October 10, 2024 • 41 mins
On this special episode of MMHC, Eddie and Justin have an honest discussion about the state of mental health. They dive into healthcare, the post-COVID world, new stressors for teens, fighting burnout, and what makes working in mental health so rewarding.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
So today we're talking about our general experiences, but how
does it weigh on your mental health to have a
football team.
Speaker 2 (00:08):
That has just been historically bad.
Speaker 1 (00:16):
This is Millennial Mental Health Channel. I'm doctor Justin Romano,
a child adolescent psychiatry fellow.
Speaker 3 (00:21):
And I'm Medi Koreo, a licensed clinical therapist. Our podcast
is here because we wanted to start a much need
to conversation about mental health.
Speaker 1 (00:28):
Our goal is to teach you as much as we
can by sharing our own experiences and interviewing experts in
the mental health field. We will discuss topics like mood disorders,
psychotic disorders, substance use, personality disorders, and many more.
Speaker 3 (00:40):
Millennial Mental Health Channel buy Millennials for everyone. We hope
you enjoy today's episode.
Speaker 1 (00:47):
MMHC is a production of Speaker from iHeartMedia, I Heart Mirror.
Speaker 3 (00:53):
And you know, here's the thing. We're talking about the
Las Vegas formerly Oakland Raiders. It's taught me a lot
about myself. A couple of things come to my grid. Perseverance,
just the will to endure hard things, I think is
really what I've learned over the last twenty four years. So, yeah,
(01:17):
the Broncos beat the Raiders this past weekend and it's
just part for the course, I think is the right
term to use. We just we just kind of suck so.
Speaker 1 (01:27):
And to be honest, the Broncos snapped a what six
game losing streak to the Raiders or was it?
Speaker 3 (01:33):
I believe it was eight? You know, No, no on
them was counting.
Speaker 1 (01:38):
So I had to I had to brag a little bit,
just because it's been nothing to brag about for eight years.
Speaker 3 (01:46):
Only four we played each other twice a year. Don't worry,
it hasn't been that long.
Speaker 2 (01:50):
Oh yeah, that's eight years.
Speaker 1 (01:51):
Ever since Peyton Manning left, we've been really bad too.
I think we haven't had a Broncos haven't had a
winning season since the old sheriff mosied on out of town.
Speaker 3 (02:00):
Yeah a light trot, yes, because he was moving gingerly
at that point.
Speaker 2 (02:07):
Hey well man, Yeah, he could barely move his neck.
Speaker 3 (02:09):
Well, we're not going to just talk about the Raiders
in the Broncos because that would be awful and there
really wouldn't be much to talk about, especially in recent history.
But what we did want to focus on for today
is just the mental health provider experience and just really
kind of just have a longer discussion between Justin and
I have just what we've seen over the last I
say about five is years, but we can go a
(02:30):
little further. And I think the five year the number
five really comes from the fact that next month we're
going to be five years old, the show will hit
it's five year anniversary. And I think a lot has
changed since November and twenty nineteen. And I want to
make that very clear. We were a pre covid podcast.
We started way before all the other people, and we're
(02:50):
still going so pre covid. Do not lump us in
to the group of the COVID podcasters, but we started before,
not long before, but far enough before where yeah, a
shit ton of things has changed. We mentioned a lot,
but our humble beginnings mostly mine with my cheap Amazon microphone.
It is really just wild to see how far the
show has come from the start to now. Just the
(03:13):
amount of listeners and supporters we continue to get is
super cool. We're excited to just kind of see what
happens in the next five years. I think over the
last five years and even before that, I know, for me,
I've been out of school and working for seven but
really over the last five years, a lot has changed, right,
COVID I think really did a number on everything and
probably sped a lot of things up, But really a
(03:35):
lot of things in our field, both in the therapy
field site in the psychiatry field, a lot of things
have changed. So really, we just kind of wanted to
talk about the experience. We wanted to reflect for a
little bit, reflect on the last five years of the
show and the last five years of our career, and
just kind of think about how we got here, what
we've seen, and just even to think about what might
(03:56):
change in the future, because things can change pretty quickly.
I think that's one thing we've is that things can
change very fast and without a whole lot of warning. So, yeah,
we just wanted to talk about our experience. We'll have
a nice discussion of different questions. We even have one
from one of our listeners from our Instagram post yesterday.
Without further ado, here's our discussion.
Speaker 1 (04:18):
Give me a little bit of an overview of your career,
especially over the last five years, and because I know
you've had a couple different changes in jobs, you know
you personally have had a couple of different changes, So yeah,
tell me where you've been in the past five years.
Speaker 3 (04:31):
Yeah, I got to do the main first job that
a lot of therapists have, which was in community mental health. Overworked, underpaid.
It was fine, It wasn't that bad. I honestly like,
if it wasn't for COVID again, COVID popping up, who
knows how long I would have stayed. Because I did
really like the job I was at. I did really
(04:52):
like the people I was working with, my clients. There
was something about working with primarily Medicare Medicare Aid clients
that was fulfilling for me that I did really enjoy
to get to just provide these services for families. We
were even a I can't remember the acronym off the
top of my head, but we were this like approved
site for this national program where if you work, if
(05:16):
you do two years of licensed work, you actually get
a chunk of your student loans paid off. And I
was fully willing to do that. But you know, COVID
changed a lot of things, and I had to kind
of change my priorities and what was important to me. So,
you know, after those those few years of working in
commune mental health, I switched to a nonprofit hospital which
again I really enjoyed. I thought it was really cool.
(05:38):
I got to specialize a little bit and not even
a little bit, a lot in needing disorders. But again,
things change, and that's kind of just shifted me to
here where I'm at now at the high school. As
they're the titles the licensed mental health specialist, I just
tell everybody I'm the school therapist. But yeah, I think
a lot has changed career wise of just like priorities
(05:58):
and thinking of like it is the best for me.
It feels weird and it feels a little selfish as
like a therapist, like should I really be thinking about myself?
And I think, for what I tell a lot of
my students as an adjunct professor, you should think about
yourself and you should think about what's important to you.
So a lot has changed for me. I think work
life balance is one of those things. Time off is
one of those things. I've had an opportunity to leave
(06:21):
to go make a little bit more money, but that
would have changed a lot of things in terms of
like work life balance and time off. So it really
helped to tell me like what was important to me
and the importance of you know, work life balance and
time off, So I think that's one of the biggest
things that's changed. It's just my priorities in terms of
a job and where I'm working and a career. What
(06:41):
about you, justin.
Speaker 1 (06:42):
As someone who knows you pretty well, I think you're
in the perfect job. I think kids gravitate towards you.
You've got such a magnetic personality, and.
Speaker 2 (06:51):
I think you're just doing a really good job with
those kids there. So I'm really happy. I'm happy you're
enjoying it too.
Speaker 3 (06:57):
Thank you.
Speaker 1 (06:58):
But oh my god, what hasn't changed in my life
in the past five years? Personal life wise. I got
married in twenty twenty COVID wedding. We were supposed to
have this giant wedding with like over two hundred people,
and then we ended up just paring it down to
just the bridal party and immediate family. But I got
married in twenty twenty. I had a son in twenty
(07:21):
twenty three. Liam's a year and a half old.
Speaker 4 (07:23):
Now.
Speaker 1 (07:23):
It's crazy to think he is talking like crazy. He's
learning words left and right. He's really obsessed with planes
right now. And we live right next to like a
small airport, so there's always these little planes flying all
over the place, and every time he hears any sort
of motor he can't say peas or l's yet, so
he'll just point to the sky and go Wayne. We
(07:46):
were like, no, it's a leafblower, man, that's not a plane.
Hear something else, Wayne, It's pretty cute. He's a pretty
special kid, but career wise, a lot his chain. Because
we started this, I was in my second year of residency,
ended up doing five years of residency, and then I
(08:07):
just completed my first year of being an attending And
one thing I wanted to throw out too is I
know we have a lot of people who are interested
in going into mental health one day, if anyone has
any questions about the journey to becoming a psychiatrist, because
it is a pretty long road, but it's a great
road and you learn a lot, and it's a lot
about self discovery and learning about who you are so
(08:29):
that you can help people with themselves a lot better too.
So if anyone has any questions or ever wants to
know about that process, like, shoot us a message, send
us an email, slide into our DMS whatever you need.
I recently tried to slide into the DMS of Reagun,
the breakdancer from Australia, immediately blocked, yeah, she hasn't messaged
(08:52):
me back. But I was like, you know what, she
faced a lot of hate and for just dancing. I
don't think she was trying to offend it with her dancing,
and so I was like, I bet you have it
a great story to tell. But she didn't apparently see
the message. I'm sure she would have replied.
Speaker 2 (09:07):
If not.
Speaker 1 (09:09):
Honestly, and being on my own, being like a full
doctor and not having like anyone above me checking charts,
checking everything has been good.
Speaker 2 (09:20):
It's been nice.
Speaker 1 (09:21):
It's been freeing in a lot of ways. It's been
nerve wracking in a lot of ways because there is
a lot more responsibility on my shoulders and a lot
of these things do fall to me.
Speaker 2 (09:30):
But I was just thinking about it the other day.
