Roger Murray

When someone makes the critical decision to start therapy, it can provoke a great deal of nervousness—beyond the underlying anxiety, depression, or other mental health issues that are prompting them to seek therapy in the first place. This is especially true if they've never been in a setting where they've been expected to focus solely on themselves and the sensitive aspects of their lives for a fixed period of time. As a new therapy client, preparation is key to help calm the nerves. Here are the top six tips for how to prepare for a first therapy session. 1. Have a Quick Reference for Health-Related Information Psychological and physical health are intricately connected, and during a first therapy session, it'll be important to come prepared to discuss health history details. People should make sure to have a readily accessible list of the medications they are currently taking, including supplements. This can be especially helpful if a person would like to start a new medication in conjunction with their first therapy session. Beyond current medications, being prepared with a list of medications one has taken in the past can be helpful, especially if certain medications caused adverse side effects or were otherwise ineffective. Be ready to discuss other health conditions, too, as many medical conditions can influence mental health or stress levels—including endocrine conditions (such as thyroid disorders), chronic pain syndromes, or chronic illnesses. Having these health details written down in a single place can serve as a handy reference and reduce stress during a first therapy session. 2. Think About the Functional Goals of Therapy Often when starting therapy, the broad goal is to feel better overall. While this is certainly a realistic and achievable goal, it can be helpful to break this goal down into smaller pieces. This way, it's easier to assess progress during a therapeutic journey. Before a first therapy session, people need to take some time to reflect on what they're looking to get out of therapy. If a person is experiencing depression and hoping that therapy will help their condition improve, they should reflect on the most challenging aspects of their current condition. For example, depression-related sleep challenges are very common. If sleep has been difficult, a goal of therapy could be to increase the number of nights per week that they get quality, uninterrupted sleep. Or, if a person is experiencing tearfulness with their depression, a practical goal of therapy would be to see a reduction in crying episodes per week. Tracking these symptoms can help a person measure the impact of their therapy and make sure they're recognizing improvement in their condition. It's important to ask one's therapist during a first therapy session about how they view and measure progress, as well. 3. Prepare First Therapy Session Questions Thinking too much about a first therapy session can make it difficult to open up and start a conversation and relationship with one's new therapist. However, going into a first therapy session with a completely blank slate can also make it difficult to know where to start. It can help to prepare a few questions to ask during the first therapy session. Examples include: What to expect from therapy? What is the therapist's counseling style? How do practical issues like billing work? A good way to come up with questions is for people to think about what details about the first session are nagging at them the most—and then reframe those as a question. For example, if a person is worried about what they should be doing during a therapy session (i.e., should they be sitting at their computer desk, or is it okay for them to be lying on their couch), they should simply ask. Or, if a person is concerned about the billing or financing aspect of a session, they should feel free to get those questions out in the open as well. 4. Focus on Creating a Supportive Environment for the Session Virtual mental health counseling sessions can help people fit therapy into their busy lives in a way that was never possible before. However, people need to think about where in their living space they will want a session to occur. Being strategic about this can ensure that a first therapy session is as productive and beneficial as possible. Some factors to consider include the following: Selecting what to wear. Choosing comfortable clothing can be a great way to feel at ease during a therapy session. People shouldn't worry about dressing to make an impression or to appear professional. Instead, they should wear clothing that makes them feel as relaxed as possible. Choosing where to have the session. If possible, people should choose to have a first therapy session in an area of their home where they're free from mental distractions. If having a therapy session in the kitchen means staring at a to-do list on the fridge, or a sink full of dishes, this can introduce more stress into the session. Instead, choose a peaceful, meditative space with as few distractions as possible. Ensuring that this is free from disruption (i.e., by locking the door to prevent roommates from wandering in) can also help one feel more comfortable during a first session. Being intentional about the physical space and nearby items. Once a person has chosen what to wear and where to set up their device for a first therapy session, it can also help to have a few items nearby to make the setting as calm and supportive as possible. Think about keeping a candle, a favorite scent, a comfort item, a framed picture, or a cozy blanket nearby. Practical items, like a box of tissues, may be helpful to have on hand, too. 5. Think Ahead of Time About Conversation Starters or Jumping Off Points One of the most intimidating aspects of a first therapy session may be the initial ice breaker or conversation starter that answers the question: "What brings you here today?" This question can feel so big that it becomes difficult to answer or even to know how to start answering. However, instead of thinking of a first therapy session as this giant, inaugural jump into a new frontier, it's helpful to realize that each therapy session is simply a resource for whatever a person may be needed at the moment. Here are some potential topics for jumping-off points people can use when it comes to talking to their therapist during a first therapy session: When was a period in their life, or a specific moment, that they felt truly happy or joyful? What factors contributed to that moment—who was there, and what was the context? Comparing that moment to the present moment, what factors are different or the same? When was a period in their life that they felt the lowest, and what factors contributed to this? How quickly did they come out of this lowest moment, or what feelings or emotions are residual from this moment and continuing into the present day? What relationships in the past have they considered to be the most nourishing and constructive? On the flip side, what relationships in the past have been the most toxic or difficult? What present hardship or situation would they want to change first if they could? What worries them the most about the future? What are they hoping will happen in the future? What small, annoying thing happened yesterday? What choice did they make recently that they regret? 6. Congratulate Oneself on the Reality of a First Therapy Session It takes a lot of courage to be vulnerable and to go through the process of seeking therapy and showing up to a first session. A final tip for preparing for a first therapy session is simply acknowledging the groundwork that a person has laid to get themselves into the position of attending a first therapy session. Showing up for oneself is often more than half the battle, as practicing true self-care takes enormous bravery. Before a first therapy session, people should take a moment to pat themselves on the back for taking this big, important next step forward. How to Learn More About First Therapy Sessions The above tips about how to prepare for therapy consultation can make it easier to leap into this rewarding journey. At Telemynd, our mental health professionals view therapy sessions as a resource for clients, and each session can serve whatever purpose is needed at the moment. Telemynd providers understand the dynamics that go into embarking upon a therapeutic journey, and they excel at easing clients into a first session. For more information about Telemynd's personalized approach to therapy, contact us to get started with an appointment today.

Controlled substances are used to treat many common mental health conditions, like anxiety, depression, sleep disorders, and more. Prior to the COVID-19 pandemic and national health emergency, federal rules regulated how these meds were prescribed and dispensed - including a requirement for an in-person health evaluation prior to a prescription being written. However, during the pandemic, federal regulators temporarily waived these regulations to permit patients the ability to manage their medication and access to prescriptions, including controlled substances via telehealth visits. With the national health emergency waivers expected to expire soon, some states have stepped in to draft their own medication management legislation; the result has been growing confusion over which rules apply and where. In this article, we attempt to answer all your questions about prescribing controlled substances, and have included resources to find out more. Why are Some Medications Deemed Controlled Substances? Controlled substances by definition are medications with a likelihood for physical or mental dependence. Many of the more common drugs for ADHD, anxiety, sleep disorders, depression, and more, such as Xanax, Klonopin, Lunesta, and Adderall are listed as ‘controlled substances”. The U.S. Controlled Substances Act (1970) puts all substances which were in some manner regulated under existing federal law into one of five schedules. This placement is based on the substance’s medical use, its potential for abuse, and safety or dependence liability. Medications listed as Schedule I have the tightest controls, and those listed as Schedule V have the least restrictive controls. These controls are mandated by the federal government. This may all sound complicated - but it boils down to prescribers and pharmacies taking extra precaution to ensure these medications are prescribed for and delivered to the right individuals, for the right reasons. What Are the Extra Steps Clinicians Must Take to Prescribe Meds that are Deemed Controlled Substances? In general, to prescribe a controlled substance, a clinician must have a DEA (Drug Enforcement Administration) license, and to fill a prescription, a pharmacist must also have a controlled substance license. Further, for a pharmacist to dispense a controlled substance, the prescription must include specific information such as date of issue, patient’s name, address, and DoB, clinician name, address and DEA number, drug strength, number of refills, and the signature of the prescriber. For these kinds of medications, there are also legal limits on the number of refills and the amount that a prescription may contain. Some drugs have zero refills, and the maximum quantity dispensed is 30 days - meaning patients must contact their clinician each month a refill is needed. In addition, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 specified that “any practitioner issuing a prescription for a controlled substance must conduct an in-person medical evaluation. A conservative recommendation to support compliance with the act is to conduct an in-person exam at least once every 24 months.” How did the COVID-19 Pandemic Impact Prescriptions of Controlled Substances? The unprecedented public health emergency created by COVID-19 caused action by state and federal regulators to ensure greater access to health care, while simultaneously limiting the spread of the virus. Therefore, as of March 2020, the DEA declared that practitioners “may issue prescriptions for controlled substances to patients via telemedicine, even for patients for whom they have not conducted an in-person medical evaluation, provided the prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of their professional practice, the telemedicine communication is conducted using an audiovisual, real-time, two-way interactive communication system, and the practitioner is acting in accordance with applicable federal and state laws.” At that time, the DEA also ruled it was “permissible to write controlled substance prescriptions to cover a 90-day supply.” However, depending on where you live or who prescribes your meds, you may have had a different experience as certain states and practitioners elected to retain pre-COVID protocols of in-person evaluations given the sensitivity of the medication being administered. What is the Current Status of Controlled Substances Prescriptions? As we move through 2022 and the threat of COVID-19 has lessened, requirements for prescribing and dispensing controlled substances in some states have begun making permanent changes to expand policies implemented under the public health emergency, while others have passed laws restricting them. This website has made an attempt to track these ongoing changes - but to be safe, always check with your own state’s official website, or contact your state or federal representatives. The DEA at the federal level said in a March press release, that it “wants medication-assisted treatment to be readily and safely available to anyone in the country who needs it." However, in the end it is up to each state and provider to do what they feel is best for the safety of constituents and/or patients. Therefore, check with your provider or prescriber to find out if you will need an in-person visit to continue receiving prescriptions of controlled substances or if telehealth visits are an option for you. Telemynd operates as a national practice, meaning that our national network of licensed providers may prescribe many types of medications, they follow federal regulation which prevents the prescribing of controlled-substances via our virtual telemedicine environment. Sources DEA.gov: Rules for Control Substances NIH | National Library of Medicine: Pharmacy Prescription Requirements

