Depression and Anxiety - Let's Talk - JLIC Event at Hillel of Brooklyn College with Amudim

ladies and gentlemen ladies and gentlemen welcome welcome to the first oh you jo I see of Mental Health Awareness panel entitled anxiety depression let's talk about it we have a very very robust very very robust multifaceted panel here with us tonight very short words of introduction my name is Robin moving bar snack I'm the OU's jic educator of Brooklyn colorful College my wife to my left is here of a snack zou jic educator of Brooklyn College we've been here for the last 10 years providing friendship mentorship education education rebby Maura for our students at Brooklyn College over the past 10 years we've had a snapshot really of really what's going on and we saw a tremendous tremendous need to really that how creation women says create homeless physical spiritual health and as a result of that's one of the reasons this panel came together we're calling it specifically mental health because everybody needs mental health the truth is our and our perspective is that each person is a-- is an hola hola male its entire world and the more they understand the interconnected slovenian to connected levels of their lives the mezzo the macro to micro levels all the different levels their interactions with themselves with their families with the society more healthy we can be in our interactions and understanding ourselves the more shell limbo will become it's in the book also but I can't help but quote a teaching form of cook where we says that you have to know yourself know your world know everything that surrounds you because when you do you'll realize that you of the wings of an eagle and if you neglect those wings to lose them but if you search for them you'll surely surely find them so that is the first step in awareness of mental health awareness of ourselves and it's a really really big school so my wife and I to be able to convene this panel to bring over us together on a fantastic journal sense sorry a fantastic journey which comprises a huge huge amount of disciplines from from psychiatry psychology Social Work rabbinic Astana's all these different senses all these different components make up our world and we're taking these steps together I'm really excited to share this panel with you so I guess without any further ado I'll also introduce my co-moderator Lord Baha okay so we'll be cool moderating and I can think of no better way to introduce Appel and that have the panel Judas themselves in their own words so to open up that to open up our panel with a question is really panelists please introduce yourself who are you and in what situation would somebody reach ask you what situation would somebody call you before they have the panel is to try to space think at national just two to three minutes is like if it's a robust panel there's a lot to say a lot of ideas but we also want to leave before creation or tomorrow morning so so so so it's a big honor to begin I think we'll just start on my rival will say a hot potato with a Meg good evening now we've sold roseburg pretty sure I'm the only non mental health professional on this panel but get as rough as around those in many ways means we play a very big role in mental health and really is I could say that's divided into two different areas that are up is often called upon firstly it's there into the world for many people people need Christmas people need direction and all of the times the first person that they're going to turn to is their rub someone who gives some spiritual guidance there are people who are still not used to the entire concept of therapy it's sometimes strange and foreign to them and when they have the comfort that is there being scented that direction by Oh rub some days they trust so in many ways that can be very helpful in addition as the rabbinic advisor to the Norgan ization that hopefully will find a bit a little later on this evening hot potato which is the organization for women who are struggling with mental illness who get together as a group there's a whole host of programs that they have but many times I'll be called upon for a lovely child was there really only someone with a knowledge of mental health in answer for example before PayPal get many pools the Seder is a very stressful time for me what specifically do I need to be by the Seder for to be mccain's amid some of the phases keep it all the Eames islands that come up after shiloh Zeca month music during Spheeris music incident say that's at Palm someone down even the Shilin came up of having someone having the music playing an entire unit advocate there are many homosexuals that come in where as ensure that many of the mental health professionals to dances question simple as well plus there's a certain feeling of comfort when it comes to her of and there are times many times I'll be called upon where someone will services saying I have a client at Cooper who I'm working with as they need to hear from the rug that what I'm asking them to do is okay so that's what I could do and finally there are some areas for example in OPD or other places where let's say the issue is just the example Latino of Italian my footage those that are constantly concerned that they've done the Tilted eyes properly so if their therapist or someone else not a non rabbinic person may tell them that it's okay they don't have to continue they may have a hard time accepting that against what they hear from around there from someone who they feel is those spousal debt areas they may be quicker to accept it at that sense you will for comfort not only to the to the person who's getting the therapy but to the entire family as well hi my name is Jordan hands on me and I'd like to take world walks on the beach whoops sorry so I'm a medical doctor my board certified child adolescent and adult psychiatrist you might give me a bite to hold the microphone closer so when I look back at all the years of my training that kind of scares me because actually this really scares me because I was here from 1988 to 1991 and when I came down here this evening this room looks a lot smaller than it used to look so after medical school to be a psychiatrist you have to do four years of residency so that's the same number of years as an OBGYN and then to be a child psychiatrist we need to do what other two years so that makes it takes me up to six years which is the magnitude of sub surgeons and things like that to put things into perspective a little bit and to be brutally honest the first lesson that they taught us on the first day of residency if they gave us our IDs and our keys was the tell us that fifty percent of what we're going to teach you in the next four years is going to be wrong in here's the problem is that we don't know which helps is going to be wrong and say that numbers are probably even a little conservative so what is the psychiatrist is the role of the psychiatrist has changed just to understand they're about eight thousand doctors like me in the entire United States than see patients there are things that have just one child psychiatrist I think the Upper West Side of Manhattan and maybe the 5-pound in Great Neck are the only places that have unknown for two minutes so you know the psychiatrist today as I was trained is mostly someone who does evaluations who manages medication who formulates treatment plans who in theory is you know kind of running the case although many times the gentleman sitting to my right is usually really running the case we'll talk about it later okay so most of the time people don't just open up the phone book and decide today that they want to see a psychiatrist most of the time they get referred either by their rug or their primary care doctor or by a therapist the times when people would come directly today or by the school actually as well when people will come to working today but someone's really not functioning or if there's a real concern that someone's a risk to themselves then the right thing to do is to skip straight to seeing a psychiatrist and now I'm going to piss on the tongue you know if you spoke about me I can speak about you expecting what the thing I'm Alice they're there and thank you the clinical social worker and addictions counselor my background in training was initially in the drug and alcohol rehab in inpatient rehab for a couple of years and then with the Jewish board and others representation of the Jewish board here for about seven and a half years and most recently in private practice and I also teach in local schools people call when there's a mental health issue and you know to be the first whole call sometimes is Vegh people aren't clear about what it is that they're looking for what they need to need a therapist they needed today a psychiatrist you need a rabbi so that's part of the process and walking people through the first phone call and when appropriate you know taking the case and working collaboratively with the other professionals that are involved which is a very important piece mental health is not just one person is going to as dr. Zhiming said one person to do everything without collaboration talking about the school's the parents the families whatever is necessary whatever is indicated you have a much greater chance of helping the client when you work together rather than working in isolation in a vacuum not to be a part of the panel tonight thinking hi good evening my name is Shree Glock before I tell you about me I just want to take a second and really thank grab all your rabbits in Boston for putting this together and more importantly thank everyone that came out here tonight to be here one of the main areas that we try to target that we try to deal with is in waking the stigma associated with fearful or lately healthy one of the main areas that we try to target that we tried it and I'd love to him because it all there's not even a cure so then you're in school also oh good Wow okay anyway we try to break the stigma associated with mental health I found that in organizations three years ago called Emotiv community resources initially started to be a crisis response and intervention organization primarily focused on victims of sexual abuse to those suffering from addiction and we could be added in the awareness component realizing that it's great that we try to help people after the fact it would be better if we could put ourselves out of business for every reason other than lack of funding that being said part of what we try to do is work with the treatment professionals treatment programs mental health world Rabbinical leadership and many others in making sure that the glue that has to maintain the treatment and the necessary care remains together on a multi-faceted approach with 30,000 foot view making sure that not only the client gets the services that they need but the family members and other affected individuals do as well in order for us to succeed in what we're doing and look for the true follow-up it really requires events such as this and making people the way are putting people you know out there and really just saying this is what we're dealing with this is what the world is I said this a few times I'll say it again many many years ago people were scared to talk about when they had children that were born with developmental disabilities often putting them in homes where they would list or many many years not being with their family that signal was broken with the signal people battling cancer where they couldn't even say the word or let people know that a loved one was sick then there was the issue with dealing with the term that I hate of at-risk youth because I think we're all at risk that broke and the time has now come to be able to look whether it's mental illness victims of abuse or other