Mayo es Mes de sensibilización sobre la salud mental, and Vaya Health celebrates the increasing recognition that mental health care is health care.
Like physical wellness, mental wellness is part of everyone’s daily life. When people have mental health issues come up, effective supports and treatment are available. That’s true for people with serious mental illnesses, as well.
Pooja Mehta, MPH, is the Asian American Pacific Islander Community Mental Health Lead for the North Carolina Division of Mental Health, Developmental Disabilities, and Substance Use Services.
“For me, mental health awareness is important because I think mental health is really kind of what makes us human—our ability to support each other, our ability to care for each other, our ability to show up for each other,” Mehta says. “That is all foundational to mental health, and that is all foundational to what a healthy society is built on—to have genuine connections with each other and to be in community with each other.”
Dr. Richard Zenn, Chief Medical Officer of Vaya Health, emphasizes that mental health conditions are treatable. “People with mental health conditions are one of the main populations Vaya serves,” he says. “We are a recovery-oriented organization, so we want to foster recovery and the empowerment of people with mental health issues to help themselves and their families. People can live full and productive lives with mental health issues. It’s very important for people to understand that.”
Kelly Crosbie, MSW, LCSW, is North Carolina’s Assistant Secretary for Mental Health, Developmental Disabilities, and Substance Use Services. Crosbie says a valuable way for people to celebrate Mental Health Awareness Month is simply to learn more about mental health.
“There’s so much misinformation about mental health,” she says. “It’s troubling. People need to take the time to better inform themselves. Popular culture and TV shows often make grandiose, unrealistic depictions about mental health that sensationalize mental health issues and scare us. But there is simple, understandable information available for all of us. I encourage people to learn a little bit about the most common mental health issues and what they really look and feel like. Look up some basic information. Watch a video from NAMI, the National Alliance on Mental Illness. Learn about the signs of depression. Learn about the signs of anxiety. Look at the basic treatments.
“Mental health issues are highly treatable. Even the serious ones aren’t as scary as you think they are. They are highly treatable, too. I cannot encourage people enough to get a little more educated about mental health.”
Reducing stigma around mental health
Reducing stigma is an important part of mental health awareness, so no one hesitates to seek support when they need it.
“Common obstacles to seeking mental health care are just shame and embarrassment—a feeling that it may be a weakness to seek help,” Zenn says. “It’s actually the opposite. It’s a sign of strength and self-care—not weakness—to be able to recognize when you’re struggling and to seek help as a result of that.”
To help reduce stigma and fear, Crosbie tries to teach people that the most common mental health issues are experienced by just about everyone.
“When I talk to high-school audiences, I always ask: Do you ever have days or periods when you don’t want to get out of bed?” she says. “Maybe you just feel anxious about going to school? You’re irritable, or you avoid your friends? Your thinking feels cloudy, or your memory seems fuzzy?
“Ninety percent of them raise their hand. I tell them: While I’m not saying you have depression, those are symptoms of depression. And it’s okay. It’s normal. We’ve all felt that way. And if the way you’re feeling is too intense, if it’s been going on for a long time, or if you just want to check in with someone and have a conversation, you can call for help or additional support. Call 988 or call the NC Peer Warmline.”
Zenn agrees that certain mental health issues are shared commonly by everyone sometimes. People just need to be mindful about them and pay attention to their degree.
“Feeling anxiety and depression are common symptoms and feelings that people have,” he says. “They are normal experiences for all of us. However, if they are getting to the point where they are interfering with our functioning—whether it’s in our relationships, our work functioning, our self-esteem, or just our ability to manage—that’s a sign it’s time to get some help.”
Zenn is hopeful that society is shifting toward a much greater acceptance of mental health support and treatment. “I think seeking mental health care is more socially acceptable for many today, particularly for younger generations and particularly to seek help when they are stressed,” he says.
Crosbie agrees. “I have great hope for new generations—I do,” she says. “Kids today are more open and accepting. They talk about their feelings now, and our culture is much better about it. But, unfortunately, pretty much everyone in my generation and above just has this long historical trauma around mental health.”
