Universal Mental Healthcare - Sustainable Development Goals are the way of the future!

Are you or a loved one experiencing social withdrawal? Mood disturbances? Thought disturbances? Changes in behavior? Irregular expression of feelings? Perhaps you or a loved one have already been diagnosed with or are actively treating a mental health condition.

I hope you can take some comfort in the fact that you are not alone. According to a survey conducted by Mental Health America (MHA), nearly 50 million Americans are living with a mental illness. The National Alliance on Mental Illness (NAMI) defines mental illnesses as medical conditions that disrupt a person’s thinking, feeling, mood, daily functioning, and ability to relate to others. Just like physical illness, mental illness requires further treatment with a healthcare professional. Unfortunately, almost a quarter of all adults struggling with mental illness were unable to access the treatment they needed as a result of absence of health insurance or coverage limitations, shortage of mental health professionals, lack of treatment types, significant disconnect between primary and behavioral health systems, and exorbitant costs for mental health services if providers do not take insurance (MHA, 2022). Another worthy factor to consider is that individuals may be hesitant to pursue mental health treatment due to societal stigma. The consequences of lack of mental health treatment are dire and can result in increased suicide rates, increased rates of chronic medical conditions, and increased incarceration rates to name a few (NAMI, 2022). 

The United Nations (UN)  is an international organization where the world’s nations can gather together, discuss common problems and find shared solutions (United Nations, 2023).  The UN is responsible for the creation of the 17 Sustainable Development Goals ‘SDG’, each with an intent to promote prosperity while protecting the planet (United Nations, 2023).  The SDG’s are: 

1. No Poverty

2. Zero Hunger

3. Good Health & Well-being

4. Quality Education

5. Gender Equality

6. Clean Water & Sanitation 

7. Affordable & Clean Energy 

8. Decent Work & Economic Growth 

9. Industry, Innovation, and Infrastructure

10. Reduced Inequalities

11. Sustainable Cities & Communities

12. Responsible Consumption & Production

13. Climate Action

14. Life Below Water

15. Life on Land

16. Peace, Justice, & Strong Institutions

17. Partnerships for the Goals 

As a whole, there are 169 unique targets divided amongst the goals to act as guiding principles to achieve said goal. All members of the UN as of 2015 have agreed upon the creation of the SDG’s and have committed to contributing towards the achievement of all 17 goals by 2030. The one we’ll be focusing in on is SDG #3 - good health & well-being, as this goal is one way in which we as a society can work together to increase access to affordable mental healthcare services. This is the first global plan documented that factors mental health as a realm in need of further development. Target 3.4 of this goal pertains to reducing noncommunicable diseases through prevention and treatment and promoting mental health and well-being (World Health Organization). 

The commitment to improving mental healthcare by the United Nations and World Health Organization are vital proponents for creating a better world and dismantling systemic barriers associated with untreated mental illness. This global scale initiative is a great step in the right direction, and will require participation from more than just United Nations members.

How can you make a difference in advocating for mental health care in your community? Stay tuned for more articles where we will discuss the expectations and benefits of therapy as well as some tips to improve your mental health outside of therapy. 

References: 

Access to Care Data 2022. Mental Health America. (2022). Retrieved from https://mhanational.org/issues/2022/mental-health-america-access-care-data#:~:text=Adults%20with%20Ami%20Who%20Did%20Not%20Receive%20Treatment%202022&text=Over%20half%20(56%25)%20of,Vermont%20to%2067.1%25%20in%20Hawaii. 

Navigating a mental health crisis. NAMI. (2018). Retrieved from https://www.nami.org/Support-Education/Publications-Reports/Guides/Navigating-a-Mental-Health-Crisis 

United Nations. (n.d.). The 17 Goals | Sustainable Development. United Nations. Retrieved from https://sdgs.un.org/goals 

World Health Organization. (n.d.). Targets of Sustainable Development Goal 3. World Health Organization. Retrieved from https://www.who.int/europe/about-us/our-work/sustainable-development-goals/targets-of-sustainable-development-goal-3 

Emotional Wellness: You're okay no matter how okay you are (or aren't)

Emotional wellness – what exactly is it?  In the age of social media, many of my clients (and friends, and family members) think that “emotional wellness” means being something along the lines of “Happy all the time” “Peaceful” “Okay with it” “Managing” “Grateful” “Perfect” … etc.  This actually makes a lot of sense, since on social media we see the “good” parts of our friends’ lives – the gratitude, the weddings, the fresh cut grass, the fresh cut hair, the make up, the new clothes.  We respond to bad days with “silver linings” and “at least it’s not…”s.  

