Reducing the Stigma of Mental Health in a New Paradigm

by: Jessi Maness, LCSW at Long Valley Health Center

Mendocino County’s unique communities are gifted with resourcefulness, heart, and a drive to bring in healthier lifestyles and a “back to the Earth” way of life. As a psychotherapist, one question comes to the forefront for me:  How are emotional and mental health needs perceived in this new, holistic paradigm? Certainly, we have journeyed far in our understanding of the mind/body connection in the past twenty-five years; a fact evidenced in neuro-biological research and kindergarten class-rooms alike.  A stigma around mental health issues remains, however, and currently creates difficulty for many people in seeking needed professional help. Ethically, we must continue to explore ways to remove stereotypes and other barriers so that our communities can truly experience ‘whole person’ care.

According to the Healthy Mendocino webpage, 12.6 % of Mendocino county residents reported frequent mental distress.  Those residents who reported frequent physical distress accounted for 12.8%, a nearly exact amount and yet only 55% of residents who need mental health assistance are receiving it.  The age adjusted death rate due to suicides from years 2012-2014 was 23.9 (per 100,000 population). Of those same years, lung cancer accounted for 37.1 deaths, strokes for 37.9 deaths, and 99.7 deaths from heart disease (all per 100,000 population). 15.6% of the Medicare population reported Depression, and of the same population 8.6% reported diabetes and 6% reported cancer (healthymendocino.org). It is because of these numbers that private-practice doctors and clinics alike have improved their screening practices for depression, and why more individuals are obtaining treatment.

This is great news and an important step which is worth acknowledgement.  Mental and emotional health issues are varied and unique, though, and often difficult to diagnose with a simple assessment tool.  There are also varying degrees of stigma for specific discomforts.  The battered woman may have great difficulty informing her medical doctor of her issue, whereas someone suffering with anxiety may not.  Contrarily, a person experiencing debilitating panic attacks may have hardship in reaching out for help while a person with psychosis (who may have no symptom control) has no choice.  The person with psychosis may yet experience being stereotyped as “crazy, violent, or obscene” nonetheless, even though they are probably more afraid than anyone else of what they are experiencing.  It is stereotypes like this that continue to prevent many people from seeking needed help. 

My personal communications with clients, may yield further insight into why some people do not seek therapy, albeit clearly skewed to those who eventually did.  People have informed me of the following: fear of breeches of confidentiality in a small town, fear that they will see/know their therapist outside of therapy, compliance with unspoken (or spoken) rules of family members who do not believe in therapy, feelings of weakness for asking for help with emotional/mental difficulties, anxiety of authorities finding out about private life/business, financial concerns related to paying for therapy out of pocket or insurance coverage, negative past experiences with mental health care workers or systems, anxiety about being vulnerable with their pain to another person, anger with doctors or court for mandating therapy in the past, and distrust of medical system overall.

In terms of efforts to reduce the stigma, this writer can only report on what is known.  Our rural clinic, The Long Valley Health Center in Laytonville, has placed a focus on recruiting and hiring therapists to a point of having three licensed behavioral health workers where before were none.  We have partnered with UCSF Department of Psychology to provide tele-psychiatry for our patients who would not otherwise have access (apart from securing transportation to Ukiah or further).  Our medical staff have implemented protocol to assess for depression, anxiety, and some other challenges and, if appropriate, refer to Behavioral Health.  In this referral process is imbedded a “warm hand-off” wherein an available therapist will meet the patient in person during their doctor visit in hopes to relieve anxiety and concerns as much as possible.  Regular articles regarding mental health issues are being published in the local Laytonville newspaper, The Observer.  The Behavioral Health Team at the clinic is also reaching out to assist the schools, the local Healthy Start, and partnering with Project Sanctuary when appropriate which creates more visibility for the community. Surely other areas in Mendocino County are providing similar efforts, and through this exposure and access the stigmas and stereotypes surrounding “a need for help” must be diminishing. 

I hope that this article engages thought and further discussion among its readers, and the torch will continue to be passed on this worthwhile journey.  We are creating communities who avoid judgement and stereotyping of differences, and individuals who are not afraid to access needed help.  We are educating ourselves and others about the significance of experiences different from our own, and honoring the individual journeys we all take.  We are creating acceptance despite the human tendency to fear what is different, and forming our own opinions of how to act despite what we have learned from an old paradigm.  And through these actions, we are helping to create safety, acknowledgement, holistic healing, and support for all of us. 

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Jessi Maness is an LCSW who works at the Long Valley Health Center in Laytonville, CA. She has worked with various age-groups as a therapist, particularly teenagers and adults.  Her special areas of interest and experience include grief and loss, survivors of domestic violence and sexual trauma, anxiety, panic, and depression. She currently works full-time and also writes bi-monthly articles for The Observer, a local newspaper in Laytonville. These articles are relate to various topics regarding mental health and are geared towards removing the stigma associated with a need for assistance.