Now Viewing: Mental and Emotional Well-Being

Mental Health Challenges of Hurricane Sandy’s Aftermath

Oct 29, 2014, 8:31 AM, Posted by Vicki Philips

Hurricane Sandy - Shore Tour Driftwood Cabana Club, Sea Bright, N.J.

On her 90th birthday, instead of celebrating, Dottie (whose last name is withheld for privacy) lost her home in Superstorm Sandy. Two years later, she is still displaced, living in temporary rentals.

Dottie’s nephew is trying to change that. He’s been rebuilding Dottie's home. Like so many New Jersey residents, he says he’s going to keep at it until reconstruction is complete. Meanwhile, he’s getting some much needed support from groups like BrigStrong, the County Long Term Recovery Group, and the Mental Health Association in New Jersey (MHANJ).

It’s been two long years since Hurricane Sandy slammed into New Jersey on October 29, 2012. As a mental health worker, I still see the aftereffects firsthand.

For the past two years, the Mental Health Association in New Jersey (MHANJ), along with other local groups, has been on the front lines of the battle to maintain the mental health of Jersey Shore residents. Thanks to a major RWJF grant, MHANJ has been able to leave the county in a better position to deal with the next disaster:

  • We’ve given mental health first aid training to city employees who, in their daily work, encounter community members with mental health issues.
  • Through our Certified Recovery Support Practitioner program, we’ve improved our ability to reach out to the most vulnerable. Many community members certified through the program have faced mental health challenges themselves, which only increases their credibility.
  • We counseled populations with mental health issues on how to safely evacuate or shelter in place, thus ensuring that first responders will be safer in future emergencies.

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Let’s Talk About Stress

Oct 2, 2014, 9:52 AM, Posted by Mike Painter

Mike Painter Mike Painter speaking at Health 2.0.

I recently returned from the Health 2.0 conference in California, which drew 2,000 health care innovators. One of the most popular Health 2.0 sessions was called “The Unmentionables”—where speakers discussed those important things that affect our health but we are often afraid to address. I participated in this year’s session where we talked stress—what it is and how it’s making us sick.

I’m an avid cyclist. That means I train a lot. Training on a bike means purposefully and intensely stressing your body—sometimes ridiculously hard—in order to make your body stronger, fitter and faster. In that sense stress can be really good. You can’t get stronger without it.

But here’s the key: as you ratchet up that stress—the miles, the hours on the bike, the intensity—you must work just as hard on the flipside, the buffering. The more you train, the more you have to focus on the rest, the sleep, your social supports, the yoga, the nutrition—whatever it takes.

If you don’t buffer you will burn out, get injured or sick, or all of the above. Without buffers, the stress will crush you.

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Stress: Withstanding the Waves

Sep 23, 2014, 11:42 AM, Posted by Ari Kramer

Infographic: stress_section
Infographic: stress_section

Infographic: How Do We Move From a Culture of Stress to a Culture of Health?

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As a kid, when you went to the beach, did you ever play that game where you’d wade into the ocean and test your strength against the waves? You'd stand your ground or get knocked over, and after a few minutes, you'd head back to shore.

We didn’t realize it at the time, but as we felt those waves roll by, we were getting an early glimpse of the stresses of everyday life. The difference is, as adults we can't choose to stand up to just the small ones. And for the most part, going back to shore is not an option.

In a survey RWJF conducted with the Harvard School of Public Health and NPR, about half of the public reported experiencing a major stressful event in the past year. In more than four in 10 instances, people reported events related specifically to health. Many also reported feeling a lot of stress connected with jobs and finances, family situations, and responsibility in general.

Over time, those waves can take their toll. And when they become overwhelming, they can truly wear us down, seriously affecting our both our physical and emotional health.

So how can we deal with these waves of stress? Certainly, there are proactive things we can all do help manage its effect on our lives—exercise, for example. At the same time, we’ve probably all experienced instances when we’d love nothing more than to get up early for a run or brisk walk—but don’t have the energy because stress kept us up at night. Or we may just be too tapped out from long hours, relationship struggles, caring for loved ones, etc., to spare the energy or the time.

If this sounds familiar, consider yourself human. Right next to you, whether at work, on the train, in your grocery store, is probably someone whose waves are similar to or bigger than your own. So at the same time as you try to manage your stress, ask yourself: What could be done to help others achieve a solid footing? In this ocean of ours, there’s never a shortage of opportunity to lend a helping hand.

Have an idea to help move from a culture of stress to a Culture of Health in the home, workplace or community? Please share below—we’d love to hear from you.