things in the face and saying we're not going to let this get to us and we're going to do what we can to help those thank you all for coming and thank you again to the Bostick's putting it together hi my name is dr. Goldstein I'm a clinical psychologist I completed my training at Hofstra University and I just interning with salvador minuchin in structural family therapy with Aaron Beck who developed CBT that learns a little bit more about later and also intensive training offer decaf in dialectical behavior therapy most people call me either it's kind of to divide you dinner in crisis and something happened recently that there they need to seek a mental health professional they're not really sure very often there and this was about it and the call itself doesn't necessarily mean as a going to seek treatment which definitely is the first step and also there are some people don't understand or can differentiate between and dynein worry we all worry but when does it impact your daily functioning or your quality of life or sadness depression and that's what we're going to talk about more about my name is Judith Leventhal I'm a licensed social worker and initially I trained at the gestalt therapist and I thought for sure I have my life tracked out for me I'm going to be a therapist and that's it but God had a different plan and see what series of incredible coincidences I became the co-author this wonderful series and over the course the past 18 years my co-author and I get to harvest and has written eight books about coincidences like you you have a many of them thank you a alongside the writing of the book I continue to train as a therapist and most recently I train is a somatic experiencing and somatic experiencing in a nutshell is basically feelings and anxiety depression anxiety are often these fields are often stored in our body in all consciousness and somatic experiencing helps the client touch those feelings that are stored and that in bringing awareness to it that's part of the recovery process so right now I'm rival practice and I work particularly people in you know sepsis problem with anxiety depression in these kind of arms so this isn't so glad to be here front three target channel thank you okay before we move on to the second question we also want to mention that the booklet in the night is lilian ich muss riff gas turbines last WSS and shuttle generally I thank you all for an introduction um so as individuals we have friends and sometimes friends come with us come to us with questions and how do you know when something is too big for for like me for instance to help a friend out so this question is directed to perfect question for me and this such a thing non-jovi so one of the things that we notice a lot is friends really care about each other and want to get each other the best help if possible now I know that I was given a special type of speech as mad as a mental health professional but I will we address that and say I am not so I'm clearly speaking as a layperson not as a mental health professional but friends need to also realize that when something is a little bit more than they can chew they need to be able to feel comfortable and take it up a level whether it's to a mental health professional whether it's to a guidance counselor in a school whether you know someone in administration many times we have friends people that come to us for help that for many many months were being guided by their best friend and while it was not very well intentioned very important care that should have been initiated was not able to be done so while it's important that friends are there and friends should be there for those in a suffering they need it it's just as important for a friend to know to be there to support that person to get the proper therapy or to seek the proper help and not try to solve the problems on their own okay dovetailing into the next question let's say let's say you have four things to them four sentences for fact that you cannot you can tell is in hi room all the people out there in facebook live land wherever this is and wherever this recording is going to go if we made it into a meme maybe their face pointing on that way what four things what you want to tell somebody who's facing an addiction somebody whose friends is facing an addiction or somebody's family member is facing an addiction so that Brandon's big loves those four things what were what were those four things great and uh let us down so it's hard to encompass you know what I want people to know in four things we're going to try the first thing that I found is that especially I worked with some young adults teenagers and adults and older children but with young adults nobody decides one night when they go to sleep I'm going to lake up tomorrow be an addict it's not planned every single person that uses says I'm going to do this recreationally once twice and the problem is you don't know and what want you're here across that line what your body chemistry is when your predisposition is to it that can lead to addiction so it's not something that people are ready for plan out or decide they want to become it happens over time and it happens slowly and gradually the second thing that I would mention is that the disease model right and I think in the 1930s I believe the AMA recognized alcoholism as a disease an addiction as a disease it's a DSM diagnosis yet there still seems to be the number of people and maybe our own feelings towards as we get angry at people for using drugs we don't get angry at people for other diseases right you don't get angry at somebody for having cancer but people do get angry at someone for using they feel that there's their choosing it and to some degree yes this choice and responsibility involved but some degree there's also an aspect of which is additive control and they need help a third thing I would mention is that there's there's no one word of addiction people use on different levels and abuse of different levels not everybody needs the same level of treatment treatment can go from once a week an outpatient therapy all the way to impatience in a hospital in a rehab and everything in between so so if you can't just make an assumption on somebody you think they need to so they need that it needs to be an assessment done and based on where they're active it's the problems that they're facing the right level of treatment to be recommended and lastly I just want to mention that because this is a hot topic now with marijuana becoming practically legal across the United States you know every kid I encounter is like it's legal it's okay it's a plant okay first of all it's a plant so is cocaine comes from a point as well it's like 3,000 plants in Africa will kill you if you eat them so this idea that's natural it's okay and we see kids lives that get destroyed through marijuana use even if they're legalizing it they're legalizing it specifically for adults first of all and for specific issues yes there is some legalization of this sport for recreation as well so if our brains are not fully developed adolescence young adults the risks are far greater in terms of being a gateway drug or in terms of people that only use marijuana yet wreck their entire lives oh so you took all my answers but if I were to just mimic some of what you said and take it another step I'm going to just reiterate addiction is a disease people do not choose to be addicts addicts are good people that need help they're not bad people they're not evil people we need to give addicts the love and compassion that they need as we would anybody with any other ailment and also to understand at the same time that no again copying it for a reason but nobody chooses to be an addict but that being said those have to remember and we get into the trouble a lot you're not alone if somebody is suffering from addiction there are many people out there seek help there is help available and there's also help available for the people that live with so it's not just about the Attic themselves getting help it's important to know that the other affected people need help as well I have people calling me up saying you know my husband's drinking too much and just get him to help he needs and when I asked the wife are you also willing to go to meetings and to be involved in to participate oh no he's the problem not me now well that may or may not be true but to solve that problem we need everybody involved and we also have to remember addiction isn't only just drugs or alcohol we are seeing a tremendous increase within our community and gambling porn addiction sex addiction and so many other things that we need to keep that all in mind these are people that are sick and just like finish Martha Mullen optionstation someone who has any other disease we need to do this thing for anyone who's suffering from an addiction what it is I wanted to add something very very important I have fortunately or unfortunately had the privilege of working with several very upstanding members of our community people in their 40s 50s even 60s the people that put on the parlour meetings in their homes for various issues and organizations who throughout their lives never thought of using anything you listened and then they needed back surgeries or they needed some procedure done and it irresponsible well-meaning physician gave them way too much medication for their pin and didn't monitor them properly and these people lost everything they ended up divorced losing their families losing everything autonomy patent AHA idea become applies very very much to addiction there is a genetic predisposition to this and we all need to watch ourselves not just young people this is a real thing that can really happen to anyone thank you before we continue I just want to make sure everyone's comfortable there are a few more seats in the front here I know me it may be a little bit difficult to get through but there are two aisles here so please feel free to move up find a seat number one eight eight three one six 903 that's the number okay so if you have that number you can text in first oh you JLI c MH a so that's if you want to if you have a question you can text it to that and it's anonymous you'll get a response and you know that's just another way of how to direct answer okay first forum that's Beyonce okay those questions while we address after we finish the LS the question is created - yes there are also some sheets on some of the chairs here regarding the texting but I'm going to continue going okay so the next version of the director dr. Pearlstein is you can talk to the counselor so it's pretty thin like so long you just answered if if you can pay for things about somebody about suicide whether it's suicide ideation or somebody who's maybe planning suicide you know whether it's a person or a friend what could you say about suicide in general for yeah so yes we're going to direct the questions doctor protein and then we lost and then to elegant breath okay thank you so it's a great question have the most important thing I would want to tell you is that you need to learn inside because a family member or someone who recently commits suicide told me confided to me that this person do some sorry louder okay close to during off of it Here I am okay so family member somebody recently committed suicide told me that this person served is said and wonderful woman is talking about it and she's not particular suicide but it's absolutely contraindicated in the literature if you look at the risk factors and this fact is our puzzle it doesn't mean that you're going to commit suicide but it does increase the likelihood that you will is that current suicidal ideation is a risk factor a plan if you are talking about a plan if you're writing a suicide note that's a risk factor and tap