School of Public Policy

Kevin Karami:

Welcome to Policy Chats, the official podcast of the School of Public Policy at the University of California Riverside. I'm your host, Kevin Karami. Join me in my classmates as we learn about potential policy solutions for today's biggest societal challenges.

Andrew Shannon:

Joining us today is the Director of operations and strategies for ACT Now for Mental Health. Joy Chen, my fellow classmates, Kevin Karami and Giovanna Arena, chatted with her about mental health awareness.

Kevin Karami:

Thank you so much, joy, for taking the time to join us for an episode of Policy Chats. We really appreciate it. Mental health is a really interesting topic in the policy. You know, side of things, I think often it gets talked about in terms of we as people can you know increase mental health awareness, what kinds of things we need to be focusing on in regards to the issue, but I think the policy side of it is also really interesting. And so that's one of the reasons why we're really excited to do this episode. Before we get into the weeds of everything, I was wondering if you can maybe overview what your work is in the mental health kind of awareness space, and what areas do you focus on specifically? So what kind of work are you are you doing in this area?

Joy Chen:

Yeah, yeah. No, that's a, that's a really great question. So I am the Director of strategy and operations for a nonprofit, a national nonprofit named ACT Now for Mental Health also known as A N M H. We are a nonprofit dedicated to destigmatizing mental health and increasing mental health access for all young adults in that we really focus on communities that have been historically underserved by the medical system, and that includes people of color, those that identify as L G B T Q those that are uninsured, underinsured, as well as those with physical and mental disabilities. And so our organization really focuses on, has three pillars, and that's kind of what, where ACT comes from. The, the first initial is for advocacy, compassion, and treatment advocacy, and really thinking about how a lot of the mental health issues that we face today as a nation are really tied to policies that have made it so right.

A lot of policies that have been either not addressed or issues that have not been addressed in policies that have not been passed to really place solutions in understanding that it really is a top down approach that in order for us to see the changes, we really need policies to make it possible to do so. And so our organization is focused on advocating for policies that increase access to mental health services for young adults, but also as we, as we think about compassion and the way we talk about mental health is really destigmatizing that conversation and how what we, what we're already seeing in the past couple of years is, you know, destigmatize, de destigmatizing certain mental health issues, right? We we're seeing a lot, a bigger conversation around depression and anxiety, which is really great and such a huge step for, for everyone, especially young adults.

Those are, are, you know, faced some of the highest rates of depression, anxiety, especially since the pandemic started. But we still have really difficult conversations and people still feel really uncomfortable talking about those with more serious mental illnesses. So those with bipolar disorder, borderline personality disorders, schizophrenia, and really we wanna focus on being able to have these conversations and to de-stigmatize these mental health issues as well. And that really is about, you know, kind of increasing peer, peer-to-peer supports and building more of that kind of support among friends among our communities and among our families as well. And then finally, as we think about treatment, right? How can we increase access to mental health treatments for, for folks? And that really kind of comes in a twofold. One, making sure that people who don't have insurance are able to access mental health treatments and be able to see, seek out therapy, but also making sure that those that are seeking out therapy can access culturally competent care.

Because what we're seeing is that people who, people ideally would love to see a therapist that looks like them, that has the same lived experience. And that can be really difficult if a lot of providers don't necessarily have that kind of culturally competent competency training. And or we're not really incentivizing enough of certain populations to be able to go into these fields to serve these pop to serve these populations. So I would say those are, that's kind of the, those are the three areas that our organization and I really focus on in mental health.

Giovanna Arena:

Mm-Hmm. <affirmative>, I'd really like to dive more deeper into your organization. What do you feel like are some more pressing challenges in your line of work?

Joy Chen:

Yeah, I mean, I think that when we think about mental health and behavioral health, especially in terms of policy, there are probably endless issues that kind of, that we have to face. And so this is by no means a complete summary of all the issues that that are facing behavioral health. But these are some that I think are probably the biggest that we need to, the biggest hurdles we need to overcome to really get to a place that we can implement longer term solutions. One of them being the shortage and lack of diversity in the behavioral health and workforce. According to the American Psychological Association, the apa, about 86% of psychologists in the US are white, meaning minority groups often see providers who do not share similar racial, cultural and or ethnic backgrounds. But cultural competency within the behavioral health workforce is critical to ensuring the quality and the effectiveness of behavioral health services for all individuals.

