April 23, 2025 • 30 mins
In this powerful episode, Dr. Janine Ellenberger joins Lisa and Gretchen to talk about the missing links in suicide prevention—namely, aftercare, family support, and community. Together, they unpack real stories, systemic gaps, and the “3 P’s” that could make all the difference: People, Place, and Purpose.
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📝 Episode Summary
Dr. Janine Ellenberger returns to The Survivors to share insights from her career in digital mental health, personal observations from the field, and reflections on what’s missing in America’s response to mental illness and suicide. The conversation tackles the painful gaps in aftercare, the burden on families, and how communities can fill the void for those who feel most alone. Dr. Ellenberger champions an empathetic approach, grounded in accessibility, connection, and purpose-driven recovery.
🌟 Lessons Learned
- Suicide recovery is possible. Like any chronic illness, mental illness requires sustained care, not just emergency treatment.
- The “3 P’s” matter: People, Place, and Purpose are foundational for anyone reentering life after crisis.
- Support must extend beyond the ER. Real change starts when communities show up and family systems are empowered with education and tools.
- Accessible therapy saves lives. Platforms like Calmerry are breaking cost and location barriers.
- We all have a role. Whether it's a listening ear or soup on the doorstep, support doesn’t have to be clinical to be lifesaving.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
[MUSIC]
(00:05):
The Survivors is brought to you by our friends at CalMory.
This podcast mentions suicide, mental illness,
grief and loss, and maybe triggering for some listeners.
So please take care of your well-being by
pausing or skipping any sections that feel uncomfortable to you.
And if you or someone you know is struggling,
please call 988 for support.
>> Welcome back to another episode of The Survivors.
(00:28):
And we are once again very excited to share some time in space with our friend,
Jenine Ellenberg.
She is a seasoned physician entrepreneur,
health executive with over 20 years of experience in digital health,
clinical practice and leadership.
She is the co-founder of Behavidence,
the digital phenotyping company for mental health conditions,
and the chief medical officer of our sponsor,
(00:51):
transforming mental health care through innovation,
expanding our services through strategic partnerships and
introducing it's also responsible for world-class virtual therapy,
training programs and improving therapist-client matching to ensure
personalized care for every individual.
And we are absolutely thrilled to have her back with us on
the Survivors to continue our just beautiful conversation from last week.
(01:13):
I feel like we got so much into that 30-minute conversation.
And we just really want to pick up in some ways where we left off.
So, Jenine, welcome back.
We're so glad to have you.
Good morning and thank you so much.
I was very excited for today because I got to have this conversation
with the two of you again.
So, thank you for including me in this.
(01:33):
So, we talked about a bunch of different topics in the green room
before we started recording.
And we really landed on a conversation about just how lacking our country is
in terms of support for people with mental illness.
And you had such profound insights on why that is and what we need to do to compensate for that.
(01:58):
So, I feel like we should just kind of keep rolling with what you were talking about a few minutes ago
and just dive right back into that same space.
I can definitely just jump over to exactly what I started with if you'd like me to.
Okay, so I recently attended a conference and had the privilege of listening to a talk by Dr. Thomas Insel.
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He used to be the former head of the NIH during the Reagan and Obama era's and spent a lot of
time researching the causes of mental illness.
And during his talk he spoke and he's written a book called Healing Our Parts from Mental
Illness to Mental Health.
But what stood out to me was his experience when he was giving a lecture about the science of why
(02:43):
people have schizophrenia or depression or anxiety and all that the phenomenal progress in research
about these things.
And a father stood up in the audience and said, you know, with all your respect,
you know, my son has schizophrenia.
He tried to commit suicide three times and our house is on fire.
And really all you're talking about is the chemistry of the paint.
It doesn't help us.
(03:04):
And he then actually went on a new journey and sort of went to California and started really
exploring the homeless situation there and came back and said, you know, really it's not just about
the treatment.
It really is about the support, the care, the community around that person.
And I think that is something that we lack in this country to be very honest with you.
(03:25):
People will go, they'll have a suicide attempt, they'll get to the ER, get the maids.
And then they are discharged and where do they go?
If they do not have that support, where do they go?
And Tom and cell or whoever it is speaks about the three Ps and I probably got the wrong person.
But anyway, the three Ps, people, place and purpose.
So if you don't have a place to go, what do you do?
(03:48):
If you don't have people, caregivers, communities, support you, what do you do?
And if you don't have a purpose, you need hope.
You need their reason to get up and go out and do something.
And I think that we have a long way to go in this country for support in that aspect.
Yeah, we do. You're right. And it's interesting because I had this conversation with my therapist
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not too long ago in terms of what happens when someone has been hospitalized for depression,
a breakdown, mental illness in general.