the tens is also very serious first of all second of all the leading cause of suicides is major depressive disorder and the leading symptom of depression is hopelessness so I would tell you that if anybody is is talking about Susana teraCopy a suicidal ideations if it's something that you know that you say is still hope in this person because it's suicide is a hopeless test okay that's second or third it's not enough to just to be passive about you in other words you need to be active about it you have to make sure that the first is actually seeking help and you have to follow up so this is something where you don't have to worry about enabling somebody right and if you think that it's attention-seeking that's not your call I would say that as well and forth and this is very very important the scariest time is when somebody starts receiving treatment special medication because it takes a couple weeks to kick in and it's very possible that they're going to experience of surge and energy because one of these are going to talk about is that depression depletes you of your energy so they're getting more energy but the suicidal ideation is still there so they have energy to go ahead and carry out the act but they don't have any hope so they're going to go ahead and do it so speaking about suicide is something really tough because uh in the past I've actually gotten into trouble about it which is okay because I'm not really a stranger to controversy but when someone has feelings of it assess something take them seriously all too often we've had people call us up and say my friend is threatening a VC ng or is acting in this way but she'll cheer you will be upset if I call an ambulance or if I get them to a hospital and I don't want to upset them so my answer to that is a living friend is better than a dead one and don't take the chance don't try to be the hero and try to figure it out on your own but get someone to help that they actually need don't overreact don't go insane about it but you're willing to get them help there's also something else that I have to touch on there are people that get diagnosed with cancer and they go through the best form of treatment and yet they still pass away and that's the sad reality of a disease and I have all too often when people have taken their own lives their friends and loved ones end up getting very depressed about it wondering what more they could have done and then they feel guilt in and they end up going into their own downward spiral over it so we also need to understand the reality that these things sadly do happen and we can't take it personal yes we have to do our part to save anyone that can't be saved but we cannot take it personal and eat ourselves up about it we just need to be able to help those that need it and get those the help that they desperately need and if we see the signs especially on the threat level try to get them help reach out do what you have to do don't just try to deal with it yourself okay the number of the points were made I'm just going to stick to one or two there's a myth that by talking about suicide you increase the risk and in fact the research shows the opposite that by discussing it you actually decrease the risk that our school that are like hesitant about addressing things like self-harm because we're going to give kids ideas we find it that's not true it's a touchy subject and sometimes just nervous let alone members our friends almost asked the client directly you need to ask somebody directly are you thinking of hurting yourself are you thinking you're throwing yourself the questions need to be very clear not saying not stepping back but direct another point I want to make is that you know sometimes when it comes to mental illness it's easy for us to like look at somebody else and really connect to understand what they're going through I just see that's like odd or strange or not normal people that are suicidal that have suicidal thoughts are in immense pain more pain than most people here experienced and if you can't connect to that pain and realize that it is not you know apply for help or a tougher for attention and weight just people to notice them as people are truly suffering to the point where if somebody's thinking about killing themselves they decided that there's less pain and not existing then there is staying in the world that there's no hope and if this is true for people that are young as a young adolescent all the way through in late adulthood so when it comes to suicide we don't always have the answers you know I remember the first patients that I lost many years ago in my private practice and after 122 this day there are lots of things in my life that didn't go the way that I wanted but I don't think that I'm going to go up asking God why I think I'm going to ask about this patient we don't always have the answers it doesn't always make sense sometimes people are horribly depressed and you can kind of see the progression when you look back but sometimes people are really not in their right mind they're completely confused they're intoxicated they have a medical condition and they're not able to think clearly and they end up doing something that ends up hurting them and there's no way for us to know whether they intentionally meant to take their lives or not okay so be careful not to overthink this the other key point is when you hear us talking about asking the question clear that's for us to do okay a family member doesn't necessarily have the tools to know what to do with that question if you have a concern it's like you know health officials which has now come to the United States if you see something say something the same thing applies here if you're really concerns say something to someone that can do something about it talk to the family rabbi talk to your pediatrician talk to your primary care doctor if there's a mental health professional involved get to them immediately if you have a legitimate concern and there isn't the mental health professional involved get someone quickly and if you can't get someone quickly that's why the emergency room is there hey I just found out just be able to need two answers approximately I've been working in this field for perhaps in the last seven or eight years ten years ago fighting fatigue was you're sitting I probably would think I've come to the wrong place right now but I can't hear about depression anxiety you know my kids taking finals and they have a very tough time and this anxiety etcetera unfortunately in the last seven years I very tombi them and tell me though it's very real and just the course you may not know about it it could be your neighbor it could be your child wailing it could be anyone who's close to the things that we're discussing your although they may seem extreme and although you personally may think that it's not touching you in wool in our community this is very real every single person on this panel I am sure is getting pools literally day and night as recently as last nineteen thirty in the morning day and nights of people who outwardly seem fine who really seemed okay etc and they're finally opening up and so on so I guess it's not to be a woman doom and all the other issues but one that people would also as they say some the best in the census and the other best families everything seems to have everything going for them this is not an isolated issue and I bring it up again because I would've thought it was before because it's not spoken about you know unfortunately the buzzword is aneurysm suppose don't go around saying that what really happened so what this is important so you don't want to say exactly what happens that's the words it's you but it's very real and it's really something that if every city person here whoops out with that awareness and will come out with that idea of seeing and feeling and being there for other people that alone you've accomplished as a major amount tonight okay so oftentimes people conflate the word psychiatrists and psychologists oftentimes people mix them up they don't always - what you doin bit does I actually once trained at NYU and it was a program for the psychiatry program and every time one of the my clients would come in the photo ringing that and the reception's would say dr. Bacchi ask your patient is here now I'm a licensed mental health counselor I have neither PhD a yeren join MD and they kept doing it and that I try to kept trying to correct them and it just didn't work so next time I said T do me a favor please inform my mother so like to answer to doctors on the panel within your specialties but we have four soft Serapis with medicine in which circumstances where we only use a medicine which sure circumstances but we only use talk therapy to put situations would we unit use a combined approach so I guess we'll start with that's a zombie then move on to that the ground okay go for it so I'm going to tell you a little secret okay you can tell other people that within the entire field of medicine not just mental health with the exception with very few exceptions medicines don't fix anything when a person has an infection and they take an antibiotic and it does what it's supposed to do it kills the bacteria but if someone has a heart condition and they take heart medicine hopefully it'll help them and if they do nothing else when they stop taking the medication what happens the hard problem comes right back yes hypertension high blood pressure you take your inside hypertension great your blood pressure comes down you stop taking it if you didn't exercise those weight stuff solved all the other things that are in style for that week you stopped the medicine the problem comes right back that doesn't mean medication is in effect so to break it down simply at the end of the day what's the difference between medication and talk therapy well the effects of medication will sometimes linger a little bit after you take them varies for medications and medication some medications leave the system within a few hours their effects can linger for sometimes a few weeks but when a person goes for a talk therapy when they go for the right type of therapy for their condition and they stick with it and they have much loca hopefully some real changes have been made and there's been plenty of research throughout the years that is shown very clearly it would you do these fancy scans that look at at metafile the metabolism in different parts of the brain and you look and see what is medications you and what it's therapy do lots of times you end up with the same changes therapy takes longer but if it's done properly the effects linger so for example if we have someone with OCD the data is very very clear there's a type of therapy called cognitive behavior therapy this type of therapy doesn't fix the problem it doesn't you know the psychologist or the social worker or the licensed mental health counselor doesn't kind of crack the brain open and dig deep down and disconnect some of the wires and reconnect them and take their head back up but what they're doing is they're giving the person two tools to handle their problem more effectively now medication will get them to feeling just as good many times a little bit faster and when you combine the two you get an even better robust response but at the end of the day if someone comes into my office with OCD in most cases unless they're really really not functioning they're going to get a referral to a therapist to get what's called cognitive behavioral therapy now you know I really really like ketchup but not on my ice cream okay so when we talk about when medication is effective when we talk about when therapy is effective we need to talk about what's the diagnosis what type of medication what type of therapy are we talking about and we also need