Sounds good, right? Surround yourself with positivity.  Perfect.  Everyone wins.  Except …

Except you had a really crappy day.  Your boss was a jerk.  You got a flat tire.  You burned dinner.  Your takeout was cold.  You couldn’t sleep.  You can’t find a way to “BE POSITIVE!!!!”  Especially because everyone on your feed is so stupidly, annoyingly, perfectly happy.  So obviously, you suck. You are a failure.  You are the problem.  It’s you. This is called “toxic positivity” (stay tuned for future posts).

My friend Amy texted me one night telling me she was the worst mom in the world.  She and her husband had recently moved their toddler from a crib in their bedroom into her own bed in her own room.  They thought Holly would be so excited – she had a “big girl bed,” the room was decorated to Holly’s liking, she was old enough to make the switch!  Holly thought differently.  When Amy texted me, Holly was screaming and crying hysterically for what felt like hours, wanting to sleep in Amy’s bed – but she was two and a half, and it was time for her to move into her own room.  Amy felt like the worst mom in the world … and then, miraculously, Holly stopped crying.  Amy snuck out of her room – she was going to snap an adorable photo of her toddler sleeping alone for the first time.  How cute!  What a milestone!

Holly wasn’t in her bed.  She wasn’t in her room.  She was next door, in her sister’s bed.  Amy sent me a picture of Holly and her big sister with a caption along the lines of “Can you believe this defiant child?!” I tried my best to provide support while I laughed behind the comfort of the cellphone at how smart and resourceful the toddler was. The next morning, I woke to a truly surprising Instagram post. 

“Went to sleep in their own beds … found them like this this morning. #sisters” 

  It was that same photo of Holly and her sister, but this time with the caption: “Went to sleep in their own beds … found them like this this morning. #sisters”  I texted her immediately – “I’m going to make a blog post about this one day.” (#goalachieved)

The number one barrier we often see when it comes to overall self esteem is comparison of self to others – so how does this relate to emotional wellness?  The answer: SIGNIFICANTLY.  The first question when evaluating emotional wellness is: “Do you see stress as something you can learn from or avoid?” Stress is defined as the deficit between the demands on you and the resources you have.  When you perceive the demands as perfection (the toddler who transitions easily to sleeping alone) and your experience is different/inadequate (a toddler who is STRONG in her expression of autonomy (developmentally appropriate, albeit exhausting and aggravating)), you will inevitably perceive yourself as less than (I am the worst mom).

 Signs of emotional wellness include:

• Having the ability to speak to someone about your emotional concerns

• Saying “no” without feeling guilty

• Feeling content most of the time

• Feeling you have a strong support network

• Being able to relax

• Feeling good about who you are

So .. can you view stress as something you can learn from (or avoid)?  In this situation, Amy was able to talk to a friend (who happened to be a therapist well versed in child development (who probably also annoyed her with articles and growth charts and comments like “it will pass!”)).  Not all of my advice was helpful, but the support was!  One thing Amy had to learn was to stop judging herself for being frustrated with her kid – parents have become socialized to think they have to see their kids are these little angels that they’ll love all the time.  Reality check: NOPE.  No, you will not. Have you ever met a child under four??  They are NEEDY!!  Their actual developmental tasks are to ask you for so many things that they can trust you’ll give them, but also to reject everything you offer to help them with to let you know that THEY CAN DO IT.

Amy’s job here was to learn that she is a good mom even though her child doesn’t always listen – everyone on Amy’s social media feed had the job of learning that social media is not real life – we saw Amy’s highlight reel, not her roller coaster.  We can make adjustments (eventually she will sleep without us) and we can avoid (I don’t have to see Amy’s kids’ photo as facts).  

Thankfully for Amy, she said “no” even though it was hard, allowed herself to express her frustrations with a good friend, had a good night’s sleep, and then was able to wake up refreshed and reframe that photo.  She was able to see her child in a new light – a kid who knew how to get her needs met!!  She allowed herself to experience her raw, unedited emotions (like all moms, she’s working on not judging herself).  Even though she was judging herself, she knew she had a support system that wouldn’t judge her – and she used it.  

How can you freely express your emotions?  What emotions do you have that are boxed up?  If it’s something you can vent to a friend safely, do it.  If not, what do you do?  Can you journal?  Can you cry? Can you go to a rage room or a kickboxing class?  Can you paint/draw/color?  How are you taking care of yourself? Can you ask yourself - is your inability to say “no” or a sense of perfectionism interfering with your ability to feel content, being able to relax, or have a positive self image?

Some great ways to relax include breathing, releasing physical tension (progressive muscle relaxation, getting a massage, yoga), writing your thoughts down (journaling), making a gratitude list, visualizing (or visiting) a calm, safe place, or listening to your preferred type of music. How else do you like to relax?