I'm just going to say as a disclaimer that there are fire alarms going off in our condo building right now.
I'm very safe. There's these are just a test.
So if you hear that, please don't be alarmed because I'm fine.
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So the interesting thing is that when someone goes in for treatment, they come out and they are
at their most vulnerable. You know, they come in and whether it's a three day hold or whether it's,
you know, a 30 day hold, whatever the case might be, the irony is when they're released,
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that's when they're at the highest risk for taking their life or for having another relapse of
some kind. And what you're saying is so profound about, you know, it's that it's that after care
in terms of someone reintegrating and and dealing with their mental illness and and having that kind
of support. And I think that it just becomes such an overlooked issue. We think of it in terms of
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like, okay, someone goes in for, you know, some kind of an operation, you know, a long transplant or
surgery of some type. And they have the whole protocol is all set. They have their follow-up
appointments and they have all of their their physical therapy appointments. Right, right, right. And
they're after care. And there's nothing that's considered when you have mental illness on the same
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left. And they can't be released from the hospital until somebody picks them up from the wheelchair
to drive them home and they say, do you have someone to care for you at home and bring you soup
because you can't walk or whatever the story is. And yes, that is what it's lacking. When I did my,
when I had my suicide attempt and I was talking to 98, they asked me if somebody was home. And
thankfully my wife was home, but I can't imagine having to made that call and been where I was and not
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having a support system around me. You know, we have that problem here in upstate New York, you know,
there's a lot of homeless up here. I live right in between two college towns and a lot of time these
kids don't have anybody close by if they have their dorms, they have their roommates, but their
families are so far away. And I think the schools do a little bit better job. At least I hope with
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suicide awareness and things like that. But we also have a homeless community up here. Whenever I look
at somebody who's homeless, like currently homeless, a lot of these people are mentally ill. And to Jean,
Jean's point, we don't have the care for them. We don't have the care for the vets. We don't have the
care for the homeless. Like when it comes to mental health, we don't have enough resources out.
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We don't. And to go to to your point, those people don't have a place. They don't have a person and
they don't have a purpose. And for me, it's really a watch people. Filly has a big homeless problem as
well. And I watch people, they walk, they take a wide berth around the person who's homeless. And I,
you know, I look at them, you can see their thoughts. One is, oh, they want to acknowledge it. I don't,
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this is bad. I don't want to be near it. But I often think in the back of their minds is the fear.
Could this happen to me one day? Because there isn't the social support system in this country.
You know, it's hard if you don't have health insurance. It's hard if you don't have a job. Unlike those
socialistic countries up all the Europe and Australia, you know, there is a bit of support. You don't
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have to care. It's a terrifying position to be in. And mental health care is expensive. A lot of
psychiatrists don't take insurance. A lot of psychologists don't take insurance. So unless you have
money, you don't get the help. Even if you have kids or family members to try and support them through
that and find the right key. And I tell you something, finding the right psychiatrist or psychologist
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is, is can be a hit in this job. Get care. Look, gee, look at you. We've had this conversation before
when you shared your story on an episode earlier in the season. You talked about how you had to
speed date your therapist because it's not often a good match right away. And that's that's hard. That's
time consuming. It's, you know, it's emotionally draining to go through kind of all of those
(08:18):
motions and go through the stories and your history and only to have to shift over to someone else.
That's a lot. Especially when you're vulnerable. Yeah. Yeah. Yeah. The first couple of days were
really hard because I had gotten the therapist. She wasn't really my cup of tea but I knew I needed
somebody right then and there. And then the next therapist I did like two weeks later still not a
(08:42):
good fit but still needed somebody to talk to. And then finally by the third one, I found the one
that really clicked. And you know, for me, I'm paying for therapy out of pocket because my insurance
doesn't cover the type of therapy that I'm going through. And I think that with like even the telehealth
platforms need to take in into accommodation that people don't have a lot of money. They need to do it
(09:06):
at a sliding scale. I understand that we all need to make money but there are millions of people
out there suffering because they can't afford mental health. Which in your so right and is such a
problem because even with the tele therapy platforms, they still have to pay the therapists. The
therapists need to live. If you look at the salaries in this country of insurance compensated
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and reimbursed therapists, it's not a lot. And it's a lot of work. You know, it's putting a lot of your
emotional energy into therapy. So it's a double its sword in a way. I must say I do think tele therapy
does offer a great platform for accessible, affordable kick now. So if you need something because
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as we spoke about last time, you could wait three months to see a therapist, you know, depending on
where you live and the availability of therapists. So you could be having this crisis and you know,
want to do anything. You just want someone to talk to to get that is hard. But tele therapy, I think,
like platforms like Conry, definitely do offer that. You can click a button and say, right, I need
someone in the next 72 hours sort of filtered by what you do and don't like. So that matching does
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sort of help the speed dating process a little bit easier and then and find someone to speak to.