to be really really honest with with ourselves about the role of research and the role of statistics you know how many people here have kids tonight are very good how many people in this room have an equal number of boys and girls okay how many have an unequal number so I have four boys and one girl does that mean that the statistics are wrong 50/50 no because statistics are meaningless when applied to an individual if there's a type of cancer that has a 95 percent survival rate that nothing else the person that was just buried that was in the other 10% so just before there's research that shows that something is very effective it doesn't predict that it's going to be effective for that individual and then it becomes our job to assess the person to see how they're doing to see what's the right intervention for them whether it continue it or not so this isn't really the right forum because I could be up here for three hours and put all of you to sleep talking about the different medications at different conditions so just understand that there are some conditions that the research is very very clear that if you're not giving medication you're essentially wasting your time you can do all the therapy you want in the world you're wasting your time and there are those conditions that even medication doesn't help okay and there are those conditions that are better served with psychotherapy that psychotherapy is more effective or equally effective and certainly has less side effects okay so you know this is part of why we have so much training and why experience is so is so necessary you know there are lots of people out in the community that say hey you know I'm a smart guy I can read same books that you read and I can you know I can tell someone what to do I get this in my office all the time people come into bringing bringing the patients in an asset from the community very very well meaning and they look at them that I say you know from guy I know how to learn how would you feel if I taught them halakha shimma SH is huge and that's one of the hugest most important parts of going to a training program is that supervision that teaches us how to make these determinations how to decide when chocolate syrups the right thing one ketchups the right thing and how to figure it out things because I think doctors are covered at all that's great I'm right six years mental school classes for years and those residency um looking so just a couple things that dark just to sort of tag onto a doctor who's ami was saying can you most clinicians the diagnosticians would agree that most forms of psychopathology is due to be but it's divided psychosocial model in other words there's something going on biologically there something going on psychologically and socially so the idea is that there are exceptions that there are some conditions as dr. Mazama pointed out that medication is actively necessary and that cognitive behavior therapy will be ineffective so for instance ADHD the research is pretty clear on that but there are some conditions like many of the anxiety these disorders that if you are just medication and you're not in active treatment in other words you're not for OCD for instance we do a lot of exposure and response prevention which we can talk about a bit later then you're not going to be treatment gates so you it's intellectually dishonest to go to a psychiatrist and assume that you might experience symptoms reduction but your quality of life is not necessarily going to get better the goal of therapy it's developed skills it's skill based and the idea that can you apply those skills in everyday life so that even if you are experiencing less systems of depression are you happier and even if you're experienced even if let's say for instance anxiety you're not experiencing the physiological symptoms so the vacation is taking care of for instance you know your increased heart rate or your hyperventilation right so they did what are you doing when you're approached by a situation of activating your anxieties what are you doing about that so the goal of therapy is to provide the client with the skills that are necessary to improve their quality of life so symptoms reduction and its quality of life so when you focus generally okay so a lot of times we miss you for you know so you know people say they're depressed they're sad they're worried they're anxious so what I'd like to ask panel is how do you know what the difference between sadness or depression or anxiety and being just general fear so this question is directed to have to go down to Jude Leventhal or at number 50 so there's a quote of sadness if the human feeling not one that is enjoyable necessarily depression is the whole other thing depression is where you feel nothing depression is where you just don't want to live another day that's a quote it's a quote from a book written by JK Rowling the author of the Harry Potter series she's reading a book on depression her own depression which really shows that depression does not discriminate depression hits people that are successful as well as are unsuccessful or which it does not discriminate now let's talk about what the difference is between sadness and depression sadness life JK Rowling said it's just a human emotion in the spectrum of feelings or so many there's joy excitement anger science is not another one of those sadness comes in gold it positive smaller attitudes but moved on depression however is a whole other animal the presidency quo has been called like the dark night of the soul depression is when you wake up your morning and you discover that gives it elephant's foot on your chest every single day we are all faced significant challenges some mild some greater challenges and sometimes a little difficult to get these days could be challenging but with depression it makes it almost impossible to get through the day because you're so busy fighting that else and foot a lip service and depression another around the thing to say about that is that sadness could be prompted by some internal and external experience whereas depression isn't necessarily haunted by a so for example like in depression there's internal and there's external counter right so external could be something like them losing some money or getting fired from the job that could be something that contributes to model depression and then there is extreme depression monitoring and exchanging and change the question you know so those could be like I grew up with Karen said well how survivors all my friends with children's Holocaust survivors I really saw depression of posts so many survivors live and believe that dark knives assault I saw it up front I thought of course when someone is in depression it's like living in a far within a cage that has no key but that's just a metaphor and that's just an illusion the truth is you are the key and I think tonight provide so many of those kids with responsible doctor speaking house advice from a therapist no one living with depression has to live in that cage with no me because there are so many visit thank you for that that great emergency yes one of the things that you have to look at if you wanted to friendship between sadness and depression or worry and anxiety is that you have to look at the frequency of how often I was how often you're experiencing worry the intensity in other words is it worry or is it tense for anxiety and then the other thing we look at is duration because depression a major depressive episode is to me so if you're waking up to me the way that I do is explain we're you just don't want to get out of it and you use socially withdrawn and you're just feeling very very sad and you have no interest in doing anything that typically would cause you pleasure but if it's going on for two weeks then you are experiencing of ages process episodes and you need to take action you need to seek out a mental health professional with anxiety works the same way if it's affecting your ability to function and you're experiencing symptoms either it's physically so you're experiencing you know the heart palpitations you know the butterflies in the stomach all that we call sympathetic response arousal or the constant rumination we call illuminating where you think about something over and over and over again and it's you you can't distract from it and the behavior component of anxieties avoidance can avoid things that were anxious about then you're dealing with anxiety it's not real life or so again you look at frequency how often it's experienced how often you're experiencing it how intensely are these symptoms and the duration can you bring yourself back to that comfortable baseline of emotion I just want to want it to add a couple of points to reiterate many times what helps us decide whether something is on the more serious side or not is an impairment in functioning one of the most common lines I hear from patients is but not of course I'm going to be depressed don't you know that this just happened in my life and I say to them and if you fall it break your arm how would you feel if I told you of course you're in horrible pain and you can't sleep your arms broken just because someone is having a bad reaction or is having an appropriate reaction to something does it mean that they shouldn't get help if they want someone if they want their job if they're having marital issues and they're having symptoms just because there's a good reason for those symptoms does it mean that we don't call it something it doesn't mean that we don't take care of it okay moving on back to the this side of the panel 2022 it okay so moving that is out towards this end of the table this is just in question that my life oftentimes will will bring home a statement from somebody or one of our students to include in social work or will call me the question take well patients travel I said that if you really had a Luna it wouldn't be depressing you and be anxious so the problem is that really you just don't have a muna so there's a question I'd like to address you know starting to the rabbi Grossberg right answer dr. Holly let us all all have an answer but okay but we we also saw a disturbing now so a swell start we'll start on electrical gas will bounce and afternoons anyone who wants to step in also feel free okay you don't think it one of the things that I thought about if I introduced myself is that as a in my position I think it's also important besides saying what I do it's important sometimes for abundance to also not look we don't do and there's a reason that is because with the best of intentions I feel and also that it was any sarcasm whatsoever many of our bottom I tell someone work on your Munna when in reality they definitely need therapy and help sick people it doesn't come from a bad place it doesn't it just comes from that if so many years that's what we were told and that if anything this question is a dangerous question don't blame the guy who answers but it was what it does it is guilt on top of everything else so not only am I depressed not only do I seem like things going world of my life on top of everything else I don't have to pull them so I'm not a good - so let's just you know going through the you know all the problems it's important for people to realize that it was this is something that's come up from the steam panel many times over no one ever looked at someone with any other ailments yet a mufflers cancer or any other issue and said well obviously their lack of or otherwise it would happen it was clearly this is something that no one chooses no one says we don't think I don't believe in a sham so I'm going to get the press so I don't if it would be as simple it's sitting down and learning a motivator so the storm stores would be doing great and everyone here we've got a