There’s another challenge in working to reduce stigma, she says.
“It’s really very hard to talk about trying to normalize mental health without minimizing mental health conditions,” Crosbie says. “I’ll be honest that it’s very hard to strike that balance.
“But I’m still over here emphasizing normalizing mental health care, because for far too many people it’s still just catastrophic and shameful to talk about mental health.”
If the normality of needing some help doesn’t encourage some people to ask for it, Crosbie says, anonymity is one way people can sometimes get past their fears around stigmatization.
“I remind people they can do it anonymously,” she says. “I tell them about things like 988, the NC Peer Warmline, or the NAMI HelpLine. The anonymity of that call—or of when you chat or text, especially for young people—that anonymity seems to be really helpful to a lot of people. So, if you are not feeling like yourself for a couple of weeks—if you’re moody, if you’re irritable, if you’re avoiding—that’s a good time to talk to somebody. All you have to do is give a call or send a text, and it’s entirely anonymous.”
Accessing mental health care, including peer supports
There are far more access points now for getting mental health support than ever before, even beyond the many help and chat lines and websites. (See the Resources list at the end of this article.)
“Most primary care doctors nowadays are quite adept at recognizing and emphasizing the importance of mental health awareness and related lifestyle issues,” Zenn says. So, talking with your primary care doctor not only about how you’re feeling physically but also how you’re doing emotionally can be a great starting point.
“Good counselors and therapists also take kind of a primary-care approach to mental health issues. It’s not a question of being in counseling or therapy until one is ‘cured’—whatever that means—but really having a place to check in and have some guidance for staying aware and on top of mental health issues and working on them over time.”
Peer supports have also had a significant positive impact on the spectrum of mental health support and care. Certified Peer Support Specialists are people with lived experience who are trained to support people and help them navigate the mental health system and access resources and services.
Felishia McPherson, LCMHC, is a Certified Peer Support Specialist and chair of the Peer Leadership Council for NAMI NC.
“We are the living proof that—regardless of someone’s diagnosis, regardless of their situation, regardless of their setback—they are still relevant and they are still whole,” McPherson says. “Peers are crucial when it comes to mental health advocacy, mental health education, and mental wellness. We are the living proof in the room, and that’s priceless.
“A lot of people say broken crayons still color, and that’s a peer leader. The peer perspective comes from someone who has been there, done that, and overcome that—y has a great wraparound system with them to support people getting to a state of wellness. What better person—what better advocate—to have by your side than someone who knows what you are going through and what your family is going through, especially when there’s so much unknown for you? Especially for someone needing mental health services for the first time or when children are involved? I have a history of being in reentry, because I’m formerly incarcerated, and now I am a fully licensed clinician and a peer leader.”
Zenn agrees about the value of peer supports. “People who have lived experience sometimes can be the best access point for people who are struggling and worry that they won’t be understood,” he says. “Or maybe they have had experiences where they haven’t felt understood in seeking help. Often people who have lived experience can help bridge that gap.”
Because there are so many options for seeking care, having a peer who can support someone and suggest places they might go for additional resources or treatment can be especially helpful.
“There are very few things more meaningful to people who are in a place that frightens them or makes them feel ‘less than’ than talking to someone else who knows exactly what they feel like—someone who has been through the journey and sometimes the frustration of the clinical treatment system,” Crosbie says. “Just being able to say: I know what it’s like and you’re not alone.
“Honestly, navigating treatment can be hard. I think peers are a comfortable, knowledgeable gateway support for so many people—and also a long-term recovery support. I cannot say anything good enough about peer supports—they are supported themselves, they are well-trained, and they are willing to share their own experiences. I think peers are extraordinary.”
Self-care and mindfulness
Recognizing that mental health is related to physical health and overall well-being is important, as well.
