Nandini Ray: Hello Friends! Welcome to the Maitri podcast Between Friends Conversations with Maitri. I am your host Nandini Ray and today we are doing a show on mental health wellness. May is mental health awareness month and it has been observed since 1949 in the United States. In this month many national organizations actively raise awareness about the importance of mental health wellbeing. So, at Maitri, we have decided to do a show on this topic in this month to broadcast an important message that taking care of your mental health is necessary. It is your right. All of us need to learn, understand, and educate ourselves about mental health illness, so that we don't make any assumption. We don't end up hurting people who are already suffering and we can help reduce stigma associated with it.

Right now, all of us are facing an unprecedented time with this global COVID-19 pandemic. All of us are worried, anxious, and uncertain about so many things, and it is really affecting our mental health. But, generally, most of us- South Asian community members, we tend to ignore, to not take care of our mental health wellbeing. So we thought that it would be a great opportunity for us to do this show to remind ourselves and our community members, how important it is to take care of our mental health, how important it is to follow good mental health practices, and most importantly, we have to remind ourselves to support others who are facing mental health issues, and we have to do something to reduce the stigma.

To discuss this very important podcast topic, we have invited Sharon Pereira as our guest today. Sharon Pereira is a mental health professional. She is a licensed marriage and family therapist and she does private practice in Mountain View, California. Sharon has 28 years of experience working with individuals, couples and families in a variety of settings, including Silicon Valley companies, schools, community and county agencies in the Bay Area. She also has extensive experience as supervising and training mental health professionals in the US and in India. Welcome Sharon I'm so excited to have you with us. Thank you.

Sharon Pereira: Thank you, Nandini. I'm excited to share whatever information I have with your audience, and I think mental health services are as important as any other health services, so thank you for taking the time to do this show.

NR: Our pleasure. Sharon, mental health is a taboo topic in our community and people are not comfortable talking about this issue, even if they're suffering or even if they need help. So it is necessary to talk about this topic, and I'm hoping, I'm really hoping that with this show we will be educating and engaging our community members, so that they can think about this issue seriously and do their part in reducing the stigma associated in help seeking. In this current situation when people are disturbed mentally, I hope this show will help them find the right resources, information, and tips that can help them to take care of their own mental health wellbeing. So let’s start on our discussion. My first question to you is, like you have been working with South Asian community members for 28 years. That's a long time. What kind of issues have you helped people with? What are the most common mental health related issues you see in your practice?

SP: Yes, Nandini. I see both among children and adults, a lot of depression in our community as well as in the mainstream, as well as anxiety, clinical anxiety, that manifests in the form of let's say obsessive compulsive disorder or like more generalized anxiety, and I know you work with Maitri, which is a nonprofit that helps victims of domestic violence. We see a fair amount of post-traumatic stress in my practice and colleagues' practices, because people are dealing with all kinds of issues that can be stressful, including marital conflict, stress in the household, crimes related to abuse of alcohol or drugs and stuff like that. I also deal with professionals in the valley who are super high achieving, very conscientious and often have a large amount of burnout among professionals. People dealing with work related stress. People struggling with work life balance issues where, you know, work never ends. People come home and they have to get you to login and that makes it very hard on families, very hard for couples to stay bonded, to stay connected with each other on a day to day basis. I also find that our children suffer a fair amount because they don't necessarily get as much time with their parents or as much quality time with their parents. And over time, I find that kids also tend to find their own ways of adapting to the lack of work life balance in their parents' lives, and they often spend inordinate amounts of time on the computer playing video games or on YouTube and stuff like that, so it is definitely affecting family life in the Bay Area that we have such high-demanding jobs. So many of South Asians are so high-achieving that it comes with a price. I also see a fair amount of academic stress among young people. You got young people to feel the pressure to be very productive, excel academically and professionally, and that in and of itself, you know, generates a fair amount of just anxiety, stress, and also burnout in some instances.

NR: My personal observation is that South Asian people are not very open to talk about their mental health issues. When people have any physical illness, whether it is diabetes, heart disease, or even cancer they share that news with even strangers, without any hesitation, but when they suffer from any mental health illness or mental health issues, or then they are very reluctant to talk about this issue even with their extended family members or, or even their friends and colleagues. So, maybe it's cultural learning. I have seen it in India, I am from India so I can talk about India. I also have friends from Pakistan and Bangladesh, and I have discussed with them, and they all agree that in our community it is a big taboo. It is a big stigma associated with it and people are, South Asian people are generally very uncomfortable if they're asked to attend any counseling session or any therapy. But this is my personal observation, but as a therapist, you can talk more. Do you see any difference when you work with South Asian versus non South Asian communities?

