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Kaiser Permanente Mental Health 101517

Oct 11, 2017|

AN INTERVIEW WITH DR. HAN LIANG, CHIEF OF MENTAL HEALTH AT KAISER PERMANENTE ABOUT THE EFFECTS OF DEPRESSION AND TEEN MENTAL HEALTH.

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Automatically Generated Transcript (may not be 100% accurate)

This isn't microscope in Entercom radio Portland public affairs program I'm Gary Locke so this time on the scope we're going to be talking about the effects of depression. On the show this time I would like to welcome doctor Han Lee Yang chief of mental health and the child and adolescent psychiatrist. At Kaiser Permanente thank you for the welcome glad to be on the show. So tell me about what you do first looked at Kaiser Permanente to me about your job. Yeah so I am a child and adolescent psychiatrist. And I staff a program called eighteen I OP. I OP stands for intensive outpatient program. Essentially we have a program. That has. It team of a psychiatrist. They're pissed case manager nurse medical assistant. All focused on helping teens deal with depression. So some of these teens are actually. Suffering from suicidal thoughts or maybe have self injured and at some point. And our program is very intense. We have four weeks were at the teams essentially. Get them moan C 36. Hum nine hours of treatment a week for four weeks consecutively. Who really try to emphasize and skills building during that process. Well so what's happening in teens lives. To let me be makes them feeling depressed. Well I think about teenage hood as the as a period of great growth and change and I think. Doesn't really matter what aero history your time here in being a teenager's tough guy. You're trying to figure out cash when my gonna do when I'm an adult. Should I be. Make my own decisions now. Boyfriends girlfriends. You know pulling out all of this stuff is it's just tough being contained. If you hormones roaming around about a couple. A little bit of impulsivity. A little bit of excitement about having a new car to drive freedom elected stuff. What about so what sort of effect can be seen Noah social media having them teenagers. Yeah I think it's double edged sword. Thing good part is when teens say that they're able to get social interaction and feedback from their friends. From social media. And you know they they tell me about. How how good that makes them feel. On the other hand when they get snubbed or. They develop a for enemy years somebody who is feels like there really negative and that's here. They can impact and severely. 'cause. Folks to have difficulties. Coping with such stretchers. They're going to be the high in the definite low yeah that's true comes at you from social media have you. With the invention of social media have you noticed changes teenagers. Well I'm so. That's a good question then and I'm afraid that I think I grew up with social media so that actually can't tell you for sure okay. But I can say is that. Internet and the idea of virtual. Personas is really interesting because. We can be whoever we want to be up when or on the Internet or when when we're the virtual us. So in some aspects that allows us to explore parts of us that might be. More of frightening to exploring in the real world. And on the flip side if it can be frightening because we don't really know. We're talking to another and is with the might say there. Can get very confusing yeah absolutely OK so now let's turn our focus ten and talk about depression some. Tell me about depression what what is depression. Yeah sue I think of depression as a head spectrum. So on mild end. It could be you're IE having. Very difficult day having stress here is that we're having difficulties coping with. As you go higher up into this spectrum. It could it can become. Intense enough for it to impact our daily living. Folks suffering from depression might have difficulties with energy levels with motivation. Might be heard to wake up during the 3 in the morning and it might be might feel like a marathon didn't even get through that they really. Folks often talk about difficulties concentrating difficulties getting tasks done that usually would be easy for them. And you know one of the the most telling aspects is one folks just have difficulties enjoying themselves doing things that usually are enjoyable for them. You know as we look deeper into that spectrum. Or concerns more concerning aspects come out. Such as hopelessness or helplessness. And related side effect or. An impact on suicidal thoughts and suicidal behaviors. To me if I'm wrong but everybody probably feels depressed at some point right I think you're absolutely right. I think the feeling of depression as part of the human condition. Now what we called clinical depression is is something. That is more defined and symptoms. And categorized. Such that. What were really talk when we talk a clinical depression we're talking about extended periods of time. Where thumb our moods and their emotional state it's so intense that it's impacting our ability to get on with life. And so when we talk about clinical depression