Erratic. Volatile. Complicated. These are the unfortunate words that people often think of when they think of someone with a diagnosis of schizophrenia - which in turn has caused a stigma that has lead to fear and isolation for those most vulnerable. A movement has developed, made up of scientists, medical professionals, mental health advocates, and those with the diagnosis, to change the name. In this week’s article, we’ll look at the pros and cons of the name change proposition as well as explain what led to the idea in the first place. What is Schizophrenia? Schizophrenia is a brain disorder that affects less than 1% of the population. When it’s in its ‘active phase’, symptoms can include delusions, hallucinations, disorganized speech, trouble with thinking, and lack of motivation. Research has shown that schizophrenia affects men and women fairly equally but may have an earlier onset in males. As with any illness, the severity, duration and frequency of symptoms can vary. The symptoms are why Dr. Eugen Bleuler named the disorder in 1908 - the term ‘schizophrenia’ derives from Greek words for “split mind” - because Dr. Bleuler thought the disease was characterized by a “splitting of psychological functions” where “the personality loses its unity.” But it turns out the condition was named erroneously. Researchers believe that a number of genetic and environmental factors contribute to the cause of schizophrenia, as well, life stress may also play a role in the start of symptoms. But since multiple factors may contribute, scientists aren’t yet sure of the exact cause in each individual case. Modern Treatment Means Symptoms are Very Manageable While there is no cure for schizophrenia, the good news is that research has led to innovative and safe treatments which means most symptoms will greatly improve and the likelihood of recurrence is diminished. A combination of pharmaceutical treatment and therapeutic treatments such as cognitive behavioral therapy or supportive psychotherapy may reduce symptoms and enhance functioning. Additional treatments are aimed at reducing stress, supporting employment, and improving social skills. Yet a Stigma Still Exists So even while treatment helps dissipate symptoms, the complexity of schizophrenia may help explain why there are misconceptions about the disease. Contrary to what Dr. Bleuler thought when he named the disease over one hundred years ago, schizophrenia does not result in split personalities or multiple personalities. Most people with schizophrenia are no more dangerous than people in the general population. However, you’d never know this based on how people with the diagnosis are portrayed in TV, film, and other media. And as with most stigmas around mental health issues, stigmas perpetuate fear, make “others” out of those with the diagnosis, and in turn encourage isolation - all of which worsen the lives of already vulnerable individuals. Research has found that “public, anticipated, and self-stigma decrease healthcare seeking and treatment adherence, and create barriers to pursuing independent living” for those living with the condition.. Would a Name Change Help Reduce the Stigma? This is how the idea of renaming schizophrenia came about. Said a recent New York Times article, "The idea is that replacing the term ‘schizophrenia’ with something less frightening and more descriptive will not only change how the public perceives people with the diagnosis but also how people with the diagnosis see themselves." Japan and South Korea have already changed the name to “Integration Disorder '', which is the term for which many in the re-naming movement are advocating. Most of the mental health community is behind the name change. A survey by the World Psychiatric Association showed that approximately half of mental health professionals around the world believe schizophrenia needs a new label, and over half believe the term is stigmatizing. Another 2021 poll found that 74% of stakeholders (mental health professionals, family members, researchers, government officials, and more) found the name stigmatizing and favored a name change. In the Meantime, How Can We Help Reduce the Stigma? Regardless of where you stand on the name change, the most important thing is to understand that schizophrenia is a physical disease of the brain - and like other medical diseases - it is treatable today. Much research has been done on how to reduce the stigma around this diagnosis, and that research has found that if we commit to educating society about schizophrenia, promote accurate representations of schizophrenia, and prioritize advocacy, we may help reduce the stigma. Sources The New York Times: ‘Schizophrenia’ Still Carries a Stigma. Will Changing the Name Help? American Psychiatric Association: What is Schizophrenia? National Alliance for Mental Illness: The Consequences of Stigma Surrounding Schizophrenia Schizophrenia Bulletin: Reducing Stigma Toward Individuals With Schizophrenia Using a Brief Video: A Randomized Controlled Trial of Young Adults

As a mental health professional, it's important to create a therapy space for yourself and your clients that is polished yet comfortable and conducive to the interactions needed for successful treatment. Much research has been done over the years on elements like comfort and privacy that can help inform the design of an effective therapy space. "A space should be something that supports you as you try to achieve specific goals…that means creating a calm and refreshing environment to balance the rigorous mental and emotional work of therapy," says Dr. Sally Augustin, an applied environmental and design psychologist. Conversely, therapy space that in any way puts your clients on edge or makes them feel uncomfortable can have an adverse impact on their progress. Creating the right space for online therapy is just as important to get the most out of your therapy sessions. In this week’s article, we provide 5 tips for creating a comfortable and effective virtual therapy space. Choosing the right technology. Investing in your virtual practice is critical to establishing confidence in your ability to deliver care, and to offer a clear environment for your clients to openly engage in the therapeutic process - even when they are far away. Start by ensuring your camera is enabled and the resolution is acceptable (we recommend 720p display resolution or higher). Make sure your internet connection can support a video session and that the audio quality is clear and concise without degradation. The best position for your camera is at face level and centered so you are able to maintain eye contact. That may mean purchasing a stand for your computer or laptop. In session, the goal is to establish a relationship with new clients, to do this we suggest minimizing the appearance of multi-tasking . In addition, if you provide virtual therapy, choose a platform that meets the needs of your clients like Telemynd. Make your online therapy space calm and comfortable for clients. Set up a designated private space that is conducive to critical conversations. Use ambient light, calming wall art, and soft-colored walls in the background to keep distractions to a minimum. If your space doesn’t have good lighting, consider buying a ring light which is specifically designed to provide lighting for cameras and computers. And keep your office clutter-free, as that can give the impression of focus, clarity, and skill in your relationship with clients. You can also utilize a virtual background during your sessions if your space cannot be augmented. Privacy is an important ingredient to the therapeutic process. Clients should always feel safe during your therapy sessions, and since they’ll be sharing thoughts they usually keep to themselves, feeling a sense of privacy is key. Even though it may be tempting, don't do your therapy sessions from the car, or with others in the background. Close doors and windows in your workspace so it feels private for your clients to open up. And make sure your phone is turned to silent as ringing phones or alarms can disrupt the session. Eliminate negative distractions from your therapy space. Keep personalization to a minimum in the background (i.e., family photos, personal mementos) to help clients feel “at home” within the space. Keep background artwork calming and neutral; if the colors or images are too loud, too specific, or evoke sadness or violence, they may be disruptive to the therapeutic process. Other distractions to avoid: open doors or views of other rooms in your residence if you are working from home, or doing your sessions in anything other than professional attire (for example, PJs definitely give the wrong impression). Make the space comfortable for you! Don’t forget to get the right chair - since you’ll likely be sitting for extended periods of time every day, it’s important to find one that is ergonomic and comfortable for you. Some therapists sit in an armchair during an online session, and some prefer to sit in a more typical “desk” chair in front of their computer. Try them out before buying and choose what works best. While there is no single right way to design an online therapy space, you can help ensure your clients have a comfortable therapeutic experience by creating a welcoming, private, and technologically-sound space for when they need to be emotionally vulnerable. What tips would you add to the list? Let us know in the comments. Sources Hospital Community Psychiatry: Design considerations for mental health facilities Healthcare: Telemedicine Workplace Environments: Designing for Success Psychiatry Advisor: Designing the Therapeutic Space: Using Layout, Color, and Other Elements to Get Patients in the Right Frame of Mind

Mental health care is critical to maintaining overall wellness - just as important as caring for your physical health. And as we noted in a recent article, 1 in 5 of us live with mental health issues on a daily basis. As many as 30% of those with a mental health issue don’t seek treatment, and a common obstacle to that care is cost. The good news is that you can pay for some mental health treatments and services with your Flexible Spending Account (FSA) or your Health Savings Account (HSA), to offset out-of-pocket expenses. This week’s article summarizes what mental health services qualify for coverage with FSA and HSA funds and how to use these accounts for mental health care. Be sure to click on the links included in this article, as we’ve referenced the original IRS and government sources for further information. What’s the difference between an FSA and an HSA? FSAs are an arrangement through your employer that lets you pay for many out-of-pocket medical expenses with tax-free dollars. You decide how much to put in an FSA, up to a limit set by your employer. Employers may make contributions to your FSA, but aren’t required to. An HSA is a type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses. HSA funds generally may not be used to pay premiums. While you can use the funds in an HSA at any time to pay for qualified medical expenses, you may contribute to an HSA only if you have a High Deductible Health Plan (HDHP) — generally a health plan that only covers preventive services before the deductible. It may sound complicated - but FSAs and HSAs are often a win-win for many people, as they allow you to reduce your tax liability and pay for your mental health care expenses, using pre-tax funds. Is mental health treatment eligible for HSA or FSA funds? According to the IRS, mental health therapy and treatment that is deemed ‘medically necessary’ is eligible for reimbursement with an FSA or an HSA - things like psychiatric care, and treatment for drug or alcohol addiction. So therapy such as marriage or family counseling - that is not required for a medical or mental purpose - may not qualify. The actual wording from the IRS is this: “treatment provided by a psychologist or psychiatrist is eligible for FSA or HSA reimbursement if the purpose of the treatment is for medical care and not for the general improvement of mental health”. Sound a bit murky? The best thing to do is to speak with your your health insurance directly to understand how to approach the situation first. Regardless of the kind of health care services you are getting, an administrator may require you to get a ‘Letter of Medical Necessity’ in order to get coverage. This is a letter written by your doctor that verifies the services you are purchasing are for the diagnosis, treatment or prevention of a disease or medical condition. Make the most of your HSA to cover mental health expenses The IRS-approved list of mental health care expenses on which you can use your HSA includes services like psychologist visits (including online therapy), psychiatric care, alcoholism and drug treatment, and prescription drugs related to psychiatric care. You can pay for these with an HSA card or by getting reimbursed, but either way, always save your receipts. You’ll need these when you file your tax return each year. You can ask your health care provider for itemized receipts after each service, or a total record of all services at the end of the year. If you have health insurance (and remember, it must be a High Deductible Health Plan in order to be allowed to contribute to an HSA), you can use your HSA funds for any qualified expense that’s not paid directly to the provider or for which you’re not reimbursed by your insurance company. This includes co-pays and expenses to meet your deductible, as well as any uncovered medical expense. Using an FSA to cover mental health expenses Eligible mental health care expenses for which you can use your FSA account include alcoholism and drug treatment, psychiatric care (including online therapy), and prescription drugs related to psychiatric care. You use your FSA by submitting a claim to the FSA (through your employer) with proof of the medical expense and a statement that it has not been covered by your plan. You will then receive reimbursement for your costs. In addition, according to the IRS, you can use FSA funds to pay deductibles and copayments, but not for insurance premiums. In summary, understanding how to use FSAs and HSAs to help offset the cost of behavioral health may feel confusing or overwhelming - but it's worth digging into, as these accounts may save you money. For more help, you can ask your employer, an accountant, reference IRS Publication 969, or research online yourself. Here’s a good article that goes into more detail - in an understandable way - about the differences between HSAs and FSAs.

