May is Mental Health Awareness Month, a national movement to raise awareness and reduce the stigma around people with mental illness and their families. Living St. Louis talked with Dr. Bart Andrews, Chief Clinical Health Officer, Behavioral Health Response, to get insight into important aspects of mental well-being. The interview has been edited for clarity.
What does mental health awareness mean?
Mental health awareness means that we recognize that our emotional well-being—how we’re feeling, how our mood is, how our thoughts are working—is just as important as how our body is functioning. We really shouldn’t be separating out physical health from mental well-being. They’re really part of the same thing. They’re different aspects of a healthy life.
How would you recognize if someone is having a difficult time with their mental well-being?
How do I know if somebody isn’t doing well? First, it’s different if you know the person versus if you don’t know the person. What we’re looking for is changes in their behavior. Changes in the things they’re saying. Changes in their outlook. Changes in what they’re doing. For instance, someone who has been unhappy and is talking about not doing well all the sudden seems at peace with the world, and everything is better—that's a change! Now maybe it’s true, things have gotten better, but that’s something to check out.
What can you do to support someone in a crisis?
A friend of mine and an expert in this area, Dr. Verna Little, has a three-step process. The first step is that if you recognize somebody’s in crisis and they need help, don’t panic. The last thing someone in crisis needs is for you to be in a crisis while they’re going through a crisis, so don’t panic.
The second step in this three-step process is to listen and reflect back what you’re hearing from them. ...Now is not a time for judgment. It’s not a time for advice giving. ...Sometimes we can literally help the problem by just offering a nice, safe, nonjudgmental place to talk about what’s going on.
The third step is to build hope. ...No matter how dark things look, we can always provide some hope. …Sometimes people don’t have their own hope, so we have to be their hope: …'I see hope for you. Let’s talk about that.'
Explain the term “compassion fatigue."
People often get terms confused. Here are four things that people often get confused: burnout, compassion fatigue, which really we should call empathy fatigue because it’s a much better name for it, vicarious trauma, and secondary traumatic stress responses.
Burnout is the result of chronic stress. If your chronic stress is work, you can get burnt out at work. Chronic exposure to stress can burn anybody out.
Compassion fatigue is specific to the caregiving and healthcare professions. You’re having a hard time empathizing with people. You’re having a hard time finding a way to help people. You are just losing this sense of being able to care about their problems.
Vicarious trauma is when you’ve been exposed to other people’s pain for a prolonged period, your literal sense of self and the world can change. For instance, if you’re working with crime victims all the time…that constant exposure to people having their safety threatened can lead you to believe the world isn’t safe anymore. It’s not just impacting you in your work environment. Outside of work, it’s affecting you and it’s impacting the way you view the world and the people in the world, yourself included.
And then, finally, we have secondary traumatic stress responses. This is when you actually experience symptoms of a traumatic stress disorder, like PTSD, from vicarious exposure to traumatic events. For instance, crisis line workers like the ones here at Behavioral Health Response, 911 operators, social media content moderators [can all have secondary traumatic stress response]. Many social media companies, like YouTube, have people monitoring these horrendously traumatic videos. Even though their lives aren’t in danger…they can develop the same symptoms of people [with life-threatening experiences].
These are all really serious things that we need to address. They all need slightly different responses.
What are some coping strategies for an issue affecting your mental well-being?
One of the key factors in coping strategies that are effective versus those that aren’t is [whether you are using] high engagement versus low engagement coping strategies. High-level engagement is when you’re tackling the problem. You’re doing something directly to address it. You have a sense of control over the situation.
There are other coping strategies that are called lower engagement strategies. These are strategies a lot of us use all the time. They don’t tend to be very effective. They are avoidant strategies. 'Oh, this thing is bothering me so I’m not going to go over here or I’m going to ignore it. I’m not going to acknowledge it. Or I’m going to retreat. Or I’m going to isolate.’ These passive avoidant strategies create a sense of hopelessness and powerlessness. So, of course, these strategies don’t tend to work, by and large.
Distraction is not necessarily an avoidant strategy. If something is really bothering you right now and you say, 'Okay, I need to distract myself from the problem right now because I’m too worked up. I’m too aroused to do anything about this.' Distraction is a good thing! It works really well…but distraction is a short-term strategy to decompress a little bit. Get a little bit of space. ‘Now, I can come up with some solution strategies to meet this [problem].’ That’s high engagement.
What does self-care look like in improving mental well-being?
Self-care is not pampering yourself, avoiding responsibility, or sitting in bed and watching TV all day because the world is super stressful. That’s the opposite of self-care. Now, that doesn’t mean that part of your self-care strategy might be a few hours of downtime where you are not going to do anything but veg. But, if that’s all of your self-care, you are not taking care of yourself because you need other things. We need social contact. We need intellectual stimulation. We need exercise. We need healthy eating. And, we need to be proactive about these things.