- [Narrator] ATX Together is made possible by Texas Mutual Insurance Company, workman's compensation insurance for Texas, and by Roxanne Elder and Scott Borders.

- [Judy Maggio] Just ahead on ATX Together.

- As a community, we are all feeling overwhelmed.

We're all struggling with the isolation, we're all struggling with the stress and the anxiety of when this is gonna stop.

- Mental health care is healthcare and we just have to realize that you have to be willing to reach out to ask for help, whatever it is.

- Sometimes giving yourself the grace and the space to say, I just need a little support.

(upbeat music) - Hello, I'm Judy Maggio and this is ATX Together.

For the past year, we have endured crisis after crisis from the pandemic to the winter weather disaster.

Some people are calling it the lost year.

It has certainly been a year of loss.

For most people, these back-to-back crises are taking a toll on our mental health.

For the next half hour, we'll take a look at how to help ourselves and each other cope, but more importantly, where to turn if you need professional help.

So joining us for the next half-hour are three people on the front lines helping, advising and teaching people about mental health and mental illness.

Let's welcome Dr. Art Markman, the co-host of KUT's popular "Two Guys on Your Head" and a professor of psychology at The University of Texas, Wendy Salazar, Practice Manager with Integral Care in Travis County, and Dr. Quevarra Moten.

She is the Deputy Executive Director of the Central Texas chapter of the National Alliance on Mental Illness.

Art, I'm gonna start with you today.

You're an expert on the brain.

What does living through this year of crisis after crisis do to our minds, do to our brains, not to mention the lack of human contact we've all been experiencing?

- So let's frame this in two different ways.

The first is we gotta understand that the human motivational system has two modes.

We have an approach mode that we use to go after beautiful, wonderful, desirable things, and an avoidance mode that kicks in when there's some kind of crisis that we're dealing with.

We've had a year of crisis and so that avoidance mode has been huge for us.

It means we experienced the emotions of anxiety, fear and stress a lot.

It means that we also become sensitive to all of the threats that are in our environment.

So it's not just the pandemic, it's every single thing that could be going wrong, all feels like it looms large right now.

So the first thing we have to realize is that we're living this avoidance mode.

And then the second thing is we have had a real lack of social contact with people.

Touch matters with people and we're in a situation in which there isn't as much of that, we don't get to hug our friends when we see them.

Some people who are living alone don't really get to hug anybody at all.

We are cooped up with the same set of people over and over and no matter how much you love those people, there are times where they may get on your nerves a little bit particularly for those folks who are caring for parents or for children who may need a lot of extra attention right now.

So it is an awful lot of stress going on right now, and honestly it feels like it will never end.

And I think all of that coming together is really making this a very difficult time for people.

- It sure is.

And Quevarra and Wendy lead groups that are on the front lines to helping people.

And Quevarra, I wanna talk to you about your group, NAMI because you provide support groups for not only people dealing with mental illness but those who are living with them, their loved ones.

What are you seeing with the people that you serve?

How has this all changed things and how are you helping them?

- Well, in this particular moment there is definitely an increase in need.

And NAMI Central Texas is trying to be able to meet that need for the community, and we are providing support and resources.

So, not only do we have support groups that are of no cost to the community, but they are support groups for those who care for their loved ones with mental illness, and those who are experiencing mental illness themselves.

There are support and training and resources for parents with children with mental illness.

There has been in outlying counties in the Central Texas area an increase of over 900% of need for children with mental health needs.

And so, we have a parent resource navigator that helps parents navigate resources to provide support for their child and that is our program called Lighthouse.

And parents can reach out to our parent resource navigator to navigate the tons of resources available to help them support their children in this crisis.

- 900% increase, that's incredible.

Windy, Integral Care is really the go-to resource in Travis County when people need to access mental health care, support and resources.

What are some of the common themes that you're seeing?

What are some of the things people are coming in with more and more to get your services and how are you pivoting your services to help them during a pandemic?

- So certainly, we as a local mental health authority have certainly seen a bit of an uptick in our helpline calls.

And some of the things that we've been seeing throughout this past year have been just feelings of just dealing with the isolation, anxiety, increased symptoms of depression and continuous worries about when this is gonna end, struggling with how to maintain that social distance, juggling working from home, juggling working with our children who are doing virtual learning.

And those have been some of the reasons for why folks have been reaching out to us.

- There are several groups that have been hit harder by this pandemic and some of the other crisis than others.

I'm talking about Black and Brown people.

We talked a little bit about young people and children and how they've been hit hard.

I wanna talk about the significant impact on those folks and their mental health.

Art, you know it's hard to be a kid anytime, especially an adolescent.

I'm sure it's also hard to be a college student like the folks that you see every day.