It's really critical that Congress increase the amount of federal grants that are available to students pursuing a career in the behavioral health workforce because they will need to use this for its tuition and related expenses. And these are huge barriers that prohibit a lot of students from going into these fields, especially those that identify as people of color as LGBTQ and those with mental and physical disabilities. And really thinking about how we can disseminate these grants to improve the mental health of providers to prevent burnout. Especially due to you know, even though the COVID 19 pandemic is technically over, you know, we're still seeing a lot of effects of the pandemic, and that's where we're seeing long wait lists and a lot of providers that close are closed to new clients. And so there's just a lack of providers are even taking clients right now.

But also, I mean, I think in terms of the cultural competency side, I think it's really important that we, we strengthen the workforce to ensure that providers receive kind of that, that culturally competency training. And that's kind of a more short term solution, right? The longer term solution is what I had mentioned about really funneling grants to, to students, but I think in the short term, really thinking about how current providers can receive culturally competency training to ensure that they can best serve individuals from diverse backgrounds. I think the second key issue that really faces behavioral health today is increasing integration and improving care coordination of primary care and behavioral health services, right? Because what we're seeing is that most, most people really only see their primary care provider throughout their entire life, right? Many don't go to see their specialists, or many, many people just don't generally go to specialists because oftentimes those are not covered by insurance or it's, you know, another step that they have to take to go and see another provider.

But PCPs are usually the most trusted source for medical information for most individuals. And when we see that, right, they're kind of the first line of defense. And while we don't wanna make sure we're not, you know, burning out our PCPs, we also wanna realize that they are capable of, you know, identifying kind of at the first line the key issues that an individual may have. And so, you know, really thinking about how we can train PCPs to properly identify and to refer behavioral health conditions you know, to either psychiatrists or to you know, psychologists as as needed. But really how we can think about integrating primary care and behavioral health better and to improve the understanding for primary care providers so that, you know, if someone has depression or has anxiety that's screened at the very beginning, and that we can identify these issues, you know, earlier on in kind of the, the continuum and, and we can help get individuals the help that they need earlier,

Kathryn Wren:

Social injustice, health disparities, climate change. Are you interested in solving pressing challenges like these currently facing our region and the world? Then consider joining the next cohort of future policy leaders like me by applying for the UCR Master of Public Policy Program. Learn more @ mpp.ucr.edu. You can also find the link in our show notes

Kevin Karami:

That's really interesting. And I, and I want to focus on the first challenge that you highlighted, the kind of the idea that it's, it's very difficult for some to, you know, take these steps to, to get help when they, the, the people that are supposed to help them, that they have trouble identifying and finding a, a kind of common ground in regards to the issues that they face because of cultural and I, and identity differences. I, I had a follow up on that. Do you think that, you know, on the one hand it's, it's 2023 and a lot of progress has been made but it's interesting that there's still, so, there's still such a massive need for support for more people to have the ability to actually get, get involved in these careers and get involved in this area. You, you had mentioned you know, there needs to be more like financial aid, for example, to actually, so people, it is really expensive to get an education. And so do you think that that's something that on a, on a federal level, maybe on state levels are, is that progress being made? Are we heading in the right direction or is it kind of stagnant and does there need to be much more support to diversify the field so that people can actually get help from others who they can identify with and understand at a deeper level the kinds of issues that they're, that they're facing? Is that progress being made, do you think?

Joy Chen:

I think that Congress and our representatives and our senators are very much aware of the issue. You know, this has kind of been a key issue for a lot of our hill champions and just among kind of constituents for the past two years, especially with the pandemic, right? But, and, and I think it's, it's really important to, to emphasize that, and mental health and behavioral health has have been issues long before the pandemic. It just, if anything, the pandemic just kind of revealed slash exacerbated this issue. And and so I, I think that, you know, over the last year or so, Congress has really made behavioral health a priority, but of course there are also all the other priorities in Congress, right? And oftentimes this can be pushed the back burner, which kind of happened last year. I think that, you know, there was a huge push from all of the different committees to put together a broad package, you know, of different mental health legislations and policies that really could have changed the field.

But given that there were so many different competing priorities, Congress did not pass that package. And so they actually took pieces of it and then included it in an end of year package. And I think what we're really seeing is Congress trying to address kind of this on a more piecemeal process. And that is through, you know, state grants that is through, you know, easing some kind of scope of practice issues you know, allowing certain providers to build directly directly built for Medicare, which they, you know, didn't used to allow for. Because, you know, because there's a shortage of providers, you know, they, I think one of the, the key solutions is really looking on how they can expand scope of practice for certain providers so that, that weren't given you know, certain billing flexibilities. And so I think that we are seeing more policies being driven in the last two, two to three years than we've seen probably in the last 10 years. But there's just so much more that we need to do on both the federal and state level. You know, one, being able to properly identify the scope of the behavioral health issues in each state, right? Because each state looks so different in what they need. But also it really takes a federal effort to allow these states to kind of have the funding to be able to address those issues within their own communities.