The number one most important component of emotional wellness is asking for help.  Sometimes this means calling a friend or family member, sometimes it means contacting a therapist. We all need help. We all have emotions.  We all need someone.  How are you noticing your strengths and improving your own self image?  Find an affirmation that fits the way you’d like to feel about yourself - affirmations follow the logic that we can speak things into existence.  What would you like to speak into existence?

The Power of Positive (and Negative) Affirmations

We’ve all heard the sayings – “Speak it into existence.”  “The power of positive thinking.”  “Put it out to the universe!”  For many of us, we say them in jest or half-heartedly.  How hokey is it to think you can change your feelings just by being positive!  Right? Can’t be that easy.

Well, except – ever thought about how real those negative thoughts feel?  You miss a turn and tell yourself you’re an idiot.  You don’t get asked on that second date and you tell yourself you’re a loser.  You don’t get a call back from a job interview and tell yourself you’re a deadbeat.  Those sure do feel real, don’t they?  So … why don’t we apply that same logic to positive thinking?

I often speak with my clients about self-fulfilling prophecies.  We tell ourselves stories about events and people in our lives – sometimes those stories are positive, sometimes neutral, sometimes negative.  But those stories MATTER.  My senior year of high school, I was placed into Honors Calculus.  Two weeks in, we had our first quiz, and the material was hard.  I got an A, but as I looked at the graded quiz in my hand that mid-September day, I told myself “There is no way I can pass this class.  This was all review.  I’m going to get Senioritis in like two days and I’m going to get a bad grade, tank my GPA, and not get into college.”  

We’ll pause the story here.  I told myself a story about how the rest of the year (and the subsequent year) was going to play out – based on?  The facts were, I was placed by my previous year teacher into Honors Calculus, and I got an A on my first quiz.  My perception was that I hate math.  The stories (or verbalizations) that I told myself were that I’m not good at math and that I was going to get Senioritis, fail, and mess up my future (YES, I was a dramatic child.  NO, I am definitely not dramatic anymore [mostly] – we’ll talk more about facts, perceptions, and verbalizations in a future blog).  So what happened?  Here comes the story of how this enlightened future therapist used positive affirmations to overcome her doubts, right?

I raised my hand, asked to go to guidance, and dropped Honors Calculus in favor of an underclassmen vocal development class.  I never did pass Honors Calculus – but I also didn’t try.  I decided that I wasn’t going to do well, and so I created a scenario in which I didn’t take Honors Calculus.  Another way that could have played out had I stayed in the class would have been deciding I wasn’t getting an A anyway and not studying, then not getting the A (thus fulfilling my own prophecy).  We tend to put in the effort we think is worth it – so if I thought I wasn’t passing anyway, I probably wasn’t going to put in a ton of effort to a “lost cause.”  

But … What if I decided I was going to nail it?  Fast forward a few years to college.  Because I didn’t take Honors Calculus, I had to take a placement test when I transferred to Rutgers my Sophomore year.  I hadn’t taken math in two full years at this point, so I placed into the pre-calculus class that takes place over two semesters (instead of the one semester version).  Of course, I used this as validation that I suck at math and then also decided I didn’t want to spend two semesters in math because I hate it (still super true, by the way). I decided to take the class at community college over the summer because “when I bombed it” the credits would still transfer.  I’m not sure what changed that summer, but I decided that I could ace any class I took over the summer if I was only taking one class.  And guess what?  I got an A in that six week precalculus course that I was “too bad at math” to take.  

So the long winded moral of my story is, you create the climate you’re working towards your goals in.  Believe in the power of your thoughts and visualizations – can you picture yourself achieving your goals?  If you’re in med school, can you buy yourself a little plaque that says “Your Name Here, MD” and put it in your study space?  If you want to open your own car shop, can you draw out your logo for “Your Name Here Mechanics” and hang it on your fridge for inspiration? 

Even simpler, can you start a daily affirmation practice?  Eventually, by repeating these small statements (I am enough.  I am successful.  I can achieve my dreams.  Fill in the blank.), they become more real.  They become attainable.  They become REAL.  Believe in the power of your dreams.  If you’re struggling to identify affirmations that speak to you, you might try thinking of one thing each day that made you happy or proud – what does that say about you as a person?  Maybe you smiled at a butterfly – I am inspired by nature.  Maybe you helped someone load their groceries into their car – I am considerate.  Maybe you spent the day in sweatpants watching 90 Day Fiancé – I am gentle with myself.  If you need more inspiration, you can purchase an affirmation deck and pick a card each day from your deck.  

What affirmations do you want to add to your daily practice?  What negative self talk do you want to replace with something neutral or positive?

“Whatever you hold in your mind on a consistent basis is exactly what you will experience in your life.” – Tony Robbins