May 23, 2025 • 59 mins
In honor of Mental Health Awareness Month, Erin sits down with Dr. Ashley Zucker, a board-certified psychiatrist with Kaiser Permanente, to explore the importance of mental health care, the stigma that still surrounds it, and what we can all do to support our own well-being. Together, they discuss practical tips for managing stress, recognizing signs of mental health challenges, and fostering a culture of openness and compassion in our families, schools, and communities. This is a must-listen episode for anyone who believes mental health matters—which should be all of us.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Unknown (00:00):
Erin Brinker,
Erin Brinker (00:10):
welcome everyone to the making hope happen radio
show. I'm Erin Brinker. I hopeyou like the new intro music
today. It's peppy for spring.
And you know, I like to changethings up, as is my practice. I
love to start the show withgratitude. Today I'm grateful
for time off. My husband and Irecently took a weekend away in
Vegas, and it was so great toeat out, sit by the pool, sleep
in, visit friends. I'm not agambler, so we didn't do that,
(00:32):
but we did lots of other funthings, got our toes done and
took walks. It was great.
Mostly, it was great not tothink about obligations and my
seemingly endless to do list,and every single one of us needs
to do that, loud familygatherings, girls night out, or
guys, long phone calls with oldfriends, and other times when
the burdens of life are liftedare so good for the soul in the
(00:55):
US, we don't take anywhere nearas much time off as they do in
much of Europe. Honestly, Ithink all of Germany shuts down
in August, because I'mexaggerating a little bit, but
everybody goes on vacation inthe US, we don't take anywhere
near as much time off as they doin Europe. Like I said, and I
think it's a mistake. We allneed to unplug and make time for
travel even nearby. I mean,we're so lucky here in Southern
(01:16):
California, because we have themountains and the beach and the
deserts and so many great placesfor shopping and things to do,
shows, to see, museums, all thefun things to do. But we need to
do that and gather together withfriends. So not just go, but
Take someone with you. So todayI'm grateful for connections,
for relationships and time off.
Okay, on to our guest. Well, Iam thrilled to welcome back to
(01:36):
the show, Dr Ashley Zucker. Sheis works for Kaiser Permanente,
is a mental health professional,and is here to talk about mental
health awareness month. DrZucker, welcome to the show.
Thank you
Dr. Ashley Zucker (01:49):
so much for having me. So first of all,
Erin Brinker (01:54):
talk about mental health awareness month. We
mental health seems to be, well,let's just say that there's a
lot of discussion about whatmental health is, what you know,
what, what it means to take careof your mental health. Let's
just define mental health.
Unknown (02:11):
Oh, well, like you said, it can be hard to define,
Erin Brinker (02:14):
right? It's kind of big. It's a blog. It's a big
one,
Dr. Ashley Zucker (02:17):
yeah. I mean, I think, you know, as a
psychiatrist, if I think in moreof the medical space, and you
know, we're thinking about sortof your your mental well being
and your emotional health, Ithink is one way to think about
it. And even though we call itmental health, it's really kind
of whole body health. You can'tjust focus on your emotions and
ignore the rest of your body,and you can't just focus on your
(02:39):
body and ignore your brain,either. So I think they're all
interconnected. But I think whenwe talk about mental health
awareness month, I think we'rethinking about sort of the big
picture of mental health. Andso, you know, how do we really
make sure that we're taking careof ourselves, our well being,
our emotional well being, andall of that to say that having
(03:01):
good mental health or goodemotional health doesn't mean
that everything is perfect orthat you're always happy or
things are always going well. Itmeans you've got awareness of
your emotions and you know howto navigate things when they get
difficult, because foreverybody, no matter what, they
will be challenging at times. So
Erin Brinker (03:21):
I wonder, because it's, it's as though, in our
culture, we have an expectationthat everything being just fine
is the norm and the reality overthe course of a life, and now
the course of your life. And Ihave to, you know, I'm on the on
the far end of farther end thanmaybe a lot of people who are
listening of mental health, yourealize that no, that, that,
(03:42):
that everything beingabsolutely, you know, perfect,
that's not the norm, right?
Unknown (03:46):
Absolutely? Yeah. I mean, I always talk to even my
own patients, about how, youknow, life is a little bit of a
roller coaster emotionally, andthat's okay. You just don't want
your roller coaster to be one ofthe, you know, craziest ones in
the world that's got 55 loop deloops prefer more of like a
kitty roller coaster, exactly,preference, but it's still going
(04:08):
to have its ups and it's stillgoing to have its downs, and
that's just part of being ahuman,
Erin Brinker (04:12):
right? And that's the good stuff, right? Because
you can't, you can't feel thehighs if you don't feel the
lows. Now, obviously, we're nottalking about bipolar highs and
lows, but your average humanhighs and lows, right? So, so
how can individuals so the bigproblem with mental health,
especially for men, is, youknow, how is the stigma
surrounding mental health? Sohow do you have those
(04:33):
conversations again, especiallyfor men, but how do you have
those conversations about stigmaand overcoming that stigma?
Yeah.
Dr. Ashley Zucker (04:42):
I mean, I think one of the best things we
can do is just to talk about itin general, right? So those of
us who feel comfortable, themore we have these conversations
and the more we talk about it,we open up that space for
others. But I also like toreally reflect on mental health
if we were to compare it tophysical health, because the way
we talk about physical health.
Is very different. And there'sactually some cartoons that
sometimes I'll show patients toand, you know, they'll show
(05:04):
somebody with a really big woundon their arm. And, you know,
saying to them, what you tend tosay to somebody who has maybe a
mental health issue would be,you know, oh, just suck it up.
You'll be fine. But if somebodyhad a big wound on their arm,
that's not what we would say tothem, you know, we would offer
them help. We would tell them toclean it out. Maybe they need
stitches to get care right andto take care of it. And so I
(05:26):
like to kind of bring that backto mental health and really
think about it is, you know,your brain is part of your body,
and your emotions are part ofyour whole physical health. And
so we really have to think aboutit like just part of our medical
health in general. Let me
Erin Brinker (05:44):
ask you that you bring up a good point. You know,
I wonder if brain scans forpeople who come in with pretty
significant mental healthissues, whether it's major
depression or bipolar orschizophrenia or borderline
personality disorder, maybethere's an injury, maybe
there's, you know, been anillness that's happened to brain
(06:04):
scan, to our brain scans, a partof mental health treatment. From
a psychiatrist standpoint,
Dr. Ashley Zucker (06:10):
not typically, but I say that with a
caveat, that if somebody comesin with like, sudden onset
symptoms that just aren't reallymaking sense, maybe aren't at
the right time of life, like weknow, certain symptoms tend to
present at certain times insomebody's life, so sudden onset
symptoms at an odd time in life,then sometimes we do maybe a CT
(06:32):
or an MRI scan of the brain, butthat's really to see if there's
something else going on, likemaybe a stroke or something like
that. Unfortunately, therearen't scans that we can do that
can help us, like, diagnosedepression or differentiate
between bipolar disorder anddepression. And so, you know, we
would love to be able to scanyour brain and tell you
everything that's going on.
Would that
Erin Brinker (06:53):
be great? Yeah, make diagnosis a lot easier.
Yeah. So is, you know, if youknow, if anybody's working on
that kind of level of brainmapping,
Dr. Ashley Zucker (07:05):
yeah, there's a lot of work that happens in
the research world where theyare looking at brain scans and
they may identify, you know,some things that may be more
common in, say, somebody who hasa diagnosis of schizophrenia,
but it's really just not at Thelevel where we can use that
diagnostically. Maybe somedaywe'll get there. But I don't
know that our scans are quitesophisticated enough to truly
(07:27):
get out what's happening in ourbrains. Our brains are way more
complicated than I thinksometimes we're willing to
admit. So I think there's a lotmore at play than just what you
could see on a scan as well. Youknow, I think a lot of this
happens really, you know, at acellular level, and that may be
really difficult to find justby, you know, a brain scan. So
Erin Brinker (07:49):
what role does self care play in maintaining
good mental health? And I'm notjust talking about going to the
spa, or, you know, whateverpeople think self care is, how
is, how is? What
Dr. Ashley Zucker (08:05):
role does self care play? Yeah, I mean, I
think of self care a couple ofdifferent ways. You're right.
It's not about going to the spa,although that's, that's pretty
awesome. You can do that great.
But I think of self care as aneveryday task that we really
need to do, and it's reallyabout making sure you're
addressing the basics. And youknow, we always make fun of what
they say on airplanes. They tellyou to put your mask on yourself
(08:28):
before you put it on somebodyelse. And the reason they say
that is the same reason for selfcare. If you can't breathe,
you're not going to be able tohelp anybody else, you're going
to be able to put that mask onthem. And so if you're running
on fumes, you're running onempty mentally, then to be able
to take care of your family orto take care of things at work
is going to be really, reallychallenging. And so just making
(08:50):
sure that we're doing again, itcan really be some of the most
simple, basic things that weneed, like making sure you're
getting enough sleep, makingsure you're, you know, getting
some movement in and you'reeating well. And self care can
also be little, kind of tinythings you do throughout the
day. So maybe, maybe it's takinga deep breath before you walk
(09:11):
into the office, or taking adeep breath before you walk back
into your house, even thatmoment of just sort of, kind of
wiping the slate clean, or alittle bit of self reflection
can actually go a long way inself care. And so I think the
point being, really that youdon't have to spend, you know,
hundreds of dollars at the spato take care of yourself, you
(09:33):
know, it can be a very smallamount of time, and it can be
free.
Erin Brinker (09:38):
So I have to say, and I know that I'm not the only
one who does this. When I getwhen things get really busy at
work or there's something reallystressful going on, I eat junk
food because that's what Icrave. I don't get the exercise
that I need because I'm glued tomy chair or whatever. By the
time I get home at night, I justsit on the couch and I zonk
because I'm working long hoursand but then my sleep. My My
(10:00):
quality of my sleep is not good,because I might wake up in the
middle of the night or whatever,and so I at a time when I need
to be engaging in self care, Ido it all wrong.
Unknown (10:12):
Yep, not, not uncommon.
Erin Brinker (10:15):
So, so, you know, I, I know it's like I hear the
right things to do, but Idoesn't mean that I do them
Dr. Ashley Zucker (10:23):
right. So, and I think that's that's okay,
right? We have to make surewe're also not being too hard on
ourselves, like no one expectsperfection. And I rattle off a
list of a bunch of differentthings, but you may not be able
to accomplish all of thosethings. Maybe you can only
accomplish one of them, andmaybe you can only accomplish it
for five minutes. So maybe it'slike getting really overwhelmed
(10:44):
at your desk and just puttingstuff down and just doing a lap
around the office or a laparound the parking lot. Maybe
that's 510 minutes, but that'smovement, and that gave you a
break, right? And so again, it'snot about perfection. It's about
even just the small, incrementalthings, I think sometimes also,
when we start to just practice alittle bit, we start to see the
(11:05):
benefit, and then we start towant to do more of that, right?
So that can be helpful too. Justthink of a small increment that
you can implement and startthere. Don't start with I'm
going to get perfect sleeptonight, and I'm going to eat
great all week long, and allthat stuff, because as soon as
you, you know, have a misstep,then you feel like you've lost
(11:26):
it all, and you might as welljust give up on everything well,
and
Erin Brinker (11:29):
that's what I do, yeah, that's what I do. Is, is
like, well, forget it, I alreadyate. You know, we had cake at
the office. I already had cake,so I might as well have a double
cheeseburger for dinner. I don'teat double cheeseburgers, but
you get my point. Yes, yeah,
Dr. Ashley Zucker (11:41):
exactly right. So have the piece of cake
at the office, you know, andjust say, alright, you know, I'm
going to try to do better thenext, next meal. That's it. You
know. That
Erin Brinker (11:51):
really impacts, you know? I will tell you that
the times when I am able to getout and move especially, I
always feel better. I mean, it,it really, you know that, you
know I always feel better and Iand I've read that, you know,
for cognitive ability,especially as we age, having
regular movement really helps,yes,
Dr. Ashley Zucker (12:12):
and it can be, again, small increments. So
I think the worst thing that wedo is we all sit down in front
of our computers, especially ifyour job is in front of a
computer, and then you justdon't move all day long. And so
even just, you know, standing upperiodically can make a huge
difference. So just a little bitof movement throughout your day
can actually help you focusbetter, too.
Erin Brinker (12:32):
So what are some warning signs that someone may
be struggling with their mentalhealth?
Unknown (12:37):
Yeah, I think, you know, there's a lot of different
warning signs. The big ones thatwe look for is if people really
start to feel like they justcan't kind of keep up with their
normal routine. So maybe you'rereally noticing big changes in
your sleeping patterns, or youryour eating habits, things like
that, where, you know, you'rejust not your usual self. It's
(12:57):
not about, you know, we talkedabout, kind of the ups and
downs. It's not about just one,you know, bad day, but really,
if it seems to be persisting,you know, kind of a key time
frame we look for in mentalhealth world is about a two week
time frame of really justfeeling like you're not
yourself. Those can be some ofthe like starting warning signs
(13:17):
that, you know, you might bestruggling a bit and might need
more help.
Erin Brinker (13:21):
You know, I'm thinking about the things that
the diagnoses that you seepeople around you struggle with,
and I know, actually many peoplewho have been who have been
diagnosed with major depression,and when they go quiet is when I
go when I get worried. So I sendthem a text, Hey, you okay? Just
checking in. And sometimes theysay, you know, I'm in a rough
(13:42):
patch, and sometimes they say,I've just been really busy, but
it's the, it's the checking inthat matters, I think,
Unknown (13:47):
absolutely, absolutely, and even if they're not doing
well, and they don't tell you,the fact that you checked in
actually matters a lot and canbe really meaningful. So don't
feel like you're not doinganything if they're not
responding, you know,dramatically to your check in.
