Mental Health and the Importance of Community Support

0:00:01 - Announcer

You are listening to the National University Podcast.

0:00:10 - Kimberly King

Hello, I'm Kimberly King. Welcome to the National University Podcast, where we offer a holistic approach to student support, well-being and success- the whole human education. We put passion into practice by offering accessible, achievable higher education to lifelong learners. Today we're discussing how to promote mental health in the community and, according to the National Library of Medicine, there are seven topic areas that have been identified collective, collaborative care, early psychosis, school-based interventions, homelessness, criminal justice, global mental health and mental health promotion and prevention. We discuss adapting the social ecological models for health promotion and provide the framework for understanding the actions of community interventions. On today's episode, we're discussing how to promote mental health in the community, and joining us is National University's program director of the social and psychological department, Dr. Henry Venter. Dr. Venter obtained his doctorate at the University of Johannesburg and has been a practicing psychologist for over 25 years and a professor at National University for over 18 years, and we welcome him to the podcast. Dr. Venter, how are you?

0:01:30 - Doctor Henry Venter

I'm good. Thank you for having me today.

0:01:33 - Kimberly King

Well, it's great to have you, and so why don't you fill our audience in a little bit on your mission and your work before we get to today's podcast?

0:01:42 - Doctor Henry Venter

The well, the most part of my work at National University consisted of training mental health therapists. So I was for 16 and a half years at National part of the program in the department of psychology, preparing the therapist called marriage and family therapist in California for licensure, which was, of course, a very rewarding endeavor, and I was part of the team that took that program online and it just exploded in enrollment because there's a great shortage projected for the future in therapists, and so last year after COVID, I was tapped to take over the position as Director of the masters in human behavioral psychology, which does not train therapists but prepare people at a master's degree level to operate in organizations such as counties, schools and departments, which is still a very rewarding endeavor.

0:02:50 - Kimberly King

I can see that, and boy, I think right now it's such a relevant. Mental health is everywhere, and so that kind of is shocking to me that there's a shortage. I think people graduating through college right now that's such an open opportunity. So today we are talking about how to promote mental health in the community and so, Doctor, what are the key factors contributing to mental health challenges in today's communities and how can we address them effectively?

0:03:19 - Doctor Henry Venter

Well, I think the first one is obvious to everybody is increased stress. I mean, since COVID started, it was like we went down an avalanche of stress, first with illness and how to treat that, and changing the way we work, the way we live, and, following the pandemic, that has not changed. Everybody noticed that we then suddenly had a lot of other stressors- financial, currently the home crisis, and how do people afford homes, even how to afford college. So it seems that the stress is just increasing exponentially, and I think that is something that exists on a macro level, because that's not something that families can control, because it's like the world, the countries at a large, is having a hard time governing us and creating safety and security. The world, though, and this stress, of course, translates back to people and how they view their world. I think, since COVID, our illusion of a safe world that is operating wonderfully and is in control has been shattered, and that has changed a lot of people. I remember when I had COVID twice, and the first time we had to isolate for 14 days, it really messed with your mental health, because you suddenly hear about other people that, in five days, pass away tragically and you think, well, what's going to happen? I think that has created a huge change and left people vulnerable, and the continuing stress is now working with that.

The other interesting factor that we have found I just concluded the study on isolation is we're experiencing a worldwide social isolation, especially among young people 18 to 28 years old. Now you would expect the opposite, with connected online and online all the time and on the devices, and you would expect that, no, that would be less. But not only is that enormously high in areas that you would expect that it's probably not relevant there, such as big, large cities like Seoul, New York and places like that. Incredibly high numbers of social isolation, and we expected the opposite. And I think just after I did a presentation last year September in Toronto, the Friday that I did the presentation, Thursday, the report was published here in America by the Surgeon General on isolation and we realized, wow, we have a bigger problem than ever. So social isolation is something also just like the pandemic that we didn't expect to happen that is playing.

So I think these two things the increased stress and this increasing social isolation is creating havoc in our mental health, because it's things that young people thought. I would go to the city. It's not going to happen. And suddenly they faced with I have no friends, I have no comment, I don't know where to go, I'm sitting on my own. So I think these two factors is responsible for the high in mental health numbers. The other thing I have to mention if we compare to 27 years ago, the mental health numbers we would have expected, with the increase in care, the increase in medication, the increase in the availability, that mental health numbers would actually go down, while the opposite is happening. In the last 10 years, before COVID this is not just COVID, before COVID, mental health numbers has also spiked tremendously. The visits to ERs due to mental health crisis has risen tremendously and a lot of people now doing studies. How is this possible? What is happening? It just says that we'll have to do more for mental health than we anticipated or thought that we had to do.