Speaker 1 (09:34):
I was thinking about some of the patients that I have,
and I felt this like overwhelming feeling of like love
and connection, and I was.
Speaker 2 (09:39):
Just like, that's awesome.
Speaker 1 (09:41):
How many jobs do you actually get to connect and
feel like you're actually getting to know young people and
hopefully making a difference in their lives, giving them a
safe place to be themselves to work through their issues,
and so I am so lucky that I get to
do what I do, and that gratefulness is a really
important part of mental health too.
Speaker 3 (10:02):
It's crazy that you mentioned that was your second year
of residency, Like that's fucking yeah. Time has fucking flowed.
But like you're doing that. I know you guys have moved.
What is stood out to you from being a resident
to then doing fellowship to now being a full blown
on your own doctor psychiatrist. What is stood out for you.
Speaker 1 (10:24):
That this job is somewhat emotionally difficult and you have
to learn how to manage it and deal with it
in healthy ways. Because yeah, I've got some unhealthy coping
mechanisms out there too, but boy, I've really had to
learn how to get out that sadness, how to not
take these things home. And by no means am I
(10:46):
perfect yet that it's still sometimes I come home and
I am exhausted, And you know, sometimes, especially like right
when school starts, is always the hardest time because everyone's
really struggling. There's lots of stress with school, and it's
easy to let it get to you and get you down.
So just learning how to take care of yourself and
the importance of it, because you can't help anyone if
(11:07):
you're struggling, if you're drowning too, you can't help anyone
get out of the water. Yeah, and all the stuff
that you've done with kids and working in the high
school and all these different settings, Like what do you
think stands out. What's the biggest learning thing.
Speaker 3 (11:19):
For me was learning the importance of time off. I
just hadn't thought about that, and I hadn't like experienced
a job that had so much time off. Like if
you remember back when you were in school, it's not
like we were missing school all the time. But you
think of a typical school year. We start end of August.
In September, you have Labor Day right away, you go
(11:41):
into October, there tends to be some kind of in
service day or some kind of random day off, which
actually is this Friday for us. You go to November,
you have Veterans Day and you have Thanksgiving me a break.
December you have holiday break, Winter break, Christmas Break, January
have MLK Day, February have President Day. You get into March,
(12:02):
spring break, Like, there's just so much opportunity for time off,
and I just hadn't had a job where that was
something that I had. I had my days off when
I worked for the county in the community mental health clinic,
I would have like the federal holidays off, but then
other than that, I'm working Monday through Friday, earning through Thursday.
When I had my four tens, So to have a
job where I had a lot of additional time off,
(12:23):
especially the summer, really has just made me appreciate how
valuable that is. When I had an opportunity to after
my first year to go to a different nonprofit organization
or nonprofit hospital, the pay increase was big, but the
time off was going to be different. Right now, I'm
contracted for one hundred and ninety days a year. I
(12:43):
think on average people work about two hundred and sixty
ish days a year, right so that's a pretty big jump.
And just to really see how much days off and
time off are really important to me and kind of
now have a dollar value to me, which I never
thought of it before and had never considered. So I think
that's that's probably the biggest thing for me, is the
(13:04):
value of time off and consistent time off.
Speaker 1 (13:08):
Even like big chunks of time off too, like it's
nice to have like a random three day weekend, four
day weekend here and there, but it's so resetting and
rejuvenating to take a week off to do something totally different,
to take yourself completely out of your situation and reset.
Speaker 2 (13:24):
And I agree.
Speaker 1 (13:26):
The longer I go on, the more I realize, like
how important it is to take a little bit of
time off to give you that time to reflect.
Speaker 3 (13:33):
Yeah.
Speaker 1 (13:33):
I think I've maybe mentioned the story in the past,
but I used to have an attending who said that
once a year she would schedule a vacation for herself
where she had She wouldn't tell anyone like where she
was going, what she was doing. She would just like
fly somewhere, and then on that first day of her vacation,
she would just sit and cry and get it all out,
(13:55):
like all the And it hits me sometimes too, like
the all the pain and suffering that you hear about
it can sneak up on you. But she gave it
a time and place to let it all out, to
let all the stuff she had absorbed over the past year.
And I love that about her. I love that she
wasn't afraid to tell us that that was something that
(14:16):
she did, and love that she did that for herself.
Speaker 3 (14:19):
There's probably something helpful too about like, Okay, I just
got to go a little longer. I'll get to that
day off or get to that time off and probably
helps you keep going. Yeah.
Speaker 1 (14:27):
Absolutely, in our teens, especially you're in the schools, what
do you see are the main stressors they're facing today?
And like how might they be different than the stressors
from ten years ago.
Speaker 3 (14:39):
I feel like one thing that's really stood out has
just been like, and this is a no fault to
our kids. I don't think, it's just how hard it
is to deal with stressors. Like the distress tolerance I
think is a little lower. And this is not to
be like oh back in my day, like none of
that bullshit, but just like it's hard to everyone has
gone through this like collective trauma without like really learning
(15:01):
how to deal with it because we just couldn't. So
I think, like the distress tolerance for not just teens,
for everybody, it's just a lot lower than it was.
But that's the overall thing. But I think another piece
to it with teens specifically is like you've talked about
it and if you haven't seen Justin's ted talk. You
got to go see it on you know, the phone
and technology addiction, but just the use of phones, the
use of social media, and how much like that's like
(15:24):
you can have your bully that lives nowhere near you
in your pocket blowing your phone up and they have
all this control over you, whereas before it was like
as long as I don't see them at school today,
I guess it doesn't matter. So I think that's a
big piece to it. Is like that overall connection all
the time to everybody everywhere is a big is a
big stressor that that other those other pieces of you know,
(15:46):
the fear of missing out, feeling like you need to
be in the know on things, you have to be
following all these trends. That's a lot of pressure that
I don't think a lot of kids had, you know,
ten years ago. If I think ten years ago, we're
in twenty twenty four. I was twenty fourteen at that time.
I was a senior in college. Like I don't know,
like we had the technology, but snapchat works different than
(16:08):
it did back in the day. At some point we
got Instagram, DMS. We didn't always have that. Like there's
just all these things that the technology has gotten better,
but in turn that might have made things worse for
the teens because now they just have all this unlimited
access to each other and to other people, and it's
a lot of stimulation to have all the time, and
there's so much technology use all the time, like you
(16:30):
know for sure, you know, you and I in college
was really for me. That's when I really started to
use a computer or a laptop. I didn't have a laptop,
so I got to college, so that's when I really
started to use a computer all the time. But now
kids in high school are getting chromebooks and iPads and
stuff everywhere, you know, so they're using technology all the time,
which is great, they need it, but it might be
(16:50):
too much at this point.
Speaker 1 (16:52):
A great and I would definitely just piggyback on that,
and I know we talk about that a lot on
this show.
Speaker 2 (16:57):
I did a couple of shadowing days where.
Speaker 1 (16:59):
I went into the high high school and in Omaha
my last year of residency, and just to see how
much it had changed from when I was a kid,
when I was growing up in high school, how technology
and iPads Like every class it was like, all right,
get out your iPads, your lectures uploaded, go through it
and then fill out the quiz on this app, and
(17:20):
it's just like everything was digital.
Speaker 2 (17:23):
Everything was on the iPad.
Speaker 1 (17:25):
No one had any books, and I thought that was
such a huge change, and so you need your iPad
for everything. It's more and more and more screen time
all the time. Plus I think it's really it's really
changing the way teens interact with the world. If you
look at the numbers I've seen the for eighteen year olds,
(17:47):
they spend about ninety three percent of their free time
on screens these days, which is an ungodly amount of
screen time. It's average, you know, seven to nine hours
per day for young people. And people are on their
phone so much now it's monopolizing so much of their
time that they're not wanting to go out and spend
(18:08):
time with people in real life, and those connections in
real life are suffering. A lot of people just sit
in the room all day playing video games on their phone.
They don't come out and talk to their parents, and
they're drawing farther and farther away from their parents. They
don't have any friends in real life. All they have
are friends on Discord, friends on Facebook, friends on different.
(18:31):
I guess kids aren't using Facebook, maybe not Face, but
they're getting all their connections online, and studies show that
they are just not as deep of connections. You don't
feel them, you don't feel like they're there for you,
and they're not there in real life. They can't empathize
(18:52):
with you and they can't hear it when you're struggling
as much. And so it's I think that's a big
part of why the distress tolerance has changed so much,
because I think kids use the technology to as a
coping mechanism. If they're stressed, if they're angry, they go
on their phones. If they're sad, they go on their phones.
(19:14):
They don't go to look for help in the real
world anymore. They're just learning how to cope with their phones.
And that's not as effective. It's not real world skills
like kids used to have to build.
Speaker 3 (19:28):
I'll take it, maybe not a step further. But something
I think that is related too is that if you've
seen I've seen a lot of articles and not so
much studies, but just articles come out with where like
school attendance is suffering, like kids are contending school a
lot less, and I don't think I think one thought
on how to fix it is we just need to
make school more engaging, and I don't think that's the
(19:51):
full picture. I think we need to make school less
accessible digitally. I think that's a big piece of it.
I've had number of students over the last few years
who are just like, yeah, my attendants sucks. I don't
go to that class, but I don't need to. I
can just check canvas, or I can check online, and
I can get the assignments and still turn it in.