Erin Brinker (14:03):
So, so, how can family and friends, you know,
like the check in, how canfamily and friends provide that
meaningful support? What canfamily and
Unknown (14:12):
friends do? Yeah, I think, you know, the biggest
thing is just sort of beingavailable, and, you know,
letting people know that you'rethere for them. And, you know,
maybe people don't want to talk,or they're not ready to talk,
but, you know, just letting themknow, Hey, if you ever want to
talk, or you ever want to go fora walk or grab a cup of coffee,
just let me know. You know,happy to help out. Just that
(14:33):
offer can actually go a really,really long way. You know, if
people are struggling a littlebit more significantly, you
know, I think it depends on therelationship to right? But if
it's somebody you're close to,maybe you can say, you know,
Hey, can I help you set up anappointment with your primary
care doctor, you know? Andreally kind of working through
(14:53):
it with them that can, that canbe a great way to help, but it's
really about just being thereand. And being available when
they're ready.
Erin Brinker (15:02):
You know, I think of, and I'm thinking about men,
because women are more likely togo to seek out mental health
support, whether it's a group ortherapy or that sort of thing.
Men typically do thingstogether, right? So it's some
activity that they're thatthey're doing together. And I,
I, you know, when my husband wasgoing through a time where he
just wasn't connecting withfriends, and I was like, Okay,
(15:25):
you're going out with so and sotoday. And you know, he's like,
You know what, I haven't seenthat person in a really long
time. And that was that level ofactivity. And he'd go out and
they'd have fun and come backand he felt better, you know,
kind of have to pay attention tothose around us, like, maybe
they haven't, maybe theyhaven't, maybe they haven't
connected with their friends ina while.
Unknown (15:43):
Yeah, and that's that key piece you're looking for,
right? That change in baseline,right? Something was off, that's
not the normal for them. That'swhen that reach out can be
really powerful.
Erin Brinker (15:53):
So how can communities and organizations
play a role in promoting bettermental health care?
Unknown (16:01):
I mean, I think the key aspect is it goes back to the
stigma reduction. Theconversations are critical, I
think, for both in ourcommunities, in our workplaces,
especially people who are in aposition of influence or
leadership, if they are the onesthat are talking about mental
health, and that doesn't meanthey have to, like, disclose all
of their medical information,but, you know, even just like,
(16:25):
Oh yeah, I'm so excited for myvacation next week, I can't wait
to just turn things off and takea break. Like, even that type of
sharing can actually be reallypowerful, because you're setting
that example that, like, it'sokay to take a break to, you
know, do things and take care ofyourself. And that can be
really, really powerful foragain, just sort of setting that
(16:46):
atmosphere, that that's animportant thing for you, and so
it's important for other peopletoo. So I think that's really
critical. It's the conversationsand that, setting the tone,
setting the example.
Erin Brinker (16:59):
So as I think about, you know, different
workplaces and different, youknow, because there are some
where it's work, work, work, go,go, go, you know, all the time.
And people may be afraid that,that if they, if they did slow
down for a second, they did takethat time off, they took a
mental health day, or they evenjust let the letting them, let
(17:21):
it, let people know that theywere going through something,
that they would be seen as weak,and they would be seen as, you
know, being unreliable or lessreliable. What do you say to
that patient?
Unknown (17:32):
Yeah, I mean, I think about how much strength it takes
to actually reach out for help.
And so I try to really remindpeople of that, you know, saying
that you need help or thatyou're not doing well is usually
the hardest part, and it's not aweakness. It's really a
strength, and it really takes astrong person to be able to do
that. So I try to remindpatients of that it can be
(17:54):
challenging. You know, differentenvironments may be, you know,
more welcoming and lesswelcoming than than others when
it comes to really talking aboutthat kind of stuff. And so I
think what's also valuable isknowing maybe I don't feel super
safe disclosing it in myworkplace, but I do have a
friend I can talk to. So kindof, where are some of those
(18:15):
outlets? Who could you reach outto? It doesn't have to be, you
know, every single person youknow has to know what's going
on. But just finding at leastthat one kind of person,
individual that you can connectwith can can be helpful, even if
you don't feel like you can dothat. Maybe in your kind of work
space
Erin Brinker (18:35):
well, and sometimes that maybe, if your
work space is toxic, maybe it'stime to find another work space
could be, you know, if you're ifyour work is making you making
you sick, you know, if you havethe ability to find something
else, I, you know, maybe that'sthe right answer,
Unknown (18:49):
yeah. And I think that's important to really
recognize too. Do I only feelreally terrible at work, right?
So if it's unique to like acertain situation, that should
really kind of raise some flagsfor you in terms of, okay, it's
very situational. And so what doI need to do to address that
situation? And it could befinding another job, if that's
(19:09):
possible,
Erin Brinker (19:10):
if that's possible. So let's talk about
children's mental health. Youknow, I don't think as I was
growing up, I ever heard aboutchildren needing a mental health
professional and I, and I'minclined to believe that it's
not that they didn't need them.
It's just that nobody thoughtthey needed them. It wasn't part
of the the thinking of the day.
(19:31):
So kind of what's going on inthe arena of children's mental
health?
Dr. Ashley Zucker (19:35):
Yeah, I mean, there's a lot going on in the
arena of children's mentalhealth, but to your point, I
think there always was, I justdon't know that we were as aware
of it, but I do think there'sbeen kind of a shift that we've
seen sort of overall, where wemight be identifying and seeing
some mental health challenges inyounger and younger kids. I
(19:55):
think there's different reasonsfor that. I think some of it's
awareness, some of it's.
Reduction in stigma. You know,kids just talk differently to
one another than they did, youknow, when we were growing up,
it's kind of a normal part oftheir their conversations now,
where certainly wasn't when Iwas a kid, to talk about your
mental health. And so I thinkthere's that is innate in the
sort of children's culture, soto speak, that there's just more
(20:19):
conversations happening. Youknow, a lot of people want to
kind of blame technology for alot of what we're seeing. I
think it does play some role,but I don't think it's the like
end all be all of why we mightbe seeing people, you know, at
younger ages, having morechallenges. I think there's a
lot of things at play, and someof it may just be that we're
(20:41):
just talking about it more, butI think we'd all agree that
being a child now is verydifferent than being a child,
you know, 20, 3040, years ago.
Yeah, I
Erin Brinker (20:54):
would agree that the world that existed in the
1970s 80s and 90s, doesn't existanymore, right? Exactly, yep.
And I wonder how much of it,because, you know, think about
technology, and technology comesin lots of forms, but kids
aren't moving. I mean, Iremember being a kid and being
outdoors all day long, and wewere riding bikes, we were
climbing on monkey bars, we werewe were moving all day long. And
(21:18):
kids don't necessarily havethat. They may have it in the in
the confines of soccer practiceor dance class, but it's not the
same of this unstructured timeto get out and move their bodies
and use their minds and problemsolve with their friends and all
of that. And I wonder how muchof a role that plays.
Dr. Ashley Zucker (21:34):
Yeah. I mean, I think there is a big part
about movement, right? We knowthat just moving in general on I
like to say movement instead ofexercise, because exercise, I
think we all think of bad thingsor things we don't need a gym or
a CrossFit or whatever, runninga marathon, but yeah, movement
is really critical to just ourwell being. So I agree. I think
(21:56):
some of it too is that a littlebit more of that isolation,
right? So you mentioned, youknow, being able to kind of run
free in the neighborhood or hangout with, you know, friends on
your block or things like that.
Some of it is just we're a lotmore spread out than we used to
be. Some of it is, I don't knowthe best way to phrase it, but
maybe a culture where we're justa little bit less comfortable
(22:17):
with our kids kind of being ontheir own. It's true, you know,
we're, I think, a little bitmore protective of children than
maybe used to be the case, andso there's less opportunity for
them to do those things. Andthen, of course, you know, you
can blame technology there, ifthey're inside playing video
games together, but at their ownhouses, right? Right? That's
(22:38):
true. That's true. They'reinteracting, but it's different.
And he may or may not involvemovement, probably doesn't,
probably
Erin Brinker (22:46):
doesn't. It probably does involve junk food,
right? So I think about, youknow, think talking about social
media. I think about, there's aphenomenon of people talking
about their diagnoses, whetherit's official diagnoses or
they've self diagnosed. Youknow, people talk about, I have
bipolar disorder, or I have, youknow, borderline personality
(23:07):
disorder, or, Oh, I have this,or Tourette's. And the people
there was a, there was a trendwith so many people saying that
they had Tourette's, who were onsocial media and taking what it
appears to be from the outside,people taking on diagnoses that
they don't really have, andthen, and then, kind of wearing
them, and I say wearing them,because it then becomes defining
who they are, which is aproblem, you know. So if you, if
(23:29):
you have borderline personalitydisorder, which is a terrible,
difficult, debilitatingdiagnosis, it's still not who
you are. It's something youstruggle with. And that, and
that differentiation, to me,makes a big difference on your
ability to see yourself outsideof that diagnosis. What do you
think?
Dr. Ashley Zucker (23:49):
Yeah, and I think that we see, you know,
certainly, there's actually beena lot of research that's been
done, like on the Tourette'skind of contagion through social
media. I think that's a reallykind of interesting sort of case
study, so to speak. But we dosee where people are really, I
think looking for connection,you know, I think of teens in
particular that, likedevelopmental time of life is
(24:12):
when you're trying to figure outwho you are, and so you're
trying on different identities,you know. So, you know, maybe
back when, when we were kids, itwas, you know, how you dressed,
and the music that you listento, and I think that's still
applicable today, too. But
Erin Brinker (24:25):
are you a goth or a punk or whatever? I think of
Dr. Ashley Zucker (24:29):
this as sometimes, like a different
iteration of that, like you'rekind of trying different things
on, I think also, like, we haveto remember that social media
has these, you know, algorithmsthat sort of feed us specific
information, and so you kind ofgo down these rabbit holes. And
so if that's all you're seeingor All you're hearing about,
then I think that's more likelyto kind of influence sort of
(24:51):
your your thought patterns,especially at a time when you're
looking for an identity. I dothink it's important, though,
that you know, no matter. Matterthe illness, the diagnosis, it
doesn't define you, you know. Sosomebody who has cancer, for
example, they're not cancer. No,they're a person that has
cancer, but that's not who theyare, you know. So I like to also
(25:15):
reflect back on on that, that itdoesn't have to define you, nor
should it really define youeither. But there's also a lot
of misinformation out there too.
There are a lot of symptoms thatoverlap diagnoses, and so you'll
see a lot of information onsocial media that makes people
think they have X diagnosis.
(25:37):
Maybe it's ADHD, maybe it'sautism, maybe it's borderline
personality disorder, and thereare subtle differences between
those. And so it's really easyto kind of, again, go down that
rabbit hole towards onediagnosis that starts to maybe
kind of sound familiar to you,and so you kind of grab onto
that one and, you know, carryforward that way.
Erin Brinker (25:57):
You see videos, you know they'll see, you know,
five ways to know that you haveautism or you have ADHD. I'm
thinking, hang on a second. Thediagnosis process for autism,
and I have a son on thespectrum, the diagnosis process
is not you can't do this in aquiz or after watching a video.
It takes a professional workingwith you over time for these,
(26:18):
for the for the issues tomanifest themselves and be
diagnosed. It's not, it's not aneasy thing. You can't click a
few buttons and have thediagnosis Right
Unknown (26:29):
exactly. Yeah, there's a lot more to really figuring
out the correct diagnosis. Ialways think to you know, we
have diagnoses. We have kind ofnames and labels for things, and
that's just sort of human natureto want to kind of categorize
things, but it's not like everyone of us fits into some pretty
perfect little box either,right? You know. So that's
(26:49):
important to remember too, isthat these are ways for us to
kind of conceptualize differentyou know, mental health
disorders, but they're not theend all be all, and they
certainly don't define who, whowe are, nor do they define all
of mental illness, right? No,well,
Erin Brinker (27:04):
they said, for autism, for example, they say,
if you've met one kid withautism, you've met one kid with
autism, Yep, absolutely, youknow. And, and I, you know,
it's, I'm trying to rememberback to middle schools, and you
know, we're talking about kids.
You feel uncomfortable in yourown skin. You just do, and
everybody feels uncomfortable intheir own skin, but they project
that they don't right, becausethey're trying to seem cool, or
(27:27):
they're trying to see seem likethey have it all together. And
so, I mean, I understand thisdesire to kind of get some
definition around all of thethings that you're feeling
because it's messy. Yep,
Dr. Ashley Zucker (27:39):
absolutely, yeah. And everybody thinks
they're the only one, right? I'mthe only one that's
uncomfortable or nervous orfeels bad about myself. And
guarantee you everybody else,everybody
Erin Brinker (27:49):
does. You know, as a matter of fact, I had with one
of our without it, we have somehigh school aged interns here at
the making hope happenFoundation. And, and she, she
was really nervous for leadingup to our gala. And, and I said,
I said, Do you know who elsefeels like they have imposter
syndrome? And she's looking atme very nervous. And I said,
everybody. She looked at mefunny, like, No, literally,
everybody, right? You don'tknow, especially at her age, you
(28:14):
know, maybe if you get to acertain point, you feel more
comfortable, but you're alwaysworking up to the next thing.
And the next thing is a placeyou've never been before, right?
You know, when you're 55 you'venever been 55 before, right?
Dr. Ashley Zucker (28:26):
I think too, like, we tend to think so much
or worry, especially teenagers,right? They're so worried about
what everybody else thinks. Andso I'll often try to remind
patients too, like, well, whatare you thinking about when you
walk in the room, you'rethinking about yourself. Why do
you think they're thinking aboutyou? Yes, they're thinking about
themselves too.