“I think our field has gone away from a focus just on a psychoanalytic model—that’s very old school—or even just a purely biological model,” Zenn says. “We understand that lifestyle issues—healthy diet, exercise, healthy sleep patterns—are all effective forms of self-care. I think those are exciting developments in the mental health field, just a recognition that lifestyle is important. We then try to augment that for people for whom self-care isn’t enough, when they still struggle with anxiety, depression, and other issues.”
Zenn encourages people to work healthy routines into each day. “Just like many of us to try to work in physical exercise—and physical exercise can help with our mental health, too—working in some mindfulness exercises like meditation, being mindful about sleep and the importance of consistent sleep, spending time outside, and being mindful of our screen use and making sure we’re spending enough time off of screens—that can all be really helpful,” he says.
Crosbie agrees that greater mindfulness is a tool for mental well-being—and for knowing when to reach out for support.
“It’s always worth thinking about mindfulness,” she says. “It’s something that I do myself. I try to make sure I’m paying attention to my emotions. I tune into how I’m doing. I think everybody should do that. I think they should tune in for a minute, a couple times a day, to how they’re doing. Depression and anxiety are the biggies—those are the biggies for all of us.
“When you’re down or anxious, how does that affect you? It affects us all in certain ways: memory, fogginess, irritability, eating too much, eating not enough, sleeping too much, sleeping not enough. What are your signs, and what do you do to take care of yourself when you find yourself in that space? Who do you tell, and what are the things you do to feel better?”
Have a game plan for when you need a little extra care. “It’s just being mindful and tuning into your own emotions, recognizing when they’re wonky, and having some very simple action plans,” Crosbie says. “It helps to have support people who you trust enough to say: It’s one of those days for me. They’re part of your support system to help you through it.”
You can help support other people in this same way, too. And sharing your own mental health issues or concerns builds trust and social connection.
“If you have family members or friends who talk about their feelings, don’t shy away from it,” Crosbie says. “Don’t shut them down. Be an open person—and think about being a little more open yourself.
“Be mindful. Kind of tap into your own emotions. If you have mental health issues, or know people with mental health issues, feel free to share that in appropriate and culturally appropriate ways and with whatever audience you’re with. It’s shocking how many doors that can open.”
Specific communities: getting appropriate care for mental wellness
For mental health awareness campaigns, as well as for treatment itself, information about reducing stigma and accessing care can be more effective when it is designed for specific demographics of people.
Such demographic groupings can include racial and ethnic groups. They also can extend to age, gender, rural-urban populations, education level, income level, and more.
“I know what it’s like to live my life and only my life, right?” Crosbie says. “I know what kind of treatment resonates with me. I think it’s very important for us to be quiet and to listen to how communities need support and how they need to hear our messages. Communities have unique cultural needs, and it’s our job as much as humanly possible to be able to support them. Everybody deserves care, and they deserve it in a way that’s meaningful to them.
“We need to ensure that we are reaching populations in population-specific ways. It’s my job to ask: What is unique about your situation, what do you need, and how do you need to digest hope and healing? So, we want to support veterans agencies, LGBTQIA agencies, Latino agencies, and agencies that serve the Asian American community, for some examples. We want to focus on our relationships with those communities and also funding supports and ‘treatment’—I put little quote marks around that word—that come from community-based organizations that people know and trust.”
Crosbie says older adults, for example, often get overlooked, even though they sometimes are more deeply rooted in stigma about mental health.
“It was the words they were taught about mental health,” she says. “It was the shame they were taught about mental health. My grandma had depression and anxiety—absolutely—and some of my grandfather’s brothers were institutionalized. Some of them may have had schizophrenia, but grandma couldn’t say those words. She talked about having ‘nerves’ her whole life. There were a lot of things that could have been helpful to treat grandma. Grandma felt shame, but she had strength and resilience, too. She had her church, but her church didn’t really allow anxiety.
“But so much of that is her culture, right? It was the culture of her age. The time she grew up in, the isolated town she grew up in, her role as a woman and as a mother, her role with the church. We need to recognize that and be able to reach the elders of the world. We’re not going to reach the elders of the world in the same way we reach younger people.”
