether you can expand on how to know if you're in a crisis versus just having a bad day. Buster, I think it's been a minute since you’ve talked, you want to answer this one?
LACKEY:
Well, we all have bad days, and I think here in the covid I think we've had more bad days than not because just everything's going on and just this pandemic time. But you know, when someone's in a crisis that's when they're really feeling just hopeless. And I guess they would say that at the bottom of the barrel and there's no hope, they can't figure out how to get out of this barrel, or this situation they're in. And then oftentimes they don't have the resources or the support people that they feel that they can call and talk to, because sometimes it's because of that stigma we talked about earlier, there's just nowhere to go and nowhere to turn to. So, you know, you’ve got people like Tyler and the groups that he represents, and NAMI, and all of our groups that represent that we’re there. That's why we do, is to help people through these things, and I think sometimes people don't realize really where they are in life because they're just trying to live minute for minute, they’re in the moment, they’re in the day and they're trying to figure out how they're going to pay their bills, can keep their lights on. Are they going to get to work tomorrow? I mean, there's so many things right now that were not factors, you know, six months ago. Or I guess, what, nine months ago or a year ago now. Gosh, it's been a year, you know, and like that, the time flies. We don't even realize it's been a year now. We've been dealing with this pandemic, and I think that, you know, we really get to a point where we burn ourselves out spinning and spinning, and we're not getting anywhere. You know, but again, the positive here is that we will get through this. We will pull through it and we'll get things back to normal. And some things will be a new normal. Like Dr. John said, you know, telehealth and some of those things that you know weren't really considered before. Now, more people are getting help because they can take a lunch break and go to their car and jump on the phone with, you know, FaceTime whatever with their therapist and have a session or whatever. So there are a lot of resources are now being advanced because of this. Good things are coming out of the pandemic, even though it seems horrible right now where we are.
WEST:
Yeah, I think that's a really good point. And we panelists, as we were trying to figure out the technology before everybody got on, we were kind of having that same discussion about you know, what are the unintended effects of covid or unexpected effects of covid, and access to care might be one of the things that we have learned that might be transformational for the mental health care field.
LACKEY:
Yeah, I know, Tyler, when we first started and started getting into telehealth, you know, I have so many people saying “Oh, I can't do that” or “it's just not personable” But, you know, once they're starting to do it, and now, even us as therapists, once we're starting to get used to doing it and familiar with the different platforms that we use to do telehealth, it’s pretty easy to jump on and have an hour session, and they're not having to miss work, they're not clocking out they’re not having to, you know, drive across town. It's a win-win, even though, you know, some of us were a little more resistant to following suit and going “Okay, yes, we can do this by telehealth,” you know, and I think some people like it. They like it better than being in my office.
MONK:
Yeah, so kind of piggybacking off of that. Another question from the audience is whether you will think that telemedicine will continue to be an affordable and accessible choice. I mean, maybe after covid is over. Tammy, do you want to-?
ALEXANDER:
I think it's here to stay and you know, working for the state our Division of Medical Services, Medicaid, really they did a great job of jumping in and authorizing telehealth for a lot of services that were not covered by telehealth previously. And I think that helped so many people be able to continue their services and then open it up to a lot of new people. And I think, and you know, the state has really had all kinds of feedback from providers about the benefits and struggles of telehealth. And what we've heard overwhelmingly is that the benefits are substantial and for both the provider and for the client, and no one really wants to go back to where it was. And so I think there's a lot of primarily things that have opened up for telehealth in the pandemic are here to stay. I don't think people are going to go backwards on that. And I think the state is very supportive of that as well, as well as legislatures and the people who need to be on board, I think are all on board to make that happen.
MONK:
That's great. So another question from the audience is kind of dealing with isolation, particularly for seniors who are alone for this time, if there's particular resources or programs geared towards that group.
LACKEY:
Well, I think you know NAMI has the different support groups across the state that most of all right now are still operating, you know, kind of, well, it's not telehealth, but it's the telehealth group I guess, you know, we're still doing it through that way. And actually, we've had more response to be able to do that, because again the same thing we were just talking about, the seniors, they don't want to get down at night, they don't want to drive, they can't drive at night, they don't know downtown Little Rock or Fayetteville, wherever the group, but now through the Zoom meetings we’re having, they can join anywhere in the state and fit in and be, and create new friends and new family. And, you now have the outreach. And I think we get quite a few calls at NAMI from senior citizens just trying to figure out, you know, there's some new, you know, maybe they've had a death, their spouses died after 50 years of marriage. So now they’re creating that new ID, that new them and they're just trying to reach out and figure it out. And I think some of our groups and some of our resources we have for them really help them. And we can also hook them up with and get that referral to that closest mental health center, the mental health center, the private practice whatever is in their area so we can get them counseling and things that they might need. So, seniors is often, we talk about them first, but then we forget that they need services, too. You know, we focus on children and youth a lot, and I know Dr. John understands this because that's what she does. But then we’ve also got to remember that our senior population is just as important. You know, they’ve paved the way for us to get to where we are now, so we really need to be able to give back and invest in them.