A Survivor’s Take on Depression: We are the Sad Ones Try to Understand Us

Aug 15, 2014, 11:22 AM

Depression Painting to go with blog post Painted in the hospital after suicide attempt

(This post was written by a member of the RWJF family who has asked to remain anonymous.)

Every day I worry that I will be caught. It could happen any time, any place, and by any one person that looks past my smile and into my eyes and knows immediately that I am not like him nor her. He or she will not see the color of my eyes, but rather that I am hiding something.

I have been in and out of therapy since the age of 9, and on and off antidepressants of every color and brand for more than 20 years. Yet I stand here today with the same diagnosis that I had when I was a child, despite the “help” and the “work” that I have devoted to my illness ever since I can remember. I have clinical depression.

I will never be “okay” by conventional standards without medication. I have finally come to realize that this is not my fault, but rather a product of my DNA. Nonetheless, I hide in shame. No one knows of my diagnosis, or the medicines that I take to help control it, or the acting that I perform daily to hide it.

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Preventing Suicide: If You See Something, Say Something

Aug 13, 2014, 9:16 AM, Posted by Brent Thompson

Dave and Brent Dave and Brent

The second week of August is one of the worst weeks of the year for me. At least it has been since 2008.

Six years ago this week, my friend Dave decided he had enough of the daily struggles of this world and took his own life on a trailhead in the desert near Tucson, Ariz.

He was 31 years old and left behind a fiancé, family, and scores of friends who loved him deeply.

Dave was one of the most incredible people I’ve ever known: a generous soul, full of humor, creativity, compassion, and love. He had more friends than anyone I know. Dave elevated everyone who knew him, inspiring them to find joy, open their minds, chase dreams, and see beauty in the world. It is impossible to count the lives Dave changed for the better, including my own.

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An Ounce of Prevention, Even for Serious Mental Illness

Aug 7, 2014, 1:30 AM, Posted by Jane Isaacs Lowe

An educator works with a student on a hard problem

As we work to build a Culture of Health for all Americans, it is time to end the stigmatizing distinctions between mental and physical health. After all, the brain and the body are in constant contact, and affect the well-being of each other in too many ways to count. A true Culture of Health recognizes the interdependence of mental and physical health, and places a premium on prevention and early detection of illness, regardless of type.

We commonly provide preemptive treatment or suggest early lifestyle changes for people at risk for diabetes before the condition evolves into full-blown disease. Yet, we typically don’t approach care for serious mental illness in the same way. It’s time for that to change.

The results from a recently released national study of the Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP), a project RWJF funded between 2006 and 2013, demonstrate that early intervention to prevent the onset or progression of psychosis in teenagers and young adults improves health and well-being. By helping family members, pediatricians, teachers, young people, and other community members identify young people experiencing early symptoms of serious mental health problems, EDIPPP was able to engage and treat these young people early. That early intervention in turn helped them stay in school, remain employed, and maintain vital connections to family and friends. These benefits mitigated the effects of mental illness, and allowed these teens and young adults to lead healthier and more productive lives.

This study should shift our thinking about how we best treat young people at high risk of serious mental illness. It should also remind us to look at good health and good health practices through a much broader lens, because building a Culture of Health means finding and sharing solutions, and celebrating signs of progress.

Read a Washington Post article on the program

Read a first-person post about depression and the best way to support those who are suffering with it

Read a post by Brent Thompson on bipolar disorder and the death of a friend

Filling in the Cracks: The Fight for Mental Health

Jun 11, 2014, 3:11 PM, Posted by Beth Toner

In December 2009, I found myself in a narrow, cramped waiting room that looked, via one small window, into the locked psychiatric unit of a suburban Pennsylvania community hospital. On the other side was my oldest son, just a week shy of his 17th birthday. He was clad only in a thin hospital gown, perched in a wheelchair that was outfitted for restraints—although he wasn’t restrained. He looked tired, frightened, and overwhelmed. My husband, his stepfather, sat next to me as we waited for answers. Tears sprang to my eyes. Could my son—and our family—find our way back?

That moment was the culmination of six months of escalating anxiety and mood swings in my son’s life. He had always been, from a very young age, an intense child: bright, intensely focused, and articulate—which occasionally manifested itself in stubbornness and a reluctance to back down from an argument. But the fall of his junior year of high school had proved to be something very different. Suddenly, his occasional anxiety multiplied exponentially, completely out of proportion to the stressors in his life. Ten-point assignments in an advanced placement bio class turned into all-night crying and screaming sessions that ended with him sitting in a corner sobbing—and us all exhausted and at wit’s end. We tried therapy, with minimal effect. His school guidance counselor, not really understanding the depth of Wesley’s despair, encouraged him to “tough it out.”