A growing number of Americans are struggling with mental health every year. In fact, 1 in 5 Americans live with mental health issues on a daily basis. We know this from Mental Health America’s 2022 State of Mental Health in America Report. For the 8th year in a row, MHA released its annual report, which looks at our mental health based on 15 prevalence and access measures for youth and adults. The report confirms the trend that mental health in the US continued to worsen leading into the pandemic and remains problematic. In this article, we summarize key findings and highlight a few policies that can improve access to mental health resources. Key findings from the 2022 report: Overall mental health Suicidal ideation continues to increase among adults in the US: 4.6% of adults report having serious thoughts of suicide, an increase over prior years. Rates of substance use are increasing for youth and adults: 7.5% of adults and 4.1% of young people had a substance use disorder in the past year - an increase over the prior year. A growing percentage of young people in the US live with generalized depression. In fact, 15.1% of young people experienced a major depressive episode in the past year, a 1.3% increase over last year. Another 10.6% of young people in the US have severe depression (depression that severely affects the ability to function), and multiracial youth are at greatest risk for severe depression. These statistics indicate that mental illness is a common problem for many. Most of us will be impacted by it at some point in our lives - or know a loved one who struggles. And if untreated, mental health issues lead to other health problems like insomnia, eating disorders, heart disease, diabetes, arthritis, and other chronic disorders. Key findings from the 2022 report: Access to mental health treatment Over 50% of adults with a mental illness do not receive treatment - often because in-person treatment is not offered locally, because they do not know how to access treatment, or due to stigma around treatment. The percentage of adults with a mental illness who report unmet need for treatment has increased every year since 2011. Over 60% of young people with major depression do not receive mental health treatment. Even in states with the greatest access to treatment, nearly 33% go without treatment, and in states where access is the most difficult, nearly 75% did not receive mental health treatment. Some adults and young people continue to lack adequate insurance coverage for mental health treatment. Are there policies and programs that can help address the state of mental health in America? The MHA report also suggests policies that may improve access to mental health resources in the US - and one has just been implemented. The 988 Suicide and Crisis Lifeline is a national network of more than 200 crisis centers around the country. The 988 Lifeline provides 24/7, confidential support to people in suicidal crisis or mental health-related distress - which they can reach just by dialing 988. The report’s second recommendation is to increase mental health education and support in schools to address disparities in access to mental health treatment for youth of color. The report found that students of color disproportionately access their mental health care at school, often because they don’t have access to mental health services elsewhere. Given this data, the report recommends that “increasing access to school-based mental health services can promote equity and reduce disparities in access to care”. Read more about the Report’s findings and recommendations here. Sources Mental Health America (MHA): 2022 State of Mental Health in America Report

In case you missed it, the new national mental health crisis line launched in July. For those in any kind of mental health distress, including thoughts of suicide, dialing 988 (24/7) immediately connects you with trained mental health counselors who can help you figure out critical next steps. The national health hotline has been several years in the making. Read on to learn how the mental health version of 911 came about. What is the 988 Suicide and Crisis Lifeline? The 988 Suicide and Crisis Lifeline is a national network of more than 200 crisis centers that help thousands of people overcome crisis situations every day. These centers are supported by local and state resources, as well as the Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA). The 988 Lifeline provides 24/7, confidential support to people in suicidal crisis or mental health-related distress. Modeled after 911, the new three-digit 988 number is designed to be a memorable and quick number that connects people who feel they are in any kind of mental health crisis, with a trained mental health professional. Currently, the number automatically routes calls by area code to the nearest crisis center. Sources of federal funding for 988 are separate from those of the 911 system, so the new hotline is not pulling any funds away from 911. Note that veterans can press “1” after dialing 988 to connect directly to the Veterans Crisis Lifeline which serves our nation’s Veterans, service members, National Guard, and Reserve members. What’s behind the development of 988? In the past, the majority of people experiencing a mental health emergency ended up dialing 911. The problem is that 911 wasn't set up to address mental health needs, so callers may end up in long lines in an ER, or interacting with law enforcement who may not be trained to handle their specific mental health crisis. Mental health advocates pushed for the new 988 hotline in the hopes that it would become a widely known, safer, and more effective alternative. In mid-2020, the FCC adopted rules to establish 988 as the nationwide, 3-digit dialing code for people in crisis, and later that year, the National Suicide Hotline Designation Act of 2020 was signed into law. The FCC adopted additional rules in November 2021 to expand access to the hotline by establishing the ability to also text to 988. As a result, covered phone service and text providers in all of the US states and territories were required to direct all 988 calls and texts to the National Suicide Prevention Lifeline by July 16, 2022. There is significant government investment to back up the new service - Congress and the current administration have dedicated $432 million toward building the capacity of local and backup call centers, and providing associated services, including a subnetwork for Spanish speakers. "One of the goals of 988 is to ensure that people get the help that they need when they need it, where they need it. And so, when a person calls 988, they can expect to have a conversation with a trained, compassionate crisis counselor who will talk with them about what they're experiencing. If it's the case that they need further intervention, then likely the crisis counselor will connect with a local mobile crisis team," says Dr. Miriam Delphin-Rittmon, the administrator of SAMHSA. The National Suicide Prevention Lifeline's 10-digit number — 1-800-273-8255 — will remain active, but calls will be routed to 988. Sources Substance Abuse and Mental Health Services Administration (SAMHSA): How does the new 988 work?

We all have a sense of the big things we should be doing to stay healthy in mind and body: things like eating well, exercising, and getting enough sleep. But sometimes life gets in the way, and as much as we want to add healthy behaviors to our routine, we just don’t. So how exactly do we form those good habits to improve wellness? In this article, we explain the steps. And we know that healthy habits are good for both physical and mental health, so as a bonus, we’ve included 6 top healthy behaviors to try today. How to form healthy habits Start by making it easy and simple. Research says we’re more likely to form new habits when we clear away the obstacles that stand in our way of doing them. And don’t try to completely change your life in one day. It’s easy to take on too much. For example, start by packing your gym bag and putting it by the door the night before, or walking for just 10 minutes at first, or choose an exercise that doesn’t require you to leave the house at all. Here are four additional tips to help you form healthy behaviors: Make a plan for the behaviors you want to change. Include small, reasonable goals and specific actions you’ll take to move toward them. Consider what you’ll need to be successful and get those things in place. For example, stock up on healthy foods, or plan a special spot to relax in advance. (And don't forget to plan for obstacles. Think ahead to what will happen when you're faced with extra stress or temptation.) Keep a record. Use a journal or mobile app - whatever makes most sense to you - to track things like diet, exercise, stress levels, or sleep patterns. Experts say that even if you think you’re about to ‘fall off the wagon,’ continue to track your behavior, as sometimes when you feel like you’re failing, you learn the most. Do the behavior every day. Research says the amount of time it can take for a behavior to become a habit ranges from 18 to 66 days, but they form faster when we do them more often, so start with something easy and simple, and do it often. Once the habit is formed, you can explore more complex or harder behavior changes. Reward yourself - early and often This is an important part of habit formation - especially as some results of habit changes take longer to show up. So, build in some immediate rewards to help you reinforce the habit, like listening to an audiobook while running, or watching a favorite Netflix series while on the treadmill. Lastly, be patient with yourself! Healthy habit-forming is hard work and even though the payoff is big, there may be missteps along the way - and that’s ok. How do you form healthy behaviors? Leave a comment below or tell us on social media. Experts say these are top behaviors for improved wellness Now that you know how to form a healthy habit, here’s how experts weigh in on some of the top healthy behaviors that benefit body and mind (besides the big ones - eating healthy, exercising, and getting enough sleep). Some may be familiar but others may be a surprise. Drink lots of water. Check with your doctor to find out how much is right for you. If it gets boring, add fresh mint, lemon, or cucumber slices to switch it up. Plan your meals. Experts recommend you get into this habit, as it reduces the chances for unhealthy eating, and also saves time and money (and who doesn’t need more of both?!) Train your muscles. Strength training helps replace body fat with muscle - so you burn more calories overall. And it’s really important for women - especially as they get older. Go offline. So hard to do! But this gives our eyes and brains a big break and frees up time for other healthy habits. Learn something new. New skills keep our brains really healthy and may even provide you with new free-time activities and friendships. Get outside in nature. More and more, researchers are learning the benefits of fresh air, sunshine (vitamin D), and the peace that comes from being in green spaces. Healthy habits ensure a better quality of life. Commit to forming healthier behaviors by starting with just one today. Sources The New York Times: How to Build Healthy Habits Harvard Business Review: Building Healthy Habits When You’re Exhausted NIH News in Health: Creating Healthy Habits