What can we as adults do to help children cope?

We heard the statistics from Quevarra, it's very troubling to see how many children are suffering right now through all this.

- This is a tough, tough time.

And I think that one of the things that we need to do and this is true in general, but it's particularly true for kids.

I'm gonna go back to this idea about approach system and avoidance system.

Because we live so much in that avoidance mode right now, it is actually important for us to help our children to live in that approach access every once in a while, to find some beautiful, wonderful, desirable things that they can do.

So instead of just focusing on what you can't do right now, let's find opportunities to do some safe things that you can do.

You can go outdoors and play in a good socially distanced way.

We encourage our college students to go outdoors and hang out with each other.

We don't want them to be isolated and alone, we just want them to be safe.

And so, creating those pods of people where you're hanging out outdoors in a safe environment is important, finding beautiful, wonderful, desirable things to do, and even when you can't be around other people, to be doing arts and crafts, to be doing music, to dance around the house, to build a fort.

You know what, if your kids make an absolute mess in the house, enjoy it.

Let them have the good time with that and then you can turn it into a family clean up time.

Blast some loud music and have a good time even in that cleaning up processes.

As little resilience as we have as parents right now, we have to just let a certain number of things happen that might we might not have allowed in in better times just to create some joy to counteract some of that anxiety.

- Gosh we all need more joy right now.

Wendy, no one's been hit harder than the Latinx community by COVID, and there is some resistance sometimes in that community to seek out mental health help.

So, what's working to break down some of those barriers?

How are you reaching out to the Latinx community to make sure those resources are provided by Integral Care?

- In working with the Latinx community, one of the things that I strive to point out as it relates to our emotional health care needs is that there is a body-mind connection.

So, if one day we wake up with a sore throat or a bit feverish, we're not gonna feel in the mood to do much.

We might feel a little bit down, we might feel a little bit of a dip.

So, where I'm coming at with this is that when we're not feeling well physically, we're not feeling well emotionally.

When we're not feeling well emotionally, we're not feeling well physically.

And so helping the Latinx community kinda make those connections is important.

We would call a medical professional when we are not feeling well because we've got a sore throat or a fever.

Why wouldn't we call a mental health professional when we're not feeling well emotionally?

It's incredibly important that when we are trying to break through this stigma, that we also consider the health disparities that are present within the Latinx community, language barriers that are oftentimes present with the Latinx community, as well as the fact that many of our Latinx community members are individuals that have to and need to work outside the home.

So you couple that with childcare concerns outside of the home now, in addition to just kind of breaking through those barriers of stigma.

- And what about accessibility issues?

Are there places that are reaching out and how do you make your services known to the Latinx community, Wendy?

- So we strive a lot to ensure that our community is aware of our 24-hour, seven day a week helpline.

Our helpline is free to the community.

We have really done a great job in just promoting that helpline.

That's the first step in getting in with the support that's needed.

Our helpline is offered in 15 different languages and it is a service, as I mentioned, that is free to the community.

And so just making that awareness to our community known is one of the things that we work really hard at trying to ensure.

We have also participated in several town hall meetings as well as other live broadcasts such as this to continue to announce the abundance of services that we are providing to our Latinx community, to our adult populations, our children populations, as well as our folks that are in need of substance use services and housing services.

So we are really an array of services available for all of our community in Travis County.

- Quevarra, you know from both personal and professional experience that culturally the Black community doesn't always reach out for support with mental health needs.

Talk about those challenges and what you're finding is working as solutions.

- Some of those challenges include our buildup of knowing that religion takes over our ability to ask for help.

And I found that even with my mother who was an ordained minister, when she was going through her crisis, someone would ask me, "how is your mother doing?"

And I would say she's blessed and highly favored because I was conditioned not to ask for help.

And so, the trouble with it when my mom was diagnosed with paranoid schizophrenia, I had to learn the balance between scripture and asking for help and it can work parallel.

And so, we at NAMI Central Texas now have a program called Bridges to Hope where we train faith leaders how to be there for their congregation and how to let their congregation know it is okay to ask for help, and it's okay to pray at the same time.

And so finding that balance, we have an upcoming Bridges to Hope the last week in March and we just want faith leaders to know that they're in an amazing position to let their congregations know it's okay.

And then understanding that you can't just reach the Black community in the Black church.

There are other ways to reach them.

Everyone is not in church.

So, making sure that they know and understand these resources are for them and it's okay to use them.

- Art, I know you've been leading the effort at The University of Texas, a kind of a game plan to deal with COVID-19 for the past year, what's worked and what hasn't worked so well?

- Well, I think that the most important thing that we did at The University of Texas was to really convene a process for making sure that we were constantly staying updated on how things were going.