So I think because of COVID, we made everything as
(20:13):
accessible as possible. Now it's still the same amount of accessible,
but we want kids to be there in person, and
because of that it's accessible. I don't have to go
to school. So I think I think we've we've almost
gotten too far to one side. We had to for
a little bit, but now maybe maybe that can help
with like that kind of stressing the importance of in
(20:34):
person connection and participation and not so much. Well, I
just turned in the worksheets, so I'm good to go.
Speaker 1 (20:40):
And I have worked with a couple of different families
where your kid has social anxiety and they call their
parents all the time or they text them in school
all the time say I'm so anxious, Please take me
out of school. Take me out of school, Take me
out of school. Parents eventually do it, and then they're like, Oh,
this is just too hard. Let's put them an online
school because it's just gonna be easier for them. It's like, yeah,
(21:02):
it's easier, but you're missing so much social development if
you just homeschool. God, I remember growing up with a
lot of homeschool kids and they were always just.
Speaker 3 (21:11):
A little weird.
Speaker 1 (21:13):
Sorry to put you on blast homeschool kids, but it's
happening a lot. And you're absolutely right that chronic absenteeism
at school is definitely on the rise after COVID, and
it's changed the way people interact with the school system,
and change is completely changing the way kids are getting
educated these days.
Speaker 3 (21:39):
Along in the same lines, COVID right has basically put
us in this position. But what kind of changes have
you seen, you know, as a psychiatrist specifically because of COVID.
We've mentioned like online school, what else have you seen.
Speaker 1 (21:53):
One thing that's actually a positive is that people are
more open and accepting of doing online and teletherapi and telemedicine.
So I think that's a good thing because especially working
in a place like Wyoming, there is not nearly enough
providers and being able to do telehealth make sure that
more people can get more help. But COVID just caused
(22:16):
a lot of different changes, and because kids were out
of school for so long now, a lot of them
didn't get the services that they need, even you know,
speech PTOT, a lot of those things had to cancel
over COVID, and so kids were way behind. I remember
listening to one piece on NPR after COVID that just
showed that kids lost a lot of ground in school
(22:42):
and it doesn't look like they're going to make it up.
Like they're just behind because of COVID in terms of academics,
in terms of social skills, and now we're just like
throwing them out into the world and saying good luck.
Speaker 3 (22:54):
Good luck. Yeah. Yeah, I think definitely like the rise
of online in school for me, like I see a
lot more kids. It's probably because I've been out of
high school for so long, right up until these last
few years, but just the amount of kids that like
just go to online school just seems like a huge
number to me. Of like, has this always been this way?
(23:17):
And it's probably not like I think COVID is a
big piece to it. I think the point of telehealth
is great. I think telehealth is a good opportunity for people.
I remember, you know, having a patient that when I
was in a different job, that lived in one area
of the state but needed was able to get the
correct specialized services that was in a different part, but
(23:39):
they were able to get it through telehealth, which I
think is great. Here's the one issue, or maybe more
than one issue. I think that I've seen, though, as
someone that does a lot of care coordination and tries
to find available therapists for students and families, is that
we've maybe gotten too much telehealth. There's a lot of
people that want in person, but it seems like providers
(24:01):
that provide in person therapy feel few and far in between.
And then along the same lines, and I get there's
a there's a certain piece that you know, there's a
we got to hold insurance company is accountable and they're
kind of putting us in this position. But to the
amount of therapists that just take zero insurance and only
do private pay, and then their private pay is two
hundred dollars an hour, I'm all for people making whatever
(24:24):
amount of money to live their life, that's great, But
then there's other things that you can't necessarily claim, like
claiming that you care about meeting people's needs and social justice,
and that might ruffle some feathers, but that's just that's
my opinion on it. Of like, if you are going
to charge two hundred dollars an hour and only see
someone on telehealth, you are either consciously or subconsciously can't
(24:47):
slean out a large population of people that can never
have your services and that you might not want to
be serving, and maybe that's why you're doing it. So
I guess along the same lines. I think that's been
a hard part for me is the amount of people
that are doing telehealth, And I get it, costs are rising.
If ultimately that's where we're going, where we have a
lot more telehealth providers, we can adjust that, we can
(25:10):
get people to be open to telehealth. But then the
other piece of it of like I'm only taking cash
pay and I'm not taking insurance, and it's really like
cutting out a huge number of people that just can't
get services because of it.
Speaker 1 (25:22):
So what do you feel about like mental health your
field as a whole right now.
Speaker 3 (25:27):
Well, besides the shitting on them that I just did,
I think I think in general we're in a better
spot of like there feels to be subjectively less stigma
around mental health. I think people are more open to
asking for help than they have been. I think more
people are able to live their true, authentic life and
(25:50):
like be open about their struggles and things that they're
going through. I'm not saying it's enough. I just think
there's more. And this is something that I kind of
felt on hone, but like back in grad school, I
had this feeling of like, I think we're moving in
the right direction in terms of like there's gonna be
jobs everywhere for us, like there will always be a
need for mental health and therapy and therapists and counseling,
(26:12):
and we're moving to a good spot. And I think
that's that's kind of transpired, which is cool. So I
think that part is good. I think other than the
other parts that I was negative about, I don't know
if I have a whole lot of negatives. I think
in general, because people are more open to talking about it,
it kind of makes the job easier and it makes
it it makes it better as a whole that you
(26:32):
just have a lot of people that are open to
talking about it. I guess actually, now that I'm saying
this out loud, the social mediaization of it has been
kind of tough. So yeah, maybe not necessarily overdiagnosing, but
just like the talking so openly about like this is
what this is, or you have people on TikTok where
like I'm an ADHD coach, It's like, what the fuck
does that mean? And like you don't know what you're
(26:54):
talking about. You get like I'm a relationship coach, and
it's like you gotta like it's hard because you don't
have enough time to educate people, and like you really
need to be careful about what kind of advice and
support you're getting from people online, especially that don't have
the correct credentials. And if you notice the people who
are out here like giving you specific things to do
and tips and this and that are not licensed medical
(27:16):
providers because that's we're not allowed to do that. So
it's I don't know, I guess that would be another
piece that I'm saying that's the negative side is the
over social social medialization of it. I think that's been
pretty negative. What do you think that makes.
Speaker 1 (27:30):
Sense, But anytime you hear a coach, you just have
to think to yourself, they didn't get formal mental health training.
Yeah most of the time, And think of like a
high school basketball coach, do they need any really formal training.
Speaker 2 (27:43):
To be a high school basketball coach?
Speaker 3 (27:45):
Pass a background check. I don't know no shit against
basketball coaches, but yeah, I mean that's that's not a terrible.
Speaker 2 (27:53):
An analogy there.
Speaker 1 (27:54):
And I know some basketball coaches and they're great, but
it's like, yeah, you don't need to go to college
to learn how to coach basketball. You don't need to
like get that training.
Speaker 2 (28:05):
So yeah, yeah.
Speaker 1 (28:06):
The social media thing is is tough, and a lot
of misinformation on the social media things and a lot
of people just trying to sell things, just trying to
promote their own brand, and you see the same trends
and what all of them are doing and all the
things that they say, and sometimes they give you false
information because they're telling people what they want to hear,
and that can be a really tough thing too.
Speaker 3 (28:28):
Did you know that if you wake up and look
at your phone, it means you were neglected as a child,
Like that's not what that like? Psychology wants you to know.
Speaker 4 (28:39):
No, they don't like it just happens all the time,
like people just say things to be trendy and to
get be viral on TikTok, and it's like there's no
one able to be there to be like, no.
Speaker 3 (28:51):
This is wrong, Like do not listen to this.
Speaker 2 (28:54):
Yeah, you need fact checkers.
Speaker 1 (28:56):
If there's one thing I learned from watching the debate
that's like you need that.
Speaker 3 (29:00):
I thought you weren't fact checking me.
Speaker 1 (29:02):
Sorry, yeah, I thought this wasn't going.
Speaker 2 (29:04):
To be fact checked.
Speaker 3 (29:07):
Besides getting rid of like the social media bs, what
do you think would make your job easier.
Speaker 1 (29:12):
If insurance companies weren't such dicks?
Speaker 2 (29:15):
I would say.
Speaker 1 (29:16):
I was even talking to a family today who is
saying that they get mental health coverage, but their mental
or their insurance company hired a third party company to
moderate and regulate all.
Speaker 2 (29:31):
The mental health care coverage.
Speaker 1 (29:32):
So everything that they do and everything that they get,
they have to justify with this third party company who
checks and monitors everything. And there are laws in the
United States that says it is illegal for insurance companies
to treat mental health any differently than physical health, but
(29:54):
they do it all the time, there was a really
big pro public apiece that came out about this that
insurance com companies are just blatantly breaking the law, the
mental health parity laws in the United States, and in
the US government's doing absolutely nothing about it. And it's
just that is what it makes my job hard because
(30:15):
I prescribed lexapro on someone who it's FDA approved for
the diagnosis that I had, and we still had to
fill out a ton of prior off paperwork just to
get the insurance company to pay for an affordable, proven
medication because they know people won't jump through those hoops
and that they won't have to eventually pay for it.