0:07:44 - Kimberly King

Wow, and it's so funny. It's not funny, it's true, when you said when we had originally, when we didn't really know what COVID was and we had to isolate for 14 days, how quickly we forget. But not only do we not know what was going to happen to us, but also that judgment like, ooh, so, and so has COVID, and that judgment makes you feel really bad about yourself too. So there's a lot going in on that mental health, isn't there?

0:08:10 - Doctor Henry Venter

That's right, that's right.

0:08:12 - Kimberly King

So how can individuals and community leaders work together to reduce this stigma regarding and surrounding mental health issues?

0:08:19 - Doctor Henry Venter

I think that is important to lead by example you mentioned during COVID, a lot of people started to struggle and initially you didn't talk about that. You had a hard time. But the more people who had COVID, the more people just started to talk about that, the more we become open with that. Yeah, I really had a hard time. It really messed with me and it is important to open up that discussion of having symptoms of mental health issues. You know, when somebody comes along and say, oh, my cholesterol numbers is high, I'm on statins, no problem. Oh, my blood pressure is high yeah, I'm in blood pressure, no problem. Nobody blinks like if somebody says, yeah, you know, I've been prescribed anti-anxiety medication, it's like, oh, something wrong with them. You know and we need to pass that it is to experience mental health symptoms and to then receive medication for some time is nothing different sometimes from having high cholesterol, high blood pressure. It is a reaction of your body, of your system, to what is happening. It doesn't mean you're going to be on that forever, and we need to normalize that by this more open discussion and encouraging conversations, such as this - that experience of mental health symptoms is actually very normal and much more normal than we ever anticipated or that some groups thought would be. But I think the most important part is education. For instance, some of the clients that I work with, for them, it is still the low point in their life If they are told by psychiatrists that they will have to take an antidepressant. And then they come to therapy and they'll tell me you know, I really feel like a failure. Well, why? Well, because I have to start taking antidepressant or something for anxiety. But why would that be? And that proves to you that the that the mental image they have in their mind is that somebody that uses medication for mental health symptoms translates to I'm now a failure. And more education is necessary from a young level to change that, that it's very normal to experience symptoms and that, in fact, to be open about it and seek help early, just like any physiological problem is, is what will help us. You know how many times you go to the doctor and say why didn't you come earlier with this physical problem? And a lot of education goes now into it for earlier checkups. And people do that. We need to do the same with mental health. Get the education out there, open this conversation that it is normal to have these symptoms and it's necessary to seek help and talk to somebody. Because this is not. It's like the newer cars on the market. You remember there was a time that every second person could work on their own cars in the backyard. With the newer cars, you can't anymore.

Mental health - don't try to fix it by yourself. Why would you do that? Seek help, talk to somebody, isn't too better than one. Two minds can solve the problem. But one of our biggest problems is this isolation that when people isolate, they also take much longer to seek mental health intervention by the time we see them. How long have you been struggling with this? Oh, probably three, six months, 12 months longer even, and I think we need to break that mentality that you do not struggle on your own. Talk to someone.

0:11:56 - Kimberly King

You know what, and I love your analogy with the cars and how they've changed and you can't do it on your own. That's a great analogy. And I also love something you said that it's not forever. It could be temporary as far as medication or just getting back to mental health and just your road, but don't do it on your own. I love your messaging there.

0:12:15 - Doctor Henry Venter

Absolutely. Yeah, yeah, this whole. A lot of people ask me well, how long do I have to be on medication and say, you know what? Maybe a year, maybe two years, but isn't that better to function? Better for this time? And then, with working with your prescribing position, you can go off. But you can. It can only improve. But a lot of people still have that perception. Once I am prescribed this mental health medication, I have to stay for it on the floor or they come into therapy.

But how long is this going to take? A year, two years? And often we say to them no, you know, if we work together for 12, 13 years, we're going to have sessions. It may be all that you need. It's like, really, is that we can do that? So, yeah, you know, it's not like you have something which can be changed. There is approaches that can help you tremendously and then we can take a break and over six months you come back. People just don't know how therapy works and they think, well, if I go to therapy, I'm going to stay here for 10 years. Because, you know, my aunt once went to therapy and she was there for the rest of her life. So the education can help us to overcome this barrier.

0:13:24 - Kimberly King

I love that, and I think that is a narrative that is missing, that it's not forever necessarily, depending on the case, and so we've talked a little bit about that role that education plays, but how can we ensure that it reaches all members of the community?