So it wasn't just a matter of building a plan, it was a matter of paying attention to the data every single week.

And so we have a group that meets on Thursday mornings with health professionals and mental health professionals, and contact tracers, and other folks and we gather all the data, we look at the pandemic models from the wonderful modeling group at UT, and then use that to enhance policy.

I think one of the things that's been really important is we've actually tried rather than to create a lot of potential punishments for bad behavior, to really put a lot of responsibility on every member of the community to keep the community safe.

I think it's so important for all of us to realize that each one of us has a responsibility not just for ourselves right now but for the entire community around us.

And I think that's been an important part.

So, we want our students to go out and get COVID tested, and so we've encouraged our students to do that.

We haven't been, there hasn't been a big stick behind them.

We're really pushing them to do this because of the service it provides the community.

And we've tried to make sure that we monitor all of the services that we provide including expanding our behavioral counseling line to include COVID so that students have one place that they can call if they have concerns whether those are physical health concerns, mental health concerns.

To echo the point that Wendy was making earlier, mental health care is health care, and we just have to realize that you have to be willing to reach out to ask for help whatever it is.

And college students are away from home.

They're away from that support group that knows them so well.

So making sure that they reach out and reach out to each other to take care of each other is incredibly important, particularly this year.

- I think that's true for everyone no matter what our age.

What are some simple things, any of you can answer this one, what are some simple things we need to recognize in ourselves and others that might signal, maybe I need some help with my mental wellbeing?

- I think it's important to, for myself, I had to recognize that I don't have to wear a cape.

I am no longer a superhero (laughs) and it is okay for me not to have super powers.

I think somehow we think asking for help or using resources is a sign of weakness.

And it is not.

It's a sign of being human.

And sometimes giving yourself the grace and the space to say, I just need a little support.

And also being authentic.

We always call each other and say, hey, how are you doing?

Sometimes we need to pause and say, how are you really doing?

And really get an answer that, and give people that space to be honest with us.

In this time of crisis, we have to be even more authentic and more grace for ourselves and others to have the space to ask for help.

- Anyone wanna add to that, ways we can really look and feel and know that this is a time that maybe we need some extra help.

- I'd love to add on to that, Judy.

I really love how the emphasis on human.

That is so important because as a community, we are all feeling overwhelmed.

We're all struggling with the isolation, we're all struggling with the stress and the anxiety of when this is gonna stop, what is it gonna look like when it does?

We have to acknowledge that it is absolutely normal and we need to recognize that and honor that for ourselves.

And the reason why I say that is because services such as the helpline, such as NAMI, we're not here for the crisis alone.

We're here to help support, we wanna be preventative, we wanna be proactive.

We want to be able to prevent a mental health diagnosis if we can at all possible.

We wanna to be able to help loved ones who are worried about their loved ones.

We wanna be able to provide the education necessary to know what those signs and symptoms are for each other, for one for an individual.

When we're feeling down, when we're feeling sad, when we're no longer finding joy in the things that previously brought us joy, when we are isolating and avoiding situations and persons, friends, family.

When we're having thoughts of suicide, those are all signals, that's the emotional body saying, hey, I'm gonna need a little bit of support here.

And so those are moments where we wanna be reaching out.

And if we're worried about someone, something as simple as picking up the phone and saying, calling the crisis line and saying, hey, I've got a loved one and I'm not exactly sure what to do here but this is what I'm seeing.

And the helpline is equipped with mental health professionals that can help guide those conversations.

- These are great suggestions.

And I just wanna add a couple of other things.

In terms of thinking about yourself and the people around you, pay a little bit of attention to the self-medication that's going on.

Having a glass of wine in the evening is a wonderful thing, but if it's every single day and it's more than one or two glasses, it might be time to really think about whether you're doing this just to relax and unwind or whether you're actually really medicating yourself, trying to get rid of some of the pain or boredom or worse.

So as we really be paying attention to the use of substances.

I think it's also really important to me to make sure that you are in connection with another human being every day.

There's a lot of people living alone right now, make sure that you are reaching out, hear a human voice every day.

If you can step outside your house now that Snovid is over and you can see another human face and smile at somebody, all of those things are really important.

If you find yourself alone, if you find yourself having difficulty getting out of bed, if you find yourself self-medicating, those are all reasons why you might wanna really increase that connection to other people and reach to some of the resources that Wendy and Quevarra mentioned.

- There was a paper that was published at the LBJ School of Public Affairs called the Female Recession and part of it is that women have kind of borne the brunt of this difficult time.

We've been the caregivers, we've tried to juggle probably more than many of the men, the work versus the childcare versus, a lot of the women are in essential worker businesses.