business unfortunately it's not that simple and that's really we're a bunion mental health professionals who have a knowledge and understanding of where someone is coming from really come in and to do it because it that's again with choosing a therapist it's not something that's part of it's so important that you're choosing someone to yourself or your channel that understands the world that you're coming from because this is a whole separate issue again they're Buddhas so it answers the question obviously it doesn't represent in any way whatsoever Alaska for another sometimes it's the chemical reactions that clearly associated with the Moodle sometimes it's just that as a human being with emotions there are things that get us down that sometimes start to spiral and get out of hand etc but the moon antitoxin so the sometimes help play a role as part of everything was done in a healthy way but clearly to just put it as a lack of emunah or pushing that a little change the thing is not only not correct but also very dangerous so the head is not this empty box with spirits swirling around inside of it the brain the central nervous system is no less physical now very very interesting thing happened to me I had the privilege of treating some of the guys that responded to the September 11th attacks and some of them were quite traumatized some of them had other issues they can only act the same way interesting now there's this new area in medicine called pharmacogenomics I know people have heard this but you know what it does is it looks at our genetic profiles looks at what we have previous positions to look at the system in the liver that metabolizes medicine and helps us understand what might be better choice of medication versus others and then this in this type of testing there's something fascinating there is a gene for a serotonin receptor serotonin is one of the brain chemicals that are affected typically in depression and anxiety so there is this where's this receptor for serotonin in the brain called SLC 684 there's going to be a test on this at the end so whoever wasn't anxious already you can start getting anxious and then we'll help you deal with it so there's a there are two possible different genes for this people that have two of the bad copies of the gene there are lots of things that we can say about them number one they're less likely to have positive responses and to tolerate SSRIs which are medicines like Prozac and Zoloft but people that have two bad copies of the gene are more likely to have long lasting effects from childhood trauma they're also more likely to develop post-traumatic stress disorder if they have a traumatic event as and adults what that could possibly have to do with Emunah is beyond okay we are all for God created us created us all differently we have different predispositions we all have things we have to work on we fall each single one of us have the capability to reach our all level of Moshe Rabbeinu the point of Emunah has nothing to do when it comes to mental illness when it comes to working on character defects that maybe I'm a little bit too jealous or a little bit too stingy or I get angry too easily that has nothing to do with mental illness and we have to be very very careful in making that distinction as Jews especially the mothers we have more than enough guilt we don't need more I think I'm especially qualified being the most religious person on this panel I regret answer this question so you're disturbing hearing everyone else talk and I can tell you that for regular people like you guys you don't have to worry I'm going to be puffing for me I can work through with my omona I want to make in one case I treated somebody came in fraction 4 OC d we're talking about OAD he was an extremely religious conscientious young man and of course where did it OCD hiss you would have inappropriate thoughts during governing really inappropriate thoughts very dominate and it drove him crazy the guilt the shame like right when he's joined a band has components images of poeple to his head and we know that the premiere treatment for OCD is CBT exposure response prevention which is they have to purposefully expose the person that which they're avoiding so imagine telling him I was a gun for a good few months telling him you need to actually purposely bring up these thoughts in your head not try to avoid them during vomiting and stay with them so of course I couldn't do this alone and I called it raw the collector arrives or a stroller Iseman with my client on the phone because my client of course I was the angel Hara I said Reisman I need you to tell my client what Soloff is so you need to work together with the Rope sometimes not just discount and say listen forget colossal forget stuff up I'm a mental health practitioner I know you need to do people obviously are from Jews they respectful also they respect my stuff many times it's important to work together with the rough usually the clients rough the claws of the road that the client feels towards and hopefully that next combination we can help people I don't go for you because you're probably going to be innovate with everyone else in and I'm going to be a resume of yourself just positive let's redirect earlier we almost someone who had unfortunately a diagnosis for some kind of illness right and what happens when you have this when we get to up to such a diagnosis you say the person come on you could take care of it you could do this let's not we spring into action pull up gets the better approach for the best faster you make appointment you do what have to be done because the person has an illness what happens when a person is diagnosed it's a question that's when the people say things like come on you could do this it's only you gotten a little bit harder if only you tried a little bit more you public this thing come on you know that it's not true depression is an illness and has nothing to do with having a homework or not having enough I have a client that came into the session this is the first session she could not get her head off the side of the couch she just laid it down because she was so depressed this girl doesn't shock me tomorrow sometimes just text me that she's just out of this mishmash 12 party night that war more than anyone I ever met but you couldn't get her head what the challenge because she was that depressed after a couple months of therapy sessions and medicine which he went on immediately oldest and now she's an upright citizen she could do hiccup function she could work she could smile she lived your life cheering muna before she had even more woman now because she realized that some things are not in our control we would love to believe that depression is completely in our control I just have to fit more better thoughts I just have to go exercise it'll be okay we all wish that that was the case but it's not some things we are totally powerless over and illness is one of them and depression is nothing less than illness so if there's one thing I think that we could take if there's one message because one of the questions is near to one message you want to take out of the night and one message is to take the stigma away from the illness which allows which would allow people who are struggling to this mental illness is step forward and take the actions daddy requires they get sweets for this disease thing all right I just wanna make two points first of all some I don't want to offend anyone here but I think that some people the confuse I'm wound up for denial so if you tell yourself oh you know I'm just going to have enough you know it wouldn't be topical and things will get better and it you're going to have to happen then you're not taking responsibility and you have to be asking about that or we'll have other people the second point is that one of the things that that I help clients that are struggling anxiety is brand their avoidance as adaptive and what I mean by that is that very often you feel guilty because you're avoiding something and so for instance I once had a client who was in a car accident and she avoided getting into that car because she was afraid of getting into another accident and she had intrusive thoughts about it that she had this flashback so remembering what it was like and she was braiding herself because she said if I had more Emunah I wouldn't avoid the car I would just trust it I said we'll take care of me and I pointed out that avoided is adaptive if she avoids that car that she increases the likelihood of being safe so that's why we avoid now obviously it's not helping her because she's not getting she's not trying she's not able to get in a car more but what she considered lack of a Buddha was was the opposite so for my clients what I work on is trying to reframe their their consumptions are these consumptions so any last one on this question but I'm not sure how your client can have a moon if she was texting now obviously that's a joke but the concept is that the world today that we're living in and the angle that our I hate to say this but I will that our leadership is taking is there misconstruing what's important in life and where they're putting religion and emphasis on things in a way that's giving it already anxious or depressed or anyone suffering from mental illness more issues instead of helping them get better so I'm going to say this very simply doctors treat medical issues rabbis can't ask and shy lists and health and things that are good for rabbis and everyone has to know their place this doesn't mean that there aren't women that are trained in other areas it doesn't mean that there aren't people that can answer or know how to guide people in certain ways but people have to know where they stand we had someone come to us who was suffering from severe depression based on a very serious sex addiction and they came to us for help to get them into a specific issue that it teaches Mooser because that's what Darrell told them will cure them and when we reached out to that road but you idly use it as a teachable moment to get that rough to understand what they were talking to we were told where I'll be Carson because we don't understand it so really I guess okay I'll take that as a compliment for the night but what we really need to do is be able to address this in a way where we can educate whether it's the Robottom or the leadership in the communities to make them more aware of what mental illness really is the treatments available and how to separate their perception of the Frug type as opposed to the reality of what's needed to help people really get over those hurdles different on Facebook too so talking about being from anyway thank you so as in fainting tonight a lot of there's a lot of reasons why a person would be held whether it's for an actual mental illness or in my opinion I believe you know just some was really struggling they may seek help and get therapy so I would like to ask what should one expect in they go therapy because you know this is just something people talk about it it may be very scary to go to see a therapist what would one expect and then how is it even know if it's working you know so people can go to a therapist for months and it may they may not realize really what effect is supposed to be taking so this question is directed to Alexander and and dr. Crowe seems your answer what did you expect when you go to therapy is to spend a lot of money it's not cheap I really recommend that people put away money for their kids and grandkids like for college for therapy as well okay we have to live as well did I say now what you expect is that confident therapists and I don't want to do this lightly have gone through enough training before they're opening up a private practice and just you know putting up a shingle and saying