Erin Brinker (28:44):
Yes, like, Oh, see, right. Are
Unknown (28:48):
you worried about everybody else? No, you're
worried about yourself too,right? That's right. You're
Erin Brinker (28:53):
worried about tripping in front of everybody
or whatever, right? So, so whatcan you know you want to be and
you want to walk the line rightwhere you validate whatever your
child is feeling, but you'd alsodon't want to make it so they
make the whatever they'refeeling so big that they it
seems impossible to grapple withtheir deal with. So how do you
(29:14):
walk that line? What does thatlook like? Yeah, I mean,
Dr. Ashley Zucker (29:17):
I think we have to take our kids really,
you know, seriously, if they'reexpressing that they're feeling
a certain way, or maybe they'reworried about it a certain
diagnosis, you know, we don'twant to shut them down or have
them not want to, you know, talkto us about things, and so maybe
that's, you know, not the rightdiagnosis. But that's a great
opportunity to say, well, reallysounds like you're struggling.
(29:38):
Maybe we should go and talk tosomebody. I think also sometimes
people worry too, if their kidsay does have a diagnosis, that
they're kind of walking oneggshells around them or having
to tiptoe or treat themdifferently. And I think it's
really important to rememberthat you need to treat them the
same, right? It doesn't meanthat they aren't the same person
(29:59):
you know. Just with a diagnosis,but same expectations should
apply in terms of going toschool and getting their work
done and and that actually canbe really helpful, because
having that same like structure,expectation schedule, those are
things that we really know helpwith our mental health. And so,
you know, really trying to justkeep things as is, but also, you
(30:21):
know, recognizing andacknowledging what our kids are
telling us is is reallyimportant. So it is kind of a
line to walk, right? You don'twant to push them away and say,
like, Oh no, that's stupid. Youdon't feel that way. Go walk it
off. Good, yeah, Buttercup.
Erin Brinker (30:38):
So, but, so let's talk about, you know, you know,
thinking about walking it off ornot walking it off, you know,
what about trauma? What ifthere's something or real loss,
like, you know, maybe a parentor a grandparent dies, or, you
know, a friend moves away, or,you know, something serious
going on in the child's life?
You know, how do you help yourchild through those difficult
times, especially if you'renursing your own grief. Yeah,
Dr. Ashley Zucker (31:02):
I think it can be very challenging if
you're struggling yourself. Ithink it goes back to role
modeling, though really criticalas adults and as parents, but
even not as parents, justrecognizing that, you know, it's
okay for us to show our ownemotions. You know you don't
necessarily want to be, youknow, a crying, upheaving mess
(31:26):
all the time, but it's okay tocry in front of our kids. It's
okay to tell them, you know, I'mreally struggling with this too,
because, again, it's settingthat example for them that it's
okay to feel bad and to haveemotions. It's really
recognizing them and figuringout what to do with them. That's
important. I think similarly foryou know, kids, who we know are
(31:47):
going through a really difficulttime, is same that we talked
about with adults, right? Isjust reaching out to them and
just offering an ear, right? SoI'm here if you want to talk.
I'm, you know, checking in withthem if they're not ready to
talk, just telling them, youknow, I'm here for you. If you
ever do want to talk about it,just let me know. Happy to happy
to chat. Or maybe there's timeswhere you don't want to talk
(32:09):
about it and you just wantsomebody to sit with you. I'm
happy to do that too. So I thinkthat role modeling, that just
leaving that door open, are someof the really key components
that we can do for for for kidsand adults. Really, it kind of
goes both ways.
Erin Brinker (32:24):
It's, it's hard.
I've had some, some friends whohave lost their husbands and and
with with kids at home. And, youknow, it's, it's, I think,
setting the expectation that thegrief will come in waves over
time. It's not going to be done.
You're not going to be done in ayear, you're not going to be
done. In two years, it'll be,you know, you create a system
(32:46):
where you can cope with it asthe as the waves come, because
they will come, yeah,absolutely.
Unknown (32:51):
And they'll comment different times and weird times,
and everybody grievesdifferently. And so I think
acknowledging that's importanttoo.
Erin Brinker (32:59):
So what if your child, so when you're when
you're a late teen, early 20s,when serious mental illness
starts to manifest itself. So,you know, schizophrenia and
bipolar disorder, for example,what if you start seeing those
signs in your own child? How doyou deal with that? Yeah,
Dr. Ashley Zucker (33:17):
I mean, if you're seeing signs, and, you
know, just so folks are kind ofaware of what some of those
signs could be for somethingmore serious like that. You
know, if they're what you talkedabout, withdrawing or isolation,
right? That can be a key signfor depression and anxiety, but
also for things likeschizophrenia, for example, we
see a big kind of pullback,isolation, really withdrawing
(33:39):
into themselves. If you know,you see things like they look
like they're responding tothings that aren't there.
They're talking to themselves inkind of a different way, like
some of us talk to ourselves,right? And some of us see
things, shadows, noises, thingslike that. That's normal. But if
it seems like it's kind of likethey're living out a dream,
almost, that can, you know,potentially be a sign. And I
(34:02):
think with bipolar, it's reallythose huge swings that we start
to look for. But one of the keycomponents can be and sometimes
the first thing that we see ispeople have a reduced need for
sleep. So not like they'restaying up all night on, you
know, social media or playingvideo games, but they just have
so much energy that they justdon't need to sleep at all, and
(34:22):
they start engaging in behaviorsthat just seem really out of the
ordinary for them, so reallykind of strange things that you
might be noticing, like they'venever done that before. And
obviously that can make you alsoworry about substance abuse too,
right? Yeah, that's part ofscreening it all all out and
figuring out what's what
Erin Brinker (34:41):
well, and it could be that they're experiencing
both of those things, those, youknow, they're self medicating
and and, you know, I've heard ofstories of people, they'll give
away the family car like anadult. They'll, you know, spend
money. They're sexuallypromiscuous, acting out in all
kinds of crazy ways that.
They're, you know, run to Vegas,you know, all kinds of things in
(35:02):
ways that they're normally aresponsible person followed by a
crash.
Dr. Ashley Zucker (35:08):
Yeah, I hear a lot about folks who really
start to develop a lot ofparanoia, so really thinking
like somebody's watching them,following them all of a sudden,
like, extreme distrust of theirspouse, but again, it's that,
like, significant change inbehavior. It's not somebody who
was always just really worried.
It's, you know, big, dramaticchange. And
Erin Brinker (35:31):
how does a family member, how do you how do you
deal with that as a familymember, if you start to see
those kinds of things happening?
Yeah,
Dr. Ashley Zucker (35:37):
I think what can be really challenging is
that oftentimes when thosethings are happening, the person
who's struggling may notrecognize what's happening or
recognize that they'restruggling. And so it can be
hard as a family member toreally try to help them see that
or point that out. It, ofcourse, depends on the
relationship, but you know, evenjust trying to get them to their
(35:58):
primary care doctor can be agreat place to start. Like, hey,
let's just go check in with yourdoctor. You haven't been in a
while, you know. But also justtalking to them about, like, do
you feel like anything'sdifferent? Is there anything
you're concerned about? But withcertain diagnoses, it can be
really challenging, because theycan also become very guarded,
and again, if they're veryparanoid, that can certainly be
(36:21):
be difficult, you know, if it'sgetting to like extreme
behaviors where you're worriedabout their safety or your
safety, obviously, 911, isalways there, right? If it's not
quite as serious as that, youknow, bringing them into an
emergency room for an urgentevaluation can often be a good
option as well. I've heard
Erin Brinker (36:41):
that people with when they're in a manic phase,
they like feeling that. Theylike it's euphoric. They want to
be manic and and so that's, youknow, maybe you wait until
they're, they're coming down offof the man, if they're not in
danger, you know. Maybe you waittill they come down off that
manic phase when, when thingsstart to look a little more
bleak for them. You know, howthey're how they're seeing the
(37:01):
world. Maybe that's the righttime. Yeah,
Dr. Ashley Zucker (37:03):
it's challenging to know, but you're
right. A lot of people, whenthey're in that manic phase,
they enjoy it, and they feellike they're, you know, super
productive, and they're verycreative. And, you know, there
are a lot of famous artists who,you know, probably had have
bipolar disorder, and they're attheir most, you know, productive
and creative at that point. Andso it can be really challenging
to get them to get help at thatpoint. Not that you shouldn't
(37:26):
try, right? But sometimes it isa bit bit harder. But again, you
really want to try to get thembefore things get to the point
where it really starts to becomevery, very dangerous. So it can
sometimes, the earlier we catchit, the better it can be.
Erin Brinker (37:43):
So what role do schools play in in the promoting
good mental health in practice,you know, habits and that sort
of thing. What can schools
Unknown (37:53):
do? Yeah, I think, you know, schools hold a lot of
responsibilities, so I certainlyfeel for them, but they also
spend a lot of time with ourchildren, and for some kids,
that may be the adults that knowthem best, and that may be the
adults that they're morecomfortable with, or it may be
the only sort of stableenvironment in their lives. And
(38:15):
so I think we can't stressenough how important schools are
for our kids. I think, you know,it depends on what schools are
able to offer based on theirresources. But I think the you
know, I think we do a prettygood job with educating our
teachers about signs to lookfor, things to, you know, be
(38:35):
aware of. There are a lot ofpartnerships with schools. You
know. I know KP does a lot ofpartnerships with schools. They
have a thriving Schoolsinitiative to really try to
bring some of that mental healthto the schools and support the
schools. I see in my own schoolsystem with my kids, they do
different like teaching sessionsfor parents too. That can be
(38:56):
really great, but I think it's,you know, the key piece I always
think about with schools is,again, they can be that like
stable environment, that maybethe only stable environment that
kids have, and so really keepingit a safe place for children, I
think, is really important. AndI think that communication with
parents and caregivers is alsoreally key for schools too. I
Erin Brinker (39:20):
know that there are schools that have developed
like lounge areas for studentsto to go and decompress, that
they've have peer kind ofcounseling. I don't want to call
it counseling, because it's, youknow, kind of peer support that
they that they offer forstudents. And you know, it
really depends if there's achampion on campus that can help
them do that, if they if they iftheir counselors or their school
(39:42):
psychologist has the bandwidthto be able to do that for them,
but I have to imagine that it'sthat it's really helpful.
Dr. Ashley Zucker (39:48):
Yeah, there's actually really good literature
that supports peer programs, thepeers should be trained. So to
your point, right? It can't justbe like everybody get in a room
and chat with each other. Oh.
Yeah, yeah. What could possiblygo wrong? Right? It'll be fine,
but there's definitely waysthat, you know, you don't have
to have, you know, a specificlicense to still be helpful.
(40:08):
Obviously, there's a role and aplace for people who have more
formal training. But that's notto say that peer programs can't
be a really significant assetto, you know, helping kids with
mental health.
Erin Brinker (40:21):
Have you seen any?
And this just popped into myhead. I you know, have you seen
projects where maybe collegestudents come down to high
schools and lead that peersupport, maybe psychology or
social work students, so thatthere's kind of a you do have
some training. They're a littlebit older, but they're not so
old that the high schoolstudents would blow them off.
Yeah.
Dr. Ashley Zucker (40:41):
I mean, I think there are programs that
exist like that, or there mayeven be maybe a little bit less
mental health geared, but Ithink about like college
students that are in training tobecome teachers, right?
Sometimes they're doing, youknow, teaching assistant types
of roles, and even though that'sabout learning how to teach,
you're still that like extraobserver in the classroom. So
that can be key. You know, thereare certain situations,
(41:06):
certainly where I've seen thatmaybe therapists who have
finished their education atgraduate school but are still
working towards their license.
So sometimes they're calledassociates. So they're they have
a degree, but they don't havetheir license yet, and so
schools use them often, and Ithink that's a great resource,
because while they're stilllearning, they already have a
(41:26):
lot of, you know, lot ofinformation, a lot of education.
And so that can be just aanother way to kind of beef up
the supply, so to speak, ofmental health care clinicians
Erin Brinker (41:40):
well, and you bring up a good point, because
nationwide, but especially inlow income, urban and rural
areas, they're just not enoughclinicians. There are not enough
especially if you are in an areawhere there's a lot of refugees
or a lot of immigrants or, youknow, there's just not enough
people to support thesepopulations that that need a lot
(42:01):
of support. So how do we make iteasier? Or, how do we remove
barriers for people to becomemental health professionals?
Dr. Ashley Zucker (42:09):
Yeah, I mean, I think that your peer support
programs are a great way to kindof extend that network. I think
really trying to think kind ofbroadly about the types of folks
that can help, right? So again,you know, is there a space for
that kind of pre licensedindividual? They can be in a
kind of, again, an expansion ofthe of the workforce, I think,
(42:32):
really providing that education,also, of what are the warning
signs when somebody really needsto seek that professional level
of care? So, kind of knowing howto almost triage, in a sense,
right? Maybe people just need asupport group or a couple of
resources versus they need, youknow, formal ongoing therapy,
for example. And that's not tosay everybody doesn't deserve
(42:54):
help, but what that help lookslike might depend on what a
person's going through. I thinkthe other piece, and this is
where technology can be great,is there's so much technology
now that we can utilize sowhether it's virtual care as an
example, right? That you know,has really, really helped to
bring clinicians intoenvironments where, maybe
(43:15):
historically, there just wasn'taccess. But there's also some
really great opportunities interms of like apps and different
online programs that people canutilize and and again, I would
recommend that more as you know,somebody who's maybe has more
mild difficulties or maybe as anadjunct to professional
treatment, but it does kind ofextend the the bandwidth, so to
(43:38):
speak, you know, to really roundout the options for folks, and
can be really helpful for peoplewho maybe are sort of dipping
their toe in the water too,right? So maybe they're a little
bit nervous about doing, youknow, therapy, for example, but
they're willing to, you know,learn some skills and some, you
know, coping strategies throughan app, so it can kind of open
that door
Erin Brinker (43:58):
indeed. And I'm and I'm and I'm thinking about,
and I know Kaiser Permanente hassome programs in both in
Northern California and SouthernCalifornia to to make it easier
for like, low income, you know,people of color, to go into the
mental health professions in insupporting them during that time
when they're I think it's 3030504,000 hours something, in that
(44:22):
window of as an associate, to beable before their license, to be
able to see people on their own,and they don't make much money.