 

Kevin Karami:

Yeah, that's, that's really interesting. And, and you kind of also were peering into the, the direction of my next question, which is the effect and impact of kind of societal or international level conflicts or crises. I know the pandemic you had mentioned is, is probably the one that's been talked about the most, but I think it's also interesting to talk about maybe some other ones. Some of the other ones I'm thinking of maybe are when Russia invaded Ukraine, the impact that had on people's minds. Is there a relationship? And, and I think maybe the, the answer to this question might be obvious, but can you maybe describe that relationship between, you know, large scale external crises and conflict or just social unrest and how that affects the individual? Because I think, and again, I think the pandemic has sided really often, but I can also think of another, like other ones. I think another big one might be the overturning of Robi Wade and the impact that, that might have had. From your experience and, and your, and, and the work you've done. What, what kinds of things do you see when, when there's something a, a major conflict or a major issue happens on a really big scale, how does that kind of translate into the individual's health? You know, what kind of relationship is that?

Joy Chen:

I mean, I think that it, it really is kind of, it builds on top of already existing issues, right? I mean, I think that all of us have really different lived experiences. You know, if I'm speaking from a very personal level you know, I identify as right, an Asian American woman. And so when, what we've seen right at kind of the beginning of the, of the pandemic and kind of throughout, were a lot of anti-Asian hate crimes, right? And I think when we think about these issues and how, of course they don't happen in silos you know, we've had, it's not as anti-Asian hate crimes have occurred for many, many years, for decades. And so growing up and seeing that, and then also being at an age where you're con we're kind of processing that and understanding that it could happen to you, it could happen to your parents and your grandparents.

And not only are you afraid for your own life, you're afraid for your families and your friends' lives, that takes a toll absolutely on the ways in which you protect yourself, protect your families. You know, I think it, it can very easily also bleed into how you approach others and think about, you know, com how you think about community safety, right? I think that in general, societal unrest has the most obvious terms, right? It has a direct correlation with mental health. And, and of course, each person's experiences are so different depending on your own lived experiences, your own identity, how your own lived experiences really influence how you approach life. But I think one thing that I would really want to caveat all of this is that I think it's so easy when we think about blame and how we kind of take our next steps when a lot of things happen, right?

When a lot of gun violence and hate crimes and kind of occur in our, in the world, but really we need to approach it from a really, a community lens and how we can take steps to protect our own communities. And that, when I say that, I really mean that in the form of, you know, like our, our local communities, right? Like people who you know, live in our neighborhoods and those that how can we really come together almost in a sense of like, you know, mutual aid and really supporting our communities. Because I think that when we think a lot about the societal issues and a lot of the conflicts that have happened, I think we can get really overwhelmed and figure and feel kind of, we feel like we're so small that there's no way that we can address anything that happens in the world or happens in our community is, but what we do have control over is, you know, being able to like volunteer in our communities and whether that's kind of like a neighborhood watch, right?

And being able to help our communities and those that are unhoused and really thinking about how can we funnel resources back into our communities so that we can at least somewhat curb some of these societal unrest that we do see, right? And I think when we think about kind of these smaller steps and things that we as individuals can do that, of course, in addition to kind of the general systemic issues that our federal government needs to address and needs to actually take accountability for, but us as individuals, like, what can we do, right? And I think that whenever I, these things happen and I, I'm trying to think more about my role and what I can do, I always try to place it back on, you know, here. So here are some small steps that I can take if I have the capacity to do so, of course, to help up my community and to kind of build more of this community safety.

Giovanna Arena:

I'd really like to talk about social media. What roles do you feel like both positive, positive and negative does social media play and mental health awareness?

Joy Chen:

I have a lot of thoughts about this <laugh>. I think that social media can be and has been very good in terms of mental health awareness. I think that we have seen, you know, I think one of the, actually the big reasons that anxiety and depression have become largely de-stigmatized is because of social media. I think a lot of people have been given platforms to talk about their mental health issues on Twitter, Facebook, Instagram, TikTok, and it has made others feel less alone. You know, we, they have the language to be able to express kind of, you know, the feelings that they're, they're going through. And I, I think that what we don't talk about enough is that like, when we are going through a lot of mental health issues, or we're going through a lot of these different feelings, even though we know that we are probably not the only ones ever feeling this way, it feels very isolating, right?