SP: I do see differences, Nandini, very similar to what you're saying. In my 28 years of experience, I find South Asian clients generally don't seek out therapy until there's some kind of crisis, and they're at their wit's end. That's when they seek therapy in my experience. I so wish that people would understand that mental health is no different, and there's nothing wrong with seeking services. In fact, it would be unusual not to need professional help from time to time dealing with the level of stressors that we deal with here in the Bay Area. Also, recently, given the COVID-19 situation people are dealing with the unknown, dealing with job losses. They're dealing with inability to look after the family members let's say who might be in India or even locally, being socially distanced from others. All these kinds of life situations can add up and create stress in people. And I think it's actually a sign of strength, and people can talk more openly with one another about their struggles and be real. Unfortunately, in our South Asian communities, I find that people put a high emphasis on projecting this image of perfection and being in perfect control, and so they don't tend to talk about the more difficult aspects of life, which is really a loss. It's a shame because when we share our common struggle, share our common humanity, we have the opportunity to explore you know what resources are available in a community we're able to share with each other what we might have tried out that has helped our kids, that has helped our marriages, that has helped our family lives. I would really like to respectfully challenge this myth that our community has that mental self-help services are only for crazy people or people who have lost touch with reality. Many times I get clients coming to me with a high level of shame, embarrassment, and they say to me they feel so bad that they have to seek out my services, and I always remind them you know we're not expected to be experts in every realm of life. I remind them how if they have financial needs they go to a financial counsellor if they have legal needs they'll go to a Lawyer, attorney, legal specialist. Why not seek out a mental health professional to learn important life skills that we may not have learned in our old culture and families growing up? I also think that the earlier we seek help from a professional, the better equipped we are to deal with life's challenges. Prevention and early intervention is way better than coming in to seek help during crisis. I mean it's better to seek help, than not at all but the earlier people seek help, the better the scope for them to learn skills and tools to help themselves, and have a better quality of life.

NR: Exactly, so early intervention and prevention are really important. Sharon, I have very limited knowledge in this field, and I really want to learn, and this show is a great opportunity for me, and I believe many listeners out there who are listening to this show today they also learn a large amount of information. And it always helps us if we have the right information then we can make the right decisions. So, let's start understanding some basic information on mental health professionals like there are so many terms like psychologist, psychiatrist, psychotherapist, counselor, marriage and family therapist, clinical social worker. For lay people like me, I may not know or many people like me may not know what is the difference between psychologists and psychotherapists. So, can you please describe their roles and any information about these mental health professionals.

SP: Sure, Nandini, I'm so glad you asked this question because it can be very confusing to the average consumer. There are so many licensed professionals who practice mental health, and it is hard to know the differences between these various professionals. I just wanted to say that psychotherapy is a generic term for a professional who provides mental health and behavior health services. Now, under the umbrella of psychotherapy and psychotherapists are various professionals, including a psychiatrist. A psychiatrist is a medical doctor who's trained to diagnose and treat mental illness, and they do that using medication, and sometimes they do that with medication and talk therapy. A clinical psychologist, on the other hand, is a mental health professional who has a PhD, or a PsyD, so they're a doctoral level professional, and they too trained to assess, diagnose and treat emotional and behavioral problems. Then you have masters-level mental health professionals like Licensed Marriage Family Therapists, like Licensed Professional Clinical Counselors or Licensed Clinical Social Workers. These are all masters level mental health professions, also trained to diagnose, assess, and treat a full range of mental and emotional disorders. If people are still confused, I would recommend that they just take a few minutes to google the difference between psychiatrists, or psychologists or psychologists and counselors and educate themselves about the range of services available.

NR: Yeah, it is always better to know the right information before you take any decision. In this time of global pandemic, all of us are stressed because it's a very new unique situation for all of us, and we are adjusting in this new situation and we are constantly learning new things to adjust. It is not easy to cope in this time of emergence right… so many changes are happening around us and it is creating a lot of mental stress for all of us. Think about clients or who are survivors of domestic violence. They're facing extra layers of anxiety and fear, those who are locked in with their abusers, they are facing increased abuse, violence at home. Those who are in abusive situations, and the path to self-sufficiency, they're also facing a lot of stress like, some are worried about job loss, income loss or threat of homelessness, custody battles, so many things. I would say, DV survivors and all community members are feeling overwhelmed and stressed in this situation that no one was prepared for. So let's say I, or anyone I know, if we are having difficulty coping with the familial stressors, work stress, etc. how should we go about seeking help from a mental health professional?