0:13:40 - Doctor Henry Venter

I think the important thing is we need to start in schools. We start an elementary school to educate children about mental health issues, because we find an alarming amount of young children struggling with mental health issues self-harm due to bullying and we need to start educating children about what is mental health, what are the symptoms and why you need to seek help, because that's when people are the most vulnerable. Your young children, elementary and middle school, are the most impressionable young people and then, of course, high school is where people can have a little bit better understanding. That is our groundwork. And then in colleges is also the place where a lot more education can take place, because if we can reach this group, they will carry that with them into the community when they become adults.

It's harder to educate adults. You know that. You know, as we say, after 40, you can't make changes anymore. A lot of people find it very hard to make any changes, although I have to say we find people. Recently, an 87-year-old person must refer to me for therapy, and that's unheard of, and that is an online therapy that is not even face-to-face. So there are changes, but we got to start young.

But we can't leave out the community to educate them, and this is where I think mental health providers need to connect much more with health organizations and that does a great work in doing education on physiological problems. But I need to sometimes look at that and I'll go and do the doctor's offices and I look what's in there and amazingly I still have to find a doctor's office where there is a whole area about mental health education. There's all this thing and that's a problem and that problem. Have you done your checkup for this? None's still there. It's like we, you know, we still expect people to find this stuff for ourselves.

So I think, from a public health perspective, this is an area education for mental health issues that has not reached the level that it could. Probably, from my observation, when I drive around, I look at billboards, I don't see billboards on mental health issues and advertising that enough, and that is, you know, worrisome to me because, where is that education? How is it going to reach people? So I think there is a lot that you know states, counties, mental health, public health organizations should do and say we need to, if we want the people to seek help, we'll need to educate them, starting young and then going through our communities and also reaching older people.

0:16:46 - Kimberly King

I love that, and that is something else that we don't talk about a lot is the aging you know of. You can't teach an old dog new tricks. I suppose is kind of what you were saying there. But another question I have is are there specific cultural or societal aspects that impact mental health differently, and how can we foster inclusivity in mental health promotion efforts?

0:17:07 - Doctor Henry Venter

Absolutely. You know, America is a cultural mix of people coming from so many different areas and each one bring with them their, their ideas about mental health and, for instance, some cultures are very confidential and do not talk outside of the family or approach things as the family will take care of that. And now? But now they're living in this modern society, you know this capitalistic, materialistic society with a lot of pressure, because you know, capitalism is great, materialism great. The only plus, the downside it takes a lot of money to make money. Making money means stress and that. So, even if you come from a different culture, you are living in this, this melting pot, and we need more education to reach the different cultures, to understand the different cultures that you know. You need sometimes to go outside of the family to seek help. When something happens, you can just hide that, but we do find that still a lot of families from different cultures feel that breaking the silence is going out of the family. Talking about your private business is breaking the code, and that is then. I do not think enough has been done to reach all of the different cultural groups in America that is living this, in this stress, and experiencing the same symptoms that other people, but struggling alone. And so we need to. You know, from a therapist's viewpoint, we need more therapists from different cultures to train them. For instance, in the program we have a National University training marriage and family therapist. Our push for years was, you know, we need students from different cultures because they need to go back to the culture, because it's so easy to work with your culture. But it was amazing how underrepresented some cultural groups were in our training. That it's as if they not only have they not really discovered the value of mental health, but they had, they miss one of the greatest careers and that's becoming a therapist. It is a great career that actually you can do well, financially very well. But there are some groups that we that that you know in California I knew what the numbers were for these groups and I would look at our student body and say why are we not reaching these groups? Because we need people to train.

Because the one of the groups that we worked with I was situated in Fresno, Central Valley of California for a long time. One of the unique groups we have there is the Hmong people that that comes from the end, and for years we are trying to get students from the Hmong community because they are a very unique community. That's very culture, you know, and Fresno is one of the areas where the Hmong from all of the country meet at the Fresno Fairgrounds once a year for their festivals and they have the most unique festivals. And at last we broke through and we did get students enrolling in our program and then they later on started counseling center for Hmong people, which is very successful. We can place enough students there, and so that is what we need to do, because gradually they will be able to adapt mental health services for their community to make it accessible, understandable and reduce the fear.

Fear plays a big role. You know, if you go to the doctor's do this day, you're kind of a little apprehensive because you know you're sitting in the waiting room and then they open a little door and they take you to the back and you don't even know what's going to happen there. So the same with mental health. We got to understand that we need to break this unknown that people have and that fear what's going to happen. And so using you know people from the different cultures and getting the training can do a lot.