(30:35):
And what the insurance companies are doing is illegal, it's immoral,
and that's the one thing I really really wish would change.
Speaker 3 (30:43):
Wow, I don't work with insurance a ton, and I
think I can see this other side as like the
part where like, okay, I can get it why people
want to move to cash be so I'd probably double
down on that as far as like baking the job,
because I got to find providers for families all the time.
So insurance has a better job, then maybe more people
(31:03):
take insurance and the more people take insurance, it's easier
to find providers. I think one thing that I would
think of is if not all parents, but just if
some parents understood that just because your child or teen
is struggling or having a hard time, it doesn't mean
you're a shitty parent. Yeah, because I think a lot
of the time when you when I've interacted with parents
(31:26):
in all three of my jobs, you call them or
you talk with them, and you have this conversation of like, oh,
you know, so and so is having a really hard time,
they take that as like you're telling me I'm a
shit parent. I never said that. I'm just telling you
that this is where we're at. And if we can
get that past that initial like taking it personally, I
think a lot more parents would be hearing a lot
(31:46):
better information and be a lot more capable of listening
to then make changes the best help out their kid.
Speaker 1 (31:53):
And teen mental health could happen to anyone, it does not,
It's not a reflection of your parenting.
Speaker 3 (31:58):
Yeah. Laurel on Instagram what are the top three things
to do to minimize burnout? I was trying to think, like,
what are my three things the minimize burnout?
Speaker 1 (32:10):
I would say, stay connected with your family, your community.
Speaker 2 (32:15):
The people that you work with.
Speaker 1 (32:17):
Take time off as my number two and number three,
find coping mechanisms that work for you that you enjoy,
whether it's writing, whether it's exercise, whether it's music. Something
that you feel like is a release, is an outlet
that helps you blow off some steam.
Speaker 2 (32:36):
How about you? What are your top three?
Speaker 3 (32:37):
I think along the same lines like self care for sure,
things that make you happy and make you feel better.
Not keeping things all to yourself, like not just struggling
through it with yourself, because I think if you I
think I've struggled with this before, Like if you just
keep something to yourself, you're not saying anything. Then you
want start to feel like a sense of resentment towards
people around you, like why aren't you asking? Or like
why don't you care that I'm struggling? But it's like
(32:59):
they don't know that you're struggling. I really know what
we know. So that's number two and then number three, Hmmm,
know when it's time if I want to come up
with something different, know when it's time to move on.
And I think of that in terms of like a job,
like knowing when it's time, like Okay, maybe I can.
I should consider something different, like this is I've given
(33:21):
it a chance. I don't want to quit on anything,
and I've probably reached the the end to where this
is just it's not going to get any better, so
I should try something different.
Speaker 1 (33:31):
This is coming from the guy who's been a Raiders
fan for twenty four years.
Speaker 3 (33:37):
God cut the show, cut the cameras.
Speaker 2 (33:43):
It's time to move on.
Speaker 3 (33:46):
This is different, This one's different.
Speaker 1 (33:49):
I think it shows that you've got a lot of loyalty,
You've got a lot.
Speaker 2 (33:52):
Of passion about your great perseverance.
Speaker 3 (33:56):
Everything we started with the show with.
Speaker 2 (33:58):
Hell come around. Do you bring your work home with you?
Does it get to you?
Speaker 3 (34:06):
Good question. I tell this story a lot to like
students and like just like on when I knew it
was time to like figure something else out when dealing
with work stress. It was Thanksgiving break twenty sixteen. I
was an intern. I was working. I was also working
at the time, but I was interning with the Juvenile Department,
(34:28):
and I was just having a hard time because my
clients were just not doing a great job. They were struggling.
And I used to like measure my self worth or
my worth as a counselor in training off of how
well they were doing well. One of my clients the
week before, sometime before Thanksgiving, got in trouble again and
they ended up, you know, facing a pretty severe consequence.
(34:52):
And I remember actually going to Dana's house after and
having like all of us were there for like a
Thanksgiving together and just having the worst attitude about it,
not trying to but struggling so hard. I'm with my friends,
I'm having a good time, but I'm not having a
good time because my client's not doing well. They're struggling,
(35:14):
and I'm just thinking about how much I could have
done something better. Looking back on it, I couldn't have
been shit better. I did the best I could. Ultimately,
they have their own decisions to make. But that's the
story I tell of, like sitting there Thanksgiving with my friends,
not having the best time because I'm letting this impact
me outside of the office.
Speaker 1 (35:34):
It's hard not to, especially because you do care about
your patients and you do want to see them do well.
And sometimes it's really hard, and I have to tell
myself all the time, like you can't save everyone, that
you can listen, you can help them, you can lead
them to water, but you cannot make them drink and
that's okay, Like you do your best, but if you
(35:58):
have the goal of saving every you're gonna drown in
the water with them. What's your favorite part about working
with young people? Because we've talked a lot about how
much we love this young generation. There's a lot of
great things about Jen Alpha gen Z. Yeah, what do
you think, what are your favorite parts?
Speaker 3 (36:14):
I think, to go back to something you just said,
like we care, Like this is our technically on a
like really basic level, we get paid to care, Like
that's kind of how it goes. But the thing is that,
like we we genuinely care about the work that we
do and the patients and the clients and the kids
we work with, and if we didn't, we would choose
(36:37):
something else to do, we would find a totally different job.
So I think that's one thing I wanted to like
reiterate with what you said of like this is this
is what we like to do, Like we love doing this,
Like this is the work that we enjoy. I think
in terms of favorite part of working with young people,
it's just the getting to hopefully be one of the
adults that believes in them that lets them know like
(36:58):
things can be okay even after really shitty times, and
to just kind of be like that cheerleader for them
and to let them know like I believe in you,
I think you can do it, Like you've got this,
I'm proud of you. Being able to tell kids like
I'm proud of you, I think makes a huge impact
on them, and I enjoy being able to have that opportunity.
I think I'm in a unique position of just getting
(37:18):
to work in a high school. So I see these
kids on more levels than just in my office. I
see them at sporting events, performing arts, all of these
different things, club events, whatever it is. So I think
getting to do that and to get to be just
a positive impact in their life and like a positive adult,
I think is really special.
Speaker 2 (37:38):
That's cool.
Speaker 1 (37:39):
Yeah, I love the fact that I learned so much
from young people.
Speaker 2 (37:46):
Skibity toilet.
Speaker 3 (37:51):
Sorry, Yeah, that's one of the best. Sure.
Speaker 1 (37:56):
I heard a patient say that something with sigma the
other day, those like like the Greek letter, Like, how
does that make any sense?
Speaker 2 (38:03):
So she had to explain that to me.
Speaker 1 (38:08):
Yeah, I know right, They're like, uh, it's just something
we say, Yeah, it's it's fun being able to to
learn and compare it to what we were doing and
all the new lingo lingo and slang that's totally normal
to us. That they're making for themselves, and they're and
they're making a whole new generation of what they want
this world to be. And it's cool to be able
(38:28):
to guide them and show them and listen to them
and and be that support. Like you said, I love
being a cheerleader for kids. But it's fun seeing what
art they're into, what music they're into, what movies they're into.
And you know, with the internet this, these young generations
are so eclectic. You never know what what they're gonna hear,
or what you're gonna hear, what they're gonna say. They're
(38:50):
into these days, Like you know, they're wearing Rolling Stone
shirts and Beatles hats and like all this cool stuff
that you know, I was into when I was a kid,
and I'm like, okay, kids still like this kind of
stuff too. But so it's just fun being with young
people who are constantly infusing new ideas into your life.
Speaker 3 (39:08):
Yeah, I think of it as just a privilege to
get to, like you said, to learn from them, be
a part of their life and get to share that
space with them, because I know for kids and teens
it could be really hard for them to find adults
that they trust and feel comfortable enough sharing. And I
think to anytime a student comes in and like, I
just have to tell you this, or you know, I
(39:30):
I thought of needing to tell you this, Like I
just had to come in and tell you like that
kind of stuff is important to me and impactful.
Speaker 1 (39:37):
And nothing warms my heart more of like more than
someone who has been struggling lately.
Speaker 2 (39:42):
And then they come in.
Speaker 1 (39:43):
And they say, I'm doing better now, I'm going to therapy,
I'm doing something I love, and things are finally turning around,
and it's just like sometimes I'll even just like pump
my fist in the office and be like yees, so
let's go. It's just such a good feeling to see
(40:03):
a young person who has been through a lot do well.
Speaker 3 (40:08):
Yeah. I'm no stranger to the quick quiet flex in
my office after you find out that one of your
kids did something well or they're doing better.
Speaker 1 (40:17):
Yeah, well thanks for talking with me. Yeah that was
a good convo. We do a lot of structured episodes
with lots of teaching. It was nice to just have
something a little bit more conversational and pick each other's
brains a little more.
Speaker 3 (40:33):
Yeah, we have some exciting stuff coming up. We have
a really exciting interview. We'll save the guest as a secret,
but I'm excited for that one. Thank you all, we've
made it to the end of the episode. You know
the drill, Apple Podcasts, Spotify, whatever else you use to
listen to your podcast, leave us a five star review.
You can leave us a comment on whichever app you
use on social media at Millennium MHC on TikTok, Instagram, Twitter, YouTube,
(40:58):
and our website dot com. Thank you all for listening.