SP: I think, for people who are comfortable talking about their emotional issues and personal struggles, it’s good if you have friends that you can open up to about your personal situations. Oftentimes, with people whom you trust may have already accessed mental health services, and I find for me in my practice, some of the best referrals come from word of mouth. So people think about who they might have used as a therapist for their children, their teenagers, or for themselves, for couples’ therapy. So, getting a personal recommendation can often be a more comfortable entry into this world of seeking mental health services. For others, you might contact your employer, you know, companies offer counseling and psychotherapy services through the employee assistance programs. So, contacting the HR department of your company and finding out about the Employees Assistance Program services and getting the names of providers who are culturally sensitive, as well as providers who may speak regional South Asian languages, could be a huge benefit for our community members. People who also have insurance can contact their insurance carrier and tell them that you are looking for mental health providers and can they provide a list of their providers. I often tell people, you know, as a friend I'm happy to look at your list that your insurance company has given you of local providers and let you know if I know anybody on that list so it makes it a little less daunting. And I know in this time of pandemic finances are definitely on the forefront of people's mind and the cost might keep people from seeking therapy. For those people, I would recommend this nationwide non-profit called Open Path Psychotherapy Collective. You can google them, they offer reduced rate mental health services for individuals, couples, children and family. There's also an organization called BASANT Bay Area South Asian Network of Therapists, and they could be researched and found through their website basantnow.org. You can go onto their website and also find referrals to South Asian therapists. Locally, in the city of Mountain View, there's the Community Health Awareness Council. Their website is check chac.org. And there's a county of Santa Clara or whatever counties your listeners are in that offer behavioral health services. For example, for emergency psychiatric services, they often offer suicide and crisis hotlines. Just as people would research other kinds of professional services that they might be interested in, so also going online, and just checking out what's available in your community or calling organizations like Maitri that maintain a list of mental health service providers might be another way to, you know, narrow down the search.

NR: It is wonderful Sharon that you shared the resources because therapy can get expensive, especially when a lot of therapy services are not covered by one’s insurance plan. And for individuals who are in an abusive relationship, and are on their partner's insurance plan, seeking a therapist becomes a non-option for them, completely non-option for them. So, your information about the resources that you have shared now, I believe it will help many people. To the listeners, I would like to share the resources once again, if you have missed this important information that Sharon shared. Community Health Awareness Council (CHAC), it's in Mountain View, and their phone number is 650-965-2020. Please go to their website to find out about them. It's www.chacmv.org. Another information Sharon gave is openpathcollective.org. So, that's another website that lets you find low cost therapies in your area. And I would also like to mention that at Maitri we have a resource list. Please call our helpline 1-888-8MAITRI or email us at maitri@maitri.org and based on your needs we can give you a resource. You can even call AACI, another agency in Santa Clara County, aaci.org, you can go to their website. They also have adult counseling programs. They provide a range of mental health services including case-management, medication, support with on-site psychiatry and rehabilitation counseling. Please, you can go to their website to find out if you need any information.

Friends, you are listening to the Maitri podcast: Between Friends, Conversation with MAITRI. I'm your host Nandini Ray and I'm having a conversation with Sharon Pereira, a Licensed Marriage and Family Therapist, and so far we have discussed two different kinds of mental health issues how and when to seek help, who are the mental health professionals, and what are the resources out there.

Sharon, at Maitri, we work with teens and young adults for our prevention program. And we did a couple of community events & podcasts with them. And a couple of teens and young adults shared that they're very disturbed seeing a big stigma associated with help seeking for mental illness in our community and those teens I'm talking about are South Asians teens, South Asian young adults. One of them said that, you know, I was depressed and I wanted to get help but my mom said that people will know about it and it will ruin my future. Another teen said that it is a big stigma in our community, our previous generation thinks that we should not talk about our mental illness, otherwise we will be labeled. Another teen I remember she shared that one of her friends took her life because she was going through a lot of mental stress. Studies show that millions of people in the United States are affected by mental illness each year. So, I was going to NAMI’s website, and I saw that 19.1% of adults experienced mental health illness in 2018. 47.6 million people- that's a huge statistic, but still there's a lot of stigma in our community. So, how can we work to de-stigmatize mental health services and create awareness of resources available to promote psychological and emotional wellbeing among members of the South Asian community?

