Protecting mental health in crazy times A ToDo list

it’s waking up on the floor of a cold

prison cell

and having no idea how you got there

it’s hiding in the bathroom at work

because you’re shaking again and if

anybody sees you you’re going to lose

your job

and it’s that little girl who used to be

so sweet that now she’s punching the

other kids at school

it’s mental injury in this pandemic

a social fabric torn asunder it’s hard

to feel

stable when the world has been collapsed

at your feet

but it’s really important to take

concrete steps

to protect our mental health both on an

individual level

and also on a societal level and so i’d

like to share with you

my 10 points the first of which is to

take stock

now even before the pandemic roughly one

billion people were estimated to be

suffering from mental health issues

and of course that leads to

corresponding issues of poverty

criminalization discrimination but the

pandemic

cracked open the facade of mental health

and exposed the insufficiencies and

injustices that have been there and of

course

also rates of mental illness have

increased during the pandemic the

suicide rate

has increased across the board and in

fact it’s being called a shadow pandemic

but in the same way that we need to take

stock on

a societal level it’s also important to

take stock on a personal level

for me i can say oh man my burnout is

back

and it has brought a friend insomnia

it’s two o’clock in the morning staring

down the barrel

of my alarm clock knowing that i have to

wake up

in a couple of hours but i can’t sleep

it’s when the colors of the rainbow

turn to black and white which leads to

point two and that is to get context

now in my family we have a long lineage

of trauma

and an equally long history of denying

it

when my mother was a little girl in the

great depression

her father killed himself under the

weight of economic ruin

but her bereavement soon turned to

horror under the hands

of the man that her mother went on to

marry

incredible abuse that happened behind

closed doors for over 10 years

everybody was in denial about it my

mother went on to have profound

psychological problems and i took care

of her

and 60 years later i still can’t sleep

in the same way that we need to look at

the deeper context however

of our personal challenges we also need

to look at societal challenges

now under the pandemic alcoholism

child abuse domestic violence have

increased across the board but they are

seen as individual trends rather than

very clear signs of collective trauma

a societal failure in dealing with

mental injury

and of course people of color and those

of marginalized gender identities

face more discrimination in the mental

health system

it’s waking up on a cold prison cell and

having no idea how you got there it’s

your black skin

it is the post-traumatic stress that you

got from multiple military tours to

afghanistan it’s being triggered by

watching the murder of george floyd on

television and the voices that told you

to take that rock and break that window

and it’s the fact that when the police

found you

you were taken to prison rather than to

get the mental health care support that

you clearly need and deserve

so then the question comes well where

is the money this is number three follow

the money

it’s amazing because on average

countries spend only two percent

of their health budgets on mental health

that is nothing that is crazy

for example in the united states a

person with a mental health challenge is

10 times more likely to end up

in prison or at jail rather than in a

facility in which they are getting care

but meanwhile of course during the

pandemic billionaires have become even

richer as our social services have been

cut it is hard to keep your personal

balance in a world that’s so

imbalanced but we must and that

leads to connecting the dots now

social services have decreased jobs have

decreased during the pandemic

alcoholism domestic violence have

increased

it is to be expected that child abuse

has also increased

and all of this suffering that is

completely unnecessary and that clearly

is going to go on and have implications

for

generations individuals often however

are blamed

rather than seeing this as a systemic

problem

but if we don’t acknowledge that then we

can’t fix the structures that created

them

in my mother’s case after so many years

of vicious abuse she was called crazy

she was ostracized

institutionalized over-medicated

and of course you know she became

suicidal again and again

i grew up really fast but these echoes

of injury do not have to continue

now one way that we can change this

path is to redefine experts

people with lived experience and people

who are actually

service users should be involved in

designing the programs

that are for healing in this capacity

the world health organization obviously

has done so much great work

and its quality rights program is

fantastic

in terms of combining human rights with

mental health

in the same way grand challenges canada

is amazing regarding

you know innovation and impact tech

and humanitarian issues and the amazing

vikram patel has taken task shifting for

capacity building to an art form

so basically when we see the whole

person in the context of broader society

it leads to the next point and that is