I treat you know this isn't everything I'm going to get a little bit of shout out to Jewish boards I spent seven years there one of my pet supervisors in their Christian it'll tear itself up with me for a few years that tells you a little bit better but what's working in in a mental health clinic for a bunch of years and getting supervised again and again and again gives people a little bit of a background what is it you want to do the initial visits should be an assessment you can't treat somebody without knowing what you're treating for someone comes in says hey I'm depressed okay great let's go go ahead and treat depression wait a minute many times clients come in they think they're coming in for one issue it's really something else so you have to a comprehensive assessment you're asking them about when the problem started how long it's been going be ready to answer a lot of questions by the way it's personal questions this is the only profession you can ask somebody anything you want and not be embarrassed about on the first visit so we're going to ask about past history we're going to ask about family relationships we're going to ask about what they enjoy their social life depression anxiety trauma we're going to cover everything if we're doing it well sexuality religion these are things that they exactly should be standard questions that are asked when someone's coming in for treatment of course catered to the age and appropriateness of each point so we'll choose what you should expect initially is an assessment and a good assessment afterwards you should have a discussion with your therapist about do you feel they're a good fit do they feel you're a good fit for them what treatment might look like meaning how are you going to help me there's many many modalities of treatment is another question here and not every modality works for every client we'd like to think that this modality works yes it does for some people in some situations there's a reason why there are many modalities that are out there it's because it will go in on different modalities so you have a tailor what is it that you're you're giving over to your client for what the clients can be a accept and receive and not just where you think you have the greatest amount of knowledge treatment itself no parents frequently asked this question how much money is going to cost me it's usually the first question they get and it's like how long it is going to become like just maybe just fix him or something so I remember one father saying to me he kept asking the questions look I can't really tell you I haven't met your child yet let's just give me a bottom line figure I don't just give me a number I said like a half a million for your child in you package deal no I didn't didn't say that I thought that nikisha's therapy school don't say everything that you're thinking but we can't we can't we can't we freak we cannot predict initially how long Serapis going to last for because it's not me setting your arm in place when it's broken which I don't need like and like the doctor mentioned before taking an antibiotic which doesn't need your anticipation in it it'll happen it'll work anyway so the clients willing to work therapies gonna go quicker if it's a good match therapy's going to go click there's less stressors in the clients life Sarah's little quicker the therapist is better trained therapy's going to go quicker but there's a lot of factors so it's hard for a clinician to answer give you a timeframe although there are issues that are short-term issues and there are issues that are long-term issues they'll get an example of both on tests and like a short-term issue for example is a specific phobia somebody that comes in and had a client recently came in a fear of driving on bridges and tunnels I needed to do that North Korea for his job that treatment is very specific that the clients motivated and want to do the exposure response prevention and continue with it they'll get better quickly this person he was motivated to save money so he followed all the homework and it took about six weeks but then there are client have been working with for two or three years and even the long-term issues and we don't know it could be years it could be two years three years four years the client should feel that therapy is working that's one thing you should never be in therapy for months and feel like this is because this isn't doing anything for me this isn't helping you should feel like you're getting helped in terms of reaching the goal what you came in for again it's hard to deserve it just going to add to that the summer comes into therapy like drugs city the initial session is about you know questionings also in addition to the interview the question it's also that the client is trying to see and affect whether this is a therapist that they could work with and the therapist is doing the same to see if there's a fictional clothes on here's if it's not it will work but you know recently the question was I'm in therapy for about six months and nothing is happening what should I do I think if anyone who's in therapy my professional opinion if your therapy for six months and nothing's happening give way too much patience wait because things should be happening not if showing the first session whether it's the interview process and all these things that have to happen and certainly within second or third session because what it's now see after all it's about bringing awareness and insight that will help change the way you think and the way you function and those kind of changes should be happening separately slowly but they should be happening even if it's happening slowly it should be happening within the first few sessions so if you're in therapy with someone and six months nothing's happening for sure for sure it's a sign to look elsewhere so a couple of things first of all the first couple of sessions are not pleasant because if it's not hurting and it's not therapy you know therapy is not supportive counseling is very different than that and it's important to know that going in so this is not going to be a pleasant process completely the other point is that if if you find that you're in session for a couple of months and it's not working then I would ask the person to I would pose the question is a miracle question that we call which is if things weren't working and things were better how would you know because sometimes people have the sort of vague idea that they're not happy but they don't exactly know what is to take place in order to make that happen to make them happy right so sometimes it's very obvious so if we're dealing with somebody with panic disorder and they're dealing with you or panic attacks or specific phobia right and now they're able to because of the exposure they're able to get to work with the freshest bridges in the tunnel that's very quantifiable but when you're dealing with personality concerns right and we're talking about with a difficulty sustaining relationships then it's much harder to gauge progress the other thing is that therapy is collaborative it's a Galit area in other words if you're concerned that there's a lack of progress and raise the concern with your therapist right because either you have to either you have to modify your expectations or or maybe the therapist can do things that are different I I always encourage my clients to you know to talk about what their experiences are after the end of every session I always ask them how do they find the session right so and the other point is that therapy is work walking into the gym is not going to cause you to lose weight right so walking into a therapy office I ask people sometimes you know what is that sometimes you have to be very am directed they do that if you're giving people the skills or the homework because CBT clinicians always before work and they're not completing it then the question is then you presented with a dilemma which is you want to change but you know what we need to session is not going to be enough so there's a lot of work if you go to therapy you do have to you know expect to work because we want to generalize it from the 45 minutes in session to the overall up to the rest of your week but to speak to the last point which is that if it's not working does raise a concern with the therapist you know and be confrontational about it because it is a collaborative process very briefly had one thing I forgot that is the question about the text that the panelists could speak in English we're translating in it at translated Yiddish Hebrew Latin German French terms of Michael cross Swahili officers I'm sorry therapy with the pressure of how am i going forward to a weaker in a month or in a year there are good clinics that are out to take insurance the Jewish board being one of them and ripping it those on the back over there that is one of the supervisors I worked there for seven and a half years I can attest to that there's oversight and there are people that are being to detecting your cases in supervision so sometimes you can't get to a private practitioner you can use a clinic and they can do with the job as well I just wanted to add one small thing the focus tonight is really about depression and anxiety and most of the types of therapy that we've been speaking about are to find limited therapies cognitive behavior therapy follows a script generally there are other therapies that you're following the script just understand that the answers that you got here tonight about if it's working or not working in six months don't necessarily apply to all different types of therapies for all different types of diagnosis or problems there are some therapies that take years to work okay so and I always encourage people regardless of the type of therapy regardless of of what the underlying problem is that they should make a they should make a cage bone her therapy kind of a reassessment of where things are holding every three to six months just to kind of review with the therapist where are things holding it back in my days in the hospital we used to have these treatment plan parties we used to have to sit around with these huge stacks of paper with this I think a Medicaid mandate we used to have to sit there with our supervisors and basically justify what we were doing is it working is it not working what are our goals that's something when you're working in a grief especially with one of the least part of it there are limited therapies that you should be doing with your therapist the last point I wanted to make and sometimes the greatest work that happens in therapy is when when the client of the patient can tell the therapist directly you know what I think you're wasting my time what are we doing here why am I not getting better sometimes that's really when you get to the bottom of going on okay so we spoke about how mental health really it something with which interact with the President on a number of levels so the next question is going through our ghost birth in terms of that we go through also in terms of his introduction the principle of banoffee Academy which is very very special and different type of school and in terms of that we'd like to know how a school the looking community can school and the community standing up school can contribute or detract from presence of mental health really reference so it's actually an excellent question for us is the reality is that we're all part of this and we're all in this together and we will can be part of the solution the fact that we here tonight is part of the solution I think that often times we make the mistake that when we talk about a big word like trauma and we dig trauma we think of abuse we think of legends of a lost someone or club the other traumatic events at supplement life