We'll see you next time, and take care of your mentors.
So today we're talking about our general experiences, but how
does it weigh on your mental health to have a
football team.
Speaker 2 (00:08):
That has just been historically bad.
Speaker 1 (00:16):
This is Millennial Mental Health Channel. I'm doctor Justin Romano,
a child adolescent psychiatry fellow.
Speaker 3 (00:21):
And I'm Medi Koreo, a licensed clinical therapist. Our podcast
is here because we wanted to start a much need
to conversation about mental health.
Speaker 1 (00:28):
Our goal is to teach you as much as we
can by sharing our own experiences and interviewing experts in
the mental health field. We will discuss topics like mood disorders,
psychotic disorders, substance use, personality disorders, and many more.
Speaker 3 (00:40):
Millennial Mental Health Channel buy Millennials for everyone. We hope
you enjoy today's episode.
Speaker 1 (00:47):
MMHC is a production of Speaker from iHeartMedia, I Heart Mirror.
Speaker 3 (00:53):
And you know, here's the thing. We're talking about the
Las Vegas formerly Oakland Raiders. It's taught me a lot
about myself. A couple of things come to my grid. Perseverance,
just the will to endure hard things, I think is
really what I've learned over the last twenty four years. So, yeah,
(01:17):
the Broncos beat the Raiders this past weekend and it's
just part for the course, I think is the right
term to use. We just we just kind of suck so.
Speaker 1 (01:27):
And to be honest, the Broncos snapped a what six
game losing streak to the Raiders or was it?
Speaker 3 (01:33):
I believe it was eight? You know, No, no on
them was counting.
Speaker 1 (01:38):
So I had to I had to brag a little bit,
just because it's been nothing to brag about for eight years.
Speaker 3 (01:46):
Only four we played each other twice a year. Don't worry,
it hasn't been that long.
Speaker 2 (01:50):
Oh yeah, that's eight years.
Speaker 1 (01:51):
Ever since Peyton Manning left, we've been really bad too.
I think we haven't had a Broncos haven't had a
winning season since the old sheriff mosied on out of town.
Speaker 3 (02:00):
Yeah a light trot, yes, because he was moving gingerly
at that point.
Speaker 2 (02:07):
Hey well man, Yeah, he could barely move his neck.
Speaker 3 (02:09):
Well, we're not going to just talk about the Raiders
in the Broncos because that would be awful and there
really wouldn't be much to talk about, especially in recent history.
But what we did want to focus on for today
is just the mental health provider experience and just really
kind of just have a longer discussion between Justin and
I have just what we've seen over the last I
say about five is years, but we can go a
(02:30):
little further. And I think the five year the number
five really comes from the fact that next month we're
going to be five years old, the show will hit
it's five year anniversary. And I think a lot has
changed since November and twenty nineteen. And I want to
make that very clear. We were a pre covid podcast.
We started way before all the other people, and we're
(02:50):
still going so pre covid. Do not lump us in
to the group of the COVID podcasters, but we started before,
not long before, but far enough before where yeah, a
shit ton of things has changed. We mentioned a lot,
but our humble beginnings mostly mine with my cheap Amazon microphone.
It is really just wild to see how far the
show has come from the start to now. Just the
(03:13):
amount of listeners and supporters we continue to get is
super cool. We're excited to just kind of see what
happens in the next five years. I think over the
last five years and even before that, I know, for me,
I've been out of school and working for seven but
really over the last five years, a lot has changed, right,
COVID I think really did a number on everything and
probably sped a lot of things up, But really a
(03:35):
lot of things in our field, both in the therapy
field site in the psychiatry field, a lot of things
have changed. So really, we just kind of wanted to
talk about the experience. We wanted to reflect for a
little bit, reflect on the last five years of the
show and the last five years of our career, and
just kind of think about how we got here, what
we've seen, and just even to think about what might
(03:56):
change in the future, because things can change pretty quickly.
I think that's one thing we've is that things can
change very fast and without a whole lot of warning. So, yeah,
we just wanted to talk about our experience. We'll have
a nice discussion of different questions. We even have one
from one of our listeners from our Instagram post yesterday.
Without further ado, here's our discussion.
Speaker 1 (04:18):
Give me a little bit of an overview of your career,
especially over the last five years, and because I know
you've had a couple different changes in jobs, you know
you personally have had a couple of different changes, So yeah,
tell me where you've been in the past five years.
Speaker 3 (04:31):
Yeah, I got to do the main first job that
a lot of therapists have, which was in community mental health. Overworked, underpaid.
It was fine, It wasn't that bad. I honestly like,
if it wasn't for COVID again, COVID popping up, who
knows how long I would have stayed. Because I did
really like the job I was at. I did really
(04:52):
like the people I was working with, my clients. There
was something about working with primarily Medicare Medicare Aid clients
that was fulfilling for me that I did really enjoy
to get to just provide these services for families. We
were even a I can't remember the acronym off the
top of my head, but we were this like approved
site for this national program where if you work, if
(05:16):
you do two years of licensed work, you actually get
a chunk of your student loans paid off. And I
was fully willing to do that. But you know, COVID
changed a lot of things, and I had to kind
of change my priorities and what was important to me. So,
you know, after those those few years of working in
commune mental health, I switched to a nonprofit hospital which
again I really enjoyed. I thought it was really cool.
(05:38):
I got to specialize a little bit and not even
a little bit, a lot in needing disorders. But again,
things change, and that's kind of just shifted me to
here where I'm at now at the high school. As
they're the titles the licensed mental health specialist, I just
tell everybody I'm the school therapist. But yeah, I think
a lot has changed career wise of just like priorities
(05:58):
and thinking of like it is the best for me.
It feels weird and it feels a little selfish as
like a therapist, like should I really be thinking about myself?
And I think, for what I tell a lot of
my students as an adjunct professor, you should think about
yourself and you should think about what's important to you.
So a lot has changed for me. I think work
life balance is one of those things. Time off is
one of those things. I've had an opportunity to leave
(06:21):
to go make a little bit more money, but that
would have changed a lot of things in terms of
like work life balance and time off. So it really
helped to tell me like what was important to me
and the importance of you know, work life balance and
time off, So I think that's one of the biggest
things that's changed. It's just my priorities in terms of
a job and where I'm working and a career. What
(06:41):
about you, justin.
Speaker 1 (06:42):
As someone who knows you pretty well, I think you're
in the perfect job. I think kids gravitate towards you.
You've got such a magnetic personality, and.
Speaker 2 (06:51):
I think you're just doing a really good job with
those kids there. So I'm really happy. I'm happy you're
enjoying it too.
Speaker 3 (06:57):
Thank you.
Speaker 1 (06:58):
But oh my god, what hasn't changed in my life
in the past five years? Personal life wise. I got
married in twenty twenty COVID wedding. We were supposed to
have this giant wedding with like over two hundred people,
and then we ended up just paring it down to
just the bridal party and immediate family. But I got
married in twenty twenty. I had a son in twenty
(07:21):
twenty three. Liam's a year and a half old.
Speaker 4 (07:23):
Now.
Speaker 1 (07:23):
It's crazy to think he is talking like crazy. He's
learning words left and right. He's really obsessed with planes
right now. And we live right next to like a
small airport, so there's always these little planes flying all
over the place, and every time he hears any sort
of motor he can't say peas or l's yet, so
he'll just point to the sky and go Wayne. We
(07:46):
were like, no, it's a leafblower, man, that's not a plane.
Hear something else, Wayne, It's pretty cute. He's a pretty
special kid, but career wise, a lot his chain. Because
we started this, I was in my second year of residency,
ended up doing five years of residency, and then I
(08:07):
just completed my first year of being an attending And
one thing I wanted to throw out too is I
know we have a lot of people who are interested
in going into mental health one day, if anyone has
any questions about the journey to becoming a psychiatrist, because
it is a pretty long road, but it's a great
road and you learn a lot, and it's a lot
about self discovery and learning about who you are so
(08:29):
that you can help people with themselves a lot better too.
So if anyone has any questions or ever wants to
know about that process, like, shoot us a message, send
us an email, slide into our DMS whatever you need.
I recently tried to slide into the DMS of Reagun,
the breakdancer from Australia, immediately blocked, yeah, she hasn't messaged
(08:52):
me back. But I was like, you know what, she
faced a lot of hate and for just dancing. I
don't think she was trying to offend it with her dancing,
and so I was like, I bet you have it
a great story to tell. But she didn't apparently see
the message. I'm sure she would have replied.
Speaker 2 (09:07):
If not.
Speaker 1 (09:09):
Honestly, and being on my own, being like a full
doctor and not having like anyone above me checking charts,
checking everything has been good.
Speaker 2 (09:20):
It's been nice.
Speaker 1 (09:21):
It's been freeing in a lot of ways. It's been
nerve wracking in a lot of ways because there is
a lot more responsibility on my shoulders and a lot
of these things do fall to me.
Speaker 2 (09:30):
But I was just thinking about it the other day.
Speaker 1 (09:34):
I was thinking about some of the patients that I have,
and I felt this like overwhelming feeling of like love
and connection, and I was.
Speaker 2 (09:39):
Just like, that's awesome.