JOHN:
And, you know, for those caregivers who, the person that they're trying to support is not at the point where they want to be engaging in mental health services, there are things we can also do to support the people we love. To me, one of the classic ones is to put on your observation caps for what in psychology we call “thought distortions” or times where your mind is playing tricks on you. And one that I've heard a lot in our communities is this idea of like “nothing is ever going to be the same”, like “everything is different now,” kind of those thoughts that leave us feeling helpless and hopeless about the world around us. Of helping our loved ones think about what's actually stayed the same, finding proof for the fact that maybe some of that all or nothing thinking, that's leading to our helplessness or our panic or hysteria. Maybe there is proof to suggest that that's not entirely true. And so, by all means, we can't expect everyone in our families to be therapists for each other. And also, I want to recognize that, like sometimes a family member is not ready to come to professionals yet. But we can at least do a small part in supporting them by kind of recognizing when those thoughts are getting derailed. And also limiting media consumption. I tell people all the time, “literally change the channel.” Too much infiltration of news for people who are worried about things isn't going to necessarily help your mental health. So we know that physical exercise, social gathering is really transformative for symptoms of depression and anxiety. Yes, Elissa, stopped looking at Facebook because that might not be helping right now, and so I would also similarly think about ways to engage your family member in positive activities that take care of their body and take care of their wellness as well.
LACKEY:
I agree with that, because we get so consumed in watching all the news channels that we put ourselves into a panic because we're worried about that, whatever they're talking about, and then we can't sleep at night. And then we're constantly stirring about this in our brains, and we can't ever shut it off because we're a 24/7 news feed now. Everywhere, you can't pick up anything without looking at something online, and I think it's important just to shut it off.
WEST:
Yeah, so I think that we get into ruts of thought, patterns of thought, that becomes superhighways of thoughts. And whenever we're focused on certain things, it becomes what we continue to focus on. It's a self-fulfilling downward spiral, and reminding ourselves and reminding the people around us that we don't have to live right here right now. It's not just today, there is tomorrow, is really important.
MONK:
I can certainly identify with the consuming too much news.
ALEXANDER:
Even though you're in the news business, we still support it now, in limited doses. But I think the caller or the panel, the participant who asked about the caregivers and support for older persons. You know, I think it's also making sure that that caregiver has an outlet, too. That they have some time away, that they have some self-care. And a lot of people who are put in that caregiver role feel guilty about taking care of themselves, when that is so vitally important for them to be a good caregiver, is taking care of themselves. So having another friend or family member come in and give them a respite, getting out and doing some of those things to take care of yourself. And it gives you some perspective, and it's very important and it's not being selfish. And so I think that's important for caregivers to hear, is that you can't do that job of caretaking of someone else, unless you are also caretaking yourself and doing those things that are going to keep you sort of stable and able to do those things.
JOHN:
Tammy, I so agree, and it made me think about that question of like “how do I know it's a mental health crisis?” Part of it also is like “Why wait until it is a crisis?” And so, like you know yourself. And if, when I think of crisis, I think the situation has gotten so bad that it's overwhelmed my ability to cope routinely. That's usually what we refer as something that is a “crisis”, right? But part of it also, is like, if you are having more symptoms or struggling with relationships, getting your work done, your home life in order, like don't necessarily wait until it hits the tipping point to get services, either. And that's a great point, and Tammy, when you're thinking about caretakers and caregivers of others as well is, you can start taking care of your mental health as a way to also like “airplane mentality,” put your oxygen mask on first before you help oxygen mask other people. It's very similar with mental health. I think of making sure to take care of yourself, so that you are also able to take care of the people that you love.
ALEXANDER:
You know, and I think that's self-awareness, also are you starting to do things that are unhealthy more often? You know, did you used to, in the past you used to drink alcohol once a week, and now you're up to four or five times a week. You know, are there things that you notice that you're kind of going down that path that, like you say, “Hey, it might be time for a check-up and to go in and take care of myself and look at these things.”
WEST:
I think that's such good advice, because I think a lot of the people who would join, who would opt-in to a conversation like this tonight, are wanting to help the people they care about. So thank you so much for that.
ALEXANDER:
Judging by driving by the liquor stores on my way home to and from work every day, there was no lack of customers there, so I think that people might find themselves in that category sometimes.