Stress and burnout are concerning - especially regarding our work lives. A recent Deloitte study found that 91% of people say that having an unmanageable amount of stress negatively impacts the quality of their work. Additionally, 77% say they’ve experienced burnout at their current job, with more than half citing more than one occurrence. But is there a difference between stress and burnout? Is burnout a kind of stress? Is stress at work always bad? And what can be done about both? In this article, we look at what the research says about the difference between stress and burnout, and how to prevent chronic stress from becoming burnout. What is burnout? What is stress? In 1974, psychologist Herbert Freudenberger first coined the term “burnout” - which he said usually occurs within the context of work - to mean emotional exhaustion, depersonalization, and feelings of inefficiency or lack of accomplishment. His studies found that burnout diminishes productivity and ultimately leads to a lesser quality of work. Stress is a physical or mental response to any external cause. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time (chronic stress). Stress can be a negative factor (scientists call this dysfunctional stress) or a positive one (called functional stress or eustress). Surprised about that last part? Yes, stress can be good - in the right context. The American Psychological Association defines functional stress as “stress that involves optimal levels of stimulation resulting from challenging but attainable, enjoyable or worthwhile tasks. It has a beneficial effect by generating a sense of fulfillment or achievement and facilitating growth, mastery, and high levels of performance.” So for example, functional stress can help you perform better in an athletic event or get a job done more quickly at work. When too much stress becomes burnout However, if stress interferes with your everyday life, causes you to avoid doing things you normally like, or seems to be always present, you may have tipped the scales over into burnout. A recent research review suggests burnout is on the extreme far end of the stress continuum. When you are stressed, although it may feel miserable, you can still take steps to cope with pressures. But once burnout takes hold, you’re emotionally fatigued and have more than likely given up hope of overcoming obstacles. You have less ability to cope with regular stress. Your interests and motivation dry up, and you may fail to meet even the smallest obligations. Here are additional symptoms of burnout: Lowered immunity to illness Withdrawal from coworkers and social situations Job absenteeism and inefficiency Sleep deprivation Foggy thinking and trouble concentrating Lack of joy Recent research on the relationship between stress and burnout found that work stress and burnout are mutually reinforcing; however, the effect of work stress on burnout is smaller than the effect of burnout on work stress. This means that the more severe a person's burnout becomes, the more stressed they’ll feel at work. Try these tactics for keeping burnout in check Bottom line, don’t let negative stress tip over into burnout if you can help it. Experts suggest these self-care tips for keeping burnout in check: Focus on very short-term and realistic goals and wins Make time for yourself Take a break from the situation, if at all possible Exercise, and make sure you are eating healthy, regular meals Stick to a sleep routine, and make sure you are getting enough sleep Avoid drinking excess caffeine Identify and challenge negative and unhelpful thoughts Reach out to friends or family who help you cope in a positive way If none of these tactics work, speaking with a mental health professional is your next step before you experience severe burnout. They can help you develop new coping skills and provide a safe space to vent. They may suggest trying a combination of medication with your therapy. Each person is unique and will respond differently to each technique. Your therapist can help you find the right combination for you. Sources Journal Personality and Individual Differences: Stress and burnout: The significant difference NIH: Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions Frontiers in Psychology (Journal): Is Burnout Primarily Linked to Work-Situated Factors? A Relative Weight Analytic Study

Summer is upon us and many of us are anticipating a return to travel. Whether staying stateside or going overseas, travel conjures up images of exciting new places, beautiful or unusual sights, visiting with family or friends, and in general, lots of relaxation and fun. But for many people, travel can also create feelings of discomfort and worry — a sensation psychologists refer to as "travel anxiety." If this describes you, you are not alone: feeling anxious about travel - before and during a trip - is very common. And of course, if you have a mental health diagnosis, you’ll want to check with your medical professional before your trip as they can make sure you are up-to-date on prescriptions, and even provide travel advice for your condition. In addition, this article offers 8 ways to cope with travel anxiety, from giving yourself extra time for transportation transitions to packing a calming item or book that provides comfort during stressful situations. Hopefully these suggestions will help reduce the anxiety and allow you to enjoy the journey! Alleviate potential anxiety before you go Experts suggest you start by thinking in advance about what situations on the trip might cause anxiety, recognize when your anxiety may be disproportionate, then challenge it with facts and planning. It’s a good idea for any traveler to do upfront research to make sure destinations and activities are safe. But if your fears about possible disaster get in the way of fully enjoying your experience, your anxieties may be at least partially unfounded. It may help to look at statistics to see how rare certain scary events really are. You can also find out in advance where to go or who to call if you do have an emergency. Often these upfront methods can provide a better sense of control and therefore alleviate some of the advance anxiety. Other Tips for coping with travel anxiety during your trip Build in extra time. This probably goes without saying. Almost every form of transportation - plane, train, even car rental - will almost certainly experience delays, lines, or schedule changes - causing even the most patient among us to feel overwhelmed. It makes sense to allow for extra time for each, as well as to plan what you’ll do in case of delays (bring a book, load up a movie on your phone, etc.), and learn to accept - rather than fight - these common inconveniences. Keep important documents handy. To reduce freak-outs at the airport or at border crossings, always keep your passport and ID in the exact same holder or bag while you travel (as well as in the same spot at home when not traveling!). Make paper copies of important documents just in case. Consider printing out copies of maps or have an up-to-date, hard copy guidebook in case GPS doesn’t work. Establish a routine that sets the tone for your trip. Familiarize yourself with your surroundings, and if you can, integrate activities that you’re used to doing at home (e.g., getting coffee at a local coffee shop each morning, reading before bed, etc.) to bring a sense of comfort and routine. Practice relaxing breathing exercises. Use these in traffic, in security lines, and whenever necessary. Also integrate physical activity like walking and stretching to relieve stress. Get the appropriate amount of sleep, eat a healthy diet, and stay hydrated. Try to stay positive — or at least neutral. Frustrating or disappointing situations are bound to happen while traveling. However, your attitude may make a difference. Boston University clinical psychologist and phobia expert, Dr. Todd Farchione, says, “A lot of times, by pulling from a mindfulness and acceptance-based approach, you can go into a situation in a way where you’re not judging it so negatively… To be calm, you have to act calm.” Know your mental and physical limits. Regularly reassess your original plans and change them to minimize stress levels. Let your fellow travelers know in advance that you will be prioritizing your mental health and that there may be activities along the way that you may not partake in. Finally, give yourself time on the back end of a trip. If possible, plan an extra day or two off after you return, to mentally and physically recover from your trip. This will help you get back into your daily routine with less stress. If you are still facing travel anxiety after trying these stress-reducing tips, a qualified mental health professional can help you work on further coping strategies for dealing with travel anxiety, or help you consider whether medication can help fulfill your wanderlust with as little stress as possible. Sources International Association for Medical Assistance to Travelers (IAMAT): Travel and Anxiety Conde Nast Traveler: What Does Travel Anxiety Look Like? CDC: Mental Health and Travel

Are you one of the many people who have a hard time saying “no”? You’re not alone! There are many reasons experts say we don’t always set the boundaries that we need for good mental health - including wanting to people-please, playing the role of ‘rescuer’, feeling manipulated, or being put on the spot. In this week’s article, we explore ways to set healthy boundaries for better mental health, and why setting boundaries is important for self-care. What are boundaries and why set them? A boundary is a limit or space between you and another person, or persons; a clear place where you begin and the other person ends. Setting boundaries is an important part of establishing one’s identity and is a crucial aspect of well-being. Boundaries help us feel safer and more comfortable. Boundaries can be physical or emotional, and they can range from loose to rigid, with healthy boundaries often falling somewhere in between. When healthy boundaries are not present, people may feel angry or sad due to interactions that create a feeling of being taken advantage of, devalued, or unappreciated. In addition, we often feel exhausted by the responsibilities brought on by saying “yes” all the time - leading to what some experts call the “treadmill of over-commitment”. So why don’t we set boundaries more firmly and frequently? Sometimes we think that saying “yes” will make other people happy regardless of our own feelings. Sometimes, we think saying “yes” all the time confirms that we are needed. And sometimes we respond to the guilt that others may employ to try to break down our boundaries. When we say “yes” for these reasons, we’re out of balance - we’ve inadvertently placed more value on the needs of others than on ourselves. How to set healthy boundaries First, know the characteristics of effective boundaries: Limits are clear and decisive, yet reasonable Value is placed on your needs The focus is on authenticity and self-care, not on pleasing others or playing the rescuer Next, give yourself permission to set personal limits with people. If you feel that love and approval are tied to pleasing others, or that you’re somehow being selfish for setting boundaries, or if it feels “risky” to set boundaries, then consider consulting with a mental health professional who can help you see that it's not selfish to take care of your own needs. Next, define your boundaries. This might include things like: How you will and won’t spend your time and energy Who you will or won’t engage with and when What types of interactions you will or won’t engage in What activities and projects you will or won’t participate in You may find it helpful to practice communicating your boundaries beforehand. Practice staying calm in the face of others’ reactions to your boundary-setting. They may be surprised at first especially if they have come to believe you will always say “yes”, but don't let that stop you! It may feel uncomfortable in the short-term, but there’s definitely a long-term payoff. And finally, heed the warning signs - and stay away from those who repeatedly don’t respect boundaries you’ve set; who may be invading your space for their own end. If you find this all difficult to do, you’re not alone. It’s a big - but very positive step - to take for better mental health. Qualified behavioral health counselors can help with things like learning how to set and maintain boundaries, and recognizing when and what to do when others try to cross those boundaries. As part of improving self-care, consider getting guidance about this from a mental health professional. Sources Forbes: The Importance Of Setting Healthy Boundaries Harvard Business Review: Set Better Boundaries Psychology Today: 7 Tips to Create Healthy Boundaries