0:21:12 - Kimberly King

And that's another great analogy. And I say doctors, dentist, we all have that big fear, right, but this is true, we need to break those barriers. What about in times of crisis, such as the pandemic that we all just went through? How can communities come together to support one another's mental well-being?

0:21:30 - Doctor Henry Venter

Well, I think one of the priority to the pandemic, one of the big questions we had, was can we train people online? One of the questions we had can we train therapists online, which I was advocating for. And there was still a question can we really do therapy online and can we do a supervision online? The pandemic forced us to do it and, lo and behold, what was the outcome we found out it worked wonderfully, and now you can do group therapy, you can do individual therapy, you can train people online. I think that was one of the positives out of the pandemic is that it just, you know, forced the debate to the practical rounds. Well, now you're going to force to do it and you'll know it works or not. And it works. So virtual support groups in any crisis where we have to isolate has proved invaluable. And it also forced the rise of different online counseling organizations and a different app. I think worldwide we now have more than 20,000 mental health apps available, which does tremendous work. I mean, we have apps now and programs online where, if you enroll today, you have the chance to start seeing a therapist today. Well, if you, you know, on ground prior to the pandemic, you would go in and call your insurance. It could take you three months to six months to get an appointment with the therapist. I mean by then. Well, the crisis is of such a nature that it was unthinkable that we can do that. So a lot has changed. So the virtual world has helped us tremendously and showed us tremendously that we can continue our work virtually.

Of course, the other main thing that it also helped out is with the expansion of helplines. I think previously we saw helplines always as well. It's, you know, it's adjacent to everything. We can do it if you want. During the pandemic we realized helplines are invaluable and their role during the pandemic, I think, is they're unsung heroes because people could just call and talk to somebody, and I saw that tremendously. But also communities is very important in community care and you know, when we travel through the country during COVID, we also sold up in California and look for another place to live, and so I traveled through many states, like eight states, looked at different counties and we could start comparing what services here like, for instance, internet. Well, not every county is equal on that. I think some hasn't heard about fiber optic cable, what's that? But mental health wise, some counties does excellent work and they prepare, they have mobile teams and some counties is like what's that? So it's very unequal and so I think there can be so much more work done to get counties, communities, to prepare teams for when we have a quite mental health teams that does checkups, that create.

The other day I drove up to an intersection here and the most beautiful bus stopped next to me - the blood bank bus. They have a problem getting people to donate blood, so what do they do? They bought a bus, they made it beautiful and they send it out to the cars. What a novel idea. I mean. I looked at it, even at three ACs on the roof, and said, well, they really keep that thing cool. But you know, that's the kind of thing community should have is their mental health mobile team to go out during crisis, and we can ask how many communities, how many counties, how many communities does have that.

It's something we haven't thought about until the pandemic hit us and that's one of the things I think we need to think much more practical. You know, first responder teams. We need to have first responder teams, mental health first responder teams that can go out and check on people. Now we have great areas like here in my area. We were working my house and one of the guys got sick. He got something in his throat and we called 911. I tell you, within three minutes we had the police here, we had the fire brigade here, we had the supervisor of some sorts that is called out in a crisis and the ambulance here. We have such great services already. What we need to add to that is a mental health team that can go out with them. We have the infrastructure. We need to expand in many areas. Now, again, some counties are excellent. They already do this stuff, but I think we are such a vast country that we need to expand this further.

0:26:21 - Kimberly King

I totally agree and I love that, your correlation with the blood mobile along with the mental health mobile and I know a lot of our at least in California, our law enforcement agencies work with a team called PERT, which is that psychological expert team that would come along, but that's a separate item. What you're saying is for community outreach, so I really like that. So what initiatives have been proven are successful in destigmatizing mental health and encouraging help seeking behaviors within communities?

0:26:53 - Doctor Henry Venter

I think the main thing is the destigmatization, and that comes through the public awareness campaigns, but also in communities where people tell their stories. What we have found was why does a group therapy work so well? You know, you take addictions, for instance. People struggle individual. You put them in a group and that person starts changing because peer support is tremendous. Sometimes, when I work with somebody, they have a problem I've never lived with and they know that I don't have that lived in experience with them. But if they have somebody that has lived that life appear talking to them, they pick up and listen. So I think sharing personal stories of recovery, resilience can truly inspire, and I have to say we have much more than that now going on where people tell their stories.

I think there's one online mental health provider that does a great job with advertising. They use public figures, songwriters, artists to make an advertisement for them that says, hey, I've been struggling with… and I saw some of that and I thought this doesn't even look like an ad. This is just showing this is person that everybody know, they have a fan base, and so that is utilizing our modern world. So you get some of these, these what they call influencers, that are struggling with mental health. You get them to tell the story and people are inspired and they listen to that.