SP: Yes, Nandini. I couldn’t agree with you more. A lot of our youngest and most vulnerable members of our community are struggling with stress, depression, anxiety, and I know the parents mean well when they ask the kids to not talk about their symptoms in public or when the parents are hesitant to access mental health services. I know that they don't intend to harm their children, they only want to protect their children. But, depression, clinical anxiety, adjustment disorders, these are all real, serious issues- health issues. And just as you would take your child to doctor if they were having a fever that doesn’t go away, just as you would get your child to a doctor if they were having pain in a certain part of their body… so also it’s very important that we consider our children, our seniors, and all the vulnerable members of our communities’ mental health. I love what actress Deepika Padukone is doing in India. She struggled personally with depression for several years and thankfully she had the courage to go public with her struggle, with mental health issues and depression, and she founded an organization called Live Love Laugh. I love the work that this nonprofit is doing in India. They are spending a lot of time and resources, and helping to reduce the stigma associated with depression, anxiety and other common mental health issues. When leaders like Deepika Padukone and other leaders from different walks of life are willing to take personal risks and be more open about their emotional and psychological struggles, it creates a huge shift in the public's perception of mental illness. I love that Deepika Padukone has started an initiative, where she encourages people on Facebook to share their experiences with mental illness using the hashtag #NotAshamed. And then I also think about organizations like the World Healthcare Organization which is doing much to de-stigmatize mental health services and make it more accessible in South Asian countries including India. I read that the World Health Organization estimates that about 20% of the Indian population is afflicted by mental illness in 2020, and now with the pandemic I would imagine the numbers would be even higher. So, I think prominent members of society taking the risk to talk openly about the emotional and personal struggles, along with international organizations like the WHO as well as national organizations like the Live Love Laugh foundation, can do much to dispel the myth of mental health services only being used by people who are crazy or somehow have lost touch with reality. All of us have a psyche all of us have a mind and just like any other organ, our brains can also from time dysfunction or malfunction, and it's important to recognize when we need mental health services and not shy away from utilizing them just as people would utilize other kinds of services including dental services, services of a physical therapist or chiropractor, and so on and so forth.

NR: I believe that all of us, we need to do our part to de-stigmatize because otherwise if all community members don't do their part we won't be able to reach our goal. So listeners please share this podcast with your network and help in changing the culture that attaches stigma with mental health illness and help seeking. Please provide unconditional support to anyone who is struggling with any mental health issue. Treat everyone with dignity and respect. Offer support and encouragement and first of all be aware of your own biases. If we all try, we will be able to de-stigmatize. So Sharon, getting help is one major part of the journey that you are saying over and over that if you need help then, please contact the right resources. So I understand that getting help is one major thing, but can you share some tips on self-care activities that we can incorporate in our lifestyle to build emotional resilience and stay mentally healthy. I really want to know- I want to learn some self-care activities.

NR: Can you give any link or any websites that people can read?

SP: I would like to actually recommend the website of a psychiatrist named David Burns, who is affiliated with Stanford. He's written many, many self-help books including the top self-help book on treating depression: Feeling Good, The New Mood Therapy. He's also written a book called When Panic Attacks. It's a self-help book for people dealing with anxiety disorders. He's also written a book called Feeling Good Together and it helps people who are struggling with interpersonal relationships to turn around conflict into more meaningful and productive relationships, and the website for Dr. David Burns is called www.feelinggood.com. There's also a good book for teenagers who might be dealing with depression. It's a wonderful self-help book written by a colleague named Jacob Towery. The book is called the Anti-Depressant Book. I think familiarizing yourself with some of the self-help material out there, and all of the information that I mentioned about self-help activities is in the Anti-Depressant Book written by Jacob Towery.

NR: Thank you so much for coming to our show and sharing such wonderful resources, information, and your experience with us. So listeners, now it's up to us. We can help, you can help, those who are suffering. You can help to remove the stigma associated with mental health illness and help seeking. Do your part! Simply giving someone space to talk and listening to how they are feeling can be really helpful in itself. If all of us tried, then we will be able to remove stigmas associated with mental health illness and help seeking.

Please keep listening to our podcast and find all of our podcasts on SoundCloud, Apple, Google, and Spotify. Search for Between Friends Conversations with Maitri. I am your host Nandini Ray saying goodbye for now, but we will be back next week with a new topic that matters to our community. Until then, stay calm, stay safe, and stay healthy. Be kind to your mind. Thank you Sharon.

SP: Thank you