we're talking about maybe ten to 20% of folks. Through their lifetime having an episode of clinical depression. Whereas here you're I could at any point ever a bad day here. Or whatnot and that and that's a separate sort of kind of colloquial expression of depressed mood. At what point do you. Seek help. Yeah that that's always excellent question. In in my head. When. Your moods are impacting. Impacting your life in such a way that you can't get the things done that. You wanna get done. You're finding it exceedingly difficult to get through the day. Those would be some red flags for. And of course says you look into the more difficult parts when you're talking about hopelessness or helplessness. Thoughts about two. Death or dying as sir I don't know what's beyond her red flag but those are you know this or they can and take off and say gosh. We really need to find some support and and wrap rapper community here Andrea. How difficult is of visit for a person. Who may be feeling this way to reach out while. Pay I believe that it's one of most brave things that somebody can do to have to reach out to a friend or family member professional and say. I'm really struggling. Can you can you help me out here so I I really believe it it is something that it's like the guts. What are some reasons people don't reach out and well I think for the most dumb people will recognize reason is statement tell us that stigma and stigmatization of mental health disorders. The idea that some people have. That depression. Might be a character flow or weakness. And that it should be hidden. In many cultures. We just wouldn't be talking about depression this radio interview. Would not be happening in and some other places and so it and in some aspects. I'm really glad to be an America where we're. People that start talking more and more freely about mental health and depression. Is depression can have an equal opportunity. Condition. Male female young old. Yeah I that I think if you are human. You. Are susceptible. When we look at the definition of clinical depression we do see that it impacts. More. More females than males. And when we look at age ranges. Equal opportunity you can you can find yourself depressed whether your teenager. An adulterer an older adult. The good news I think is the flip side as long as you're human. I do believe you have the capacity for resilience in the capacity to improve from symptoms of depression. To be able to. Learn build skills in practice skills to. To really find yourself in a better spot. We're talking today with a doctor Hahn being from Kaiser Permanente. Don't doctor Gupta to talk about the state of the American health care system as it relates to mental health and what can we do to improve it. Yeah. So I. Again I'm really impressed by the fact that he. Here in America. We are working on battling stigma. And I'm impressed by the fact that were able to speak freely. About such things as depression suicide. Addictions and and so that's something that I'm I'm really grateful for. On the flip side I think that we have significant opportunities. And making sure that we don't silo things. But I mean is if somebody. Is dealing with depression. Or addiction. Anxiety there should be no wrong door to knock on two find support her or get treatment. I'm I'm just thinking anecdotally of of kind of funny college student health days where. Maybe if you if you needed to see some defer an emotional issue he needed to come on Mondays through Wednesdays and if maybe she came and went in on a Tuesday. There wasn't anybody there to see you on the maybe it yet you had a concern about a drinking issue and you came in on a Friday but no that that's you know that's a Thursday today. Wished we shouldn't have those sorts of issues people should be able to get access to resources when they need them and where they need them. So the idea of breaking down silos and being able to integrate our health care system. Across behaved girl. Addiction. And primary care specialty care old all of these things under one house that would be my dream. How long you've been a psychiatrist in what changes have you seen over the time. I'm so I have been practicing here with Kaiser Permanente for the last. Seven years. And I think. Even in the last ten years there's been exciting developments. And seeing more and more. Opportunities. And procedural psychiatry. So that this would be. When you're traditional routes of medications. And therapy. Behavioral interventions. Have perhaps not worked as well. We have new treatments such as trans cranial magnetic stimulation. That's an awful how yeah. These surge treatments for treatment resistant depression. And here Kaiser Permanente. We're we're using these new technologies to. Help folks improve and in their struggles with depression. That sounds. Kind of like a big deal it is owed to giant deal but it's harder to walk through the through the door but didn't to seek these specialty treatment is going to be something else to so again I think the idea of no wrong door. To people to talk to your primary care physician about. You know exercise nutrition therapy medications. You