It's it's it's that accessibility, I think, that makes tele therapy so much more attractive now
than it ever used to be. Almost definitely. And of course, there are so many different options,
so many different platforms that all have their kind of unique spin on providing therapy and and
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connecting with therapists and the way that their platforms are structured. And I think at the end of
the day, if you were to go out of pocket to a traditional therapist, kind of a brick and mortar
therapist, you could be paying hundreds of dollars to get in the door if you're not insured, which
so many of us are not insured. And on the other side, when you do go to, you know, a tele therapist,
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not only are you given the advantage of having so many different options and you can do it from home
and it's private and it's secure, but you're also paying a fraction. You may be paying a quarter or
a third of the cost of what you would pay a traditional therapist. So there are so many advantages,
but it feels like like I'm listening to this conversation and it feels like to me, what might be
(11:20):
beneficial to people who are listening might be like, we've established that the point of this
conversation is that we are lacking in that mental health care piece of our society exactly, exactly.
So, okay, we've talked, we've identified, we've identified tele therapy as a thing that people
can source. So maybe it makes sense to have the conversation of, okay, what are the other things?
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What if you're somebody who is struggling with your mental health? You know someone who's
struggling with your their mental health? What's out there? What's available for people to support them
in those ways? And like beyond tele therapy, let's talk purpose, let's talk, you know, involvement,
community involvement, things like that, mindfulness, the other options that are out there.
(12:06):
So I was just going to say here in upstate New York, I live in a very small farming committee,
very small county in upstate New York, but it's full of college kids. They do have mental health
resources that are free, but I'm going to use this disclaimer just because of what's currently going
on within the administration that some of these resources are pulling back. But if you are struggling,
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you can definitely go to mental health centers like family care. You can certainly go to those people
and they will find you somebody to help you. Even if you're homeless, they're going to be able to
find you somebody to talk to. But you know, the other part of that too is let's just all be a
have a little bit more empathy for what people are going through and like offer whatever help you
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can. So that's that's my two cents. And I'm going to go back to I think families become the
involuntary mental illness experts in a way. And I think more support needs to be given to families
because then they could actually play a better role in a way because if you don't, I think you've
got two sort of groups yet. If you if you as a family are overwhelmed by your family members'
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mental illness, you can step back and just say, oh well, there's nothing we can do. Let them
be. Let them go. We've tried our best. But a lot of people really learn to understand like the
the dear man has said his house that you know, you don't want to know what the chemistry of the paint,
his house is on fire. He was very well aware of what was going on with his son. So I think
they're the experts and we should lean into that as a society. We should support the families because
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if the families get the support, the people in the place is already taken care of. Those are two
of the three piece that we've picked the box to. And but I think often for families, it's a lot.
It's it's it's overwhelming and it takes so much time and it takes so much resources. So I think
the families need the support as well. Absolutely. I mean, I think in terms of families who I know
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who deal with family members with mental illness, it can be so all-consuming where they flow or the
vibe of the family or the structure of the family is dictated by the person who is experiencing
the mental illness or the struggle. And then everyone else in the family is really just kind of
running around with their, you know, hands open trying to catch the person before they fall. And so
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everything else gets ignored. And the family dynamic as a whole is completely turned upside down.
And it's a really hard environment to function in because so many things can come up from a situation
like that. Like resentment can come up from things like that. It can be very difficult to manage
your day-to-day responsibilities. Most families have at least one or two family members who are working,
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who are providing financially, who are caregiving, who maybe in some cases are raising children. So
so there's so much more involved in the day-to-day family unit, but it's all consumed often when
that family unit has someone who is in such desperate need of support that it takes over everything.
And that's difficult. You're right. I mean, families really need to have support because they're
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at the end of the day. They're on the front lines. They're the ones who are dealing with it the most.
And I can say just for my own personal experience, you know, when when I finally was able to open up to
my wife about what was going on on that day, she's like, why didn't you come to me sooner with her?
For me, I didn't know how to tell her because I didn't understand what was going on with me.
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And then the more probing questions, the more probing questions, and I couldn't answer her. And so I
wish there were more resources for like for my example. Why couldn't I find my voice? Why couldn't I
find my footing? Why didn't I open up to her? And for me, my answer was I didn't know how to because
I didn't understand what was going on in my own body. Take a step to your mental well-being with
(15:54):
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I think that really speaks to the importance of just good communication. Whether you're dealing with
someone who's unwell or not, it's just general foundational block of a family unit should be
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having those open conversations sitting down like I know we always talked with our girls as early on
as we could in an age appropriate way each time as they got older just to really ensure that they
felt like they could come and talk to us if things were not okay. I mean the obvious things like
talking about sex or talking about drinking or talking about peers or you know all of those things
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as well. But I think we also have to be having the conversations about the mental health piece too
and integrate that. If we want things like mental health and wellness and mental illness to become
mainstream then we need to start integrating those conversations into our day to day so that
people are used to hearing it so that people don't feel put off or unprepared to have a conversation.