Zenn says other groups with heightened vulnerability to mental health issues include people with intellectual/developmental disabilities, physical illnesses, or substance use conditions.
“People may turn to toxic substances when they’re feeling distressed, so being aware of the mental health effects of substances and of the triggers for using substances is really important, as is reaching out to supports related to that,” he says. “Being able to effectively use mental health strategies to help us cope with serious physical illnesses is important. And for people with intellectual and related disabilities, similarly, just stay aware of how mental health issues can end up interfering with living as independently and as well as possible. Mental health issues are universal across all populations, but for special-needs populations in particular it’s very important to be proactive about mental health care and support.”
Latino, African American, and Asian American Pacific Islander populations are also groups that can benefit from specific and culturally appropriate outreach and support.
Latino mental health
Lennin Caro is the director of Camino Research Institute in Charlotte. “Historically, discussing mental health has been very taboo and stigmatized among Hispanic communities, especially immigrants,” he says. “But in the past couple of years I am noticing more immigrants being open about mental health, even among Latino men. Multiple Latine community leaders and mental health advocates I have spoken to point out that the COVID pandemic was a cause in this shift. The impact of social isolation and fear across the Latino community caused more awareness and demand for mental health services.”
El Futuro provides culturally responsive mental health and substance use services for the Latino community with direct clinical services and virtual appointments; training, education, and capacity building; and community engagement work.
Molly Hayes, MEd, LCMHCS, is the director of clinical enhancement services for El Futuro.
“Oftentimes in the Latino community there’s a sense that one is weak or not capable if there’s a struggle in mental health capacity or with substance use, like it’s a personal deficit or like someone has done something wrong,” Hayes says. “That can look like hiding symptoms, not sharing experiences, or not reaching out to family members, friends, or community members for support.”
El Futuro strives to overcome such cultural barriers by showing up in community and talking about mental health care and wellness. “Having those experiences be normalized and validated takes us a long way toward destigmatization,” Hayes says. “Hearing those stories in all of the spaces where folks are living their lives—be that in a faith community, in a community center, in our neighborhoods, at the grocery store, or at the fiestas that we go to—we try to have information about mental wellness and about needing support become just a normal part of the everyday experience.
“Culturally responsive mental health care is a community investment. It looks like a whole community coming together to destigmatize and to speak openly about mental wellness. So, that involves community events. It looks like gardening and green spaces. It looks like camps for kids. It looks like parent nights with parents coming together. That community presence is incredibly powerful, because that’s where people live their lives.”
While outreach and reducing stigma is an important part of the work, culturally respectful practices by mental health professionals are equally critical. “We need to understand how to incorporate identity, culture, and need into every clinical conversation, so that each person is heard, respected, and understood within their individual context,” Hayes says. “It’s not just ‘I speak Spanish, you speak Spanish.’ Really understanding all the contextual clues—that’s the care that we need.”
Hayes also emphasizes that the Latino community is not a monolith. “There are multitudes within this umbrella term of ‘Latino,’ even within North Carolina,” she says. “Understanding where those nuances lie and where the overlaps of identity and experience lie is important. It’s regional, it’s economic, it’s race, ethnicity, sexual orientation, gender identity—all of the things that make up an identity come into play with the Latino community.”
Hayes says the most common mental health diagnoses in the Latino community are trauma and adjustment disorders. “Those come from pre-migration experiences, during-migration experiences, and then post-migration experiences—any and all of those can go together,” she says. “We have depression. We have anxiety, which is separate from trauma. And we have substance use concerns. All of those get heightened, too, when you’re under a higher level of scrutiny and when your community and family members have had very negative experiences.”
She says the Latino community is under increased stress now, but she also notes that the community is incredibly resilient.
“People don’t migrate without having a lot of strength and grit,” Hayes says. “It’s very difficult to recreate a community when you’re an adult. But you can see the thriving Latino community all over North Carolina.