Speaker 1 (09:41):
How many jobs do you actually get to connect and
feel like you're actually getting to know young people and
hopefully making a difference in their lives, giving them a
safe place to be themselves to work through their issues,
and so I am so lucky that I get to
do what I do, and that gratefulness is a really
important part of mental health too.
Speaker 3 (10:02):
It's crazy that you mentioned that was your second year
of residency, Like that's fucking yeah. Time has fucking flowed.
But like you're doing that. I know you guys have moved.
What is stood out to you from being a resident
to then doing fellowship to now being a full blown
on your own doctor psychiatrist. What is stood out for you.
Speaker 1 (10:24):
That this job is somewhat emotionally difficult and you have
to learn how to manage it and deal with it
in healthy ways. Because yeah, I've got some unhealthy coping
mechanisms out there too, but boy, I've really had to
learn how to get out that sadness, how to not
take these things home. And by no means am I
(10:46):
perfect yet that it's still sometimes I come home and
I am exhausted, And you know, sometimes, especially like right
when school starts, is always the hardest time because everyone's
really struggling. There's lots of stress with school, and it's
easy to let it get to you and get you down.
So just learning how to take care of yourself and
the importance of it, because you can't help anyone if
(11:07):
you're struggling, if you're drowning too, you can't help anyone
get out of the water. Yeah, and all the stuff
that you've done with kids and working in the high
school and all these different settings, Like what do you
think stands out. What's the biggest learning thing.
Speaker 3 (11:19):
For me was learning the importance of time off. I
just hadn't thought about that, and I hadn't like experienced
a job that had so much time off. Like if
you remember back when you were in school, it's not
like we were missing school all the time. But you
think of a typical school year. We start end of August.
In September, you have Labor Day right away, you go
(11:41):
into October, there tends to be some kind of in
service day or some kind of random day off, which
actually is this Friday for us. You go to November,
you have Veterans Day and you have Thanksgiving me a break.
December you have holiday break, Winter break, Christmas Break, January
have MLK Day, February have President Day. You get into March,
(12:02):
spring break, Like, there's just so much opportunity for time off,
and I just hadn't had a job where that was
something that I had. I had my days off when
I worked for the county in the community mental health clinic,
I would have like the federal holidays off, but then
other than that, I'm working Monday through Friday, earning through Thursday.
When I had my four tens, So to have a
job where I had a lot of additional time off,
(12:23):
especially the summer, really has just made me appreciate how
valuable that is. When I had an opportunity to after
my first year to go to a different nonprofit organization
or nonprofit hospital, the pay increase was big, but the
time off was going to be different. Right now, I'm
contracted for one hundred and ninety days a year. I
(12:43):
think on average people work about two hundred and sixty
ish days a year, right so that's a pretty big jump.
And just to really see how much days off and
time off are really important to me and kind of
now have a dollar value to me, which I never
thought of it before and had never considered. So I think
that's that's probably the biggest thing for me, is the
(13:04):
value of time off and consistent time off.
Speaker 1 (13:08):
Even like big chunks of time off too, like it's
nice to have like a random three day weekend, four
day weekend here and there, but it's so resetting and
rejuvenating to take a week off to do something totally different,
to take yourself completely out of your situation and reset.
Speaker 2 (13:24):
And I agree.
Speaker 1 (13:26):
The longer I go on, the more I realize, like
how important it is to take a little bit of
time off to give you that time to reflect.
Speaker 3 (13:33):
Yeah.
Speaker 1 (13:33):
I think I've maybe mentioned the story in the past,
but I used to have an attending who said that
once a year she would schedule a vacation for herself
where she had She wouldn't tell anyone like where she
was going, what she was doing. She would just like
fly somewhere, and then on that first day of her vacation,
she would just sit and cry and get it all out,
(13:55):
like all the And it hits me sometimes too, like
the all the pain and suffering that you hear about
it can sneak up on you. But she gave it
a time and place to let it all out, to
let all the stuff she had absorbed over the past year.
And I love that about her. I love that she
wasn't afraid to tell us that that was something that
(14:16):
she did, and love that she did that for herself.
Speaker 3 (14:19):
There's probably something helpful too about like, Okay, I just
got to go a little longer. I'll get to that
day off or get to that time off and probably
helps you keep going. Yeah.
Speaker 1 (14:27):
Absolutely, in our teens, especially you're in the schools, what
do you see are the main stressors they're facing today?
And like how might they be different than the stressors
from ten years ago.
Speaker 3 (14:39):
I feel like one thing that's really stood out has
just been like, and this is a no fault to
our kids. I don't think, it's just how hard it
is to deal with stressors. Like the distress tolerance I
think is a little lower. And this is not to
be like oh back in my day, like none of
that bullshit, but just like it's hard to everyone has
gone through this like collective trauma without like really learning
(15:01):
how to deal with it because we just couldn't. So
I think, like the distress tolerance for not just teens,
for everybody, it's just a lot lower than it was.
But that's the overall thing. But I think another piece
to it with teens specifically is like you've talked about
it and if you haven't seen Justin's ted talk. You
got to go see it on you know, the phone
and technology addiction, but just the use of phones, the
use of social media, and how much like that's like
(15:24):
you can have your bully that lives nowhere near you
in your pocket blowing your phone up and they have
all this control over you, whereas before it was like
as long as I don't see them at school today,
I guess it doesn't matter. So I think that's a
big piece to it. Is like that overall connection all
the time to everybody everywhere is a big is a
big stressor that that other those other pieces of you know,
(15:46):
the fear of missing out, feeling like you need to
be in the know on things, you have to be
following all these trends. That's a lot of pressure that
I don't think a lot of kids had, you know,
ten years ago. If I think ten years ago, we're
in twenty twenty four. I was twenty fourteen at that time.
I was a senior in college. Like I don't know,
like we had the technology, but snapchat works different than
(16:08):
it did back in the day. At some point we
got Instagram, DMS. We didn't always have that. Like there's
just all these things that the technology has gotten better,
but in turn that might have made things worse for
the teens because now they just have all this unlimited
access to each other and to other people, and it's
a lot of stimulation to have all the time, and
there's so much technology use all the time, like you
(16:30):
know for sure, you know, you and I in college
was really for me. That's when I really started to
use a computer or a laptop. I didn't have a laptop,
so I got to college, so that's when I really
started to use a computer all the time. But now
kids in high school are getting chromebooks and iPads and
stuff everywhere, you know, so they're using technology all the time,
which is great, they need it, but it might be
(16:50):
too much at this point.
Speaker 1 (16:52):
A great and I would definitely just piggyback on that,
and I know we talk about that a lot on
this show.
Speaker 2 (16:57):
I did a couple of shadowing days where.
Speaker 1 (16:59):
I went into the high high school and in Omaha
my last year of residency, and just to see how
much it had changed from when I was a kid,
when I was growing up in high school, how technology
and iPads Like every class it was like, all right,
get out your iPads, your lectures uploaded, go through it
and then fill out the quiz on this app, and
(17:20):
it's just like everything was digital.
Speaker 2 (17:23):
Everything was on the iPad.
Speaker 1 (17:25):
No one had any books, and I thought that was
such a huge change, and so you need your iPad
for everything. It's more and more and more screen time
all the time. Plus I think it's really it's really
changing the way teens interact with the world. If you
look at the numbers I've seen the for eighteen year olds,
(17:47):
they spend about ninety three percent of their free time
on screens these days, which is an ungodly amount of
screen time. It's average, you know, seven to nine hours
per day for young people. And people are on their
phone so much now it's monopolizing so much of their
time that they're not wanting to go out and spend
(18:08):
time with people in real life, and those connections in
real life are suffering. A lot of people just sit
in the room all day playing video games on their phone.
They don't come out and talk to their parents, and
they're drawing farther and farther away from their parents. They
don't have any friends in real life. All they have
are friends on Discord, friends on Facebook, friends on different.
(18:31):
I guess kids aren't using Facebook, maybe not Face, but
they're getting all their connections online, and studies show that
they are just not as deep of connections. You don't
feel them, you don't feel like they're there for you,
and they're not there in real life. They can't empathize
(18:52):
with you and they can't hear it when you're struggling
as much. And so it's I think that's a big
part of why the distress tolerance has changed so much,
because I think kids use the technology to as a
coping mechanism. If they're stressed, if they're angry, they go
on their phones. If they're sad, they go on their phones.
(19:14):
They don't go to look for help in the real
world anymore. They're just learning how to cope with their phones.
And that's not as effective. It's not real world skills
like kids used to have to build.
Speaker 3 (19:28):
I'll take it, maybe not a step further. But something
I think that is related too is that if you've
seen I've seen a lot of articles and not so
much studies, but just articles come out with where like
school attendance is suffering, like kids are contending school a
lot less, and I don't think I think one thought
on how to fix it is we just need to
make school more engaging, and I don't think that's the
(19:51):
full picture. I think we need to make school less
accessible digitally. I think that's a big piece of it.
I've had number of students over the last few years
who are just like, yeah, my attendants sucks. I don't
go to that class, but I don't need to. I
can just check canvas, or I can check online, and
I can get the assignments and still turn it in.