to expand

the narrative and during this pandemic

anybody who needs to have their

narrative expanded is

frontline workers they have clearly

borne the brunt

of this pandemic it’s that nurse who is

hiding in the bathroom

of the hospital because she’s shaking so

much because now she’s got anxiety

attacks and if somebody sees her she

might lose her job

it’s the long and grueling shifts that

she has to work

the fact that she’s been treating and

burying her colleagues

it’s her intense fear of catching covid

and then giving it to her

elderly parents and her child within

that context

of course she would have anxiety and we

should be dealing with that

and another element of expanding our

narratives

is to redefine target groups and the

united nations

secretary general guterres has done a

great job

in saying that we must focus for example

on the elderly we must focus more on

youth

and to that extent the youth envoy ms

vikramana yaki has also been

just done a great job during this

pandemic when the narratives are

expanded

holistic approaches to mental health

follow suit

and that leads to the next point which

is to find

synergies for example in zimbabwe

there’s this fantastic thing called a

friendship bench

where a grandmother sits on one side and

the person suffering

from anxiety sits there and then they

just talk and

the person feels better in italy there

have um

psychotherapists have come up with an

online platform

providing free consultation to those who

need it

and there are all kinds of really great

initiatives focused on the educational

system

for example the born this way foundation

lady gaga

and cynthia germanotta founded this and

they’re

in public schools doing amazing work

similarly

generation mental health is mobilizing

on campuses

we’ve got to find unique ways of

reaching out

and ultimately this means to go global

now mental health connects societies in

ways we cannot even

understand we are connected

across borders across generations across

belief

these challenges are global and

international

and intersectional so the solutions have

to be as well

now in this regard for example

generation unlimited

aims to bring cognitive behavioral

therapy to underserved youth globally

and united for global mental health is

doing amazing work

but that also leads to a really

important point and that is

to make noise every single person needs

to do

what we can to break the stigma i’m

always really really happy when famous

people come out and say hey i’m having

some challenges

thank you adele thank you beyonce thank

you the queer eye guys

you know for every time somebody who is

well known comes out and says hey

i have this then it just makes it easier

to talk about

and a special shout out to bts

for informing and motivating its army

supporting

unicef and its love myself campaign at

the un general assembly this stuff

really really matters

and of course in the very same breath

thank you very much to rani ali for

connecting

tolerance with mental health thank you

to every single person

who discusses lived experience

breaking the stigma one voice at a time

and that leads to the last point and

that is taking action

now i have lived experience with mental

health on an intergenerational level i

have it in my own personal burnout

but you know what i don’t have i don’t

have shame

i have pride i have conviction i have

determination

that i’m going to make a difference i am

going to

do anything in my power to protect

other people regarding mental health now

that means that on a personal basis

i need to finally take care of my

burnout

and i will do that i will break this

chain of trauma

now on an activist basis i will continue

advocating for mental health and that

means addressing social

failures that means advocating for

funding

on a work basis as a psychotherapist and

also a virtual learning expert

what i really want to do my focus now is

to bring

cognitive behavioral therapy to

underserved youth across the world with

an emphasis on people of a refugee

background

and in really innovative ways and i’m

currently developing

projects in that regard and i’m so

inspired by the work

for example of queen matild of the

belgians

intergenerational and focused on the

sdgs both very important and of course

queen rania of jordan

linking education and health

basically all of these things are

critical but it leads to

the single most important point of all

and that is how about you how

are you doing in this pandemic

have you had any mental injury are you

getting the support that you need

does your community have services

available

if not is there anything that you want

to do to try to create them

because look just keep in mind you are

so not

alone there are so many people across

the world

going through the same thing and

thinking the same thing and together

we really are stronger when the whole

world has crashed and burned at your

feet and

splintered into a thousand pieces it is

that

crystalline moment of brutal honesty

yet impossible beauty when you realize

that you’ve got the opportunity

if not the responsibility to pick up

those pieces

and put them back together in a way

that’s even better

a way that is more just and more humane

and more inclusive and ultimately more

sustainable

thank you

you