I mean, it's, it's, they're agreat, phenomenal resource, but
they're just not getting paidenough. And these are highly
skilled professionals who, theyhave families very often. And
so, you know, that is asignificant barrier. I think you
(44:43):
know, what would it? What wouldit mean if, if you know we're
talking about how governmentsspend their money, or how
organizations spend their money,I think that supporting those
individuals would really help.
Yeah,
Dr. Ashley Zucker (44:55):
absolutely.
But I think it's also makingsure that. Opportunity is there
for them. So, you know, justlike you said, as an example, it
used to be, several years agothat Kaiser Permanente didn't
use associates. We only uselicensed professionals. And we
really recognized an opportunityto really build and expand the
workforce and actually be ableto help people who are trying to
(45:17):
get to that place where theyhave a license, where they can
earn, you know, a significant,you know, better income. And so
that was really kind of a winwin for everybody, indeed. So,
you know, just offering thoseopportunities so people can get
in those hours and get them inpretty quickly, helps take them
to that, that next level. But Ialso think it again, it expands
(45:39):
that access for our patients andand honestly, I'll tell you,
sometimes, some of ourassociates are the best
therapists I've seen. They'reeager, they're ready to go. You
know, they do an amazing job,and they have, we have that
built in kind of support networkand, you know, supervision for
them as well. So I know, and Ihave full confidence that, you
(46:02):
know, if my patients seeing anassociate, they're getting
equal, if not, sometimes bettercare, because again, they're,
you know, they're ready to go.
They're learning, but they alsohave a supervisor to kind of run
everything past, too. So it'salmost like you get two for one,
Erin Brinker (46:17):
which is which is excellent. I've heard about
people graduating from gettingtheir master's degree and then
not being able to find aclinical supervisor, which means
they can't do their hours. Sothe fact that you all are hiring
them is fabulous, because then,you know, I'm sure that they're
then loyal to Kaiser Permanente.
They've, they've learned thesystem. They they know the
patients, and so for them tocontinue on in Kaiser Permanente
(46:38):
makes perfect sense for them.
Yeah, it
Dr. Ashley Zucker (46:43):
kind of creates this great career
pathway too, because they mightstart it as an associate and
then become a licensed therapistand then eventually become a
supervisor themselves. So it'skind of cool to see them kind of
progress through through theircareers.
Erin Brinker (46:57):
So you chose psychiatry when you were in
medical school, and what led youin, because we have just a few
minutes left, what led you intopsychiatry? Why was that? Was
Was that always where you wantedto go? Or is that, was that
something that you as you weregoing through residency, or
whatever you decided that youwanted to do?
Unknown (47:18):
Oh, that's a good question, and that's hard to
answer quickly.
Erin Brinker (47:22):
We have about eight minutes. Well,
Dr. Ashley Zucker (47:25):
I would say, actually, I became interested in
psychiatry in high school. Ithink it was, you know, just
seeing a lot of my peers thatwere struggling mentally and
wanting to be able to help them.
But by the time I got to medicalschool, I actually thought I was
going to do OBGYN, so, which isvery different than I agree. But
in medical school, you know, youdo your coursework in the
(47:49):
classroom, but then you start todo your rotations. And so when I
did my rotations in OBGYN, I waslike, hmm, maybe this isn't what
I want to do. And so you do getthat opportunity to kind of
experience each of the differentspecialties. And when I did
psychiatry, I still wasn't quitesure, but it's actually my
husband who was like, you havethe most fun telling me your
(48:09):
stories from psychiatry. Andhe's, you know, kind of pointed
out, like, you really love thatpatient population and really
love connecting, you know, withthose folks. But I always really
knew I wanted to be more gearedtowards adolescence. And so it
also just kind of opened up thatpossibility to be able to do
(48:30):
psychiatry, but also to, youknow, to see kids, to see
adolescents. And so to do thattraining, you actually have to
get trained in adult psychiatrybefore you can do child and
adolescent psychology. So that'salso really helpful, because,
yes, I take care of kids, butkids come with adults. They
Erin Brinker (48:50):
do, and some of those adults are stuck at being
kids. They're mentally they'reemotionally stuck at 16.
Dr. Ashley Zucker (48:57):
Yep, absolutely. And sometimes the
it's the adult that actuallyneeds the help. So, you know,
being able to recognize that andhelp them through that is, it
was also really rewarding, too,but that's kind of how I landed
there. That's the short version.
But that's
Erin Brinker (49:11):
awesome. That's awesome. I know, again, there's
just not enough. I i love thatthere are multiple medical
schools popping up all over theor, you know, that are, that are
that have popped up in theInland Empire. So in addition to
Loma Linda, there's now UCR andthere's the California
University of Science andmedicine out at the hospital in
(49:32):
Colton. There's one in Pomona.
There's, you know, and so andCal State San Bernardino is
opening a physician's AssistanceProgram, which is a different,
different thing. But it's, it's,I love that we're building this
capacity in the Inland Empire toto have mental, mental health
and physical healthprofessionals here, because we
need them here.
Unknown (49:51):
Yeah, I think what's important to note one. I should
note that KP has a medicalschool now too. But
Erin Brinker (49:57):
really I didn't know that. I didn't know that.
That tell me about it. Well,
Dr. Ashley Zucker (50:01):
so it's the Kaiser Permanente School of
Medicine. It's based out ofPasadena, but we actually have
the students. They rotate outwith us in San Bernardino for
all of their rotations, not justpsychiatry, but they kind of go
all over Southern California,but especially to to San
Bernardino, because we do haveour kind of tertiary care
(50:23):
center, so we have a lot ofdifferent specialties there. And
then, you know, they it. We'veonly had two classes graduated.
We just graduated our secondclass. So it's, you know,
relatively new medical school,but we have seen a, you know,
fair number of med students whoare really interested in
psychiatry. Excellent, exciting,excellent. We don't, you know,
(50:44):
we don't streamline themstraight into KP residencies.
You know, KP does have a numberof of our own residencies, and
we have a psychiatry for apsychiatry residency for adult
and for the child in Fontana,actually ourselves. But we don't
say they have to stay. We'rehappy to have them go out and
learn, you know, and expand the,you know, medical field
(51:05):
elsewhere too. But it's alsojust a great opportunity for,
you know, those of us who loveto teach too, because a lot of
medicine is about teaching. Soit's kind of a great sort of
feedback loop. But the other keypiece is that we can build all
the medical schools in theworld, but if we don't have the
residency program. So for folksthat don't know you, you know
(51:27):
you go to medical school andthen you actually go to
residency, which is where youspecialize, and you you're paid,
but not very much. It's almostlike a paid apprenticeship. But
if you don't have thoseopportunities, then you can't
become specialized or boardcertified, for example. So if we
have too many medical schoolsand not enough residencies,
(51:49):
we're still not creating enoughdoctors. And so that's really a
challenge that we're seeing kindof nationwide, particularly in
certain specialties, where wedon't what determines
Erin Brinker (51:57):
that? What? What determines how many, how many
places spot slots you have, so
Dr. Ashley Zucker (52:02):
residencies are usually sponsored by the
government. So, like mostthings, it comes down to
dollars, right? So that that'sbeen an issue that I know a lot
of folks have been working, youknow, not just in California,
but also, you know, federally inWashington to to try to increase
that funding for for residencyprograms.
Erin Brinker (52:25):
So if you have, you know, I know that residents,
they have to, you have to match.
You graduate from, from yourmedical school, and then you
have to match somewhere. So youcould go to go to, you could go
to medical school here inSouthern California, but be
matched in Minnesota or Illinoisor Mississippi or wherever, and
and so the number of slotsnationwide is determined by
(52:46):
funding from the government. Isthat what I'm hearing? Yep, wow,
yeah. We need to make I mean,think about things that that a
government would invest in, thatwould seem like was a pretty
important one seems obvious tome. Yeah, right. Kind of a no
brainer. Wow. Well, that's,that's good. So when? So if, if
a, say, a high school student,is interested in maybe going to
(53:08):
medical school, what? How shouldthey train themselves? And I
know this is a little bitoutside what we, you know about
mental health awareness, but Iif we want to improve the the
capacity for clinicians and thecapacity, just in the in
general, for mental health, thisis an important piece. Yeah,
Dr. Ashley Zucker (53:25):
absolutely. I mean, I think the best thing
that people can do is just getthemselves a well rounded
education. You know, I think ofall the things sort of, I've
been through and in kind ofgetting to medical school, and
it wasn't just do medicine,right? You have to have kind of
life experience that makes you abetter person. I think too, you
(53:47):
know, I wouldn't want, you know,especially somebody in high
school, to not do the thingsthat they love in high school,
you know, you got to get intocollege. So there's that, right?
But even once you're in incollege, you know, not all
medical schools are looking fora bio major. For example, there
are prerequisites you have to doto get into medical school, but
(54:08):
it doesn't mean that that hasthat science has to be your your
major. So I think it's importantpeople really continue to pursue
their passions and not just gettoo narrowly focused on on
medicine. But you know, the moreexperiences you can have within
healthcare, it can be veryhelpful. But that could be, you
know, volunteering or, you know,volunteering at a hospital or a
(54:31):
clinic or even just a communityprogram, you know, those types
of things can be really, reallyhelpful.
Erin Brinker (54:37):
Yep, because public health hits everything
right, hits everythingabsolutely so as a kind of, we
have about a minute and a halfleft. What is, if you could say
one thing about mental health ona community level, and kind of
where we're going and what towhat to look, what to think
about, what would that be?
Dr. Ashley Zucker (54:57):
I think the number, well, it's hard to pick
one. I'll say that, but I thinkthe number one thing that I
think about, that we really haveto do a better job communicating
is that emotions are not a badthing, that it's okay to feel
bad. It's okay to have a badday. It's really what you do
with it. I think we, in sort oftrying to destigmatize mental
(55:20):
health, we've somehow landed onthis message that, like
everybody's supposed to be happyall the time, and that's not
reality. So I think that's whatI think about too, is how do we
build that conversation? So it'snot about, how do we make sure
you're happy all the time, orthat you feel good all the time,
to how to make sure we we havethe supports in place for when
(55:41):
things are not going great,
Erin Brinker (55:43):
cuz very often, if you're just having a rotten day,
just sitting with a girlfriendor sitting with a family member
and saying, You know what, todayjust was terrible. And these are
the things that happen and you,you know, and you have that
conversation over a glass ofwine or a whatever, and you feel
better, yeah, you wake up thenext day and you have a new day,
Dr. Ashley Zucker (56:03):
yeah? And sometimes we kind of torture
ourselves, right? We have a badday, and we beat ourselves up
for it, and that just makes usfeel worse, as opposed to, you
know what? Today was just a badday, a bad
Erin Brinker (56:13):
day. Oh, you know, I'm the queen of beating myself
up, so I gotta stop that, right?
Well, Doctor Ashley Zucker,board certified psychiatrist
from Kaiser Permanente here inSan Bernardino County. Thank you
so much for joining me today.
Thank you so much for having me.
It was a great conversation. Itwas a lot of fun. Always is, and
I look forward to having you onagain. Yes. Well, that is about
all we have time for today. I'mErin Brinker. You've been
(56:37):
listening to the making hopehappen radio show, and if you're
listening to this on MemorialDay weekend, when it first airs
here on local radio in SouthernCalifornia, I hope that you take
the time this weekend toremember those who paid the
ultimate price, made theultimate sacrifice, the men and
women in uniform who haveensured that we have lived
(56:59):
prosperously and freely,prosperous and free since 1776
so to all those men and womenwho have fallen, thank you for
your sacrifice. To the familieswho are left behind and the
loved ones who are left behindand the men and women in uniform
who are left behind, you are inour thoughts and prayers. Thank
(57:19):
you for all you do. You've beenlistening like I said to the
making hope happen radio show.
I'm Erin Brinker and I'll seeyou next week. You
Noraly Sainz (57:40):
Hi. My name is Nora Lee science and I am
(58:01):
Program Coordinator at upliftSan Bernardino, a collective
impact initiative at the makinghope happen Foundation. And this
is my story. In November of 2017my husband, our four young sons
and I moved away from ourfamilies to San Bernardino with
the hope of reaching our goal ofhome ownership in 2018 as our
(58:22):
oldest son started kindergarten,I connected with the school
district and learned aboutmaking hope happens Kids program
with my oldest in kindergartenand my twins at preschool. I had
the opportunity to tote myyoungest to the kids parenting
classes. In January of 2020, myhusband and our family's
breadwinner unexpectedly passedaway, I found myself in a
(58:42):
pandemic with my sons in anuncertain future. It was then
that that oasis that I found atkids turned into my support
system, as the staff and friendsrallied around me while my sons
and I struggled to find our newnormal. In October of 2020 after
seven years as a homemaker, Ijoined the making hope happen
foundation as a programcoordinator for uplift San
(59:04):
Bernardino. This careeropportunity reignited my
family's dream of home ownershipin November of 2022 through the
mutual support of the uplift SanBernardino Housing Network, my
family was able to buy our firsthome in my role as program
coordinator and as I connectwith other families in our
community, I can wholeheartedlyattest to the opportunities that
(59:26):
the foundation is bringing toour community and truly making
hope happen. For more
Erin Brinker (59:31):
information about the making hope happen
foundation and to make adonation, please visit
www.makinghope.org That'swww.makinghope.org your
donations make our workpossible. You.