“So, the resiliency factors are there, while the trauma is there and the anxiety is there. I think it’s both/and. That encapsulates the paradox of the Latino community in some ways.
“Folks are traumatized. The level of anxiety in community has skyrocketed. There’s more isolation. People are scared to do the things that they need to do in their daily lives. But the resilience, strength, and solidarity of the Latino community persist.”
Black mental health
McPherson, the chair of the Peer Leadership Council for NAMI NC, says a lot of stigma in the Black community still exists around mental health conditions and seeking care.
“In the African American community, you would rather be an alcoholic than a person labeled with schizophrenia or labeled as bipolar, because then you’re crazy,” McPherson says. “And what do we do with crazy people? You’re quiet about them. It’s an imperfection, and nobody wants imperfection in their family. Everybody wants smart kids and hardworking children. So, in the African American culture, mental illness is very much looked down upon, because, again, what did we do wrong? Concerns about mental well-being are something you often can’t talk about or verbalize safely in your own family or community.”
A distrust of medical professionals, including mental health professionals, adds to that resistance to seeking mental health care. “We have been taught from a lot of experience to have a lack of trust when it comes to the medical profession,” McPherson says.
There also are often cultural barriers with clinicians.
“What I was going through when I was incarcerated, well, it took the first year of my therapy for my therapist to catch up culturally,” she says. “We were from different cultures, so there was a barrier in communication.
“People have biases and are taught not to admit to them: ‘Oh, I don’t see color.’ Well, are you blind? You don’t see? That’s not realistic, nor is it helpful. I need you to see me. I need you to see todos of me. How can you help meet my needs, and do you really want to?”
McPherson says a lot of African American culture comes from spirituality. “It’s our culture, but we’re not given the vocabulary to express concerns about mental well-being,” she says. “NAMI is addressing that with FaithNet, a program that is specifically including churches—and African American churches—to create faith communities free of judgment about mental health and wellness.”
Peer supports can also make a huge difference in understanding and acceptance, McPherson says.
Breaking down stigma remains a key. “We’ve got to teach each other how to actively listen and respect one another,” McPherson says. “If I do not listen, how can I understand? We have to be able to talk about mental health and verbalize it safely in our own families and our community. Again, there’s still a stigma. I’d rather say my child has a learning disability versus saying my child is bipolar. That’s the stigma—those are the roots that we’ve got to chop up.”
Asian American Pacific Islander (AAPI) mental health
Tarang is an initiative led by Mehta through the North Carolina Division of Mental Health, Developmental Disability, and Substance Use Services. Tarang partners with AAPI community organizations throughout the state to break a culture of silence around mental health, substance use, and suicide. “Added cultural nuances can increase the level of stigma in certain communities,” Mehta says.
Still, she believes a general societal increase in openness in how people talk about mental health has affected people’s ideas about it on an individual level in AAPI communities.
“I think where I’m seeing the disconnect—specifically in Asian American community, from my perspective in working with different groups—is that I don’t know that people’s own ideas about stigma are really the issue anymore,” Mehta says. “I don’t know that it’s people seeing mental health as a topic they don’t want to be associated with or affiliated with.
“I see the problem being an issue of community safety. They don’t know if other people are okay with them talking about mental health. They don’t know if other people will treat them well if they are acknowledging that they are struggling. So, on an individual level—which is where I see stigma as occurring—I don’t hear people having their own prejudices around mental health anymore. But I think there’s a perception that other people hold those prejudices, which is why we’re not seeing enough progress being made in the Asian American community.”
The Tarang initiative is trying to change that by engaging in AAPI spaces and encouraging AAPI community organizations to take the lead in normalizing conversations about mental health.
“Our end goal is that people can be in their community spaces—the temple, the church, the grocery store, the dance group, in whatever way and place you engage with your community and with your culture—and you can feel safe to talk about challenges you’re experiencing around mental health, substance use, and suicide,” Mehta says. “You can trust that the people who you are talking to can receive that information with care and compassion. They might not know how to fix it, but they can hold your hand and support you in getting to where you need to go.