many times I'll speak to a student who is really really struggling and when it comes down to it they were made fun of for the formative years of their life by classmates and they are just as trauma that that there's a way to quantify trauma but what I need to say is that they are damaged to an extent that say many times unfortunately given up completely on the religious because they somehow they put it all together I always say God is the easy target but he can't answer back necessarily but as a community what we could do is though to realize how tonight is not the time to discuss the resilience and why perhaps children are not as resilient as they once were they can't put up with as much as they once did they're not as strong and I going back it really doesn't belong here tonight but I can't hold back the loose professionals sitting here you know I remember my dad was one father who says my son doesn't need a psychologist he has two psychologists this one and this one some have another we many of us don't say we will survive but many of us survive that's not going on now working me today having a high school for girls that are have been thrown out of school or on the streets I could tell you that it's not working that would ever work before if it did work it's definitely not working now so the question is what is we can do as a community is we could try to make every single one of our precious children feel at home we can be on the lookout for problems and many times we'll make the mistake of things this is for Muslims this is for those that are in education those that are working you'd be surprised what as a neighbor you can do when you see one of the children many people here know the tell-tale signs perhaps a little bit of change in dress hanging out at home when seven being in school there are a lot of things and is it me I'm going to mix it someone else's business I'm just a neighbor you'd be surprised as if just parents many times simply because their parents and I'm one too so they can't play ball pens but they are not gonna be with simply because there's there's too much emotions and so much turmoil involved in that relationship as a neighbor as a friend as really in so many different ways each and every person can help and can see the signs there's children who have just been forgotten about parents are very very busy there are many hospitals many weddings that people are going to their five by five is great the community is thriving you see if you look for a good supper every night there's a parlour meeting and now they follow meetings and not just you know the old okay kit in those else's building the barbecues at the student sushi etcetera there's something to do every single night parents are very very busy but as a community we need to be low so that sometimes children become the sacrifice and together if we really it becomes a community-wide thing not every parent is capable of dealing with their child's problems sometimes parents are dealing with so much shame over what their child is doing that they they did brenton choices we can get up to that parent who's suffering and struggling say don't worry we know what you're going through it must be so difficult for you and they can start to rest and read a little bit easier and feel that they're you know they're not being ostracized by the community they're not being looked at as their parents then they can start to parents better they could be helped but it really it's the mistakes and things that this is what they just the educators are just as our bottom each and every person here can do it and create really a change within the community we become more accepting we become more welcoming to everyone even anybody else use the simple words we need baby to make the Box a little bigger when we're trying to make people fit beside the box so I'm going to answer this a little bit similar to the question about the Robottom schools are a place for going to educate our children and make them feel safe when the school principals administration and teachers take on the role of psychologists and therapists instead of recognizing your problem and sending it to somebody appropriately you are doing a disservice unfortunately in our current system the schools by the way I speak as an expert there's probably not many people in this room if anyone that has as much experience in attending as many schools as I do so there's nobody here that knows more about education than me the biggest consultants the mystery of our school systems has a lot to be desired I will give a tremendous credit to Taurus or for really working on and changing that but we're nowhere near where it should be the schools have a setting right now when you do something wrong we throw you out I guarantee you when you throw that kid out boy or girl younger old you're guaranteeing the next district coming up not very helpful I'm going to use the example of the show how many people here are familiar with the Netflix show 13 reasons why heard about it how many people have watched it how many people here have children through school sent home letters standing and making sure you don't let your children watch it how many people have children in school that that don't letter saying since we know your kids going to watch it anyway here's some great talking points had it speak to your child so you can explain to them what is it isn't going on okay that's the problem that we have today with our school systems and I'm going to say this publicly we are living in an age where everything is being bathed everything is probably should instead of moderation we're not explaining and we're not educating if we know that our kids are going to see something and want something it is our job as parents and our job experience to force it on the schools to be a part of their process allowing the schools to arbitrarily make these decisions that destroy our next generations will have to come to an end and I will say this most of our children spend more waking hours in school settings at our home settings we need the schools to step up to the plate we need the schools to allow mental health professionals such as sitting on this panel into the school to open conversations with the students with the teachers and we need the schools to understand that mental illness is real and people that suffer from that need help not to be further punished further tortured or embarrassed by it but to make sure that they can get the help that they need everything begins with prevention education and that starts with our school systems [Applause] [Music] we're going to end up with the scripted portion of the night taking away articulate a little bit with the how the final question was really on the timeless question number 11 but we moved around and look similar so we're all widows literally unwillingly influenced by Millennials some of us are Millennials later Millennials so it's true each panel is to feel comfortable doing so can you try to please express one message about mental health in 144 characters it doesn't have to be hundred forty-four characters but but uh but one statement one line if there's one message to share you know if you feel that you give advantage that's okay with that pharmacist who once an ex-analyst but if you give us one message to walk away from from the scripted scripted part of the panel before we go down a safety net and they bring up some of our questions from the floor on the announcement when personable we'll pick some hands and then move on to the last portion which will be our our research there I guess I'll go first okay so very often mental illness is is it's a disease of separation where people feel different isolated alone and you really don't have to be covered at all mental build oh I will mental illness is real it's something that needs to be addressed and something that we cannot show you away from anymore confront it deal with it dead proper help and help support these wonderful therapists I just want to reiterate what he no I just want to mention that have business cards okay for a lot of them you want one one thing people people aren't crazy unit behavior every behavior that somebody does is a reason behind it let's try to understand why before we judge it so as a child psychiatrist I always get a very very thorough family history and I always ask the mother for her maiden name maiden name not right at the defense purposes and I always ask afterwards what their family history is I tell them both merits I want you to go up to your grandparents look at everybody underneath so multiple generations hopefully large families and I want you to tell me what additions run in the family I want to know what psychiatric problems whether the family 99 percent of the time nothing you know why I ask for the mother's maiden name because I know more about their family history than they do themselves every one of our families has mental illness just like every one of our families has cancer has diabetes has hypertension we can't run away from this and how do I know because it's the same grandparents paying the bill that's how I know and lots of times it helps me to pick the right treatment I could make huge mistakes because I didn't know that it's time for us to be open with each other and time for us to stop thinking and worrying about this you don't have of six-year-olds with ADHD and what's going to be when they turn 18 or 19 or 20 it's time for us to stop running away from the problems the ostrich approach to the wife doesn't work face the problems so I'm bout to say now a little embarrassing to me but it'll be honest [Laughter] so as I mentioned that one of the things I do as rabbinic adviser for an organization called capital in the pulse which is amazing organization of peer support where people support each other those women that are struggling and siedel members of might have with a male sons or husbands that are struggling and there's a whole host of phone of support groups and it really it's an amazing organization and I don't get paid to that but the first time that I spoke with a hot potato event I have to see Amin I walked in and I was waiting for the people with mental illness to come in because I was way too dull maybe it will be obvious and the room starts building others and well they have so many people here that is just here to help one of the people with the mental illness is going to come in and that there's no more season 2 this is terrible all the volunteers took seats the people at the mental is open there's not even room for them and the answer is that they look and act and are just like everyone else there are husbands wives children neighbors cousins who have this but they're struggling but they're the words mental illness woods and I admitted in education for me the words that look sometimes to Europe you know a vision in our mind that is so wrong and just soul and that's where the stigma comes from that's where the single what we're looking for is people with jobs with families with tremendous success they're perhaps the only difference babies the medication that they take in the morning or the therapy that they're making sure to go or as they're having that support group but it's important since we wanna as a sigma we have to just education would end the stigma we have I got educated that night we have met a most wonderful group of people who clearly are thriving clearly are strong and facing challenges that many of us could even dream of facing those houses and surviving thriving with those challenges it's important that we get a clear picture of what it is so that we stopped stigmatizing without really realizing what it's all about sure you all heard the phrase we don't we don't have a choice about what happens to us you have a choice of then how to react what