Gaming is wildly popular. 60% of Americans say they play video games daily, and 75% of US households own a device they can play games on: phones, tablets, big screens, and other devices. Not unexpectedly, video games saw a 73% growth in sales during the pandemic, as people went online to socialize and escape. As popular as they are, games are also controversial; some believe they are addictive and others think they interrupt normal social interaction. However, recent scientific studies have found gaming can play a positive role in mental health, and in this article, we’ll tell you about those studies and debunk a few gaming myths along the way. Survey finds gaming can provide stress relief Video games can be a fun way to pass the time, and for those with challenges, they can provide a much-needed distraction from difficult situations. Games can be a low-stakes outlet for people to let off steam when they feel frustrated by school or work. Games which encourage exercise and socializing can even promote emotional wellness. Dr. Alok Kanojia who researches game addiction at Harvard Medical School says on the very positive side, “video games literally allow us to escape negative emotions and suppress them.” A 2019 survey found that almost 80% of gamers say video games provide them with mental stimulation, relaxation, and stress relief. The same survey found that some gamers - like competitive athletes who ‘live and breathe’ their sport - also report anxiety associated with game performance and expertise. The key here, like anything, is balance - and having tools and supports in place to manage mental health issues. Two studies find positive correlation between gaming and mental health Several research studies have found that some games can play a positive role in mental health. For example, a study at Oxford University which focused on those who play Nintendo’s Animal Crossing, found that people who played more games tend to report greater wellbeing. In fact, Animal Crossing is part of the ‘cozy game’ movement - a new genre of video games that rose in popularity during the pandemic, whose beautiful graphics, clever storylines, soaring soundtracks, and fluid end goals make them feel “approachable, stress-free and bite-sized.” Gamers who play cozy games say these games provide a way for them to “chill out with cute and colorful graphics, meditative tasks, and feel a sense of accomplishment” - all of which can contribute positively to mental health. Another study on location-based, mobile games like Pokémon GO (a game that lets players combine gameplay with real-world exercise), found that these games may be able to help alleviate depression symptoms in players, because they encourage exercise, contact with nature, community, and social connection. The researchers reported they were “able to connect use of Pokémon GO to a ‘significant short-term decrease in depression-related internet searches’, which is a common and reliable method of monitoring mental health, and therefore the game may help with mild, non-clinical forms of depression.” On a positive side note, the game maker community appears to be tackling the depiction of mental illness within games. Negative tropes about mental illness have existed in games since the beginning, but lately, creators have been trying to change that - even hiring psychologists to make sure there are no negative stereotypes in their games (even if inadvertently). If you or a loved one need help with mental health issues, consider contacting a telebehavioral health professional As with anything, if you or your loved one is a gamer and is experiencing symptoms of depression or anxiety, it's best to turn to a qualified mental health professional who can distinguish between everyday stress and something more serious. Sources Frontiers in Psychology: Gaming well: links between video games and flourishing mental health The Guardian: Video gaming can benefit mental health, find Oxford academics Journal of Management Information Systems: Location-Based Mobile Gaming and Local Depression Trends: A Study of Pokémon Go

Over 12% of adults in the US meet the diagnostic criteria for a specific phobia. However, phobias come with much misunderstanding: some people believe they are just ‘overrated fears’ while others believe phobias can’t be overcome. On the contrary - phobias are a mental health issue. And they can be treated. In this article, we’re setting the record straight about common phobias - what they are, what they aren’t, how they are diagnosed, and how to get help. What is a phobia? Phobias are a kind of anxiety disorder; so they’re in the same diagnostic category as generalized anxiety disorder, but manifest differently. A phobia is defined as an overwhelming and debilitating fear of an object, place, situation, feeling or animal. But phobias are more pronounced than fears. They develop when a person has an exaggerated or unrealistic sense of danger about a situation or object. If a phobia becomes very severe, a person may organize their life around avoiding that thing that's causing them anxiety - so phobias can become debilitating. And in some cases, even thinking about the source of a phobia can make a person feel anxious or panicky (known as anticipatory anxiety). Types of phobias According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), there are three main types of phobias: Specific phobias. Refers to an intense, persistent, and marked fear of a specific object or situation (such as flying, insects, or heights). People with specific phobias may be aware that their anxiety is out of proportion but feel helpless to control it. Agoraphobia. Refers to a deep fear of being in an environment (often outside or with many other people) where escape might be difficult or help unavailable in the event of developing panic-like symptoms. Social phobia. Also called social anxiety disorder; involves acute fear and self-consciousness in social situations. Can lead people to avoid attending events, meeting new people, or even seeking employment. Studies indicate that specific phobias concerning heights and animals/insects are the most common, but here is a list of other common specific phobias for which people seek treatment: Acrophobia - fear of heights Aerophobia - fear of flying Aquaphobia - fear of water Astraphobia - fear of storms Claustrophobia - fear of confined or tight spaces Dentophobia - fear of dentists Hemophobia - fear of blood Nosocomephobia - fear of hospitals Zoophobia - fear of animals In all cases, these intense fears are real for the people experiencing them. They are not figments of imaginations nor deliberate exaggerations of fear. People with phobias feel very specific and often debilitating symptoms when they come into contact with the source of their fear. Symptoms may include the following if you find yourself around the phobia source: unsteadiness, dizziness, lightheadedness nausea sweating increased heart rate or palpitations shortness of breath trembling or shaking upset stomach Risk factors for phobias The causes of anxiety disorders like phobias are unknown but likely involve a combination of genetic, environmental, psychological, and developmental factors. Anxiety disorders can run in families, suggesting that a combination of genetics and environmental stresses can result in a diagnosed phobia. Help for phobias Mental health professionals can diagnose a phobia - and they can be treated successfully. Often treatment involves a combination of exposure, medication and coping strategies - all of which a qualified professional can provide. Scientists are finding that the phobias start out less intense and grow in acuteness over time - suggesting the possibility that interrupting the course of phobias with treatment early on could reduce their prevalence. A recent study, published in Lancet Psychiatry found that, “phobias can persist for several years, or even decades in 10-30% of cases, and are strongly predictive of the onset of other anxiety and mood disorders. Their high comorbidity with other mental disorders, especially after onset of the phobia, suggests that early treatment of phobias could also alter the risk of other disorders.” The key takeaway? Consult with a mental health professional as early as possible if you or a loved one believe you have symptoms of a phobia. Sources Lancet Psychiatry Current Topics in Behavioral Neuroscience National Institute of Mental Health

Health care providers in the medical and behavioral health fields are increasingly recognizing that experiences of past trauma significantly influence our overall health, our relationships, school, work, and our ability to adopt healthy behaviors. And while we often associate trauma with things like soldiers in war settings, victims of crime, or the death of a loved one, it turns out that multiple life experiences clinically qualify as traumatic. In this article, we explore how the concept of holistic, trauma-informed care can improve the outcomes of mental health treatment. What is meant by ‘trauma’? Recent studies show that by the time they reach college, 66-85% of 18 year-olds report lifetime traumatic event exposure, with many reporting multiple exposures. That’s a lot. According to the American Psychological Association, trauma is an emotional response to a terrible event like an accident, rape, or natural disaster. But a person may experience trauma as a response to any event they find physically or emotionally threatening or harmful - for example, bullying and other character attacks; loss of a friend or loved one whether through death, moving, or a break-up; emotional, physical or sexual abuse; or even seeing something violent or disturbing. What matters is how the individual perceives an event, not how society judges how an individual should perceive an event. According to the Substance Abuse and Mental Health Services Administration, “the effects of traumatic events place a heavy burden on individuals, families and communities. Although many people who experience a traumatic event will go on without lasting negative effects, others will have more difficulty. Emerging research has documented the relationships among exposure to traumatic events, impaired neurodevelopmental and immune systems responses and subsequent health risk behaviors resulting in chronic physical or behavioral health disorders.” What is a trauma-informed approach to care? Trauma-informed care changes the opening question for those seeking mental health services from “what is wrong with you?” (i.e., patient or consumer) to “what has happened to you?” (i.e., survivor). Trauma-informed care is based on the assumption that every patient seeking services is a trauma survivor who can inform his or her own path to healing, facilitated by support and mentoring from a mental health provider. A trauma-informed approach to care acknowledges that providers “need to have a complete picture of a patient’s life situation — past and present — in order to provide effective health care services with a healing orientation.” The six key principles of a trauma-informed approach are: Safety Trustworthiness and transparency Peer support Collaboration and mutuality Empowerment, voice, and choice Humility and responsiveness In addition, potential biases and stereotypes based on race, ethnicity, sexual orientation, and age are recognized and addressed within the context of trauma-based care. Clinicians who train in trauma-based care also learn there are 10 domains of implementation of this approach, including governance and leadership, policy, physical environment, training and workforce development, progress monitoring and quality assurance, and more. Why is trauma-informed care important? It’s a win-win for everyone. For patients, trauma-informed care offers the opportunity to engage more fully in their own mental health care, develop a trusting relationship with their provider, and improve long-term outcomes. Studies have found that adopting trauma-informed practices can potentially improve overall patient engagement and adherence to treatment. It also reduces the need to relive experiences and retraumatize the patient. In addition, trauma-based care has been found to improve provider engagement. Overall, adopting a trauma-informed approach to care has the potential to improve patient health outcomes as well as the well-being of providers. If you feel you or a loved one could benefit from trauma-based care, consult your doctor or mental health provider. If you or a loved one need help with mental health issues, consider contacting a qualified telebehavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Substance Abuse and Mental Health Services Administration (SAMSA) Center for Health Care Strategies National Council for Mental Wellbeing