“Then the second thing we’re really trying to employ is representation. We can talk about how mental health is important. We can talk about how it’s okay to not be okay. But unless you’re hearing that message from someone who looks like you, who speaks your language, who understands your cultural nuance, you don’t feel like you’re really allowed to engage in it.”
So, shared culture and experience remain essential to effectiveness. Mehta says, “One thing that I’m really adamant about is that in every piece of education we’re doing and every platforming opportunity that we’re creating with Tarang, we’re specifically centering the perspectives of lived experience from the Asian American and Pacific Islander community.”
Some Mental Health Awareness Month takeaways
The message from Dr. Zenn is that mental health support and treatment work. “There’s a lot of evidence that it works,” he says. “There are a lot of different options. In some ways, there’s now so much information that it can get a little confusing. The important thing is that you start. Find a resource to help guide you through options, whether that’s a primary care doctor or a counselor, to sort through what will be most effective for you.”
Assistant Director Crosbie hopes everyone will become more open to conversations about mental health. “If you have family members or friends who talk about their feelings, don’t shy away from it—don’t shut them down,” she says. “Be an open person, and think about being a little more open yourself. Be mindful. If you have mental health issues, or know people with mental health issues, feel free to share that in appropriate and culturally appropriate ways with whatever audience you’re with. Because it’s shocking how many doors that opens for everyone.”
And Mehta of Tarang wants people to reframe what they think of as “mental health” and deepen all their connections.
“My hope for Mental Health Awareness Month is that we can think a little bit bigger when we talk about shaping mental health care systems and the future of mental health,” she says. “So, we’re not just thinking about the individual level supports of therapists, insurance reform, and access to care. We’re also thinking about the things that we need to be putting into place to make sure that we have a society that can truly support good mental health—like making sure that people have a basic sleep at night, making sure that people are not having to spend their entire paycheck on basic necessities, and finding ways to have genuine human connections in third spaces and not have to rely on digital spaces or AI chatbots to be able to find care and support.
“The best way to support a loved one is to be there when it’s not fun to be there. When you love someone and care about them, you don’t want them to suffer. You don’t want them to be experiencing challenges. But sometimes the best thing you can do is not try to fix it.
“When you try to fix it, you’re asking questions. Why is this wrong? What’s happening? What’s going on? A person probably doesn’t have those answers. They’re just as confused, right?
“So, to help, just listen to them. Hold their hand. Don’t try to make it better. Just remind them that, whatever they’re dealing with, you’re not going to leave. You’re going to be there. You want to be there. That takes effort, to be able to form those bonds of trust and care and to learn to lean on each other. That’s also not something that you have to wait until someone is struggling to do. Reach out, and make a connection.”
Recursos
Below are resources and help lines for mental health information, support, and awareness. If you feel you are experiencing a mental health crisis, you can call Vaya Health’s Behavioral Health Crisis Line at 1-800-849-6127.
- Vaya Mental Health Services (call the Member and Recipient Service Line at 1-800-962-9003)
- 988 Línea de ayuda en caso de suicidio y crisis (llame o envíe un mensaje de texto al 988)
- North Carolina Peer Warmline: 1-855-PEERS-NC (habla con un especialista en apoyo entre iguales)
- El Futuro
- Tarang
- Veterans Crisis Line Chat (or call 988 and then press “1”)
- The Trevor Project Support Line for LGBTQ+ youth
- NAMI Carolina del Norte: call the NAMI NC HelpLine at 1-800-451-9682, text 919-999-6527, or email helpline@naminc.org
- Alianza Nacional de Enfermedades Mentales (NAMI)
- Administración de Servicios de Salud Mental y Abuso de Sustancias (SAMHSA)
- Instituto Nacional de Salud Mental (NIMH)
- División de Salud Mental, Discapacidades del Desarrollo y Servicios de Uso de Sustancias de Carolina del Norte