Have you noticed in your practices at NAMI and at Integral Care that women seem to be more, we're recording this on the International Day for Women, so I just think it's important to show that women really have been hit harder than men during this pandemic and these crises that we've had.

- I think it's important to, I agree a 100%, but there's also this other factor there where men have been conditioned not to talk about mental health.

And that's another barrier and challenge that in the mental health world we're trying to think of ways to navigate and letting men know, because it's a sign of weakness, that's been the stereotype and that has been the stigma that we're trying to remove that it's okay for men to talk about their mental health.

I think women, we're voice full about everything.

And so, it's a lot easier for us to be in touch with our feelings and state that out loud.

I'll give you an example for my brother.

My brother was in denial for a long time about my mother having schizophrenia, but somehow I had to let him know it was okay for him to take the Family to Family the class just so he could get the knowledge and he could help me understand better.

And that worked for him because that was a sign of strength.

And so I think it's us figuring out ways to help men navigate their mental health journey so that they can be more aware and say when they need help, as well.

But women indeed have been the largest amount that are utilizing our resources.

- It's time for our call to action and traditionally, we have a call to action at the end of this program.

But I think considering that there are probably a lot of people watching today, who are facing mental health struggles, or they know someone who is, I think it's vitally important for each of you, as we end our program, to tell our viewers about ways to find help, a variety of ways to find help and why they shouldn't wait to seek that help.

Art, I'm gonna start with you for our ending.

- So first off, just to amplify this idea of not waiting, we know that when we're not feeling well physically that if we don't seek help that we can get worse in ways that can make it take a lot longer to get better.

I think the same thing is true when you're dealing with any kind of mental health issue.

The sooner that you begin to get treatment for that, that you engage with others, the easier it is for you to return to those feelings of living a normal life.

I think it's incredibly important to reach out to any resources that you have available.

And I know that Wendy and Quevarra have some specific ones but I'm gonna suggest a couple.

If you don't know who to reach out to for mental health care, call out to your health provider.

Doctors now have become much better at being connected to the mental health providers in areas and making recommendations.

And so if you have a doctor that you trust, reach out.

Talk to your friends.

You may think that you're the only one who's struggling with things, it turns out that mental health issues are pervasive in every community.

If you start to talk about it, you will suddenly find all sorts of other people who will come out and share their experiences but also share healthcare providers and others who've helped them, and share some resources.

So, those are a couple of easy things that you can do to begin to get help.

- Wendy?

- I just wanna emphasize that Austin Travis County Integral Care is the local mental health authority for the Travis County area, and we've been such since 1967.

We offer an array of services across the age span.

We offer services for counseling, psychiatric services, we offer substance use, alcohol treatment services, we offer services for individuals living with developmental and intellectual disabilities, as well as, and I mentioned earlier, housing services to help folks who are trying to recover and get back on their feet.

Our services through the helpline is free.

Those services are available in 15 different languages.

And I want to encourage folks to reach out to the hotline.

There's a lot of resources available in our community, and it's nice to know that we can call one number, pick that line up, and be able to talk about what other resources are available as well as the hotline.

- Quevarra.

- At NAMI, we partner with Integral Care and other resources to help those navigate those resources.

So we're also in education, so we have classes and support groups that are free of charge, but we partner with all of the mental health in every county.

So I think we service about over seven counties.

And so we are a link to Integral Care.

We are a link to Bluebonnet, and there are many resources that you can just register for online on our website, NAMICentralTX.org and just click education and you're right there with the support groups, the various classes, and they're all free at no cost.

And the one thing that I really wanna stress to those is the reason why you shouldn't wait is because waiting can brew more problems.

And I can just give you my own example.

My mother was diagnosed with cancer later and the doctor told us her cancer was 100% curable.

Unfortunately, my mom passed away in July 2016 and it wasn't because there wasn't help and resources available, but it was because she couldn't accept the help.

And I know that is a bit drastic but I just need people to understand that every day is a moment in your life and it's valuable and it's precious, and the help is there and it's available to you.

So whichever way works best for you to ask for the help, even if you don't wanna make the call, get someone to ask, to make the call for you.

You don't have to make the call yourself but just get the help that you need and don't wait.

- Thank you so much Quevarra Moten, Wendy Salazar and Art Markman for shedding light on ways we can get a better handle on our mental health during this challenging time for all of us.

If you, or someone you know needs mental health resources, simply go to the Austin PBS website and click on ATX Together to find links.

Another way to keep the conversation going, join the ATX Together Facebook group or on Twitter, use the #atxtogether.

Thank you for watching, and join us next time for another vital discussion on ATX Together.

(upbeat music) - [Narrator] ATX Together is made possible by Texas Mutual Insurance Company, workman's compensation insurance for Texas and by Roxanne Elder and Scott Borders.

(flute music)