Addiction to drugs and alcohol (often called Substance Use Disorder or SUD) is a mental health problem. It can be caused by a combination of behavioral, biological, and environmental factors, and like other mental health issues, can disrupt the ability to function at work or school, maintain healthy relationships, and cope with stressful situations. According to the Substance Abuse and Mental Health Services Administration (SAMSA), over 20 million people aged 12 or older have a substance use disorder related to their use of alcohol or illicit drugs. It’s important to know that mental health problems and substance use disorders often occur together (you’ll hear medical and mental health professionals refer to this as comorbidity) - but sometimes it's hard to predict which came first. In this article, we’ll discuss the close connection between addiction and mental health, four facts about that connection, general warning signs, and how to get help. What causes the connection between addiction and mental health issues? Multiple scientific studies have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder at some point and vice versa. The 2019 National Survey on Drug Use and Health found that an estimated 9.2 million adults aged 18 or older had both a mental health problem and an addiction to at least one substance in the past year, while another 3.2 million adults had a co-occurring severe mental health problem and substance abuse. Medical and mental health professionals theorize that these problems frequently occur together for various reasons, such as: Certain kinds of illegal drugs can cause people with addiction issues to experience one or more symptoms of mental health problems Some people with a mental health problems may misuse drugs or alcohol as a form of self-medication Mental and substance use disorders share some underlying causes, including changes in brain composition, genetic vulnerabilities, and early exposure to stress or trauma The bottom line is that dealing with substance abuse and drug addiction is never easy, and it’s even more difficult when you’re also struggling with mental health problems. And to make matters worse, these co-occurring disorders can affect each other. For example, when a mental health problem goes untreated, the substance abuse problem usually gets worse. And when alcohol or drug abuse increases, mental health problems usually increase too. To expand on the information above, here are 4 important things to know about the connection between addiction and mental health. Untreated mental health disorders increase the risk of substance abuse. People who suffer from mental disorders are often more likely to turn to drugs or alcohol to relieve their symptoms. And although the substances may provide temporary relief, they can exacerbate symptoms in the long run, leading to further addiction problems and ultimately, an unhealthy cycle. Substance abuse can cause depression, anxiety, and other mental health problems. Although not everyone who misuses substances like drugs or alcohol will develop mental health problems, if someone is predisposed to a mental health disorder, those symptoms can be triggered by substance abuse. Substance abuse shares common symptoms with some mental health issues. Alcohol and other central nervous system depressants can trigger symptoms of depression. Conversely, stimulants, such as cocaine, can cause drug-induced psychosis - a symptom usually associated with schizophrenia. In both cases, chronic use can result in irreversible changes to brain chemistry. Mental disorders and substance use disorders - even when occurring together - are treatable. The good news - whether a person has a mental disorder, a substance use disorder, or both, there are a number of treatment options that can result in effective and long-term management of symptoms. Getting help for co-occurring substance use and mental health disorders It can take time to tease out which symptoms are associated with a mental health disorder and which are associated with a drug or alcohol addiction problem. The signs and symptoms may also vary depending on the type of mental health problem and type of substance being abused. However, there are some general agreed-upon warning signs that someone may have a co-occurring disorder: Using alcohol or drugs to cope with unpleasant memories or feelings, or to control pain or mood intensity Feeling depressed, anxious, or plagued by unpleasant memories when using drugs or alcohol Feel depressed or anxious even when sober A family member who has also struggled with both a mental disorder and alcohol or drug abuse Mental health professionals can help diagnose and treat co-occurring disorders, so the first step if you notice any of these symptoms in yourself or a loved one, is to consult a professional. Although the combination of mental health and addiction issues may seem complicated, there is help. Some people respond to treatment right away. Others will need to try different treatments before finding a combination that works for them. But stick with it as they have been proven effective. If you or a loved one need help with substance abuse or mental health issues, consider contacting a qualified telebehavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Substance Abuse and Mental Health Services Administration (SAMSA) National Institute on Drug Abuse MentalHealth.gov

It’s estimated that 20% of people aged 55 years or older experience some type of mental health issue - the most common are anxiety and depression. Indeed, more common later-life events such as chronic medical disorders, loss of friends and loved ones, and the inability to take part in once-cherished activities can take a heavy toll on a person’s emotional well-being. But mental health problems are not a “normal” part of aging and should be identified and treated, not tossed off as unavoidable. In this article, we look at the facts about mental health issues in older adults and what can be done to address them. Facts about mental health and aging Mental health problems are a risk for older adults, regardless of history. While some adults go through life managing a chronic mental illness, mental health problems can also suddenly appear late in life. Changing bodies and chemistry, changes in family and friendships, and changes in living situations – all have an effect on mental health and need to be considered in treatment. Some sobering facts about older adults and mental health include: Adults 85 and over have the highest suicide rate; those aged 75 to 84 have the second highest. 75% of those who commit suicide have visited a primary care physician within a month of their suicide. It's estimated that only 50% of older adults who discuss specific mental health problems with a physician receive the right treatment. Up to 63% of older adults with a mental disorder do not receive the services they need. On the good news side, research also shows that if older adults are diagnosed with a mental health disorder, and are able to access services, then 80% will recover or receive the tools to live successfully with their disorder. Is there such a thing as psychological aging? Recent studies have shown that how old we “perceive” ourselves contributes to our level of well-being also. This is known as psychological aging. Essentially, our ‘subjective age’ (how young or old we perceive ourselves to be regardless of physical age) has a significant effect on our health decisions - the idea being that if we ‘feel’ younger than we are, we will make more healthy lifestyle decisions - including decisions that may help our mental health. Depression is common in older adults - what we can all do to help One of the most common mental illnesses affecting older adults is depression. Depression can have a negative “halo effect” on the health of older adults in many ways. According to the American Psychological Association, depression “can lead to eating habits that result in obesity or, conversely, can cause a significant loss of appetite and diminished energy levels, sometimes resulting in a condition known as geriatric anorexia; it can also cause higher rates of insomnia and memory loss, and longer-than-normal reaction times'' - making driving, cooking, or self-medicating more dangerous than normal. However most older adults see an improvement in their symptoms when treated with anti-depression drugs, therapy, or a combination of both - so the key is to get help as early as possible. Watch for these warning signs in yourself or loved ones that may signal a mental health issue: Noticeable changes in mood, energy level, or appetite Feeling flat or having trouble feeling positive emotions Difficulty sleeping or sleeping too much Difficulty concentrating, feeling restless, or on edge Increased worry or feeling stressed Anger, irritability, or aggressiveness Ongoing headaches, digestive issues, or pain A need for alcohol or drugs Sadness or hopelessness Suicidal thoughts And experts say to be tactful when talking to an older loved one about potential warning signs. An older person with fragile self-esteem may interpret well-intentioned encouragement as further proof of their declining condition. Some may even resent attempts at intervention. And because older people tend to be less amenable to lifestyle changes, they may be reluctant to adopt new, healthier habits. A trained mental health specialist who understands aging issues can help friends and family members craft positive approaches for talking about sensitive issues, and can help tailor an individualized therapeutic strategy to combat depression. If you or a loved one need help with mental health issues, consider contacting a qualified telebehavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources CDC: The State of Mental Health and Aging in America National Institute of Mental Health: Older Adults and Mental Health American Psychological Association: Aging and Depression

It is no doubt alarming to learn that LGBTQ youth experience more violence, victimization, and report higher suicide risk than their peers; in fact, they are more than 4 times as likely to attempt suicide. Another study found 42% of LGBTQ youth have seriously considered attempting suicide in the past year. Everyone has the right to feel safe and accepted in their community - especially children - and in this article, we discuss some of the things that can be done to address this issue. And to be clear, LGBTQ youth are not inherently more prone to suicide risk because of their orientation or gender identity but are put at higher risk because of how they are stigmatized in society. Key risk factors for LGBTQ youth suicide Research shows that multiple factors are key risk factors for LGBTQ youth suicide. Like anyone who experiences highly negative emotional experiences, lack of acceptance amongst family and peers, lack of what would be considered a “safe place” to find peace and comfort, and outright discrimination can cause stress, anxiety, and depression in this group. Research backs up the following experiences that correlate with mental health issues: Only a third of youth in this group find parental acceptance, another third experience outright parental rejection, and another third do not dislcose their LGBTQ identity until they are adults due to fear of rejection. Young adults who report high levels of parental rejection are 8 times more likely to report attempting suicide and 6 times more likely to report high levels of depression. 75% of LGBTQ youth report that they have experienced discrimination based on their sexual orientation or gender identity at least once in their lifetime, and more than 50% said they experienced this discrimination in the past year. Those who experienced discrimination attempted suicide at more than 2x the rate of those who did not. 72% of LGBTQ youth reported symptoms of anxiety in the past year, including more than 75% of transgender and nonbinary youth. 62% of LGBTQ youth reported symptoms of depression in the past year, including more than ⅔ of transgender and nonbinary youth. What can we do to help LGBTQ youth? As with others experiencing mental health issues, nearly half of LGBTQ youth have wanted counseling from a mental health professional in the past year - but in this case, they were not able to receive it for one reason or another. Helping LGBTQ youth find and get good mental health counseling is a good place to start. Telebehavioral health services - qualified therapy done virtually - may be a way to break down barriers, remove stigmas, and increase access for this group. Studies have also found that LGBTQ youth who had access to spaces that affirmed their sexual orientation and gender identity reported lower rates of attempting suicide. As well, affirming transgender and nonbinary youth by respecting their pronouns and allowing them to change legal documents is also associated with lower rates of attempting suicide. When asked in a survey what helps them get through daily challenges and feel better about themselves, LGBTQ youth mentioned things like: Connection with others Identity pride events Art and creative expression Feeling seen and validated Faith and spirituality Moving away from unsupportive situations and people Representation in media Online and offline support groups LGBTQ support in school If you or a loved one need help with mental health issues, consider contacting a qualified telebehavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources The Trevor Project MMWR/CDC The Trevor Project