So I think our campaigns need to change on a larger scale where we can listen to people, because nobody really wants to listen to me telling them, hey, you need to take care of your mental health. I think, well, you're a trained psychologist, you don't know what problems are, you know you don't live like that. So there is a barrier immediately, even though they don't know my story. But that's the initial- but if one of their own people comes and say, hey, I live among you, I'm like you and you know what. For years I struggled and I didn't tell nobody that I was struggling and I went to therapy. This is what happened to me. I think we need to embrace that model of sharing personal stories of recovery and resilience in young communities on a larger scale to help people, to see there's people like me that struggle, that went for therapy, and not necessarily just listen to you know so called experts that tell them what to do, because there's a, there's a natural gap there.

0:29:19 - Kimberly King

Yeah, those stories really do sit with people. They remember those, especially, as you said, with those influencers. This is such great information. Thank you so much. We need to take a quick break, but we'll have more in just a moment. Don't go away. We will be right back.

[break]

And now back to our interview with National University's Dr. Henry Venter, and we're discussing such an important topic how to promote mental health in the community and some great ideas coming forward. How can technology and social media be harnessed to promote mental health rather than exacerbate issues like cyber bullying and digital overwhelm?

0:29:59 - Doctor Henry Venter

Yeah, there is a lot of groups existing online that focuses on attacking other people, and we need to use the same technology to do the opposite and create more safe spaces, because I'm always so saddened when I read about a young person, a teenager, for instance. They go home and harm themselves because they are being cyber bullied. We need more spaces where they can go to a group, an app that they can access. That's a safe space that they can share about, where other young people are used to share their stories. I've been there and it always amazed me why did they find the negative groups but they didn't find the positives? Is it because they don't exist more of the positive groups? Should we do more there? And that goes back to my point of education for young people. We also need to educate them about groups online that they can find, that can support them, that can tell them, that can empower them. It's like you don't need to take this. You can speak out because, remember, a lot of bullying exists in isolation.

It only has power because the victim doesn't speak out, because they're afraid. But we need to create more safe spaces and that's where the new technology and social media is a great tool to use and we need to learn more how to use it positively and create these spaces of peer support where people that struggle can go to, say, here's a group that I can go to and that tells me this is what I can do, just a safe space for the moment, until I'm ready to speak out, because not everybody is always ready to speak out immediately about their problem. We know that it's a while to develop the courage and the confidence to speak out, and if we can create a space where they can be anonymous but they can be helped to listen to, that is important.

I think social media is not just negative. There is a lot of positives and I think the I'm not sure if I mentioned before, but worldwide there is a surge in developing mental health apps and because we are seeing that the space is there, so I feel positive that we are beginning to do that. It's also apps that can help people track their mental health, mindfulness techniques that they can use every day, relaxation that they can use every day. So I see a great development, positive development in this area, that companies has seen the value in creating apps for mental health and people buying into that. Now, the more people buy into that and it's really not always that expensive. The more that buy into that, the more people will create. Like the fitness industry I mean apps in the fitness industry is a multi-billion dollar business. We need to have more people that create these apps and more people using that so that we can have more of this technology help available for people strongly.

0:33:12 - Kimberly King

That's a good point, and I know you just said maybe there aren't those stories out there. They really are, it's just that they don't have a place for them to be hit shirt. So, yeah, we just need to balance that. Are there any creative approaches or unconventional methods that have been effective in promoting mental health at the community level?

0:33:30 - Doctor Henry Venter

There were I've seen the other day where they had art therapy focused on mental health for children and youth, and it was an outdoor activity in Costa Mesa, and I think that's the kind of takes it out. It is in an art form, it shows that expression, it creates, it gets the community together, and so I think that is that's the type of different approaches that we need to look at, because sometimes you need to look at all right, we've done something in a certain way. We didn't get the result we had. That way, they anticipated it means it's not working. So we need to look at different ways and more ways that can reach the younger population much more.

We know we I grew up in a world of brochures- no online, no computers. You guys, you know some of you listening in the older generation- no brochure. We've done with brochures, we don't want brochures anymore is to create new ways. So I think the technology is opening the door for us to develop more creative approaches in sharing the you know, the knowledge about mental health, and I see more of that coming along and I hope there's more that comes along. But we need to look at all right, what worked in the past that worked about. What can we do differently? How can we advertise differently? And I think a lot of people are embracing the online world to do that, and especially now with AI. I see some brilliantly created art forms about mental health through that and young people look at that because they’re drawn to them, and so I think there are signs of some very creative approaches to do that.