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But I think Lisa you're so right there but it also depends on the family structure. I mean some
families don't theme these topics to be discussable. You know some families have different sort of
it might be a religious thing it might be I don't know whatever it is they're just not that open.
And then you have the single parent family and I think this is where the village I would say
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takes a village to raise a child. I've come into play because and I think here like we're transparent
you know we came from South Africa so I don't have my sisters and my brothers and the aunts and
the uncles and the cousins here who often pick up things when the parents don't see things or even
you know my sister might notice something about me that my husband may not. Or if I'm alone at least
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you know you have cousins who you might pop into who check in on you that village I think is so
incredibly important in managing mental illness because you need more than one person. It takes one
person to help initially but you need more than one person you need a little village to rally around
you when you need to bring you the soup when your leg is broken or to you know offer to walk the
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dog when you're too tired. Those little things are so important because that is where you feel like
you belong. Yeah in a slightly different context I understand that I'm all I'm thinking about as
my own childhood and the way that he was raised by a single mother I mean I lost my father he took his
life when I was 10 years old I didn't know that he had taken his life my mother did so my mother not
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only had to keep that secret chose to keep that secret of his suicide from me to save me from that
pain but she was also dealing with the loss of her husband and dealing with raising a child and
dealing with everything that all of a sudden now was on her plate which was the entirety of our
life and I think about that I of course couldn't see it for what it was then because I was a 10-year-old
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kid and I just didn't have that perspective but as I've grown up as I've as I've formed my own family
and and understood what it takes to be a mother be a wife to to be all of the things that all of us
have to be every day I'm astounded and dumbfounded at the same time that my mother did what she did
but she did it because she like what you said she had community you know my grandmother came and
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lived with us and our house was always full we we always had some part of our larger family unit
there and I don't know if my mother would have been able to just manage the day to day were it not
for that extra support you could understand mentally illness creeping in day if you're on your own
and dealing with that yeah and in the healthiest individual that's a lot to to manage yeah and at
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that time I mean we're we're talking about the 1970s and 1980s people were not regularly visiting
with their with their therapist not not in the mainstream type of way that it is now my mother would
always laugh about it after the fact but whenever I would get frustrating or a situation would become
frustrating my mother would get in the car and she we had a loop we lived with a let me you know
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in a circular neighborhood so she would get in the car and drive loops around the neighborhood
and just talk it out to herself she would just have a conversation with herself and that's how she
worked her way through whatever the issue or the problem was and then there were also the days
when my mother would be the first to say this that when I was really getting under her skin she would
get in the car and she would scream her way all the way around the block just to kind of you know
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avoid doing that to me but I just I think about how remarkable it was in my mother's case that she
maintained a balance in spite of all of those things and I think about the fact that she had
people in her life and she had a community and she went back to college late in life and so she had
those those purpose her exactly exactly I mean that she did that six months after my father
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good for her as a way at the age of 40 years old decided to go back and get her college degree that
took her five years and she did it and she did it she just excelled in every way and and I think about
we we talk about that all the time how not only was that just such a highlight of her life but it saved
her life in so many ways to be able to do something that was just for her in that way I think I think
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maybe it makes sense to to dig a little deeper into the what what can we do part of this conversation
what can people do like let's let's put therapy aside and talk about kind of the the purpose and
community and you know positive self-talk what can people do like when they stop listening to this
podcast today if they're feeling overwhelmed if they feel like they need some kind of support
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additional support what do they do where do they go do they do they turn to mindfulness apps
it's on the person I think and where they're at you know some people on such a dark space they
cannot do anything they're almost paralyzed like Gritun was saying she couldn't communicate
she didn't know what to say she didn't know how so it's something just had they just it's so dark it's
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so they so deep underground that they don't know how to put their hand up and I think that in that
case somebody needs to reach out but somebody who is feeling overwhelmed who's feeling really like
they are not coping right now reach out reach out to anybody and for anybody who's listening to this
podcast if someone reaches out take their hand and just walk with them you don't have to tell them
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what to do you don't have to solve the problem just be there and know that they have someone that
they can actually turn to if they win when they're ready to when they want to speak be there support
don't judge those are two very very powerful pieces of information and I would add one thing that
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GM sure you're getting ready to add this to about 988 calling the lifeline like we talk about
okay there are people who have insurance and they have access to therapy and then there are other
people who may not have the insurance piece but they have the means to do tele therapy and they have
a community but okay who about how about the people who don't have any of that where did they go what
(23:02):
did they do they always have a resource there is always someone on the other end of the 988
crisis lifeline and it can't say this enough especially speaking as a counselor who often takes calls
from people who say should I even really be calling and using this lifeline I'm really not sure because