MONK:
We're starting to run a little short on time here, but one topic we did get a lot of questions about was kind of dealing with loss and trauma, which I know we've talked about broadly, but these were specific to people who had lost loved ones or lost their jobs during the pandemic. And Dr. John, maybe we'll start with you, because I know you do a lot of work in trauma and just kind of how people can deal with that.
JOHN:
Yeah, sure. And so, the first thing I think of is that it's not probably what people think. There's a large misconception around treating trauma, but trauma’s actually one of the most treatable mental health disorders we have. We know how to help people who are struggling with post-traumatic stress disorder, who are struggling with grief reactions. But often people aren't getting connected with the right type of care. And so, just like all car mechanics are not treated equally, all mental health therapists are not trained to do all the different types of therapies equally either. And so, particularly with trauma, what we find, at least in the child trauma world, is just run-of-the-mill general type of counseling doesn't seem to make a dent in trauma symptoms the way that we often would hope that it would. And so what I'll do is put in the chat the program that I direct, ARBEST has a free clinician look-up tool, where you can search by county, you can search by therapists to find one of the 2,000 therapists in Arkansas who have been trained in evidence-based trauma treatments for children. Trauma can have really devastating impacts across a broad range of things that can persist into adulthood. And so for me, when I think trauma, don't wait to get mental health services and make sure you're getting mental health services from someone who is trained specifically to treat trauma. A shortcut way to know that is, If you ask your therapist, what model are you using to train me? They should be able to quickly tell you an acronym because in mental health, we love acronyms. So if there's not an acronym, that might give you a sense of like, “I want to know more about my care,” remember, you're a consumer, and you have the rights of any consumer to shop around until you find a therapist that's well suited to your needs.
MONK:
Buster, Would you want to add anything to that? Maybe, I know you had a personal experience with covid.
LACKEY:
Yeah, so you know back in October, I came down with covid and spent the month of October in the hospital in intensive care. And then I spent all of November and just about all of December home trying to get better on oxygen and things. I went through so many, my own emotions, you know, when I was in ICU, became delusional and then depression sunk in and then with, then I got to thinking about “I'm not able to work.” Being off work for 100 days came into place, and at the same time, my wife had covid at home, but I didn't know that because I was in the hospital. So it's all these factors came in and it really took over my mental health and the covid experience. I deteriorated quickly with my mental health, and what I realized is that all the medical staff at the hospital was focused on my breathing, which I'm glad it was because I needed to breathe. But, you know, they're focused on getting my lungs working and keeping my blood stats, my oxygen stats up, and all the different therapies that they was doing, that there is a huge gap in my mental health that there was not. I can't speak to my family, no one can visit me. I couldn't talk to my kids or see my kids. You know, the only person that came in the room was the nurse, pretty much or to draw blood from me. So, you know, I wasn't looking forward to that visit for sure. And what I realized was, and I've had several conversations after I got out. You know, the doctors will tell me how bad I am and that you know, if things don't get better then I’m going on a ventilator and all these fears are overtaking me and my whole psyche changed. And now that I'm, you know, post-covid and I'm back and kind of getting better. I'm still dealing with a few side effects, but better now. Now, I realized that my mental health played a huge part in my recovery. And what we've got to do is get the message out that you’ve got the mental health component of covid, and you’ve got the physical health component of covid and
You know, in the hospital they were just trying to save my life and keep me breathing. But there was a whole different battle going on inside of my head with the depression and just isolation and everything we talked about tonight, pretty much I went through to the hospital, and then I got home, because I'm used to working, you know, I do two or three things together, I'm on the go, on the run all the time, and now I can't get out of my chair. I can't get off the couch without almost passing out because I can't breathe. I can't get enough oxygen. So you take that and you basically broke me down and I can't function like I used to. So I've lost the ability to work, I've lost ability to earn money, I've lost the ability to keep my practice open and, you know, be the boss of NAMI, and all the different things that I do in a day is who makes Buster Lackey up, I lost. So there had to be a time when and thankfully, I'm trained in this as you know, the therapist that it's like, “Oh, wait, this can't be happen. I've got to get this turned around or I will be one of those, the next number is going down in this hospital as a covid death.” And I think that now that I'm talking to different people at the Health Department and over at the hospital, now that everyone, I'm saying “We've got to look at how do we bring in mental health?” Because in a traditional setting, we're not looking at doing therapy with somebody, you know, because we're just trying to get them to survive. And I think in everything I said tonight there's a component there that it's got to reach out. You got to keep the brain stimulated, you know, laying there in the ICU for 28 days, there is no stimulation. The brain is, you really actually start delusions and there's a whole syndrome at this, but you can really start having delusions of, from, you know, I saw the clock dancing on the wall. You know, it's like, what is wrong with me? Well, it's part of that mental health breakdown that was, that I was going through. Now, did that mean that I'm a bad person or whatever? No, it means that I was experiencing what most people will experience in that situation. But the problem is, is that there was no identification at that point in the game to help me with it. And I think that, you know, maybe Tammy or Tyler or Dr. John can jump in, but, you know, we've really got to address, and we had a long conversation with Congressman French Hill’s office about this because mental health workers need to be brought to the forefront and work right alongside of the physical health workers here in order to fight this.