0:35:31 - Kimberly King

So true, I love that and yeah, just, we have to be creative. How can workplaces and schools become mental health supportive environments, and what are the benefits of such initiatives?

0:35:44 - Doctor Henry Venter

You know, the workplace is just a phenomenal area to start, and here I got to point out National University, since I've been here for 18 years, I think in the beginning we had nothing. There was no mental health available, even for faculty, in our medical insurance. Then we went to three sessions and I remember as therapists we had this laugh and say what can you do in three sessions? Well, you can say hello, how are you? And goodbye, so it's great. And then things have expanded and now not only have our medical insurance expanded and we have ample sessions to use, but we have also made mental health services for free available to students. If we have a student that's struggling, we can simply connect them and same day we can get them in with a group that can start seeing them, because they are already part of the organization. So the organization needs to take ownership of that and I could see that over the years happening at National University. And I think our mental health providing for faculty as well as for students is one of the highlights that we have, and it's because it must be easily accessible, easily available. If I teach a class, I can tell students if you click there on the resources, you'll see there. That's where you can go. But we also have, like in my program, one of my full-time faculty is a mentor. I simply send a name through to her. She personally calls the student. Find out what's happening. We see note in your work. There's something. Can we connect you so organizations can do a lot to take ownership for their people, not just for the materialistic side making money, earning more money but also for the fact that you are using yourself to produce in this company, and we recognize that, that you have issues and this is your community.

Because, remember, some people have only their work and their family. They're so busy they have about nothing else and therefore I think companies can do, should do more, can do more. And then I got to say some companies do phenomenally well. I think one of the things that COVID also showed us that we didn't have before is flexibility of work and study. Covid forced us to become flexible and it showed us you can. You can actually run a massive organization without being in offices. I think a lot of companies say that doesn't work that well, but it did show that we don't need to have everybody every day In and of. We can become flexible and sometimes that's the flexibility that somebody needs just to step away from an office and the driving LA, where I've worked for eight years, a commute can take hours. Oh my gosh, what if somebody has made an issue and say we're from home for a week or two, you don't need to drive in, can do a lot for that person. So I think then, also the education of supervisors, managers, directors, to be aware of this and to educate the people notice it, Like currently we are focusing on student persistence, we are looking for science, that they're struggling for early intervention, not just academically, but also, if we notice something is wrong, the start of discussion what is happening?

Is there something else happening that you need to tell us that we can help you? And time and time again, we find out. Yes, they tell us oh, there's three major crises that happen simultaneously. And then now, it's always amazing to me why didn't they contact us first off? But that's the way it is.

The company needs to set the tone that we were there to listen. We reach out to you, and so I'm impressed with National, with our emails we're receiving. We have this week, we have many now for week. We have this, yes, because people will always be slower to respond, Students will be slower to respond. We can't say, well, they can call us. We need to always say we create the service, then we reach out and that can do a tremendous amount of work and some companies are doing excellent there.

Not just I'm part of National, but I'm seeing that and I can track where we are as a good example of what can be done to reach out to students, to faculty, to say let's take responsibility for our people, let's take the services to them, let's make them aware so that they can garnish that trust to open up. Because remember, it takes a lot of trust to open up about your personal life, because most of us grew up not talking about our family. I mean, I have yet to find a family where you’re trained as a child to say, oh, you can talk about all our problems, just go out. All of us grow up with a certain sense of privacy that goes with us and that carries in your adult life. So we need to understand it takes trust, it needs to until people will talk out, and sometimes we need to breach that gap. They say to reach out and say is something happening? Do you want to talk to us? And then they open up.

0:41:02 - Kimberly King

Oh great. This is great advice and so true and relevant. So what challenges do rural or underserved communities face in accessing mental health resources and what strategies can help bridge this gap?

0:41:18 - Doctor Henry Venter

Obviously logistics, because it's as we see in the medical field, you don't find a massive practice for oncology in a very small rural town. They go to where they can attract business. We see it here in the mountains where I live in the western North Carolina. In some of the towns they have services, but not in the next. People need to travel, but they do a great work to say, ok, we have satellite offices. So, although this is the main office in this town, that there was satellite offices, you can see there, but if necessary, you come here. So they do a great work in the medical field. That's a model we need to look at in mental health. We can have satellite offices. We can have back to my mobile team, my blood bank bus, we can have the bus going out.