I'm not suicidal and I stop them right there and I say are you feeling like you're struggling don't
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even need to tell me right in this moment what it is that you're struggling with but are you struggling
and the answer is yes it's all relative it doesn't matter what you're struggling with because if
that's enough to affect your mental health and wellness then that's enough to pick up the phone
into call counselor and any of us on these lifelines are here to listen 24 hours a day every day of the
(23:46):
week to whatever it is that's compromising your mental health and wellness so I think that as we
identify in this conversation what those pieces are like go go seek some purpose in your life go find
community go explore therapy keep things like the 988 lifeline on the top of your brain and make
(24:08):
those phone calls when you need that help so my question to both of you is like what do we do for the
homeless community that doesn't sometimes don't have phones right are there people that can actually
go out to those encampments and talk to these people because a good portion of the homeless are
mentally ill but they don't have the resources they don't have somebody to talk to and it's just an
(24:32):
endless cycle right so yes they won't end up going to the hospital go into emergency getting kicked
back out into the world and nobody to talk to so as a community what can we do to help those
population because for the population like you and I and Jeanine we all have resources right we have
(24:52):
so full we get friends they have a roof over our head but I feel bad for the homeless and for those
people that really don't have the resources that we have so I'm trying to think of how we can use
our platform to so that people can understand what's going on yeah I think that's a hard question
and I and I think it's such an important population to focus on in this conversation I think that
(25:19):
it just speaks to how much more we need to build into our infrastructure the fact that unfortunately
it's not designed right now to support such a vulnerable population but we do have homeless
shelters there every city has a community of homeless shelters where people can go and can receive the
basics to to sustain them and to get a roof over their head and food and their stomachs and whatnot
(25:44):
it's it's a really hard problem to solve I wish I had the ready made answer it's interesting because
I um I was in San Francisco to conference recently and the city was clean I was there previously when
I dropped my son of a college and it was overrun with homeless people it was so sad the next time
I like the scheme because they moved to homeless people because there was a big delegate from some
way from foreign country came to visit so they housed him temporarily so they there is a post they
(26:08):
can do it the states can do it the infrastructure needs we need to push for that to happen because yes
a homeless person go get food tonight and if the shelters are not full they may have a bed but if
the shelters are full they don't they sleep in the station or wherever they can find some place warm
because it's very cold in most of the cities in the US and the North so they need warmth and then
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but when they get out the next day where do they go they don't have a purpose and they have mental
illness which needs to get treated and they don't get that in the shelter so I think that it needs
to become a federal mandate that we take care of the people and the second thing is I think more
of us need to volunteer because if we all help they're more hands they're more with it's more support
(26:54):
and I think that it will do us all the world of good to to understand that again this could be
happen to anybody it's a problem that if you don't have a job and you have not say what do you do
it's very easy to land on the streets so let's let's all help yeah I think as a way to to wrap up
this beautiful conversation just I think it's worth making reiterating the point that we all need
(27:19):
to be not only taking care of ourselves the whole oxygen mask put that on you first to ensure that
you're capable of helping yourself and helping others but we just need to be paying better attention
to people we need to I mean G say it all the time we need to show more compassion to ourselves
and also to the people around us and it's once we start doing that once we really start checking
(27:44):
in on each other regularly then I think things will start to shift things will start to change and
you'll see see you know a lot more people feeling supported and feeling capable of reaching out for
support and understanding that mental illness is not a life sentence people can recover it's like
having you know heart disease or having diabetes for example if you leave it untreated it has a lot
(28:08):
of negative complications and side effects but if you're able to address it and treat it and
management and again something like diabetes is not just about medication you know it's about
the right food and the right lifestyle and the right support well mental illness is the same
you need to have the right very good thing you need the right support around it as well and 100
(28:28):
percent you can recover so why do we let it become this epidemic when we know that that
key part of of hospitality not hospitalization as Tom I'm quoting again is part of the theory is
let's to trace that part of the cure and make sure that people have access to it absolutely and
let's start here let's start today let's start now and anyone listening we hope that you'll you'll
(28:52):
do the same we hope that you'll you'll move through your your day and and have a little bit more
intention in the way that you look after the people around you yeah I'd love this conversation this
was so awesome thank you Janine you are just so lovely you know I actually get more out of this
than anybody because every time we speak I realize how deep this problem is and that people have
(29:19):
governments people psychiatrists ecologists states have been trying to solve this for so long but
we're just not getting it right so it actually fires me up to do more good and it fires me up too
and I know here's you she look at her I'm all fired up today she's all fired up um Janine will you
will you come back someday soon yes we'd love to chat again wonderful thank you so much for
(29:41):
just your wisdom and your insight and just for spending a little bit of time we appreciate you
I appreciate you too thank you thanks for joining us on the survivors remember no matter how tough
things feel you are enough and the world needs you just the way you are you're not alone in this
journey there's a community here and every step forward counts we're so grateful you took the
time to listen and we hope they'll take one day at a time just know there's always more right ahead
(30:05):
thanks for being here friends just remember help is out there in so many different places
so if you or someone you know is struggling please call 988 and a trained crisis counselor like me
will be there to help you can also find an inclusive and comprehensive directory of mental health
resources tools and content at the help hub dot CEO just remember that help is always just a call
(30:29):
or a click away. We'll catch you next week. In the meantime, keep surviving.