Erin Brinker,
Erin Brinker (00:10):
welcome everyone to the making hope happen radio
show. I'm Erin Brinker. I hopeyou like the new intro music
today. It's peppy for spring.
And you know, I like to changethings up, as is my practice. I
love to start the show withgratitude. Today I'm grateful
for time off. My husband and Irecently took a weekend away in
Vegas, and it was so great toeat out, sit by the pool, sleep
in, visit friends. I'm not agambler, so we didn't do that,
(00:32):
but we did lots of other funthings, got our toes done and
took walks. It was great.
Mostly, it was great not tothink about obligations and my
seemingly endless to do list,and every single one of us needs
to do that, loud familygatherings, girls night out, or
guys, long phone calls with oldfriends, and other times when
the burdens of life are liftedare so good for the soul in the
(00:55):
US, we don't take anywhere nearas much time off as they do in
much of Europe. Honestly, Ithink all of Germany shuts down
in August, because I'mexaggerating a little bit, but
everybody goes on vacation inthe US, we don't take anywhere
near as much time off as they doin Europe. Like I said, and I
think it's a mistake. We allneed to unplug and make time for
travel even nearby. I mean,we're so lucky here in Southern
(01:16):
California, because we have themountains and the beach and the
deserts and so many great placesfor shopping and things to do,
shows, to see, museums, all thefun things to do. But we need to
do that and gather together withfriends. So not just go, but
Take someone with you. So todayI'm grateful for connections,
for relationships and time off.
Okay, on to our guest. Well, Iam thrilled to welcome back to
(01:36):
the show, Dr Ashley Zucker. Sheis works for Kaiser Permanente,
is a mental health professional,and is here to talk about mental
health awareness month. DrZucker, welcome to the show.
Thank you
Dr. Ashley Zucker (01:49):
so much for having me. So first of all,
Erin Brinker (01:54):
talk about mental health awareness month. We
mental health seems to be, well,let's just say that there's a
lot of discussion about whatmental health is, what you know,
what, what it means to take careof your mental health. Let's
just define mental health.
Unknown (02:11):
Oh, well, like you said, it can be hard to define,
Erin Brinker (02:14):
right? It's kind of big. It's a blog. It's a big
one,
Dr. Ashley Zucker (02:17):
yeah. I mean, I think, you know, as a
psychiatrist, if I think in moreof the medical space, and you
know, we're thinking about sortof your your mental well being
and your emotional health, Ithink is one way to think about
it. And even though we call itmental health, it's really kind
of whole body health. You can'tjust focus on your emotions and
ignore the rest of your body,and you can't just focus on your
(02:39):
body and ignore your brain,either. So I think they're all
interconnected. But I think whenwe talk about mental health
awareness month, I think we'rethinking about sort of the big
picture of mental health. Andso, you know, how do we really
make sure that we're taking careof ourselves, our well being,
our emotional well being, andall of that to say that having
(03:01):
good mental health or goodemotional health doesn't mean
that everything is perfect orthat you're always happy or
things are always going well. Itmeans you've got awareness of
your emotions and you know howto navigate things when they get
difficult, because foreverybody, no matter what, they
will be challenging at times. So
Erin Brinker (03:21):
I wonder, because it's, it's as though, in our
culture, we have an expectationthat everything being just fine
is the norm and the reality overthe course of a life, and now
the course of your life. And Ihave to, you know, I'm on the on
the far end of farther end thanmaybe a lot of people who are
listening of mental health, yourealize that no, that, that,
(03:42):
that everything beingabsolutely, you know, perfect,
that's not the norm, right?
Unknown (03:46):
Absolutely? Yeah. I mean, I always talk to even my
own patients, about how, youknow, life is a little bit of a
roller coaster emotionally, andthat's okay. You just don't want
your roller coaster to be one ofthe, you know, craziest ones in
the world that's got 55 loop deloops prefer more of like a
kitty roller coaster, exactly,preference, but it's still going
(04:08):
to have its ups and it's stillgoing to have its downs, and
that's just part of being ahuman,
Erin Brinker (04:12):
right? And that's the good stuff, right? Because
you can't, you can't feel thehighs if you don't feel the
lows. Now, obviously, we're nottalking about bipolar highs and
lows, but your average humanhighs and lows, right? So, so
how can individuals so the bigproblem with mental health,
especially for men, is, youknow, how is the stigma
surrounding mental health? Sohow do you have those
(04:33):
conversations again, especiallyfor men, but how do you have
those conversations about stigmaand overcoming that stigma?
Yeah.
Dr. Ashley Zucker (04:42):
I mean, I think one of the best things we
can do is just to talk about itin general, right? So those of
us who feel comfortable, themore we have these conversations
and the more we talk about it,we open up that space for
others. But I also like toreally reflect on mental health
if we were to compare it tophysical health, because the way
we talk about physical health.
Is very different. And there'sactually some cartoons that
sometimes I'll show patients toand, you know, they'll show
(05:04):
somebody with a really big woundon their arm. And, you know,
saying to them, what you tend tosay to somebody who has maybe a
mental health issue would be,you know, oh, just suck it up.
You'll be fine. But if somebodyhad a big wound on their arm,
that's not what we would say tothem, you know, we would offer
them help. We would tell them toclean it out. Maybe they need
stitches to get care right andto take care of it. And so I
(05:26):
like to kind of bring that backto mental health and really
think about it is, you know,your brain is part of your body,
and your emotions are part ofyour whole physical health. And
so we really have to think aboutit like just part of our medical
health in general. Let me
Erin Brinker (05:44):
ask you that you bring up a good point. You know,
I wonder if brain scans forpeople who come in with pretty
significant mental healthissues, whether it's major
depression or bipolar orschizophrenia or borderline
personality disorder, maybethere's an injury, maybe
there's, you know, been anillness that's happened to brain
(06:04):
scan, to our brain scans, a partof mental health treatment. From
a psychiatrist standpoint,
Dr. Ashley Zucker (06:10):
not typically, but I say that with a
caveat, that if somebody comesin with like, sudden onset
symptoms that just aren't reallymaking sense, maybe aren't at
the right time of life, like weknow, certain symptoms tend to
present at certain times insomebody's life, so sudden onset
symptoms at an odd time in life,then sometimes we do maybe a CT
(06:32):
or an MRI scan of the brain, butthat's really to see if there's
something else going on, likemaybe a stroke or something like
that. Unfortunately, therearen't scans that we can do that
can help us, like, diagnosedepression or differentiate
between bipolar disorder anddepression. And so, you know, we
would love to be able to scanyour brain and tell you
everything that's going on.
Would that
Erin Brinker (06:53):
be great? Yeah, make diagnosis a lot easier.
Yeah. So is, you know, if youknow, if anybody's working on
that kind of level of brainmapping,
Dr. Ashley Zucker (07:05):
yeah, there's a lot of work that happens in
the research world where theyare looking at brain scans and
they may identify, you know,some things that may be more
common in, say, somebody who hasa diagnosis of schizophrenia,
but it's really just not at Thelevel where we can use that
diagnostically. Maybe somedaywe'll get there. But I don't
know that our scans are quitesophisticated enough to truly
(07:27):
get out what's happening in ourbrains. Our brains are way more
complicated than I thinksometimes we're willing to
admit. So I think there's a lotmore at play than just what you
could see on a scan as well. Youknow, I think a lot of this
happens really, you know, at acellular level, and that may be
really difficult to find justby, you know, a brain scan. So
Erin Brinker (07:49):
what role does self care play in maintaining
good mental health? And I'm notjust talking about going to the
spa, or, you know, whateverpeople think self care is, how
is, how is? What
Dr. Ashley Zucker (08:05):
role does self care play? Yeah, I mean, I
think of self care a couple ofdifferent ways. You're right.
It's not about going to the spa,although that's, that's pretty
awesome. You can do that great.
But I think of self care as aneveryday task that we really
need to do, and it's reallyabout making sure you're
addressing the basics. And youknow, we always make fun of what
they say on airplanes. They tellyou to put your mask on yourself
(08:28):
before you put it on somebodyelse. And the reason they say
that is the same reason for selfcare. If you can't breathe,
you're not going to be able tohelp anybody else, you're going
to be able to put that mask onthem. And so if you're running
on fumes, you're running onempty mentally, then to be able
to take care of your family orto take care of things at work
is going to be really, reallychallenging. And so just making
(08:50):
sure that we're doing again, itcan really be some of the most
simple, basic things that weneed, like making sure you're
getting enough sleep, makingsure you're, you know, getting
some movement in and you'reeating well. And self care can
also be little, kind of tinythings you do throughout the
day. So maybe, maybe it's takinga deep breath before you walk
(09:11):
into the office, or taking adeep breath before you walk back
into your house, even thatmoment of just sort of, kind of
wiping the slate clean, or alittle bit of self reflection
can actually go a long way inself care. And so I think the
point being, really that youdon't have to spend, you know,
hundreds of dollars at the spato take care of yourself, you
(09:33):
know, it can be a very smallamount of time, and it can be
free.
Erin Brinker (09:38):
So I have to say, and I know that I'm not the only
one who does this. When I getwhen things get really busy at
work or there's something reallystressful going on, I eat junk
food because that's what Icrave. I don't get the exercise
that I need because I'm glued tomy chair or whatever. By the
time I get home at night, I justsit on the couch and I zonk
because I'm working long hoursand but then my sleep. My My
(10:00):
quality of my sleep is not good,because I might wake up in the
middle of the night or whatever,and so I at a time when I need
to be engaging in self care, Ido it all wrong.
Unknown (10:12):
Yep, not, not uncommon.
Erin Brinker (10:15):
So, so, you know, I, I know it's like I hear the
right things to do, but Idoesn't mean that I do them
Dr. Ashley Zucker (10:23):
right. So, and I think that's that's okay,
right? We have to make surewe're also not being too hard on
ourselves, like no one expectsperfection. And I rattle off a
list of a bunch of differentthings, but you may not be able
to accomplish all of thosethings. Maybe you can only
accomplish one of them, andmaybe you can only accomplish it
for five minutes. So maybe it'slike getting really overwhelmed
(10:44):
at your desk and just puttingstuff down and just doing a lap
around the office or a laparound the parking lot. Maybe
that's 510 minutes, but that'smovement, and that gave you a
break, right? And so again, it'snot about perfection. It's about
even just the small, incrementalthings, I think sometimes also,
when we start to just practice alittle bit, we start to see the
(11:05):
benefit, and then we start towant to do more of that, right?
So that can be helpful too. Justthink of a small increment that
you can implement and startthere. Don't start with I'm
going to get perfect sleeptonight, and I'm going to eat
great all week long, and allthat stuff, because as soon as
you, you know, have a misstep,then you feel like you've lost
(11:26):
it all, and you might as welljust give up on everything well,
and
Erin Brinker (11:29):
that's what I do, yeah, that's what I do. Is, is
like, well, forget it, I alreadyate. You know, we had cake at
the office. I already had cake,so I might as well have a double
cheeseburger for dinner. I don'teat double cheeseburgers, but
you get my point. Yes, yeah,
Dr. Ashley Zucker (11:41):
exactly right. So have the piece of cake
at the office, you know, andjust say, alright, you know, I'm
going to try to do better thenext, next meal. That's it. You
know. That
Erin Brinker (11:51):
really impacts, you know? I will tell you that
the times when I am able to getout and move especially, I
always feel better. I mean, it,it really, you know that, you
know I always feel better and Iand I've read that, you know,
for cognitive ability,especially as we age, having
regular movement really helps,yes,
Dr. Ashley Zucker (12:12):
and it can be, again, small increments. So
I think the worst thing that wedo is we all sit down in front
of our computers, especially ifyour job is in front of a
computer, and then you justdon't move all day long. And so
even just, you know, standing upperiodically can make a huge
difference. So just a little bitof movement throughout your day
can actually help you focusbetter, too.
Erin Brinker (12:32):
So what are some warning signs that someone may
be struggling with their mentalhealth?
Unknown (12:37):
Yeah, I think, you know, there's a lot of different
warning signs. The big ones thatwe look for is if people really
start to feel like they justcan't kind of keep up with their
normal routine. So maybe you'rereally noticing big changes in
your sleeping patterns, or youryour eating habits, things like
that, where, you know, you'rejust not your usual self. It's
(12:57):
not about, you know, we talkedabout, kind of the ups and
downs. It's not about just one,you know, bad day, but really,
if it seems to be persisting,you know, kind of a key time
frame we look for in mentalhealth world is about a two week
time frame of really justfeeling like you're not
yourself. Those can be some ofthe like starting warning signs
(13:17):
that, you know, you might bestruggling a bit and might need
more help.
Erin Brinker (13:21):
You know, I'm thinking about the things that
the diagnoses that you seepeople around you struggle with,
and I know, actually many peoplewho have been who have been
diagnosed with major depression,and when they go quiet is when I
go when I get worried. So I sendthem a text, Hey, you okay? Just
checking in. And sometimes theysay, you know, I'm in a rough
(13:42):
patch, and sometimes they say,I've just been really busy, but
it's the, it's the checking inthat matters, I think,
Unknown (13:47):
absolutely, absolutely, and even if they're not doing
well, and they don't tell you,the fact that you checked in
actually matters a lot and canbe really meaningful. So don't
feel like you're not doinganything if they're not
responding, you know,dramatically to your check in.
Erin Brinker (14:03):
So, so, how can family and friends, you know,
like the check in, how canfamily and friends provide that
meaningful support? What canfamily and
Unknown (14:12):
friends do? Yeah, I think, you know, the biggest
thing is just sort of beingavailable, and, you know,
letting people know that you'rethere for them. And, you know,
maybe people don't want to talk,or they're not ready to talk,
but, you know, just letting themknow, Hey, if you ever want to
talk, or you ever want to go fora walk or grab a cup of coffee,
just let me know. You know,happy to help out. Just that
(14:33):
offer can actually go a really,really long way. You know, if
people are struggling a littlebit more significantly, you
know, I think it depends on therelationship to right? But if
it's somebody you're close to,maybe you can say, you know,
Hey, can I help you set up anappointment with your primary
care doctor, you know? Andreally kind of working through
(14:53):
it with them that can, that canbe a great way to help, but it's
really about just being thereand. And being available when
they're ready.