WEST:
Yeah. One of the questions that I'm seeing coming through: Mary asked “Is there a need for specialized mental health treatment for covid survivors?” I think that's an interesting question. But I think to your point, Buster, we look at the data. We look at people who have who have, who are recovering from heart disease, people who have recovering from any type of trauma, there's always a mental health component to that. It's been important in treatment protocols for years. So I think that I think what we're learning right now, hopefully what we're learning right now, is that we need to continue to expand this side, this kind of side-by-side treatment protocol that is both for physical health and mental health.
LACKEY:
Yeah, like the way you said, Tyler. It’s side-by-side, one is not higher than the other. I mean, yes, I needed my pulmonary doctors and I needed the, you know, the common, the covid doctors there to make sure that I was breathing right and all that took place. But, you know, I really needed that mental health piece there to go right alongside and coincide with that as we move through that, those 20-plus days in the hospital.
MONK:
Yeah. Thank you so much for sharing about your experience, Buster. Tammy, you can go ahead.
ALEXANDER:
Oh, I was just gonna say that, you know, bringing this to the forefront, maybe another positive that comes from the covid experience, is that need for the physical-mental health combination treatment. So thank you for talking about that, Buster.
MONK:
Yeah, thank you so much. We are running up on 7:00 here, so I'm gonna kind of go around and let our panelists, if you have any final points you want to make, resources you want to remind people about, you can go and do that. Tyler, why don't we start with you since you're unmuted?
WEST:
Sure. Again, I would encourage everyone throughout the state, go to afsp.org/Arkansas. There are lots of programs that we’re about to be rolling out as soon as it is safe to do so. We have been planning for this for nearly nine months now to help communities bounce back, help families bounce back. So be sure and check out that website for programs as they're announced. Again, the quickest way to do that is to sign up on our email list. Also, I want to thank everybody who's been here. There are 31 of us here right now, and I want to thank you all for being here, for showing up for yourselves, showing up for your families, showing up for your communities. Nights like tonight are really important as we start to see a glimpse of recovery from the last year. It takes all of us to do that in our communities and our family. So thank you, everybody for being here, and thank you for my fellow panelists and thank you to the Arkansas Democrat-Gazette and Ginny.
MONK:
Yeah, thank you, Tyler. Buster, you wanna go ahead?
LACKEY:
Yeah, I saw one question where there's a middle school counselor that talked about, I posted on, but NAMI Arkansas has NAMI On Campus for middle and high school students, and, you know, if she’ll call the office, I put the number there (501) 661-1548, then you know, we would be able to talk more about that. But there's a whole program that we do on high school campuses across the state. And you know, and I appreciate you for hosting this, you know, it's again. It's reducing that stigma. And it's something that, you know, we just don't want to talk about, but it's time we bring to the table and talk about it, you know? So thank you. Ginny and Brianna for hosting this tonight, and I’m glad to be on this with the other panelists.
MONK:
Yeah. Thank you so much for joining us, Tammy, do you want to, do you have any final thoughts to share?
ALEXANDER:
Sure. I think my final thought would be to just say to everyone, be as kind and forgiving to yourself as you are to those you care about. And thank you to the panelists, It was nice to get to talk to you all. I think hopefully we will have some conversations in the future. And thank you, Ginny and Brianna and Democrat-Gazette for pulling this together. These are the kind of things that will help us to make steps towards reducing the stigma and helping people to understand it's okay to seek help and to know where those resources are. So thank you.
MONK:
Thanks. Dr. John?
JOHN:
No final thoughts for me. It's 7:00, I've put resources in the chat. But yeah, I just appreciate everybody's time and wisdom on this call.
MONK:
Yeah, Thank you so much to all of our panelists for joining us on everyone who participated. We will have an article with a lot of links to a lot of the resources we've talked about tonight available on the Democrat-Gazette website first thing tomorrow morning and that will be translated into Spanish. The recording of this session will also be available online, as well as a transcript. So that will be on the Arkansas Coping with Covid page that you all registered at. So, thank you so much.