can procedural treatments that's got to be you know where we're we're gone. Another thing that I think is really. Starting to take office the idea of the technology assisted. Behavioral treatments. So we've all got. Some sort of Smartphone and these Smartphones have apps that. Might help us with. Something simple like a daily meditation or in my infamous. Exercise and these are guided exercise this. And I I think there's a lot to be said about practicing my infamous. For some people that might be meditation for some folks that might be playing a specific game on their phone. But. When I first. Learned meditation it was in a martial arts studio or accuracy. Eight. Cash fifth grader and all I remember is my my senses saying sit there close your eyes. And it will happen. Who would sit there for 2030 minutes not knowing what the heck we're supposed to do. And now I think when we're treating teens that that there's this luxury of having guided meditation and it's so much easier when something or somebody is guiding you. Rather than the sitting just sitting there and trying to figure it out yourself as as of you know tenure old. Yeah I can see that the makes sense. And what are people starting to. Take care of their physical health as well as their mental health there are people starting to piece those two things together and realize that you're kind of out of whole person. He need to do bull. Yeah I think it's. Very difficult task it to stay on top of both ends. I I do believe that the ancients. You know recognize this as as well as folks in modern times. That they're they're is a connection between the mind in the body. And so we here at Kaiser Permanente. Were about treating the mind body and spirit as one. Thinking that total health can't be. Addressed unless we really take a holistic view. And it in that view I think about. You know perhaps somebody who. Who has a neck pain her shoulder pain. And that that neck pain her shoulder pain might be actually a result of something simple like cash. There and their shoe size is wrong or there's 11 issue with the smaller fuel than other Shaquille says their. There watching round crooked and says the hell of a sudden unity through. Your foundation is is come balance or your your upper. Body parts are starting to get sore but what. What caused that difficulty of that imbalance in the first place well maybe there was stress in your life that was distracting you from realizing that. Your shoes are imbalanced or. Mean maybe there's. You know maybe there's a rocker key in your shoe and it really hurt hurts and and it holds you gotta do is. Take the time to kind of realize your situation. Figure out what's what's going on. So what you're saying is that there is actually the connection between physical health and mental well yeah absolutely. And I think we will we didn't have studies that might say that when your emotional health is at risk. You end up spending more time at the doctor's office for physical conditions X and because he's. Unfortunately there's an unfortunate statistic. That issues that. Folks that are dealing with emotional issues are more likely to be prescribed. Opiate pain medications. Four physical issues. So I think we've got we've got to wrap themselves around and make sure that we take a holistic view at the mine in the body. To the degree they do to me and we talk about stigma now tell me about what Kaiser Permanente is doing to address stigma of mental health. Yeah. One of the exciting campaigns that we've been running has called the find your words campaign. The started in 2016. And we've done a few things locally. Last year. We were able to commission a couple. Earnest to paints and murals Sundays. And these. With wells out. In Portland in one of the buildings was quite dilapidated and were able to have the artists creative beautiful mural. That really talks about taking time in making sure that. You. Address your depression and understand that addressing depression does does take time and effort and you should give yourself. Two. That. That space and time to do so. So to find your words campaign is is really about. Decreasing the stigma. By encouraging folks to talk about. Mental health and emotional health. To encourage people to have conversations about. Oh this. The campaign. Encourages. Other aspects such as that educational aspects of emotional. Health and depression. So the website itself you can you can go to www. Find your words stuck or G. And learn about depression. You can learn about how you can support your friends are firmly if the have depression. Gives you ideas about how to start the conversation. Even gives you tips on what not to say. Like you know pull up your boot boot straps or. It'll get better she just with the next day. Those sorts of things can be less helpful whereas. If we earned their and we listen and we keep an open mind. That can be more supportive often. We we go into this advice giving. And if mindset for a lot of times when people are sharing their struggles Britain I think really they just wanna be heard. And they they wanted to feel connected. To people that have depression. Too they