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Why Empathy is Essential to a Culture of Health

Apr 11, 2014, 11:34 AM, Posted by Tara Oakman

Peace activist Zak Ebrahim speaks at TED 2014

Everyone knows it is hard to get 2-year-olds to do anything on a schedule. They want to do everything their way, on their own time. As you can imagine, trying to get my twins out the door each morning—let alone take a bath or eat a meal, can be quite a challenge. After trying a number of different parenting methods, I have discovered that the one way I can usually motivate them is to talk about feelings, and get them to recognize how their actions affect their sibling. Just yesterday, the only way I could get my son out of the bath was by telling him that his sister was sad and lonely waiting for him. And then, and only then, did he move.

Building empathy has been a critical strategy in my household of late—not only because it helps motivate them, but also because it is an important part of their social development. Lately I have been thinking about empathy on a larger scale, beyond my household, and how critical it is to building a Culture of Health.

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Head Start Program Uses Brain Science to Help Kids Heal

Mar 20, 2014, 3:40 PM, Posted by Jane Isaacs Lowe

In the late 1990s, a major study of adverse childhood experiences by Kaiser Permanente in California found that people who had been exposed to traumatic events such as violence or abuse during childhood were much more likely to have serious health problems as adults. Over the next decade, advances in neuroscience explained how childhood trauma can harm brain development and change the way kids feel and act in response to even normal events in their lives.

So, what to do? How do you protect or heal vulnerable children? An article on an innovative pre-school program in the Fixes column of yesterday's New York Times is an example of some solutions that are starting to emerge.

In 2010, the Robert Wood Johnson Foundation (RWJF) partnered with local funders and Crittenton Children's Center in Kansas City, Mo. to pilot a new kind of Head Start program that would provide caring support to pre-schoolers exposed to traumatic events—homelessness, abuse, the loss of a parent, for example. The idea was to create a web of support among all of the adults who would interact with kids throughout their day, including parents, teachers, administrators, even the school bus driver. The school would also give kids specific tools to help them deal with their emotions in a healthy way and build resilience.

Head Start Trauma Smart wanted to ensure that the children would master the skills they need by the time they start kindergarten, because kids who are already falling behind in kindergarten have a much harder time succeeding in school and living a healthy life. The results of the pilot were so promising that in 2013 RWJF gave Crittenton Children's Center a $2.3 million grant to expand the Head Start Trauma Smart model throughout the state of Missouri. 

Watch a new video documenting how Head Start Trauma Smart works. Hear some of the stories of kids who have been exposed to traumatic events that are almost unimaginable and of the caring adults who are helping them heal. 

The parents and school staff are trailblazers, doing inspired and inspiring work to help bring out the best in each and every child. And while there is nothing that they are doing in Missouri’s Head Start programs that couldn’t be done in every community, it’s not easy to get systems of care to adopt this kind of change.

New York Times columnist David Bornstein explains why this program is so significant. “Trauma interventions can be highly effective but the challenge today is extending them from therapeutic settings—which are limited and expensive—into the broad systems that serve larger numbers of children.”

Here at RWJF we think a lot about what it takes to build a culture of health in America. There are few better examples than the Head Start Trauma Smart pre-school, where every child has the chance to thrive, and every adult who crosses their path has an opportunity to be a positive influence. And where great ideas that improve health spread to more communities where they can help more families in need.

Alzheimer's: Let's Search for Better Care Models as Well as a Cure

Jul 9, 2013, 2:00 PM, Posted by Catherine Arnst

An elderly disabled man walks with a stick on a path in a garden.

The New Yorker recently ran an excellent article by Jerome Groopman MD, Before Night Falls, about efforts to find a drug that can delay or even stop the onset of Alzheimer’s. What struck me most about this thorough piece of reporting, however, is that it covers much the same ground as a feature I wrote for Businessweek—in 2007. Despite the huge amount of money and other resources devoted to Alzheimer’s research, the quest for an effective treatment has moved forward by mere fractions in the past six years.

Almost every drug I wrote about in 2007 has since failed, which means it will be at least a decade, and probably far longer, before an effective treatment wins regulatory approval. Meanwhile, the Alzheimer’s Association recently reported that one in three seniors will die with Alzheimer’s or another form of dementia in the U.S. this year, and 5.2 million people are currently living with Alzheimer’s. By 2025, the number of people living with the disease will likely reach 7.1 million. So while we’re waiting for a cure, the medical community should also be developing better methods for caring for the millions of patients who are suffering right now.

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