But telehealth has helped us a lot. One thing I have to mention years ago, insurances in California, for instance, where I'm licensed, did not allow online therapy and that COVID has broken this problem and insurances now allow online mental health and it is expanding the delivery service to the rural communities tremendously, tremendously. And so I've talked to two of these companies now that have told me the work they do and it's tremendous because they can now get people reach out to people that has that insurance in the middle of nowhere and connect them to a therapist within a day or two.

So I think telehealth has broken the gap. But it also needed to change in policy. So the big insurance companies had to rethink what they're doing, and the pandemic forced them to rethink and to see that the evidence shows there's no difference in the quality. Just like we are recording here. This could be a group therapy for us or individual therapy, and unless it's not in a very acute case, there's nothing that stops us from meeting once a week and it is a great news that that has happened. I think big insurances started to accept that we can do. Telehealth is doing a great work for the rural communities, because that is one of the - and I think that's going to be a game changer in the next years now.

0:43:37 - Kimberly King

I hope so, and that's good. I'd like to see where that is going in that direction.

0:43:42 - Doctor Henry Venter

Yeah, and I can only speak for California, I don't know about the other 50 states and there I know this one group is working with 10 other states currently to market their services also to those states. So it seems to me that it is going to be eventually countrywide, that insurance is going to allow the telehealth, mental health services, and that is going to be tremendous for the rural communities.

0:44:09 - Kimberly King

Good, good, and we've been talking about just how we communicate this. How can family and friends best support someone dealing with mental health challenges while maintaining their own well-being and that's you know, I've been a caregiver. That comes in your mental health, but also when you have kids with special needs in your family and sometimes people don't really know what mental health, you know what fits under that umbrella.

0:44:41 - Doctor Henry Venter

That's right and I think that the main thing that one and again we go back to education. If you have a family member that suddenly diagnosed with, you know, a severe mental health issue, let's use, for instance, bipolar disorder, which is not an easy disorder to understand initially because you know it's not anxiety, it's not depression, but it has these spikes up and down. So you need a lot of education to understand it. The also understanding the medication for bipolar is very important and that not all medication works initially the same way. What is the therapeutic level of medication is that you know you start at lower dosage and then they go higher. So a lot of education and patience is needed. But over time, taking care of that person also takes a toll on the family. So they need to realize but we cannot just give this care. We, at the same time we need to care for ourselves. So support starts with also making sure you have support, because it is kind of draining to deal with that issue and to be the person that that walks ahead to carry your family member. But you need to be sure that you were supported. But also educate yourself about what is the best approach, finding new ways, new solutions for that loved one that's struggling. The main thing is to have that empathy, to move away from judgment and also to understand not every mental health diagnosis is a life sentence, just like if I go back to my analogy of blood pressure, high blood pressure and you know, I know families that that people have been diagnosed with blood pressure around 50 years old and some of them are now 78 years old and they still living a great life. Incidentally, they're using blood pressure medication and cholesterol medication, but they are 78 and they don't look like they're giving up soon. So it's not a life sentence. But when they initially diagnosed and start using it, they think, oh, this is terrible. And we need to understand that that being diagnosed with the mental health disorder is number one, not a life sentence.

Sometimes it is the disorder that can be treated and will go away. Sometimes, like bipolar, it's probably not something that's going to go away. It's going to take a lifetime of management and so some of the more serious disorders is kind of lifetime, although the person and we’re following the recovery model here, where within your own diagnosis you can be helped, you can be supported to still live the best life you can. So it's important that families that have a family member join with groups that can support them, educate them about how to approach the family member. What is the best support for the family member to have a positive outlook, to say you know, you don't need to put them in a room and watch them the whole time and don't let them go out. You don't need that because there you can still fulfilling life.

At times the mental health disorder is probably going to cause a little bit more impairment, at times less, but it's not always, you know, a complete breakdown and people need to have that education and have that practical assistance. But it comes with support. So I see it as the two tier First, the family need education and support so that they can provide education, support to the family member struggling and then become the logistical connection because somebody needs to connect that person to services. Because the one thing I should say about mental health that is different is when you struggle with depression, you all know that. You know you have low energy, you feel hopeless, worthless and helpless, and so even getting online and finding signing up for a company oh, you need your credit card, I don't know where my credit card is oh, I think it's updated.

You know it becomes overwhelming and somebody needs to do it for you and say I've signed you up, here you are. All you need to do is you're going to be there at that time in that room and we set up that's the kind of help, that, some very practical support. Because with some of the anxiety, just you know that if you have to even go online and look for help, it raises your anxiety Because the one thing we have the internet, is good, but there is a plethora of information. You go online. It's like who do I choose? There's now you know where there was nothing. There's now 20 organizations coming up.