want to talk about it. Neighbors that kind of person to person dependent. Gosh I think that goes back into that the wide spectrum of things that have worked with folks. Where. It could be as easy is how's your day and they're able to. To really start talking about their emotional states pocket talking about. Not only how their day was spent. Why they felt down what their triggers were. There's other folks. That that might just you know. Say one or two words there are other folks that will. Feel quite clammed up when. Folks ask them about these things. So I think we. We shouldn't be sensitive and offer and ten year when we can. And not be disappointed or upset when somebody you might not feel uncomfortable talking at that. Specific time. Here find shortstop ORG looks like it's a really great resource for people to go and figure out at least a starting point right. Yeah first somebody who is depressed and maybe somebody who wants to speak to somebody in their life who they may think it's depressed yeah a great place to start. I I think that I'm really proud that Kaiser Permanente has put the time and effort and the energies into this campaign. And it really. Speaks to me is this how how much not only terrorist organization but I think America is starting to. Pay attention to mental health and and wellness. It. The other thing that I think about is that. In find your words it encourages us to talk to our friends or family members. But there's certain situations where. We may want to speak with they are a professional. And and sometimes that can be self initiated hum other times it may be that. You might want to give your friend or family member a little nudge to to seek professional. Fingers in the Kaiser Permanente just released findings when national consumer pull on mental health what was in that. Yeah why I have some of the information right here so with an exciting for addition to share. To this consumer poll was conducted. By Kaiser Permanente in it and choose that we've made some significant progress from last ten years as far as awareness. And work towards reducing stigma but at the same time there's some lingering. Misperceptions. I'm sue the very specifically. One question. Asked. About. How people feel about discussing mental health issues I'm now vs ten years ago. And more than 70% of respondents felt that people are more off open to talking about mental health issues now than ten years ago. So that's that's really heartening for me. The same time. Nearly 60% of respondents indicated. That they viewed depression. Has caused in some part by a personal weakness or failing. So we definitely know that that's not true. And and unfortunately that might be some of the lingering. Stigma and misperceptions that we. Have significant opportunities to. Provide more education on. And that's in part like Kaiser Permanente is continuing to support this. Initiative and improve it in improving mental health awareness. What kind of impact is. The news having on people to you of the word consciously. Were bombarded with. Lots of stuff for it now. So. Four from eight personal perspective like I do believe that there are times. When. We can take a lot of information. And we can process that. Those are the times when we're in a good emotional state. Where were not stressed her or her not as stressed. But there's times when we may be feeling stressed her down and those are times when too much news may be. Bad news. And those of the times where we probably wanna look at simplifying our life. Turning off that the news because. We might not be able to handle. News about a hurricane or wildfire. Or shooting. These are times when we might. Be better supported by. Talking with their friends and family about. More immediate issues and local issues. In the lesson that we have here what do you see in the future for mental. Well. Star Trek future or are more like ten years you gave me a little more realistic. In our lifetime but I. So. Again my my dream would be. That should. Folks can come in. To any. Medical visits and be able to talked about emotional stress or send fine support there. At the primary care setting. That if if somebody. Needed the heat to an up or a preventative check on emotional wellness that that would be available to them. That we start looking at how we can. Help at the beginning of folks journeys rather than towards middle or at the end. And soon that to me elf suit that involves the community. And our educational system. Really excited to hear about folks starting to teach my infamous at the schools. And so I think there's a significant opportunity to in to instill skills. That our kids can start practicing when they're young so that when they become teens and adults. They can be much more resilient. So my my dream for mental health and future is that that our society. Makes it important. Two to teach skills and to reinforce skills. Whom it may be rather than pills into the future. I like your future they have to. You've given us some great and important information today thanks for being on the show thank you. Mitchell's bill is an Entercom radio Portland public affairs program.