Erin Brinker (15:02):
You know, I think of, and I'm thinking about men,
because women are more likely togo to seek out mental health
support, whether it's a group ortherapy or that sort of thing.
Men typically do thingstogether, right? So it's some
activity that they're thatthey're doing together. And I,
I, you know, when my husband wasgoing through a time where he
just wasn't connecting withfriends, and I was like, Okay,
(15:25):
you're going out with so and sotoday. And you know, he's like,
You know what, I haven't seenthat person in a really long
time. And that was that level ofactivity. And he'd go out and
they'd have fun and come backand he felt better, you know,
kind of have to pay attention tothose around us, like, maybe
they haven't, maybe theyhaven't, maybe they haven't
connected with their friends ina while.
Unknown (15:43):
Yeah, and that's that key piece you're looking for,
right? That change in baseline,right? Something was off, that's
not the normal for them. That'swhen that reach out can be
really powerful.
Erin Brinker (15:53):
So how can communities and organizations
play a role in promoting bettermental health care?
Unknown (16:01):
I mean, I think the key aspect is it goes back to the
stigma reduction. Theconversations are critical, I
think, for both in ourcommunities, in our workplaces,
especially people who are in aposition of influence or
leadership, if they are the onesthat are talking about mental
health, and that doesn't meanthey have to, like, disclose all
of their medical information,but, you know, even just like,
(16:25):
Oh yeah, I'm so excited for myvacation next week, I can't wait
to just turn things off and takea break. Like, even that type of
sharing can actually be reallypowerful, because you're setting
that example that, like, it'sokay to take a break to, you
know, do things and take care ofyourself. And that can be
really, really powerful foragain, just sort of setting that
(16:46):
atmosphere, that that's animportant thing for you, and so
it's important for other peopletoo. So I think that's really
critical. It's the conversationsand that, setting the tone,
setting the example.
Erin Brinker (16:59):
So as I think about, you know, different
workplaces and different, youknow, because there are some
where it's work, work, work, go,go, go, you know, all the time.
And people may be afraid that,that if they, if they did slow
down for a second, they did takethat time off, they took a
mental health day, or they evenjust let the letting them, let
(17:21):
it, let people know that theywere going through something,
that they would be seen as weak,and they would be seen as, you
know, being unreliable or lessreliable. What do you say to
that patient?
Unknown (17:32):
Yeah, I mean, I think about how much strength it takes
to actually reach out for help.
And so I try to really remindpeople of that, you know, saying
that you need help or thatyou're not doing well is usually
the hardest part, and it's not aweakness. It's really a
strength, and it really takes astrong person to be able to do
that. So I try to remindpatients of that it can be
(17:54):
challenging. You know, differentenvironments may be, you know,
more welcoming and lesswelcoming than than others when
it comes to really talking aboutthat kind of stuff. And so I
think what's also valuable isknowing maybe I don't feel super
safe disclosing it in myworkplace, but I do have a
friend I can talk to. So kindof, where are some of those
(18:15):
outlets? Who could you reach outto? It doesn't have to be, you
know, every single person youknow has to know what's going
on. But just finding at leastthat one kind of person,
individual that you can connectwith can can be helpful, even if
you don't feel like you can dothat. Maybe in your kind of work
space
Erin Brinker (18:35):
well, and sometimes that maybe, if your
work space is toxic, maybe it'stime to find another work space
could be, you know, if you're ifyour work is making you making
you sick, you know, if you havethe ability to find something
else, I, you know, maybe that'sthe right answer,
Unknown (18:49):
yeah. And I think that's important to really
recognize too. Do I only feelreally terrible at work, right?
So if it's unique to like acertain situation, that should
really kind of raise some flagsfor you in terms of, okay, it's
very situational. And so what doI need to do to address that
situation? And it could befinding another job, if that's
(19:09):
possible,
Erin Brinker (19:10):
if that's possible. So let's talk about
children's mental health. Youknow, I don't think as I was
growing up, I ever heard aboutchildren needing a mental health
professional and I, and I'minclined to believe that it's
not that they didn't need them.
It's just that nobody thoughtthey needed them. It wasn't part
of the the thinking of the day.
(19:31):
So kind of what's going on inthe arena of children's mental
health?
Dr. Ashley Zucker (19:35):
Yeah, I mean, there's a lot going on in the
arena of children's mentalhealth, but to your point, I
think there always was, I justdon't know that we were as aware
of it, but I do think there'sbeen kind of a shift that we've
seen sort of overall, where wemight be identifying and seeing
some mental health challenges inyounger and younger kids. I
(19:55):
think there's different reasonsfor that. I think some of it's
awareness, some of it's.
Reduction in stigma. You know,kids just talk differently to
one another than they did, youknow, when we were growing up,
it's kind of a normal part oftheir their conversations now,
where certainly wasn't when Iwas a kid, to talk about your
mental health. And so I thinkthere's that is innate in the
sort of children's culture, soto speak, that there's just more
(20:19):
conversations happening. Youknow, a lot of people want to
kind of blame technology for alot of what we're seeing. I
think it does play some role,but I don't think it's the like
end all be all of why we mightbe seeing people, you know, at
younger ages, having morechallenges. I think there's a
lot of things at play, and someof it may just be that we're
(20:41):
just talking about it more, butI think we'd all agree that
being a child now is verydifferent than being a child,
you know, 20, 3040, years ago.
Yeah, I
Erin Brinker (20:54):
would agree that the world that existed in the
1970s 80s and 90s, doesn't existanymore, right? Exactly, yep.
And I wonder how much of it,because, you know, think about
technology, and technology comesin lots of forms, but kids
aren't moving. I mean, Iremember being a kid and being
outdoors all day long, and wewere riding bikes, we were
climbing on monkey bars, we werewe were moving all day long. And
(21:18):
kids don't necessarily havethat. They may have it in the in
the confines of soccer practiceor dance class, but it's not the
same of this unstructured timeto get out and move their bodies
and use their minds and problemsolve with their friends and all
of that. And I wonder how muchof a role that plays.
Dr. Ashley Zucker (21:34):
Yeah. I mean, I think there is a big part
about movement, right? We knowthat just moving in general on I
like to say movement instead ofexercise, because exercise, I
think we all think of bad thingsor things we don't need a gym or
a CrossFit or whatever, runninga marathon, but yeah, movement
is really critical to just ourwell being. So I agree. I think
(21:56):
some of it too is that a littlebit more of that isolation,
right? So you mentioned, youknow, being able to kind of run
free in the neighborhood or hangout with, you know, friends on
your block or things like that.
Some of it is just we're a lotmore spread out than we used to
be. Some of it is, I don't knowthe best way to phrase it, but
maybe a culture where we're justa little bit less comfortable
(22:17):
with our kids kind of being ontheir own. It's true, you know,
we're, I think, a little bitmore protective of children than
maybe used to be the case, andso there's less opportunity for
them to do those things. Andthen, of course, you know, you
can blame technology there, ifthey're inside playing video
games together, but at their ownhouses, right? Right? That's
(22:38):
true. That's true. They'reinteracting, but it's different.
And he may or may not involvemovement, probably doesn't,
probably
Erin Brinker (22:46):
doesn't. It probably does involve junk food,
right? So I think about, youknow, think talking about social
media. I think about, there's aphenomenon of people talking
about their diagnoses, whetherit's official diagnoses or
they've self diagnosed. Youknow, people talk about, I have
bipolar disorder, or I have, youknow, borderline personality
(23:07):
disorder, or, Oh, I have this,or Tourette's. And the people
there was a, there was a trendwith so many people saying that
they had Tourette's, who were onsocial media and taking what it
appears to be from the outside,people taking on diagnoses that
they don't really have, andthen, and then, kind of wearing
them, and I say wearing them,because it then becomes defining
who they are, which is aproblem, you know. So if you, if
(23:29):
you have borderline personalitydisorder, which is a terrible,
difficult, debilitatingdiagnosis, it's still not who
you are. It's something youstruggle with. And that, and
that differentiation, to me,makes a big difference on your
ability to see yourself outsideof that diagnosis. What do you
think?
Dr. Ashley Zucker (23:49):
Yeah, and I think that we see, you know,
certainly, there's actually beena lot of research that's been
done, like on the Tourette'skind of contagion through social
media. I think that's a reallykind of interesting sort of case
study, so to speak. But we dosee where people are really, I
think looking for connection,you know, I think of teens in
particular that, likedevelopmental time of life is
(24:12):
when you're trying to figure outwho you are, and so you're
trying on different identities,you know. So, you know, maybe
back when, when we were kids, itwas, you know, how you dressed,
and the music that you listento, and I think that's still
applicable today, too. But
Erin Brinker (24:25):
are you a goth or a punk or whatever? I think of
Dr. Ashley Zucker (24:29):
this as sometimes, like a different
iteration of that, like you'rekind of trying different things
on, I think also, like, we haveto remember that social media
has these, you know, algorithmsthat sort of feed us specific
information, and so you kind ofgo down these rabbit holes. And
so if that's all you're seeingor All you're hearing about,
then I think that's more likelyto kind of influence sort of
(24:51):
your your thought patterns,especially at a time when you're
looking for an identity. I dothink it's important, though,
that you know, no matter. Matterthe illness, the diagnosis, it
doesn't define you, you know. Sosomebody who has cancer, for
example, they're not cancer. No,they're a person that has
cancer, but that's not who theyare, you know. So I like to also
(25:15):
reflect back on on that, that itdoesn't have to define you, nor
should it really define youeither. But there's also a lot
of misinformation out there too.
There are a lot of symptoms thatoverlap diagnoses, and so you'll
see a lot of information onsocial media that makes people
think they have X diagnosis.
(25:37):
Maybe it's ADHD, maybe it'sautism, maybe it's borderline
personality disorder, and thereare subtle differences between
those. And so it's really easyto kind of, again, go down that
rabbit hole towards onediagnosis that starts to maybe
kind of sound familiar to you,and so you kind of grab onto
that one and, you know, carryforward that way.
Erin Brinker (25:57):
You see videos, you know they'll see, you know,
five ways to know that you haveautism or you have ADHD. I'm
thinking, hang on a second. Thediagnosis process for autism,
and I have a son on thespectrum, the diagnosis process
is not you can't do this in aquiz or after watching a video.
It takes a professional workingwith you over time for these,
(26:18):
for the for the issues tomanifest themselves and be
diagnosed. It's not, it's not aneasy thing. You can't click a
few buttons and have thediagnosis Right
Unknown (26:29):
exactly. Yeah, there's a lot more to really figuring
out the correct diagnosis. Ialways think to you know, we
have diagnoses. We have kind ofnames and labels for things, and
that's just sort of human natureto want to kind of categorize
things, but it's not like everyone of us fits into some pretty
perfect little box either,right? You know. So that's
(26:49):
important to remember too, isthat these are ways for us to
kind of conceptualize differentyou know, mental health
disorders, but they're not theend all be all, and they
certainly don't define who, whowe are, nor do they define all
of mental illness, right? No,well,
Erin Brinker (27:04):
they said, for autism, for example, they say,
if you've met one kid withautism, you've met one kid with
autism, Yep, absolutely, youknow. And, and I, you know,
it's, I'm trying to rememberback to middle schools, and you
know, we're talking about kids.
You feel uncomfortable in yourown skin. You just do, and
everybody feels uncomfortable intheir own skin, but they project
that they don't right, becausethey're trying to seem cool, or
(27:27):
they're trying to see seem likethey have it all together. And
so, I mean, I understand thisdesire to kind of get some
definition around all of thethings that you're feeling
because it's messy. Yep,
Dr. Ashley Zucker (27:39):
absolutely, yeah. And everybody thinks
they're the only one, right? I'mthe only one that's
uncomfortable or nervous orfeels bad about myself. And
guarantee you everybody else,everybody
Erin Brinker (27:49):
does. You know, as a matter of fact, I had with one
of our without it, we have somehigh school aged interns here at
the making hope happenFoundation. And, and she, she
was really nervous for leadingup to our gala. And, and I said,
I said, Do you know who elsefeels like they have imposter
syndrome? And she's looking atme very nervous. And I said,
everybody. She looked at mefunny, like, No, literally,
everybody, right? You don'tknow, especially at her age, you
(28:14):
know, maybe if you get to acertain point, you feel more
comfortable, but you're alwaysworking up to the next thing.
And the next thing is a placeyou've never been before, right?
You know, when you're 55 you'venever been 55 before, right?
Dr. Ashley Zucker (28:26):
I think too, like, we tend to think so much
or worry, especially teenagers,right? They're so worried about
what everybody else thinks. Andso I'll often try to remind
patients too, like, well, whatare you thinking about when you
walk in the room, you'rethinking about yourself. Why do
you think they're thinking aboutyou? Yes, they're thinking about
themselves too.
Erin Brinker (28:44):
Yes, like, Oh, see, right. Are
Unknown (28:48):
you worried about everybody else? No, you're
worried about yourself too,right? That's right. You're
Erin Brinker (28:53):
worried about tripping in front of everybody
or whatever, right? So, so whatcan you know you want to be and
you want to walk the line rightwhere you validate whatever your
child is feeling, but you'd alsodon't want to make it so they
make the whatever they'refeeling so big that they it
seems impossible to grapple withtheir deal with. So how do you
(29:14):
walk that line? What does thatlook like? Yeah, I mean,
Dr. Ashley Zucker (29:17):
I think we have to take our kids really,
you know, seriously, if they'reexpressing that they're feeling
a certain way, or maybe they'reworried about it a certain
diagnosis, you know, we don'twant to shut them down or have
them not want to, you know, talkto us about things, and so maybe
that's, you know, not the rightdiagnosis. But that's a great
opportunity to say, well, reallysounds like you're struggling.