[MUSIC]
(00:05):
The Survivors is brought to you by our friends at CalMory.
This podcast mentions suicide, mental illness,
grief and loss, and maybe triggering for some listeners.
So please take care of your well-being by
pausing or skipping any sections that feel uncomfortable to you.
And if you or someone you know is struggling,
please call 988 for support.
>> Welcome back to another episode of The Survivors.
(00:28):
And we are once again very excited to share some time in space with our friend,
Jenine Ellenberg.
She is a seasoned physician entrepreneur,
health executive with over 20 years of experience in digital health,
clinical practice and leadership.
She is the co-founder of Behavidence,
the digital phenotyping company for mental health conditions,
and the chief medical officer of our sponsor,
(00:51):
transforming mental health care through innovation,
expanding our services through strategic partnerships and
introducing it's also responsible for world-class virtual therapy,
training programs and improving therapist-client matching to ensure
personalized care for every individual.
And we are absolutely thrilled to have her back with us on
the Survivors to continue our just beautiful conversation from last week.
(01:13):
I feel like we got so much into that 30-minute conversation.
And we just really want to pick up in some ways where we left off.
So, Jenine, welcome back.
We're so glad to have you.
Good morning and thank you so much.
I was very excited for today because I got to have this conversation
with the two of you again.
So, thank you for including me in this.
(01:33):
So, we talked about a bunch of different topics in the green room
before we started recording.
And we really landed on a conversation about just how lacking our country is
in terms of support for people with mental illness.
And you had such profound insights on why that is and what we need to do to compensate for that.
(01:58):
So, I feel like we should just kind of keep rolling with what you were talking about a few minutes ago
and just dive right back into that same space.
I can definitely just jump over to exactly what I started with if you'd like me to.
Okay, so I recently attended a conference and had the privilege of listening to a talk by Dr. Thomas Insel.
(02:19):
He used to be the former head of the NIH during the Reagan and Obama era's and spent a lot of
time researching the causes of mental illness.
And during his talk he spoke and he's written a book called Healing Our Parts from Mental
Illness to Mental Health.
But what stood out to me was his experience when he was giving a lecture about the science of why
(02:43):
people have schizophrenia or depression or anxiety and all that the phenomenal progress in research
about these things.
And a father stood up in the audience and said, you know, with all your respect,
you know, my son has schizophrenia.
He tried to commit suicide three times and our house is on fire.
And really all you're talking about is the chemistry of the paint.
It doesn't help us.
(03:04):
And he then actually went on a new journey and sort of went to California and started really
exploring the homeless situation there and came back and said, you know, really it's not just about
the treatment.
It really is about the support, the care, the community around that person.
And I think that is something that we lack in this country to be very honest with you.
(03:25):
People will go, they'll have a suicide attempt, they'll get to the ER, get the maids.
And then they are discharged and where do they go?
If they do not have that support, where do they go?
And Tom and cell or whoever it is speaks about the three Ps and I probably got the wrong person.
But anyway, the three Ps, people, place and purpose.
So if you don't have a place to go, what do you do?
(03:48):
If you don't have people, caregivers, communities, support you, what do you do?
And if you don't have a purpose, you need hope.
You need their reason to get up and go out and do something.
And I think that we have a long way to go in this country for support in that aspect.
Yeah, we do. You're right. And it's interesting because I had this conversation with my therapist
(04:08):
not too long ago in terms of what happens when someone has been hospitalized for depression,
a breakdown, mental illness in general.
I'm just going to say as a disclaimer that there are fire alarms going off in our condo building right now.
I'm very safe. There's these are just a test.
So if you hear that, please don't be alarmed because I'm fine.