happens to us so similarly we don't have a choice about whether we get mental illness or someone we know that we love has it but we do have a choice by the way the same denial or whether we come out denial and date action and fight it and I think that that's what tonight was all about the opportunity to come out of denial and step forward and speak to us and see is any way that you can come out of it [Applause] okay so we'd like to take a couple of questions from the floor if anyone has the questions from the floor um okay what was that yeah why is my query hi my name is Mukesh as a and I am training to become a peer counselor in the state of New York that we have a medical diagnosis and kind of been active participant in the specific was divorce about mid-south community for about ten years and I have been a volunteer I have been a he should consumer fly and every word under the Sun myself and I am now training in mental health counseling to help others that having a hard time in an internship at Columbia um and my question is how can we get funding for two specialized therapy that people need when they graduate from the basic clinic therapy and people realize that it has greater traumas and they need things because tech budget shut down their DVD Group a Ludum only helps people who have very specific types of abuse in their background and um and as a valve shut down a few months ago and I am have so many friends that are going through their savings and there is nothing we cannot have a high life line or AB ovo Lenore Akua from mental health we need one we need one now because people are spending their life savings and I have had five therapist and went they're charging $250 an hour they need a really good amount of experience on me another charging I need to know how we can afford this thank you as the only one on this panel who runs an organization who relies on publics important donations I can say thank you for that question and when you get that answer you when you get that answer you can let us know this is a major misconception in the world and I'm going to say this just we can all get that straight organizations don't run by the mere fact that somebody wakes up one day and post is an office and staff and material and people in organizations do the best that they can but realistically speaking if you're looking for specific funding and it's not out there I welcome anyone to open up an organization and try to raise the money to expect an organization that's working as hard as it is to continuously be a bank is not realistic unfortunately and I also recommend people to speak to their politicians for elected officials who control hundreds of millions of dollars of state funding federal funding and city funding and ask them to create additional programming from the purely financial perspective I will speak on behalf of any organization that works hard to help people they do the best they can and people need to learn to appreciate the work the organization's are doing and look at the positive and not the upset that there isn't enough funding because that's not up to the organization's that's up to the public who has to support it in the back rabbit Winograd where are you because I think round me we're going to actually answer that question I will tell you that tarps are currently launched two new initiatives one of them called Project list for another one is partnering with other organizations to start dealing with those issues there are certainly schools out there that have signed up to various awareness and mental health programming that we know of and we get calls from schools on a pretty regular basis at the very least to train some of their staff but the simple answer to your question is not enough so I'm going to repeat the question because I like that question I'm going to go for it no it's a good question people bd-r it she working my food I'm gonna say she works with my wife we're suggesting in case you can feed you the question was one of the administrators so scared of so I'm going to tell you one of the questions that was posed tonight is everybody always is open-minded about issues yet when it comes to shizuka which by the way in my opinion the dirtiest nastiest word of the Jewish dictionary today is the word sugar because that is the number one excuse what people don't do what they need to do what they're scared of is confronting the reality of what's going on unfortunately that shape and stigma that we keep talking about that I must again say thank you to everybody here for coming to help me to break that barrier and you can give yourselves a round of applause to that it's what we need to work on as a group and as a people the school systems are still living in that box unfortunately for the most part no it's not every school but a lot of them and I know this from the clients that we deal with that should have never come to us because they should have been had early detection within the school system has a better programming but really don't deposit of children at schools and those that are watching it's upon us to get the schools to make those changes we have to come in as a parent body and say we understand this is a real problem and we would like to see the school make those changes because if we don't push for it and ink in a cover on its own and I'll tell you everybody said it's impossible to make those changes so just quick props to my community I live in Queens in Kew Gardens ills the first community as an entire community to bring in sexual abuse awareness programming into schools was all of the Queen's elementary schools in conjunction with the Valerie bottom of Queens this was to import yes to a lot of community leaders have put it together but getting enough appearance to say we want this we demanded we'd appearance of a lot more power than we believe and we need to step up it's my our children and the next generation we need to get the schools more involved [Applause] hi so reporter nefesh is a pretty new organization it's only about a few months old what your thoughts on that my particular role is in charge of outreach so basically trying to bring different campaigns pretty much across throughout the paragraph clearing out all of them so my particular position is trying to bring them an outreach in a to different communities we're probably going to second them by age bracket to probably one for adolescents one for young adults college age and then general adults in vyasa I think our first campaigns they were going to be rolling out into the fall it's basically like an X a writing contest many traditional tried and true and then I'm also sort of secretly at work in trying to develop more deeper fundamental kind of game changing things to try to tackle stigma in a much more elemental level so that's Mario's going to roll out in the next few months but if you want to get involved in some new organizations in definitely ways to get involved with people across a range of speculation religion prevention most of us do what what is it what we do what is it you I'm sorry at it pretty new we're not doing that much yet a lot of the stuff we're doing is still in the planning stages we have started is there is a chat room where people can go into either people who have a mental health condition it was a family member friend do it ever they can post questions Oh meaning there's places you forms you can ask questions and get answers and it is also specific sense that there's chats that people and it's moderated people can get answers and discuss different issues related to this there's a lot of social media activity trying to share information that's relevant and like I said there's some other things anything is mental okay so any single diagnosis the questions people have will usually be specific to a mental health disorder and the forms on the website are divided usually by the specific diagnosis but it gives us think much pretty broad I don't have it showing the police by stigma get first type of disorder intuitive abilities were really focused on having mental health think about the sector last question and then we'll be really realizing the room here push up the front actually one with regard to if you want to ask it more clearly itself but what happens when you have a child who minor in the ceiling but really does not want to go for therapy but you really do there's a nice edge but more so anybody I mean okay it's very hard to help someone who doesn't want to be helped so what I do when I work with kids that are resistant it's sort of trying to collab with them in and create this some insight trying to have another word but I'm a collaboration where okay what will it take for you to give it to your parents if you don't have to come back and that's how you usually draw people in but I can say that working with kids you need to work with the parents and that's the barrier very often where parents very often they think that there's my kids success and I'll be back in 45 minutes is that is the case can you answer that so it depends okay depends what the underlying problem is if we're dealing with a little kid that has behavioral difficulties there are certain types of therapy that can be effective even if they're not willing participants when once we're dealing with adolescents though it depends on the problem you know if we have if we have a teenager that has a substance abuse problem then we're going to drag them kicking and screaming even if they don't want to go what kind of problem is defiant defiant depending on the age of the child and whatever else is going on there are some therapies that can be effective even if they don't want to participate but sometimes quite honestly has it be really really smart about choosing the right time to make the intervention sometimes it's better to just work on building the relationship with the child and just has a new consult with the therapist on how to do that and try to help them from the side a little bit of the meantime until they're ready to go and get help themselves but also lots of points the clients is part of something else and it really needs to be identified and what is it why is this child defiant is it just a normal part of their development is a part of ADHD is it something else that's going on because the way to deal with it will vary and some things don't need to be treated sometimes people make sure and they get better one time I think it's a very very relevant question and it comes up a lot especially with addiction people don't really want to get help with adolescents what I found is that is this thing when I think on therapist which is terrible it's unfair and we got to break that stigma that we're not cool we are cool people and I tell the parents get me that give me the child in one and let me see it's like my sense of humor and show you that I'm cool we'll get us a continue but all kidding aside actually should know I think like my most proud moment was when there was a young man from a local school said to me you want to come hang out with my friends we're going to the club tonight I'm like you don't really going to the club trust him when I'm good in this office on Norco in the club but I think the therapists job sometimes is to connect that child during that first session you know to try to connect find some you think they can speak about sports to start the relationship and break that stigma of you're crazy that's why you're here you're weird and you know etc thank you very much we're now going to move to the next guy the final portion of our program for the night all of our panel will be around past questions to especially more specific questions that were asked earlier on but which engages not for the public forum so you can come in as depending of our panel members we also want to present to you