So I think because of COVID, we made everything as
(20:13):
accessible as possible. Now it's still the same amount of accessible,
but we want kids to be there in person, and
because of that it's accessible. I don't have to go
to school. So I think I think we've we've almost
gotten too far to one side. We had to for
a little bit, but now maybe maybe that can help
with like that kind of stressing the importance of in
(20:34):
person connection and participation and not so much. Well, I
just turned in the worksheets, so I'm good to go.
Speaker 1 (20:40):
And I have worked with a couple of different families
where your kid has social anxiety and they call their
parents all the time or they text them in school
all the time say I'm so anxious, Please take me
out of school. Take me out of school, Take me
out of school. Parents eventually do it, and then they're like, Oh,
this is just too hard. Let's put them an online
school because it's just gonna be easier for them. It's like, yeah,
(21:02):
it's easier, but you're missing so much social development if
you just homeschool. God, I remember growing up with a
lot of homeschool kids and they were always just.
Speaker 3 (21:11):
A little weird.
Speaker 1 (21:13):
Sorry to put you on blast homeschool kids, but it's
happening a lot. And you're absolutely right that chronic absenteeism
at school is definitely on the rise after COVID, and
it's changed the way people interact with the school system,
and change is completely changing the way kids are getting
educated these days.
Speaker 3 (21:39):
Along in the same lines, COVID right has basically put
us in this position. But what kind of changes have
you seen, you know, as a psychiatrist specifically because of COVID.
We've mentioned like online school, what else have you seen.
Speaker 1 (21:53):
One thing that's actually a positive is that people are
more open and accepting of doing online and teletherapi and telemedicine.
So I think that's a good thing because especially working
in a place like Wyoming, there is not nearly enough
providers and being able to do telehealth make sure that
more people can get more help. But COVID just caused
(22:16):
a lot of different changes, and because kids were out
of school for so long now, a lot of them
didn't get the services that they need, even you know,
speech PTOT, a lot of those things had to cancel
over COVID, and so kids were way behind. I remember
listening to one piece on NPR after COVID that just
showed that kids lost a lot of ground in school
(22:42):
and it doesn't look like they're going to make it up.
Like they're just behind because of COVID in terms of academics,
in terms of social skills, and now we're just like
throwing them out into the world and saying good luck.
Speaker 3 (22:54):
Good luck. Yeah. Yeah, I think definitely like the rise
of online in school for me, like I see a
lot more kids. It's probably because I've been out of
high school for so long, right up until these last
few years, but just the amount of kids that like
just go to online school just seems like a huge
number to me. Of like, has this always been this way?
(23:17):
And it's probably not like I think COVID is a
big piece to it. I think the point of telehealth
is great. I think telehealth is a good opportunity for people.
I remember, you know, having a patient that when I
was in a different job, that lived in one area
of the state but needed was able to get the
correct specialized services that was in a different part, but
(23:39):
they were able to get it through telehealth, which I
think is great. Here's the one issue, or maybe more
than one issue. I think that I've seen, though, as
someone that does a lot of care coordination and tries
to find available therapists for students and families, is that
we've maybe gotten too much telehealth. There's a lot of
people that want in person, but it seems like providers
(24:01):
that provide in person therapy feel few and far in between.
And then along the same lines, and I get there's
a there's a certain piece that you know, there's a
we got to hold insurance company is accountable and they're
kind of putting us in this position. But to the
amount of therapists that just take zero insurance and only
do private pay, and then their private pay is two
hundred dollars an hour, I'm all for people making whatever
(24:24):
amount of money to live their life, that's great, But
then there's other things that you can't necessarily claim, like
claiming that you care about meeting people's needs and social justice,
and that might ruffle some feathers, but that's just that's
my opinion on it. Of like, if you are going
to charge two hundred dollars an hour and only see
someone on telehealth, you are either consciously or subconsciously can't
(24:47):
slean out a large population of people that can never
have your services and that you might not want to
be serving, and maybe that's why you're doing it. So
I guess along the same lines. I think that's been
a hard part for me is the amount of people
that are doing telehealth, And I get it, costs are rising.
If ultimately that's where we're going, where we have a
lot more telehealth providers, we can adjust that, we can
(25:10):
get people to be open to telehealth. But then the
other piece of it of like I'm only taking cash
pay and I'm not taking insurance, and it's really like
cutting out a huge number of people that just can't
get services because of it.
Speaker 1 (25:22):
So what do you feel about like mental health your
field as a whole right now.
Speaker 3 (25:27):
Well, besides the shitting on them that I just did,
I think I think in general we're in a better
spot of like there feels to be subjectively less stigma
around mental health. I think people are more open to
asking for help than they have been. I think more
people are able to live their true, authentic life and
(25:50):
like be open about their struggles and things that they're
going through. I'm not saying it's enough. I just think
there's more. And this is something that I kind of
felt on hone, but like back in grad school, I
had this feeling of like, I think we're moving in
the right direction in terms of like there's gonna be
jobs everywhere for us, like there will always be a
need for mental health and therapy and therapists and counseling,
(26:12):
and we're moving to a good spot. And I think
that's that's kind of transpired, which is cool. So I
think that part is good. I think other than the
other parts that I was negative about, I don't know
if I have a whole lot of negatives. I think
in general, because people are more open to talking about it,
it kind of makes the job easier and it makes
it it makes it better as a whole that you
(26:32):
just have a lot of people that are open to
talking about it. I guess actually, now that I'm saying
this out loud, the social mediaization of it has been
kind of tough. So yeah, maybe not necessarily overdiagnosing, but
just like the talking so openly about like this is
what this is, or you have people on TikTok where
like I'm an ADHD coach, It's like, what the fuck
does that mean? And like you don't know what you're
(26:54):
talking about. You get like I'm a relationship coach, and
it's like you gotta like it's hard because you don't
have enough time to educate people, and like you really
need to be careful about what kind of advice and
support you're getting from people online, especially that don't have
the correct credentials. And if you notice the people who
are out here like giving you specific things to do
and tips and this and that are not licensed medical
(27:16):
providers because that's we're not allowed to do that. So
it's I don't know, I guess that would be another
piece that I'm saying that's the negative side is the
over social social medialization of it. I think that's been
pretty negative. What do you think that makes.
Speaker 1 (27:30):
Sense, But anytime you hear a coach, you just have
to think to yourself, they didn't get formal mental health training.
Yeah most of the time, And think of like a
high school basketball coach, do they need any really formal training.
Speaker 2 (27:43):
To be a high school basketball coach?
Speaker 3 (27:45):
Pass a background check. I don't know no shit against
basketball coaches, but yeah, I mean that's that's not a terrible.
Speaker 2 (27:53):
An analogy there.
Speaker 1 (27:54):
And I know some basketball coaches and they're great, but
it's like, yeah, you don't need to go to college
to learn how to coach basketball. You don't need to
like get that training.
Speaker 2 (28:05):
So yeah, yeah.
Speaker 1 (28:06):
The social media thing is is tough, and a lot
of misinformation on the social media things and a lot
of people just trying to sell things, just trying to
promote their own brand, and you see the same trends
and what all of them are doing and all the
things that they say, and sometimes they give you false
information because they're telling people what they want to hear,
and that can be a really tough thing too.
Speaker 3 (28:28):
Did you know that if you wake up and look
at your phone, it means you were neglected as a child,
Like that's not what that like? Psychology wants you to know.
Speaker 4 (28:39):
No, they don't like it just happens all the time,
like people just say things to be trendy and to
get be viral on TikTok, and it's like there's no
one able to be there to be like, no.
Speaker 3 (28:51):
This is wrong, Like do not listen to this.
Speaker 2 (28:54):
Yeah, you need fact checkers.
Speaker 1 (28:56):
If there's one thing I learned from watching the debate
that's like you need that.
Speaker 3 (29:00):
I thought you weren't fact checking me.
Speaker 1 (29:02):
Sorry, yeah, I thought this wasn't going.
Speaker 2 (29:04):
To be fact checked.
Speaker 3 (29:07):
Besides getting rid of like the social media bs, what
do you think would make your job easier.
Speaker 1 (29:12):
If insurance companies weren't such dicks?
Speaker 2 (29:15):
I would say.
Speaker 1 (29:16):
I was even talking to a family today who is
saying that they get mental health coverage, but their mental
or their insurance company hired a third party company to
moderate and regulate all.
Speaker 2 (29:31):
The mental health care coverage.
Speaker 1 (29:32):
So everything that they do and everything that they get,
they have to justify with this third party company who
checks and monitors everything. And there are laws in the
United States that says it is illegal for insurance companies
to treat mental health any differently than physical health, but
(29:54):
they do it all the time, there was a really
big pro public apiece that came out about this that
insurance com companies are just blatantly breaking the law, the
mental health parity laws in the United States, and in
the US government's doing absolutely nothing about it. And it's
just that is what it makes my job hard because
(30:15):
I prescribed lexapro on someone who it's FDA approved for
the diagnosis that I had, and we still had to
fill out a ton of prior off paperwork just to
get the insurance company to pay for an affordable, proven
medication because they know people won't jump through those hoops
and that they won't have to eventually pay for it.
(30:35):
And what the insurance companies are doing is illegal, it's immoral,
and that's the one thing I really really wish would change.