This week, we continue our mental health resources series by curating 8 inspiring and engaging films about mental health topics - from PTSD to depression to bipolar disease and more. We think these films are sensitive and worthy portrayals that explore the nature of mental illness - and ultimately help us get the word out - and more exposure equals greater understanding. Most of these films can be found on the major streaming networks. Share the list with friends and family, or if you are a clinician, with patients who may also benefit. Then grab the popcorn (and possibly a box of tissues) and start watching. Silver Linings Playbook - This popular, Oscar-winning 2012 romantic comedy is based on Matthew Quick's novel of the same name, and follows two main characters dealing with mental illness. Bradley Cooper plays Pat who is diagnosed with bipolar disease, and Jennifer Lawrence plays a widow dealing with her own mental illness in the aftermath of her husband's death. The Perks of Being a Wallflower - 2012 was a good year for quality films addressing mental health issues and this one continues the trend: it explores the social-psychological effects PTSD has on young adults and how love can help heal the wounds. Based on a novel of the same name. Girl Interrupted - This best-selling memoir turned movie is a firsthand account of a young woman's experience inside an American psychiatric hospital in the 1960s. Care wasn’t as good as it is now - which is hard to watch in the film - and although we still have a long way to go, it's good to see how much treatment for mental illness has improved. Good Will Hunting - The main character (Will - played by Matt Damon, who also wrote the screenplay with friend Ben Affleck) was abandoned as a young boy and suffers from attachment disorder because of it. The film details how his mental health has an impact on the choices he makes - he’s clearly a genius who belongs inside the classrooms that he cleans for a living at MIT. The success of his work with a local therapist ultimately gives viewers hope for the future. A Beautiful Mind - Tells the true-life story of brilliant mathematician John Nash (Russell Crowe), a Nobel Laureate in Economics and Abel Prize winner, who develops paranoid schizophrenia and endures delusional episodes while watching the burden his condition brings on his family and friends. The Soloist - A Los Angeles Times columnist (Steve Lopez) finds and writes about a homeless street musician (Nathanial Ayers) who possesses extraordinary talent. In his attempt to help Ayers, Lopez has to also deal with the mental illness that landed Ayers on the street in the first place, as well as the stigma against those with mental health issues. When Love Is Not Enough: The Lois Wilson Story - Deals sensitively with addiction. Winona Ryder plays the wife of the founder of Alcoholics Anonymous, Bill Wilson, who made it big on Wall Street before the Crash of 1929 - which wreaked havoc on his sense of worth - and founded Alcoholics Anonymous in 1935 after getting sober himself. Lois Wilson later founded Al-Anon to help the loved ones of those struggling with addiction. Cyberbully - Takes a realistic and thoughtful approach to the issue of online bullying as seen through the eyes of a teen victim who attempts suicide. Ultimately has positive messages about tolerance, resilience, getting help and support, and standing up to peer pressure. This would be a good film to start a discussion with any teens in your life. Are there any films that you would add to the list? Let us know in the comments. If you or a loved one need help with mental health issues, consider contacting a qualified telebehavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.

In April, the Defense Department recognizes military children in an awareness campaign to make sure the well-being and mental health of the youngest members of our military community are brought to light. The DoD says about the Month of the Military Child that the goal of the campaign is to “highlight the unique challenges of military children. Our goal is to improve their quality of life and help mitigate the demands they experience from all the transitions, such as frequent moves, parental separations for military training, and worrying about their parents when they're deployed.” Unique challenges faced by military children Unlike kids whose parents are not military, this community of children moves 6 to 9 times on average during their school years. In the past, we’ve written about this particular challenge and have highlighted research that shows that military kids who move frequently are significantly more likely to have mental health issues such as depression or anxiety and that in fact, age is an important predictor of the impact on mental health, i.e., military kids aged 12-17 are four times as likely to need help from a mental health professional as military kids aged 6-11. This makes sense intuitively, as teens are already going through the changes and stresses of puberty. In addition: Students involved in sports who move later in the year can miss team tryouts, or the new school may not offer the same athletic programs. Kids who move may feel the loss of having to end close relationships with friends at a previous school. It’s more difficult for kids to gain acceptance in a new school where cliques and social networks are already established. In addition to frequent moves, other stressors of military life impact kids. For example, when their parents are deployed, they may miss big milestones such as birthdays, holidays, school and sports events, and graduations. Resources for families We’ve written articles in the past about how parents, teachers, and other community members can help monitor military kids for signs of mental health issues. For example, these warning signs should not be ignored: Kids who talk about fears or worry frequently Complain about frequent stomach or headaches with no known medical cause Are in constant motion and cannot sit still Sleep too much or too little, have frequent nightmares or seem sleepy during the day Are spending more and more time alone, are not interested in playing with other children, or have difficulty making friends Struggle academically or have experienced a recent decline in grades Repeat actions or check things many times out of fear that something bad may happen. Have lost interest in things that they used to enjoy As part of publicizing Military Children Awareness Month, the Department of Defense also wants military parents to know that support exists for their kids year-round. For example, at the installation level, there are typically child development centers, youth centers, Military and Family Support Centers, and family life counselors. Off the installations, there is community-partner support for military children through schools and organizations such as 4-H and the Boys and Girls Clubs of America. In addition, the DoD’s militaryonesource.mil website has updated resources and events which are dedicated to the Month of the Military Child. A DoD spokesperson said, "I'd like us to remember what military children's lives are like and how unique their challenges are. It's quite incredible when we think about the transitions they go through that most children don't, and our military children are so resilient through it all."

Last week, we curated 8 informative podcasts [link] about mental health, and this week, we continue our mental health resources series in a more visual medium. Listed below are 8 compelling and illuminating TED Talk videos about mental health. TED Talk videos are described as “the best talks and performances from the TED Conference, where the world's leading thinkers give the talk of their lives in 18 minutes or less”. Topics range from depression to PTSD to schizophrenia and everything in between; and from mental health issues for teens to mental health issues for veterans. The nice thing about TED Talks is that each video is short - meaning you can watch and learn a lot in a small amount of time - maybe even squeeze one in between classes or meetings, or while waiting in line at the coffee shop. Feel free to bookmark this page, go through the videos, and share with friends, family, or if you are a clinician, patients who may also benefit. There's no shame in taking care of your mental health - Entrepreneur Sangu Delle found himself suffering from anxiety and depression but up against the stigma that seeking help meant weakness. In this inspiring TED Talk, he describes confronting his own deep prejudice: that men shouldn't take care of their mental health, and then shares how he learned to handle anxiety in a society that's uncomfortable with emotions. The voices in my head - She started off college like every other student: hopeful, energized, and ready to meet the world. But author Eleanor Longden soon began hearing voices in her head. Soon the voices became antagonistic, turning her life into a nightmare. Finally diagnosed with schizophrenia and hospitalized, she describes the moving tale of her years-long journey back to mental health. Confessions of a depressed comic - “For a long time, I felt like I’d been living two lives…” So starts comedian and perpetual “life of the party” Kevin Breel’s story of the night he realized he had to admit he was suffering from depression in order to save his life. Inspiring and relatable tale of how what looks like a happy life from the outside might not necessarily be so. We train soldiers for war. Let's train them to come home, too - Frontline psychologist Hector Garcia urges society to help our soldiers better learn how to transition from the battlefield back to civilian life. He tells stories of real soldiers suffering from PTSD and explains how we can improve our care of veterans’ mental health. Why students should have mental health days - Teen mental health advocate Hailey Hardcastle describes how school days can be rife with stress, anxiety, panic attacks, and burnout – but there's often no formal policy to help students prioritize their mental well-being. We have “sick” days but no “mental health” days. She advocates for that to change. The brain-changing benefits of exercise - Author and Professor of Neuroscience and Psychology at New York University, Wendy Suzuki discusses the science of how exercise boosts our mood and how it can be used to work alongside therapy and pharmaceutical solutions to address mental health issues. How to connect with depressed friends - Very useful and actionable discussion on how to approach friends who may exhibit symptoms of depression or have been diagnosed with depression. Comedian and storyteller Bill Bernat provides ‘dos and don'ts’ for talking to people living with depression - and how to handle the conversation with grace and maybe even a little humor. Break the silence for suicide attempt survivors - Host JD Schramm addresses this very sensitive topic with care and concern. He advocates for resources for suicide attempt survivors because “it gets better”, and hopes that those who have tried and failed but found their way back to a meaningful life may be willing to speak up to convince those thinking about suicide that their lives matter. [If you or a loved one have thoughts of suicide, call the National Suicide Hotline at 800-273-8255.]Are there any TED Talks that you would add to the list? Let us know in the comments. If you or a loved one need help with mental health issues, consider contacting a qualified telebehavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.

Are you a podcast fan? If so, you’re with 41% of Americans who regularly listen to a podcast. If you haven’t jumped on the podcast trend yet, grab a pair of headphones, turn to Apple, Spotify, or any of the many independent broadcasters, and listen in to be educated, entertained, and inspired by the amazing audio content available. Podcasts are like a mini-radio show, but about a specific topic in which you are interested - and they're free and typically easy to find. Thousands of podcasts are available on every possible topic from business and sports to technology and health - and everything in between. We’ve curated eight popular and highly-rated podcasts about mental health and listed them here. Topics covered include anxiety, depression, addiction, and more. Whether you are living with a mental health disorder, caring for a loved one with mental health issues, or are a clinician treating patients, we think you’ll find these podcasts informative and inspiring. The Anxiety Podcast - Host Tim JP Collins suffers from anxiety and panic attacks himself and now supports others with anxiety. Each week on this top-rated podcast, Tim interviews relatable guests of all ages who talk about their own anxiety stories and how they’ve learned to cope with the disorder. The Hilarious World of Depression - Humor is not the first thing that comes to mind when thinking about depression - but give this 5-star podcast a chance before writing it off. It’s a series of conversations with comedians who suffer from depression - that’s right, comedians (it's a lot more common in the industry than you’d think), and how they’ve dealt with (or not dealt with) the symptoms of depression. Very inspiring. Dear Therapists - Each week, therapists Lori Gottlieb and Guy Winch (who are also popular authors and TED speakers), give advice to ordinary (but anonymous) people looking for help with mental health issues. The audience gets to be a “fly-on-the-wall” and hear the informative and relatable conversations - including actionable advice - between the hosts and the patients. Therapy for Black Girls - Licensed psychologist Dr. Joy Harden Bradford offers a weekly discussion about all things mental health, personal development, and personal care - aimed specifically at issues experienced by black women in America. Terrible, Thanks For Asking - One of our personal favorites; Lest you think your friends and neighbors all seem ‘fine’ on the outside, host Nora McInerny asks real people to share their complicated and honest feelings about how they really are. It’s happy, sad, funny, and truly relatable. We all have issues, and sometimes it's nice to have that feeling validated. The Gratitude Diaries - Regularly acknowledging feelings of gratitude has been shown to be a coping skill for anxiety and depression, and in this podcast, host Janice Kaplan explores how gratitude can transform relationships, careers, health, and well-being. She explains the science behind the practice of gratitude and how to make it a regular habit. Also in book form, the podcast can stand alone. Latinx Therapy - Host Adriana Alejandre, LMFT, engages in conversations about mental health and well-being issues specific to the Latinx community. She tackles tough subjects and interviews experts in the field. Some episodes are in Spanish. The Mental Illness Happy Hour - 500 episodes in and it remains a top podcast in the category. The Mental Illness Happy Hour delivers weekly conversations with comedians, artists, doctors, psychologists, and friends of host Paul Gilmartin - about all things mental illness, trauma, addiction, and negative thinking. There’s something for everyone here. What podcasts would you add to this list? If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.