Somebody with anxiety disorder suddenly feel overwhelmed. That's where family support comes in. That logistical support is say, don't worry, we'll set it up, we'll get you there, we'll monitor with you what's happening If something comes up. But it's not only the person struggling needs support. The family needs to find a way to support themselves, to educate themselves all the time. And then we still find the most effective care comes from the family around. Somebody that has mental health disorder, that has a caring family around them does exponentially better than somebody that's isolated. Now we go back to what I said in the beginning. One of our biggest problems is that we now see that people move to the city's young people without an isolate, and I think this is where it becomes a problem, because they don't have the help to help them connect to services, because they're not with their family anymore. But family remains a major, major support system without which we sometimes cannot function.

0:50:10 - Kimberly King

So, and that is it's true. I love how you talked about just even the practical things that we don't think about when you step into a caregiving situation or a mental health. That's something that's a new. You know, there's many ways to support and I do like those practical steps, because we don't talk about that. In your opinion, Dr., what is the most critical step that individuals can take to contribute to a mentally healthy community?

0:50:36 - Doctor Henry Venter

I think there's three things that's important. I go back to the first one we need to educate ourselves a little bit about mental health issues. So if I have a neighbor that I can, that I and I and I noticed my neighbor is isolating, and then I connect with my neighbor and talk to them that I noticed my neighbor is not doing well and this is not just a cold, this is not the flu or the pandemic, like the other day my neighbor was 79 years old, sick, and we all said you know, do you have COVID? But you know, because we all know COVID science now. But we also need to be aware is there something? Is this a mental health issue? So that we can be aware? You know, this is not normal.

This person was also always vibrant, always out, and suddenly they are shut down, they're not coming out. So if the population as such is more educated about what is mental health symptoms, what are the first things we need to look at? Is a change in behavior, isolation, not contacting people important? Then, secondly, reaching out with small acts of kindness and care. You know, just not just noticing that, but acting, interacting with that people will help us to more see if there's something wrong and, and you know, find out if family members know about them. Do they know this person is struggling?

But we live in a world where we're very busy people, you know, because that comes with the capitalist, materialistic world that we're in. We need to produce, so people are very busy. But small acts of kindness and care, focusing on our neighbors around us, can help tremendously. And notice these, these, these, uh, the size, and then breaking the silence around the mental health issue is like don't struggle alone. We, you know it is, and I don't know where did we lose that? Because years and years ago, helping each other was a mainstay of the American society.

Somewhere along the line. Uh, after World War II, I think there was a tremendous change that that came with urbanization and living in our uh, you know, urban communities with isolated and I think it's also with the design of houses. You have your garage door opening, you drive within your house and it closed, nobody sees you. Previously, you had no fences, you parked, you could, hey, you wave to your neighbors, and I think a lot of even urban design has started to contribute to isolation, that that we and I've lived in these neighborhoods for years and years, um, and now where I live, now you know on the mountain, the people around me, you know my neighbors here, there we see each other, we can constant contact because we don't have these prescribed ideas, and so we are much more aware of each other. So I think, breaking that silence but be aware of the people around me, that if we can realize I I'm not just there to take care of myself, but I'm also there to watch out for my neighbor, uh, to break, you know, I know it's the opposite of the materialistic world, but if we can go back to some of that values and say that I'm there to look out for my neighbor and I can see something is wrong and just start a conversation we might find out. Yeah, I lost a loved one and you realize this person is in grief.

The therapy can help tremendously with grief. I've helped people that were stuck in grief for six years, four years that didn't know what to do about it. They were isolated, they were shut down simply because they didn't know what to do with grief and nobody could reach them. Now I gotta say those people were brought to me by other people that's at one point realized we need to do something and you know it didn't take a long time to help them. Those were some of the shortest thing times that I worked with people because you were able, just they. They struggled with one issue that you could help them. They. So again it goes back to what I say mental health issue doesn't need to be a life sentence. Sometimes working with a professional solves a big problem that you try to struggle with alone. So we need to break that silence and realize you know what I can be helped and I think that is the most important thing.

0:54:46 - Kimberly King

Well, thank you for sharing all of your knowledge. It's just really spot on and you're so relevant and you've just given us all some things to think about. So thank you for your time today, and you can get more information about what we just talked about with mental health in the communities by visiting National University’s website at nu.edu. And thank you, Dr., so much for your time today.

0:55:10 - Doctor Henry Venter

Thank you for having me. It was a pleasure.

0:55:15 - Kimberly King

You've been listening to the National University podcast. For updates on future or past guests, visit us at nu.edu. You can also follow us on social media. Thanks for listening.