Speaker 3 (30:43):
Wow, I don't work with insurance a ton, and I
think I can see this other side as like the
part where like, okay, I can get it why people
want to move to cash be so I'd probably double
down on that as far as like baking the job,
because I got to find providers for families all the time.
So insurance has a better job, then maybe more people
(31:03):
take insurance and the more people take insurance, it's easier
to find providers. I think one thing that I would
think of is if not all parents, but just if
some parents understood that just because your child or teen
is struggling or having a hard time, it doesn't mean
you're a shitty parent. Yeah, because I think a lot
of the time when you when I've interacted with parents
(31:26):
in all three of my jobs, you call them or
you talk with them, and you have this conversation of like, oh,
you know, so and so is having a really hard time,
they take that as like you're telling me I'm a
shit parent. I never said that. I'm just telling you
that this is where we're at. And if we can
get that past that initial like taking it personally, I
think a lot more parents would be hearing a lot
(31:46):
better information and be a lot more capable of listening
to then make changes the best help out their kid.
Speaker 1 (31:53):
And teen mental health could happen to anyone, it does not,
It's not a reflection of your parenting.
Speaker 3 (31:58):
Yeah. Laurel on Instagram what are the top three things
to do to minimize burnout? I was trying to think, like,
what are my three things the minimize burnout?
Speaker 1 (32:10):
I would say, stay connected with your family, your community.
Speaker 2 (32:15):
The people that you work with.
Speaker 1 (32:17):
Take time off as my number two and number three,
find coping mechanisms that work for you that you enjoy,
whether it's writing, whether it's exercise, whether it's music. Something
that you feel like is a release, is an outlet
that helps you blow off some steam.
Speaker 2 (32:36):
How about you? What are your top three?
Speaker 3 (32:37):
I think along the same lines like self care for sure,
things that make you happy and make you feel better.
Not keeping things all to yourself, like not just struggling
through it with yourself, because I think if you I
think I've struggled with this before, Like if you just
keep something to yourself, you're not saying anything. Then you
want start to feel like a sense of resentment towards
people around you, like why aren't you asking? Or like
why don't you care that I'm struggling? But it's like
(32:59):
they don't know that you're struggling. I really know what
we know. So that's number two and then number three, Hmmm,
know when it's time if I want to come up
with something different, know when it's time to move on.
And I think of that in terms of like a job,
like knowing when it's time, like Okay, maybe I can.
I should consider something different, like this is I've given
(33:21):
it a chance. I don't want to quit on anything,
and I've probably reached the the end to where this
is just it's not going to get any better, so
I should try something different.
Speaker 1 (33:31):
This is coming from the guy who's been a Raiders
fan for twenty four years.
Speaker 3 (33:37):
God cut the show, cut the cameras.
Speaker 2 (33:43):
It's time to move on.
Speaker 3 (33:46):
This is different, This one's different.
Speaker 1 (33:49):
I think it shows that you've got a lot of loyalty,
You've got a lot.
Speaker 2 (33:52):
Of passion about your great perseverance.
Speaker 3 (33:56):
Everything we started with the show with.
Speaker 2 (33:58):
Hell come around. Do you bring your work home with you?
Does it get to you?
Speaker 3 (34:06):
Good question. I tell this story a lot to like
students and like just like on when I knew it
was time to like figure something else out when dealing
with work stress. It was Thanksgiving break twenty sixteen. I
was an intern. I was working. I was also working
at the time, but I was interning with the Juvenile Department,
(34:28):
and I was just having a hard time because my
clients were just not doing a great job. They were struggling.
And I used to like measure my self worth or
my worth as a counselor in training off of how
well they were doing well. One of my clients the
week before, sometime before Thanksgiving, got in trouble again and
they ended up, you know, facing a pretty severe consequence.
(34:52):
And I remember actually going to Dana's house after and
having like all of us were there for like a
Thanksgiving together and just having the worst attitude about it,
not trying to but struggling so hard. I'm with my friends,
I'm having a good time, but I'm not having a
good time because my client's not doing well. They're struggling,
(35:14):
and I'm just thinking about how much I could have
done something better. Looking back on it, I couldn't have
been shit better. I did the best I could. Ultimately,
they have their own decisions to make. But that's the
story I tell of, like sitting there Thanksgiving with my friends,
not having the best time because I'm letting this impact
me outside of the office.
Speaker 1 (35:34):
It's hard not to, especially because you do care about
your patients and you do want to see them do well.
And sometimes it's really hard, and I have to tell
myself all the time, like you can't save everyone, that
you can listen, you can help them, you can lead
them to water, but you cannot make them drink and
that's okay, Like you do your best, but if you
(35:58):
have the goal of saving every you're gonna drown in
the water with them. What's your favorite part about working
with young people? Because we've talked a lot about how
much we love this young generation. There's a lot of
great things about Jen Alpha gen Z. Yeah, what do
you think, what are your favorite parts?
Speaker 3 (36:14):
I think, to go back to something you just said,
like we care, Like this is our technically on a
like really basic level, we get paid to care, Like
that's kind of how it goes. But the thing is that,
like we we genuinely care about the work that we
do and the patients and the clients and the kids
we work with, and if we didn't, we would choose
(36:37):
something else to do, we would find a totally different job.
So I think that's one thing I wanted to like
reiterate with what you said of like this is this
is what we like to do, Like we love doing this,
Like this is the work that we enjoy. I think
in terms of favorite part of working with young people,
it's just the getting to hopefully be one of the
adults that believes in them that lets them know like
(36:58):
things can be okay even after really shitty times, and
to just kind of be like that cheerleader for them
and to let them know like I believe in you,
I think you can do it, Like you've got this,
I'm proud of you. Being able to tell kids like
I'm proud of you, I think makes a huge impact
on them, and I enjoy being able to have that opportunity.
I think I'm in a unique position of just getting
(37:18):
to work in a high school. So I see these
kids on more levels than just in my office. I
see them at sporting events, performing arts, all of these
different things, club events, whatever it is. So I think
getting to do that and to get to be just
a positive impact in their life and like a positive adult,
I think is really special.
Speaker 2 (37:38):
That's cool.
Speaker 1 (37:39):
Yeah, I love the fact that I learned so much
from young people.
Speaker 2 (37:46):
Skibity toilet.
Speaker 3 (37:51):
Sorry, Yeah, that's one of the best. Sure.
Speaker 1 (37:56):
I heard a patient say that something with sigma the
other day, those like like the Greek letter, Like, how
does that make any sense?
Speaker 2 (38:03):
So she had to explain that to me.
Speaker 1 (38:08):
Yeah, I know right, They're like, uh, it's just something
we say, Yeah, it's it's fun being able to to
learn and compare it to what we were doing and
all the new lingo lingo and slang that's totally normal
to us. That they're making for themselves, and they're and
they're making a whole new generation of what they want
this world to be. And it's cool to be able
(38:28):
to guide them and show them and listen to them
and and be that support. Like you said, I love
being a cheerleader for kids. But it's fun seeing what
art they're into, what music they're into, what movies they're into.
And you know, with the internet this, these young generations
are so eclectic. You never know what what they're gonna hear,
or what you're gonna hear, what they're gonna say. They're
(38:50):
into these days, Like you know, they're wearing Rolling Stone
shirts and Beatles hats and like all this cool stuff
that you know, I was into when I was a kid,
and I'm like, okay, kids still like this kind of
stuff too. But so it's just fun being with young
people who are constantly infusing new ideas into your life.
Speaker 3 (39:08):
Yeah, I think of it as just a privilege to
get to, like you said, to learn from them, be
a part of their life and get to share that
space with them, because I know for kids and teens
it could be really hard for them to find adults
that they trust and feel comfortable enough sharing. And I
think to anytime a student comes in and like, I
just have to tell you this, or you know, I
(39:30):
I thought of needing to tell you this, Like I
just had to come in and tell you like that
kind of stuff is important to me and impactful.
Speaker 1 (39:37):
And nothing warms my heart more of like more than
someone who has been struggling lately.
Speaker 2 (39:42):
And then they come in.
Speaker 1 (39:43):
And they say, I'm doing better now, I'm going to therapy,
I'm doing something I love, and things are finally turning around,
and it's just like sometimes I'll even just like pump
my fist in the office and be like yees, so
let's go. It's just such a good feeling to see
(40:03):
a young person who has been through a lot do well.
Speaker 3 (40:08):
Yeah. I'm no stranger to the quick quiet flex in
my office after you find out that one of your
kids did something well or they're doing better.
Speaker 1 (40:17):
Yeah, well thanks for talking with me. Yeah that was
a good convo. We do a lot of structured episodes
with lots of teaching. It was nice to just have
something a little bit more conversational and pick each other's
brains a little more.
Speaker 3 (40:33):
Yeah, we have some exciting stuff coming up. We have
a really exciting interview. We'll save the guest as a secret,
but I'm excited for that one. Thank you all, we've
made it to the end of the episode. You know
the drill, Apple Podcasts, Spotify, whatever else you use to
listen to your podcast, leave us a five star review.
You can leave us a comment on whichever app you
use on social media at Millennium MHC on TikTok, Instagram, Twitter, YouTube,
(40:58):
and our website dot com. Thank you all for listening.
We'll see you next time, and take care of your mentors.
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