(04:29):
So the interesting thing is that when someone goes in for treatment, they come out and they are
at their most vulnerable. You know, they come in and whether it's a three day hold or whether it's,
you know, a 30 day hold, whatever the case might be, the irony is when they're released,
(04:50):
that's when they're at the highest risk for taking their life or for having another relapse of
some kind. And what you're saying is so profound about, you know, it's that it's that after care
in terms of someone reintegrating and and dealing with their mental illness and and having that kind
of support. And I think that it just becomes such an overlooked issue. We think of it in terms of
(05:14):
like, okay, someone goes in for, you know, some kind of an operation, you know, a long transplant or
surgery of some type. And they have the whole protocol is all set. They have their follow-up
appointments and they have all of their their physical therapy appointments. Right, right, right. And
they're after care. And there's nothing that's considered when you have mental illness on the same
(05:37):
left. And they can't be released from the hospital until somebody picks them up from the wheelchair
to drive them home and they say, do you have someone to care for you at home and bring you soup
because you can't walk or whatever the story is. And yes, that is what it's lacking. When I did my,
when I had my suicide attempt and I was talking to 98, they asked me if somebody was home. And
thankfully my wife was home, but I can't imagine having to made that call and been where I was and not
(06:03):
having a support system around me. You know, we have that problem here in upstate New York, you know,
there's a lot of homeless up here. I live right in between two college towns and a lot of time these
kids don't have anybody close by if they have their dorms, they have their roommates, but their
families are so far away. And I think the schools do a little bit better job. At least I hope with
(06:27):
suicide awareness and things like that. But we also have a homeless community up here. Whenever I look
at somebody who's homeless, like currently homeless, a lot of these people are mentally ill. And to Jean,
Jean's point, we don't have the care for them. We don't have the care for the vets. We don't have the
care for the homeless. Like when it comes to mental health, we don't have enough resources out.
(06:50):
We don't. And to go to to your point, those people don't have a place. They don't have a person and
they don't have a purpose. And for me, it's really a watch people. Filly has a big homeless problem as
well. And I watch people, they walk, they take a wide berth around the person who's homeless. And I,
you know, I look at them, you can see their thoughts. One is, oh, they want to acknowledge it. I don't,
(07:12):
this is bad. I don't want to be near it. But I often think in the back of their minds is the fear.
Could this happen to me one day? Because there isn't the social support system in this country.
You know, it's hard if you don't have health insurance. It's hard if you don't have a job. Unlike those
socialistic countries up all the Europe and Australia, you know, there is a bit of support. You don't
(07:33):
have to care. It's a terrifying position to be in. And mental health care is expensive. A lot of
psychiatrists don't take insurance. A lot of psychologists don't take insurance. So unless you have
money, you don't get the help. Even if you have kids or family members to try and support them through
that and find the right key. And I tell you something, finding the right psychiatrist or psychologist
(07:55):
is, is can be a hit in this job. Get care. Look, gee, look at you. We've had this conversation before
when you shared your story on an episode earlier in the season. You talked about how you had to
speed date your therapist because it's not often a good match right away. And that's that's hard. That's
time consuming. It's, you know, it's emotionally draining to go through kind of all of those
(08:18):
motions and go through the stories and your history and only to have to shift over to someone else.
That's a lot. Especially when you're vulnerable. Yeah. Yeah. Yeah. The first couple of days were
really hard because I had gotten the therapist. She wasn't really my cup of tea but I knew I needed
somebody right then and there. And then the next therapist I did like two weeks later still not a
(08:42):
good fit but still needed somebody to talk to. And then finally by the third one, I found the one
that really clicked. And you know, for me, I'm paying for therapy out of pocket because my insurance
doesn't cover the type of therapy that I'm going through. And I think that with like even the telehealth
platforms need to take in into accommodation that people don't have a lot of money. They need to do it
(09:06):
at a sliding scale. I understand that we all need to make money but there are millions of people
out there suffering because they can't afford mental health. Which in your so right and is such a
problem because even with the tele therapy platforms, they still have to pay the therapists. The
therapists need to live. If you look at the salaries in this country of insurance compensated
(09:29):
and reimbursed therapists, it's not a lot. And it's a lot of work. You know, it's putting a lot of your
emotional energy into therapy. So it's a double its sword in a way. I must say I do think tele therapy
does offer a great platform for accessible, affordable kick now. So if you need something because
(09:50):
as we spoke about last time, you could wait three months to see a therapist, you know, depending on
where you live and the availability of therapists. So you could be having this crisis and you know,
want to do anything. You just want someone to talk to to get that is hard. But tele therapy, I think,
like platforms like Conry, definitely do offer that. You can click a button and say, right, I need
someone in the next 72 hours sort of filtered by what you do and don't like. So that matching does
(10:14):
sort of help the speed dating process a little bit easier and then and find someone to speak to.