And I think to hear other people talk about what they're going through is so helpful in helping us process our own emotions and helping us really understand that, you know, it's really not just us and that every other person probably on this planet has, has had these feelings before. And I think that med social media has really helped than that. However, I think also social media has, I think, has kind of perpetuated this idea that therapy can fix everything, and that if someone just goes to therapy that boom, their problems are gone, right? But that a lot of the issues that of impacts mental health are actually tied to the social determinants of health. And that kind of includes access to really tangible resources, right? So if someone, you know, who lives in poverty cannot access food healthy foods, does not have access to housing and does is uninsured, so can't get access to the healthcare services that they need, that will ultimately impact a direct correlation you know, impact on their, on their mental health.

And so I think it, it's really important that when we think about, you know, how, when we think about mental health, it really, therapy is a huge part of it. Don't get me wrong. You know, I think that most of us would probably benefit from being in therapy if we, you know, have the resources to do so. But I, I don't want people to think that if, you know, as long as they get into therapy that all of their problems will go away, that, you know, soci that suddenly society will be better for it, because that just isn't the case. It's just there are so many systemic factors that have led us to where we are now in terms of a behavioral health crisis.

Kevin Karami:

Definitely. I, I think social media is, is one of the most interesting topics to, to talk about in, in this context, because like you mentioned there, there are a lot of positives to it. And, and I, and I def I love how you, how you put it that, you know, one of the reasons why it's so much more destigmatized to talk about our, our personal feelings is because of social media and the platforms people have. You know, we talk about the negatives of social media and the impact that it's had on our society so often that we forget that there are actually positives to it, and there are some significant positives that are also worth mentioning. So I really like the way you put that. Joy, as we kind of close out the episode, if, if there was one message, and I, this is probably really difficult, but if there was one message you could kind of leave our audience with in regards to mental health awareness or maybe something policy related what would it be and why?

Joy Chen:

Yeah, that's a, that's a hard one. There are a lot of things that I think we could say about mental health and, you know, particularly for young adults, I think that, similar to what I had mentioned prior, I would love to, for, as we, as we again, think about mental health and the feelings that kind of come with it, and the ebb and flow as we, you know, many of us who, you know, experience mental health issues, is that as isolating as it really feels to go through, through all of this, is that you really are not alone in that no matter what your mental health condition is, right? Whether it is anxiety, depression, or schizophrenia, bipolar disorder, borderline personality disorder, that a lot of these feelings are a lot of these mental health issues are incredibly common and that you know, those, there are many of us who have experienced have either ex or, or have that experienced that condition, or we know of someone who has experienced that condition.

And so I think oftentimes those of us who experience mental health issues also feel as though we cannot reach out, and we don't wanna be a burden to those around us. But I think it's really important to know that you know, you have people that care about you and there are resources out there to help you, you know, act now for mental health. A m H really is one, and we, we want to be a starting point for all young adults, and of course, we, we focus on young adults, but there are so many organizations like us who want to be a starting point for your mental health journey. And so I think it, it takes just, you know, reaching out and taking that first step, no matter how hard that feels, whether that is kind of call is calling a crisis hotline, the 98 number that was rolled recently rolled out, or doing a quick search to see, you know whether there are organizations that can help you kind of figure out your first step.

 So I really hope that those that listen to this will know that, you know, behavioral health, even though it seems like I would say it can sometimes seem like a buzzword now, because so many people are talking about it, that it's still such a personal issue. And I want those to know that this is, this is a very personal issue, but that there are many people who are here to help and are willing to help because all of us, it, it's really a much more common issue than many of us talk about.

Kevin Karami:

Great. I think that's a, a great way to end the episode. Joy, thank you so much for taking the time to join us on policy chats. We had a wonderful time speaking with you, and I'm really excited to get this episode out. I think mental health is often forgotten a little bit in regards to the policy side of things but it's like you mentioned a really, really important topic to talk about. So thank you so much for taking the time to join us.

Joy Chen:

Yeah. Thank you to you both.

Kevin Karami:

Thank you so much.

Kevin Karami:

This podcast is a production of the UC Riverside School of Public Policy. Our theme music was produced by C Codeine. I'm Kevin Kami. Till next time.