(29:38):
Maybe we should go and talk tosomebody. I think also sometimes
people worry too, if their kidsay does have a diagnosis, that
they're kind of walking oneggshells around them or having
to tiptoe or treat themdifferently. And I think it's
really important to rememberthat you need to treat them the
same, right? It doesn't meanthat they aren't the same person
(29:59):
you know. Just with a diagnosis,but same expectations should
apply in terms of going toschool and getting their work
done and and that actually canbe really helpful, because
having that same like structure,expectation schedule, those are
things that we really know helpwith our mental health. And so,
you know, really trying to justkeep things as is, but also, you
(30:21):
know, recognizing andacknowledging what our kids are
telling us is is reallyimportant. So it is kind of a
line to walk, right? You don'twant to push them away and say,
like, Oh no, that's stupid. Youdon't feel that way. Go walk it
off. Good, yeah, Buttercup.
Erin Brinker (30:38):
So, but, so let's talk about, you know, you know,
thinking about walking it off ornot walking it off, you know,
what about trauma? What ifthere's something or real loss,
like, you know, maybe a parentor a grandparent dies, or, you
know, a friend moves away, or,you know, something serious
going on in the child's life?
You know, how do you help yourchild through those difficult
times, especially if you'renursing your own grief. Yeah,
Dr. Ashley Zucker (31:02):
I think it can be very challenging if
you're struggling yourself. Ithink it goes back to role
modeling, though really criticalas adults and as parents, but
even not as parents, justrecognizing that, you know, it's
okay for us to show our ownemotions. You know you don't
necessarily want to be, youknow, a crying, upheaving mess
(31:26):
all the time, but it's okay tocry in front of our kids. It's
okay to tell them, you know, I'mreally struggling with this too,
because, again, it's settingthat example for them that it's
okay to feel bad and to haveemotions. It's really
recognizing them and figuringout what to do with them. That's
important. I think similarly foryou know, kids, who we know are
(31:47):
going through a really difficulttime, is same that we talked
about with adults, right? Isjust reaching out to them and
just offering an ear, right? SoI'm here if you want to talk.
I'm, you know, checking in withthem if they're not ready to
talk, just telling them, youknow, I'm here for you. If you
ever do want to talk about it,just let me know. Happy to happy
to chat. Or maybe there's timeswhere you don't want to talk
(32:09):
about it and you just wantsomebody to sit with you. I'm
happy to do that too. So I thinkthat role modeling, that just
leaving that door open, are someof the really key components
that we can do for for for kidsand adults. Really, it kind of
goes both ways.
Erin Brinker (32:24):
It's, it's hard.
I've had some, some friends whohave lost their husbands and and
with with kids at home. And, youknow, it's, it's, I think,
setting the expectation that thegrief will come in waves over
time. It's not going to be done.
You're not going to be done in ayear, you're not going to be
done. In two years, it'll be,you know, you create a system
(32:46):
where you can cope with it asthe as the waves come, because
they will come, yeah,absolutely.
Unknown (32:51):
And they'll comment different times and weird times,
and everybody grievesdifferently. And so I think
acknowledging that's importanttoo.
Erin Brinker (32:59):
So what if your child, so when you're when
you're a late teen, early 20s,when serious mental illness
starts to manifest itself. So,you know, schizophrenia and
bipolar disorder, for example,what if you start seeing those
signs in your own child? How doyou deal with that? Yeah,
Dr. Ashley Zucker (33:17):
I mean, if you're seeing signs, and, you
know, just so folks are kind ofaware of what some of those
signs could be for somethingmore serious like that. You
know, if they're what you talkedabout, withdrawing or isolation,
right? That can be a key signfor depression and anxiety, but
also for things likeschizophrenia, for example, we
see a big kind of pullback,isolation, really withdrawing
(33:39):
into themselves. If you know,you see things like they look
like they're responding tothings that aren't there.
They're talking to themselves inkind of a different way, like
some of us talk to ourselves,right? And some of us see
things, shadows, noises, thingslike that. That's normal. But if
it seems like it's kind of likethey're living out a dream,
almost, that can, you know,potentially be a sign. And I
(34:02):
think with bipolar, it's reallythose huge swings that we start
to look for. But one of the keycomponents can be and sometimes
the first thing that we see ispeople have a reduced need for
sleep. So not like they'restaying up all night on, you
know, social media or playingvideo games, but they just have
so much energy that they justdon't need to sleep at all, and
(34:22):
they start engaging in behaviorsthat just seem really out of the
ordinary for them, so reallykind of strange things that you
might be noticing, like they'venever done that before. And
obviously that can make you alsoworry about substance abuse too,
right? Yeah, that's part ofscreening it all all out and
figuring out what's what
Erin Brinker (34:41):
well, and it could be that they're experiencing
both of those things, those, youknow, they're self medicating
and and, you know, I've heard ofstories of people, they'll give
away the family car like anadult. They'll, you know, spend
money. They're sexuallypromiscuous, acting out in all
kinds of crazy ways that.
They're, you know, run to Vegas,you know, all kinds of things in
(35:02):
ways that they're normally aresponsible person followed by a
crash.
Dr. Ashley Zucker (35:08):
Yeah, I hear a lot about folks who really
start to develop a lot ofparanoia, so really thinking
like somebody's watching them,following them all of a sudden,
like, extreme distrust of theirspouse, but again, it's that,
like, significant change inbehavior. It's not somebody who
was always just really worried.
It's, you know, big, dramaticchange. And
Erin Brinker (35:31):
how does a family member, how do you how do you
deal with that as a familymember, if you start to see
those kinds of things happening?
Yeah,
Dr. Ashley Zucker (35:37):
I think what can be really challenging is
that oftentimes when thosethings are happening, the person
who's struggling may notrecognize what's happening or
recognize that they'restruggling. And so it can be
hard as a family member toreally try to help them see that
or point that out. It, ofcourse, depends on the
relationship, but you know, evenjust trying to get them to their
(35:58):
primary care doctor can be agreat place to start. Like, hey,
let's just go check in with yourdoctor. You haven't been in a
while, you know. But also justtalking to them about, like, do
you feel like anything'sdifferent? Is there anything
you're concerned about? But withcertain diagnoses, it can be
really challenging, because theycan also become very guarded,
and again, if they're veryparanoid, that can certainly be
(36:21):
be difficult, you know, if it'sgetting to like extreme
behaviors where you're worriedabout their safety or your
safety, obviously, 911, isalways there, right? If it's not
quite as serious as that, youknow, bringing them into an
emergency room for an urgentevaluation can often be a good
option as well. I've heard
Erin Brinker (36:41):
that people with when they're in a manic phase,
they like feeling that. Theylike it's euphoric. They want to
be manic and and so that's, youknow, maybe you wait until
they're, they're coming down offof the man, if they're not in
danger, you know. Maybe you waittill they come down off that
manic phase when, when thingsstart to look a little more
bleak for them. You know, howthey're how they're seeing the
(37:01):
world. Maybe that's the righttime. Yeah,
Dr. Ashley Zucker (37:03):
it's challenging to know, but you're
right. A lot of people, whenthey're in that manic phase,
they enjoy it, and they feellike they're, you know, super
productive, and they're verycreative. And, you know, there
are a lot of famous artists who,you know, probably had have
bipolar disorder, and they're attheir most, you know, productive
and creative at that point. Andso it can be really challenging
to get them to get help at thatpoint. Not that you shouldn't
(37:26):
try, right? But sometimes it isa bit bit harder. But again, you
really want to try to get thembefore things get to the point
where it really starts to becomevery, very dangerous. So it can
sometimes, the earlier we catchit, the better it can be.
Erin Brinker (37:43):
So what role do schools play in in the promoting
good mental health in practice,you know, habits and that sort
of thing. What can schools
Unknown (37:53):
do? Yeah, I think, you know, schools hold a lot of
responsibilities, so I certainlyfeel for them, but they also
spend a lot of time with ourchildren, and for some kids,
that may be the adults that knowthem best, and that may be the
adults that they're morecomfortable with, or it may be
the only sort of stableenvironment in their lives. And
(38:15):
so I think we can't stressenough how important schools are
for our kids. I think, you know,it depends on what schools are
able to offer based on theirresources. But I think the you
know, I think we do a prettygood job with educating our
teachers about signs to lookfor, things to, you know, be
(38:35):
aware of. There are a lot ofpartnerships with schools. You
know. I know KP does a lot ofpartnerships with schools. They
have a thriving Schoolsinitiative to really try to
bring some of that mental healthto the schools and support the
schools. I see in my own schoolsystem with my kids, they do
different like teaching sessionsfor parents too. That can be
(38:56):
really great, but I think it's,you know, the key piece I always
think about with schools is,again, they can be that like
stable environment, that maybethe only stable environment that
kids have, and so really keepingit a safe place for children, I
think, is really important. AndI think that communication with
parents and caregivers is alsoreally key for schools too. I
Erin Brinker (39:20):
know that there are schools that have developed
like lounge areas for studentsto to go and decompress, that
they've have peer kind ofcounseling. I don't want to call
it counseling, because it's, youknow, kind of peer support that
they that they offer forstudents. And you know, it
really depends if there's achampion on campus that can help
them do that, if they if they iftheir counselors or their school
(39:42):
psychologist has the bandwidthto be able to do that for them,
but I have to imagine that it'sthat it's really helpful.
Dr. Ashley Zucker (39:48):
Yeah, there's actually really good literature
that supports peer programs, thepeers should be trained. So to
your point, right? It can't justbe like everybody get in a room
and chat with each other. Oh.
Yeah, yeah. What could possiblygo wrong? Right? It'll be fine,
but there's definitely waysthat, you know, you don't have
to have, you know, a specificlicense to still be helpful.
(40:08):
Obviously, there's a role and aplace for people who have more
formal training. But that's notto say that peer programs can't
be a really significant assetto, you know, helping kids with
mental health.
Erin Brinker (40:21):
Have you seen any?
And this just popped into myhead. I you know, have you seen
projects where maybe collegestudents come down to high
schools and lead that peersupport, maybe psychology or
social work students, so thatthere's kind of a you do have
some training. They're a littlebit older, but they're not so
old that the high schoolstudents would blow them off.
Yeah.
Dr. Ashley Zucker (40:41):
I mean, I think there are programs that
exist like that, or there mayeven be maybe a little bit less
mental health geared, but Ithink about like college
students that are in training tobecome teachers, right?
Sometimes they're doing, youknow, teaching assistant types
of roles, and even though that'sabout learning how to teach,
you're still that like extraobserver in the classroom. So
that can be key. You know, thereare certain situations,
(41:06):
certainly where I've seen thatmaybe therapists who have
finished their education atgraduate school but are still
working towards their license.
So sometimes they're calledassociates. So they're they have
a degree, but they don't havetheir license yet, and so
schools use them often, and Ithink that's a great resource,
because while they're stilllearning, they already have a
(41:26):
lot of, you know, lot ofinformation, a lot of education.
And so that can be just aanother way to kind of beef up
the supply, so to speak, ofmental health care clinicians
Erin Brinker (41:40):
well, and you bring up a good point, because
nationwide, but especially inlow income, urban and rural
areas, they're just not enoughclinicians. There are not enough
especially if you are in an areawhere there's a lot of refugees
or a lot of immigrants or, youknow, there's just not enough
people to support thesepopulations that that need a lot
(42:01):
of support. So how do we make iteasier? Or, how do we remove
barriers for people to becomemental health professionals?
Dr. Ashley Zucker (42:09):
Yeah, I mean, I think that your peer support
programs are a great way to kindof extend that network. I think
really trying to think kind ofbroadly about the types of folks
that can help, right? So again,you know, is there a space for
that kind of pre licensedindividual? They can be in a
kind of, again, an expansion ofthe of the workforce, I think,
(42:32):
really providing that education,also, of what are the warning
signs when somebody really needsto seek that professional level
of care? So, kind of knowing howto almost triage, in a sense,
right? Maybe people just need asupport group or a couple of
resources versus they need, youknow, formal ongoing therapy,
for example. And that's not tosay everybody doesn't deserve
(42:54):
help, but what that help lookslike might depend on what a
person's going through. I thinkthe other piece, and this is
where technology can be great,is there's so much technology
now that we can utilize sowhether it's virtual care as an
example, right? That you know,has really, really helped to
bring clinicians intoenvironments where, maybe
(43:15):
historically, there just wasn'taccess. But there's also some
really great opportunities interms of like apps and different
online programs that people canutilize and and again, I would
recommend that more as you know,somebody who's maybe has more
mild difficulties or maybe as anadjunct to professional
treatment, but it does kind ofextend the the bandwidth, so to
(43:38):
speak, you know, to really roundout the options for folks, and
can be really helpful for peoplewho maybe are sort of dipping
their toe in the water too,right? So maybe they're a little
bit nervous about doing, youknow, therapy, for example, but
they're willing to, you know,learn some skills and some, you
know, coping strategies throughan app, so it can kind of open
that door
Erin Brinker (43:58):
indeed. And I'm and I'm and I'm thinking about,
and I know Kaiser Permanente hassome programs in both in
Northern California and SouthernCalifornia to to make it easier
for like, low income, you know,people of color, to go into the
mental health professions in insupporting them during that time
when they're I think it's 3030504,000 hours something, in that
(44:22):
window of as an associate, to beable before their license, to be
able to see people on their own,and they don't make much money.