As the 2022 Olympics and Paralympics wind down in Beijing and athletes return home, the glow of their accomplishments is sure to last for a while. But what happens after the glow dies down - after the hometown celebrations, victory parties, and media interviews subside? Holly Brooks, a well-known therapist to Olympic athletes, says, "A lot of athletes fall into a deep depression after the Olympics… (They) need a lot of support, a lot of people reminding them of their worth beyond just their athletic achievements and results." In this article, we look at the mental health issues that returning Olympians often face, and what can be done to address this. Post-competition mental health issues are not uncommon It is estimated that one-third of elite athletes around the world experience symptoms of depression or anxiety. In recent years, athletes like Simone Biles, Chloe Kim, and Michael Phelps have helped raise awareness and normalize mental health issues by talking openly about their own anxiety and depression. At the same time, the number of research studies around this topic has increased - confirming the high incidence of mental health issues in this group. Studies have found there are several reasons that athletes may experience post-competition depression. Some athletes are dealing with disappointment over performances that didn't seem to measure up. But even for those who walk away with gold, that post-competition, somewhat “lost” feeling of “what do I focus all my energy and attention on now?” can loom large. One athlete said, “When you get home it’s really lonely… It’s quite depressing, and it is a little bit overwhelming, starting from square one again.” Sports psychologist and director of the Performance Psychology Center at the University of Michigan, Scott Goldman, explains it this way: “This ninety-mile-per-hour ride comes to a screeching halt the second the Olympics are over. …This emotional drop is not that different from the drops we all feel after major milestones, such as getting married or giving birth…. But in the case of Olympic athletes, some find themselves at such a loss they can’t stop the slide—and wind up in clinical depression.” What can be done to address mental health issues faced by athletes? Some experts suggest that athletes should have a plan in place for what to do after the excitement of the competition ends - from going on vacation to beginning a degree, a new job, or even a new athletic season. The key may be in an athlete’s willingness to build and maintain an identity off the playing field - and this may be where these other life goals come in. Support is also critical: The U.S. Olympic and Paralympic Committee formed a mental health task force in 2020 and among other things, made sure Olympic athletes now have access to a dedicated team of counselors and other mental health resources, such as wellness and meditation apps and support groups - during and after the games. One athlete summarized the challenge this way: "People are finally recognizing that these athletes are not superhuman robots like everyone thinks they are. It's like, 'Oh they're a normal person who has their own mental health issues.'" If you or a loved one need help with mental health issues, consider contacting a qualified telebehavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources NPR Frontiers in Psychology British Journal of Sports Medicine

Where is telehealth in 2022? The pandemic showed how telemedicine could change how we think about health care interactions, with virtual visits increasing almost 40 times, according to data from McKinsey. Today, telehealth utilization has stabilized at levels 38 times (yes, that’s 38 times!) higher than before the pandemic. And consumer and provider attitudes toward telehealth have also improved since before the pandemic. Telemynd’s CEO, Patrick Herguth, said only 6 months ago, “between third quarter 2020 and second quarter 2021 we experienced 4X growth in new patients seeking mental health services, an upward trend we continued to see as we move through 2021 at a record-setting 61% increase in demand. Both clinicians and patients have demonstrated their ability to quickly adapt to telemedicine with no sign of slowing down.” In this article, we look at the most recent trends, why telebehavioral health works, how to address any remaining barriers, and predictions for the future. Consumer demand for virtual health care remains high going into 2022 One study found that 78% of patients who currently use telebehavioral health are very or extremely satisfied with their telehealth experiences, and 75% are more likely to continue to use it going forward. In another recent study, 40% of surveyed consumers (including those who have never used telehealth) said they would try it or continue using it — up from 11% prior to the pandemic. Why has telebehavioral health been so successful? For providers, it remains a convenient, cost-effective way to diagnose and treat many behavioral health issues. As well, it removes the overhead and upkeep of a physical location. Consumers continue to see the following benefits of telebehavioral health: Creates unprecedented convenience - appointments can be done wherever and whenever is most convenient. Removes the stigma associated with physically going to an office or treatment facility. Saves time with virtual screenings and evaluations. Expands access for those who live in a rural area, have limited mobility, or reside in long-term care facilities. Shortens delays to meet with providers. What’s the future of telebehavioral health? Most experts who study trends in health care see telebehavioral health expanding further in the future, where it makes sense. The American Medical Association says that providers and practices “have built successful telehealth systems that are making care more accessible and convenient for patients—there should be no turning back now.” Telemynd’s Patrick Herguth says, “The pandemic exposed and exacerbated the mental health crisis. It is a highly personal matter that requires a real human connection in order to succeed. Telemedicine expands our ability to match the right provider to patients, irrespective of where they’re located. People-oriented technology advancements will lead to even greater innovative care models that improve outcomes while lowering the cost of care for everyone.” Telehealth issues like the following will need continued work to create an even better experience for providers and consumers: technology security care payment mechanisms patient feedback methods education and promotion so that more Americans know they can access telehealth As long as we continue to address these, what started off as just ‘a necessity’ during the pandemic will become the norm for health care even beyond 2022. If you need help with mental health issues, consider contacting a qualified telebehavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources McKinsey TechCrunch Yale Medicine

The news is full of stories of natural disasters - hurricanes, tornadoes, blizzards, forest fires, floods, and more. In fact, the number of disasters has increased 5 times over the past 50 years - driven by climate change and the weather extremes caused by it. And the trend won’t be changing anytime soon. But beyond the dramatic pictures on the news of homes and businesses underwater or destroyed by fire - what is the psychological toll that natural disasters take? In this article, we look at the link between natural disasters and mental health, and what can be done to address it. Research shows a clear link between natural disasters and mental health The impact of a natural disaster is often measured by obvious numbers such as fatalities and injuries, number of homes and buildings destroyed, and the cost of cleanup and repair. But those numbers don’t account for the emotional wounds suffered by survivors. Last year, the Federal Emergency Management Agency (FEMA) said, “the toll that disasters put on mental health is well documented… and more Americans are affected by climate-driven disasters every year”. Multiple studies show that natural disasters often result in a large number of ‘psychological casualties’. One well-known study, conducted after Hurricane Katrina, found that suicide and suicidal ideation more than doubled in survivors, with 1 in 6 people meeting the diagnostic criteria for PTSD. The study went on to say that the potential for immediate and severe psychological trauma after a natural disaster is high, and related to “personal injury, injury or death of a loved one, damage to or loss of personal property (e.g., home) and pets, and disruption in or loss of livelihood”. Another report suggests that natural disaster survivors are at higher risk for depression, anxiety, and other mental health conditions; even more specifically, people whose homes had suffered from adverse weather events had a 50% increase in risk for mental health issues. Following Hurricane Sandy, a telephone screening of local residents 6 months afterward, identified 15% of adults still suffering from PTSD. How does our body and brain react to trauma like natural disaster? When any kind of trauma occurs, the brain stem - the part of the brain which is responsible for the most vital functions of life (breathing, blood pressure, heart rate, etc.) - takes over. The brain stem kicks in the “fight or flight" response and all nonessential body and mind functions are shut down so that we can focus only on what we need to survive. When the threat ceases, the parasympathetic nervous system - that part of the brain that controls activities that occur when the body is at rest - steps in again and resumes the higher functions that were recently shut down. However, for some trauma survivors, after-effects remain. Some survivors become so distressed that they become withdrawn or increase their use of drugs and alcohol. Even after the disaster ends, many people continue to feel an enormous amount of stress and anxiety that, if not dealt with, can turn into long-term mental health problems. Chronic stress can impair the parts of the brain which govern reason and self-control — leading to more unhealthy choices and an increased likelihood of addiction. To add to the suffering, after a natural disaster many are unable to return to work, lack strong social support, or suffer the added financial burden of repairing or replacing damaged property. The long rebuilding process can perpetuate feelings of uncertainty and chronic stress. More vulnerable populations - children and the elderly, for example - are especially susceptible to mental health impacts of natural disasters. They may experience changes in behavior, memory, or executive function. Other common psychological responses in the days and weeks following a disaster can be: Disbelief Fear and anxiety about the future Disorientation; difficulty making decisions or concentrating Apathy and emotional numbness Nightmares about the event Irritability and anger Sadness and depression Feeling powerless Changes in eating patterns; loss of appetite or overeating Headaches, back, or stomach pains Difficulty sleeping or falling asleep What can be done to better help survivors of natural disasters? Implementing targeted psychological care is critical to saving lives, jobs, and families after a natural disaster. Many have advocated for local and federal government agencies to incorporate psychological recovery programs into their disaster preparedness plans - and that has been happening - but slowly. On a local level, experts urge survivors to recognize that symptoms of mental health issues after a disaster are normal. And asking for help is not a weakness. To move toward healing, survivors can: Talk about the event: share experiences with others in order to relieve stress. Spend time with friends and family: stay in touch with family outside the area by phone if possible. Get plenty of rest and exercise, and eat properly. Avoid drugs and excessive drinking: drugs and alcohol may seem to temporarily remove stress, but in the long run, they create additional problems. Limit exposure to images of the disaster: it’s tempting, but watching news about the event over and over increases stress. Take one thing at a time: pick one urgent task and work on it, then once you accomplish that task, choose the next one, and so on. Join a support group of individuals with similar life experiences. Ask for more help when you need it: if you have strong feelings that won’t go away or if you are still struggling more than 4-6 weeks after the event, seek professional help. Don’t try to cope alone. If you’ve been involved in a natural disaster and need help with mental health issues, consider contacting a qualified mental health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Journal Family Medical Primary Care Current Psychology International Journal of Emergency Mental Health and Human Resilience Scientific American