I mean, it's, it's, they're agreat, phenomenal resource, but
they're just not getting paidenough. And these are highly
skilled professionals who, theyhave families very often. And
so, you know, that is asignificant barrier. I think you
(44:43):
know, what would it? What wouldit mean if, if you know we're
talking about how governmentsspend their money, or how
organizations spend their money,I think that supporting those
individuals would really help.
Yeah,
Dr. Ashley Zucker (44:55):
absolutely.
But I think it's also makingsure that. Opportunity is there
for them. So, you know, justlike you said, as an example, it
used to be, several years agothat Kaiser Permanente didn't
use associates. We only uselicensed professionals. And we
really recognized an opportunityto really build and expand the
workforce and actually be ableto help people who are trying to
(45:17):
get to that place where theyhave a license, where they can
earn, you know, a significant,you know, better income. And so
that was really kind of a winwin for everybody, indeed. So,
you know, just offering thoseopportunities so people can get
in those hours and get them inpretty quickly, helps take them
to that, that next level. But Ialso think it again, it expands
(45:39):
that access for our patients andand honestly, I'll tell you,
sometimes, some of ourassociates are the best
therapists I've seen. They'reeager, they're ready to go. You
know, they do an amazing job,and they have, we have that
built in kind of support networkand, you know, supervision for
them as well. So I know, and Ihave full confidence that, you
(46:02):
know, if my patients seeing anassociate, they're getting
equal, if not, sometimes bettercare, because again, they're,
you know, they're ready to go.
They're learning, but they alsohave a supervisor to kind of run
everything past, too. So it'salmost like you get two for one,
Erin Brinker (46:17):
which is which is excellent. I've heard about
people graduating from gettingtheir master's degree and then
not being able to find aclinical supervisor, which means
they can't do their hours. Sothe fact that you all are hiring
them is fabulous, because then,you know, I'm sure that they're
then loyal to Kaiser Permanente.
They've, they've learned thesystem. They they know the
patients, and so for them tocontinue on in Kaiser Permanente
(46:38):
makes perfect sense for them.
Yeah, it
Dr. Ashley Zucker (46:43):
kind of creates this great career
pathway too, because they mightstart it as an associate and
then become a licensed therapistand then eventually become a
supervisor themselves. So it'skind of cool to see them kind of
progress through through theircareers.
Erin Brinker (46:57):
So you chose psychiatry when you were in
medical school, and what led youin, because we have just a few
minutes left, what led you intopsychiatry? Why was that? Was
Was that always where you wantedto go? Or is that, was that
something that you as you weregoing through residency, or
whatever you decided that youwanted to do?
Unknown (47:18):
Oh, that's a good question, and that's hard to
answer quickly.
Erin Brinker (47:22):
We have about eight minutes. Well,
Dr. Ashley Zucker (47:25):
I would say, actually, I became interested in
psychiatry in high school. Ithink it was, you know, just
seeing a lot of my peers thatwere struggling mentally and
wanting to be able to help them.
But by the time I got to medicalschool, I actually thought I was
going to do OBGYN, so, which isvery different than I agree. But
in medical school, you know, youdo your coursework in the
(47:49):
classroom, but then you start todo your rotations. And so when I
did my rotations in OBGYN, I waslike, hmm, maybe this isn't what
I want to do. And so you do getthat opportunity to kind of
experience each of the differentspecialties. And when I did
psychiatry, I still wasn't quitesure, but it's actually my
husband who was like, you havethe most fun telling me your
(48:09):
stories from psychiatry. Andhe's, you know, kind of pointed
out, like, you really love thatpatient population and really
love connecting, you know, withthose folks. But I always really
knew I wanted to be more gearedtowards adolescence. And so it
also just kind of opened up thatpossibility to be able to do
(48:30):
psychiatry, but also to, youknow, to see kids, to see
adolescents. And so to do thattraining, you actually have to
get trained in adult psychiatrybefore you can do child and
adolescent psychology. So that'salso really helpful, because,
yes, I take care of kids, butkids come with adults. They
Erin Brinker (48:50):
do, and some of those adults are stuck at being
kids. They're mentally they'reemotionally stuck at 16.
Dr. Ashley Zucker (48:57):
Yep, absolutely. And sometimes the
it's the adult that actuallyneeds the help. So, you know,
being able to recognize that andhelp them through that is, it
was also really rewarding, too,but that's kind of how I landed
there. That's the short version.
But that's
Erin Brinker (49:11):
awesome. That's awesome. I know, again, there's
just not enough. I i love thatthere are multiple medical
schools popping up all over theor, you know, that are, that are
that have popped up in theInland Empire. So in addition to
Loma Linda, there's now UCR andthere's the California
University of Science andmedicine out at the hospital in
(49:32):
Colton. There's one in Pomona.
There's, you know, and so andCal State San Bernardino is
opening a physician's AssistanceProgram, which is a different,
different thing. But it's, it's,I love that we're building this
capacity in the Inland Empire toto have mental, mental health
and physical healthprofessionals here, because we
need them here.
Unknown (49:51):
Yeah, I think what's important to note one. I should
note that KP has a medicalschool now too. But
Erin Brinker (49:57):
really I didn't know that. I didn't know that.
That tell me about it. Well,
Dr. Ashley Zucker (50:01):
so it's the Kaiser Permanente School of
Medicine. It's based out ofPasadena, but we actually have
the students. They rotate outwith us in San Bernardino for
all of their rotations, not justpsychiatry, but they kind of go
all over Southern California,but especially to to San
Bernardino, because we do haveour kind of tertiary care
(50:23):
center, so we have a lot ofdifferent specialties there. And
then, you know, they it. We'veonly had two classes graduated.
We just graduated our secondclass. So it's, you know,
relatively new medical school,but we have seen a, you know,
fair number of med students whoare really interested in
psychiatry. Excellent, exciting,excellent. We don't, you know,
(50:44):
we don't streamline themstraight into KP residencies.
You know, KP does have a numberof of our own residencies, and
we have a psychiatry for apsychiatry residency for adult
and for the child in Fontana,actually ourselves. But we don't
say they have to stay. We'rehappy to have them go out and
learn, you know, and expand the,you know, medical field
(51:05):
elsewhere too. But it's alsojust a great opportunity for,
you know, those of us who loveto teach too, because a lot of
medicine is about teaching. Soit's kind of a great sort of
feedback loop. But the other keypiece is that we can build all
the medical schools in theworld, but if we don't have the
residency program. So for folksthat don't know you, you know
(51:27):
you go to medical school andthen you actually go to
residency, which is where youspecialize, and you you're paid,
but not very much. It's almostlike a paid apprenticeship. But
if you don't have thoseopportunities, then you can't
become specialized or boardcertified, for example. So if we
have too many medical schoolsand not enough residencies,
(51:49):
we're still not creating enoughdoctors. And so that's really a
challenge that we're seeing kindof nationwide, particularly in
certain specialties, where wedon't what determines
Erin Brinker (51:57):
that? What? What determines how many, how many
places spot slots you have, so
Dr. Ashley Zucker (52:02):
residencies are usually sponsored by the
government. So, like mostthings, it comes down to
dollars, right? So that that'sbeen an issue that I know a lot
of folks have been working, youknow, not just in California,
but also, you know, federally inWashington to to try to increase
that funding for for residencyprograms.
Erin Brinker (52:25):
So if you have, you know, I know that residents,
they have to, you have to match.
You graduate from, from yourmedical school, and then you
have to match somewhere. So youcould go to go to, you could go
to medical school here inSouthern California, but be
matched in Minnesota or Illinoisor Mississippi or wherever, and
and so the number of slotsnationwide is determined by
(52:46):
funding from the government. Isthat what I'm hearing? Yep, wow,
yeah. We need to make I mean,think about things that that a
government would invest in, thatwould seem like was a pretty
important one seems obvious tome. Yeah, right. Kind of a no
brainer. Wow. Well, that's,that's good. So when? So if, if
a, say, a high school student,is interested in maybe going to
(53:08):
medical school, what? How shouldthey train themselves? And I
know this is a little bitoutside what we, you know about
mental health awareness, but Iif we want to improve the the
capacity for clinicians and thecapacity, just in the in
general, for mental health, thisis an important piece. Yeah,
Dr. Ashley Zucker (53:25):
absolutely. I mean, I think the best thing
that people can do is just getthemselves a well rounded
education. You know, I think ofall the things sort of, I've
been through and in kind ofgetting to medical school, and
it wasn't just do medicine,right? You have to have kind of
life experience that makes you abetter person. I think too, you
(53:47):
know, I wouldn't want, you know,especially somebody in high
school, to not do the thingsthat they love in high school,
you know, you got to get intocollege. So there's that, right?
But even once you're in incollege, you know, not all
medical schools are looking fora bio major. For example, there
are prerequisites you have to doto get into medical school, but
(54:08):
it doesn't mean that that hasthat science has to be your your
major. So I think it's importantpeople really continue to pursue
their passions and not just gettoo narrowly focused on on
medicine. But you know, the moreexperiences you can have within
healthcare, it can be veryhelpful. But that could be, you
know, volunteering or, you know,volunteering at a hospital or a
(54:31):
clinic or even just a communityprogram, you know, those types
of things can be really, reallyhelpful.
Erin Brinker (54:37):
Yep, because public health hits everything
right, hits everythingabsolutely so as a kind of, we
have about a minute and a halfleft. What is, if you could say
one thing about mental health ona community level, and kind of
where we're going and what towhat to look, what to think
about, what would that be?
Dr. Ashley Zucker (54:57):
I think the number, well, it's hard to pick
one. I'll say that, but I thinkthe number one thing that I
think about, that we really haveto do a better job communicating
is that emotions are not a badthing, that it's okay to feel
bad. It's okay to have a badday. It's really what you do
with it. I think we, in sort oftrying to destigmatize mental
(55:20):
health, we've somehow landed onthis message that, like
everybody's supposed to be happyall the time, and that's not
reality. So I think that's whatI think about too, is how do we
build that conversation? So it'snot about, how do we make sure
you're happy all the time, orthat you feel good all the time,
to how to make sure we we havethe supports in place for when
(55:41):
things are not going great,
Erin Brinker (55:43):
cuz very often, if you're just having a rotten day,
just sitting with a girlfriendor sitting with a family member
and saying, You know what, todayjust was terrible. And these are
the things that happen and you,you know, and you have that
conversation over a glass ofwine or a whatever, and you feel
better, yeah, you wake up thenext day and you have a new day,
Dr. Ashley Zucker (56:03):
yeah? And sometimes we kind of torture
ourselves, right? We have a badday, and we beat ourselves up
for it, and that just makes usfeel worse, as opposed to, you
know what? Today was just a badday, a bad
Erin Brinker (56:13):
day. Oh, you know, I'm the queen of beating myself
up, so I gotta stop that, right?
Well, Doctor Ashley Zucker,board certified psychiatrist
from Kaiser Permanente here inSan Bernardino County. Thank you
so much for joining me today.
Thank you so much for having me.
It was a great conversation. Itwas a lot of fun. Always is, and
I look forward to having you onagain. Yes. Well, that is about
all we have time for today. I'mErin Brinker. You've been
(56:37):
listening to the making hopehappen radio show, and if you're
listening to this on MemorialDay weekend, when it first airs
here on local radio in SouthernCalifornia, I hope that you take
the time this weekend toremember those who paid the
ultimate price, made theultimate sacrifice, the men and
women in uniform who haveensured that we have lived
(56:59):
prosperously and freely,prosperous and free since 1776
so to all those men and womenwho have fallen, thank you for
your sacrifice. To the familieswho are left behind and the
loved ones who are left behindand the men and women in uniform
who are left behind, you are inour thoughts and prayers. Thank
(57:19):
you for all you do. You've beenlistening like I said to the
making hope happen radio show.
I'm Erin Brinker and I'll seeyou next week. You
Noraly Sainz (57:40):
Hi. My name is Nora Lee science and I am
(58:01):
Program Coordinator at upliftSan Bernardino, a collective
impact initiative at the makinghope happen Foundation. And this
is my story. In November of 2017my husband, our four young sons
and I moved away from ourfamilies to San Bernardino with
the hope of reaching our goal ofhome ownership in 2018 as our
(58:22):
oldest son started kindergarten,I connected with the school
district and learned aboutmaking hope happens Kids program
with my oldest in kindergartenand my twins at preschool. I had
the opportunity to tote myyoungest to the kids parenting
classes. In January of 2020, myhusband and our family's
breadwinner unexpectedly passedaway, I found myself in a
(58:42):
pandemic with my sons in anuncertain future. It was then
that that oasis that I found atkids turned into my support
system, as the staff and friendsrallied around me while my sons
and I struggled to find our newnormal. In October of 2020 after
seven years as a homemaker, Ijoined the making hope happen
foundation as a programcoordinator for uplift San
(59:04):
Bernardino. This careeropportunity reignited my
family's dream of home ownershipin November of 2022 through the
mutual support of the uplift SanBernardino Housing Network, my
family was able to buy our firsthome in my role as program
coordinator and as I connectwith other families in our
community, I can wholeheartedlyattest to the opportunities that
(59:26):
the foundation is bringing toour community and truly making
hope happen. For more
Erin Brinker (59:31):
information about the making hope happen
foundation and to make adonation, please visit
www.makinghope.org That'swww.makinghope.org your
donations make our workpossible. You.
Popular Podcasts
Bookmarked by Reese's Book Club
Welcome to Bookmarked by Reese’s Book Club — the podcast where great stories, bold women, and irresistible conversations collide! Hosted by award-winning journalist Danielle Robay, each week new episodes balance thoughtful literary insight with the fervor of buzzy book trends, pop culture and more. Bookmarked brings together celebrities, tastemakers, influencers and authors from Reese's Book Club and beyond to share stories that transcend the page. Pull up a chair. You’re not just listening — you’re part of the conversation.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com