It's it's it's that accessibility, I think, that makes tele therapy so much more attractive now
than it ever used to be. Almost definitely. And of course, there are so many different options,
so many different platforms that all have their kind of unique spin on providing therapy and and
(10:35):
connecting with therapists and the way that their platforms are structured. And I think at the end of
the day, if you were to go out of pocket to a traditional therapist, kind of a brick and mortar
therapist, you could be paying hundreds of dollars to get in the door if you're not insured, which
so many of us are not insured. And on the other side, when you do go to, you know, a tele therapist,
(10:57):
not only are you given the advantage of having so many different options and you can do it from home
and it's private and it's secure, but you're also paying a fraction. You may be paying a quarter or
a third of the cost of what you would pay a traditional therapist. So there are so many advantages,
but it feels like like I'm listening to this conversation and it feels like to me, what might be
(11:20):
beneficial to people who are listening might be like, we've established that the point of this
conversation is that we are lacking in that mental health care piece of our society exactly, exactly.
So, okay, we've talked, we've identified, we've identified tele therapy as a thing that people
can source. So maybe it makes sense to have the conversation of, okay, what are the other things?
(11:43):
What if you're somebody who is struggling with your mental health? You know someone who's
struggling with your their mental health? What's out there? What's available for people to support them
in those ways? And like beyond tele therapy, let's talk purpose, let's talk, you know, involvement,
community involvement, things like that, mindfulness, the other options that are out there.
(12:06):
So I was just going to say here in upstate New York, I live in a very small farming committee,
very small county in upstate New York, but it's full of college kids. They do have mental health
resources that are free, but I'm going to use this disclaimer just because of what's currently going
on within the administration that some of these resources are pulling back. But if you are struggling,
(12:29):
you can definitely go to mental health centers like family care. You can certainly go to those people
and they will find you somebody to help you. Even if you're homeless, they're going to be able to
find you somebody to talk to. But you know, the other part of that too is let's just all be a
have a little bit more empathy for what people are going through and like offer whatever help you
(12:50):
can. So that's that's my two cents. And I'm going to go back to I think families become the
involuntary mental illness experts in a way. And I think more support needs to be given to families
because then they could actually play a better role in a way because if you don't, I think you've
got two sort of groups yet. If you if you as a family are overwhelmed by your family members'
(13:14):
mental illness, you can step back and just say, oh well, there's nothing we can do. Let them
be. Let them go. We've tried our best. But a lot of people really learn to understand like the
the dear man has said his house that you know, you don't want to know what the chemistry of the paint,
his house is on fire. He was very well aware of what was going on with his son. So I think
they're the experts and we should lean into that as a society. We should support the families because
(13:39):
if the families get the support, the people in the place is already taken care of. Those are two
of the three piece that we've picked the box to. And but I think often for families, it's a lot.
It's it's it's overwhelming and it takes so much time and it takes so much resources. So I think
the families need the support as well. Absolutely. I mean, I think in terms of families who I know
(14:02):
who deal with family members with mental illness, it can be so all-consuming where they flow or the
vibe of the family or the structure of the family is dictated by the person who is experiencing
the mental illness or the struggle. And then everyone else in the family is really just kind of
running around with their, you know, hands open trying to catch the person before they fall. And so
(14:26):
everything else gets ignored. And the family dynamic as a whole is completely turned upside down.
And it's a really hard environment to function in because so many things can come up from a situation
like that. Like resentment can come up from things like that. It can be very difficult to manage
your day-to-day responsibilities. Most families have at least one or two family members who are working,
(14:49):
who are providing financially, who are caregiving, who maybe in some cases are raising children. So
so there's so much more involved in the day-to-day family unit, but it's all consumed often when
that family unit has someone who is in such desperate need of support that it takes over everything.
And that's difficult. You're right. I mean, families really need to have support because they're
(15:10):
at the end of the day. They're on the front lines. They're the ones who are dealing with it the most.
And I can say just for my own personal experience, you know, when when I finally was able to open up to
my wife about what was going on on that day, she's like, why didn't you come to me sooner with her?
For me, I didn't know how to tell her because I didn't understand what was going on with me.
(15:31):
And then the more probing questions, the more probing questions, and I couldn't answer her. And so I
wish there were more resources for like for my example. Why couldn't I find my voice? Why couldn't I
find my footing? Why didn't I open up to her? And for me, my answer was I didn't know how to because
I didn't understand what was going on in my own body. Take a step to your mental well-being with
(15:54):
CalMary. Trust it online therapy platform that supports you through life's challenges,
connect with licensed therapists and reap the benefits of traditional therapy enhanced with
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I think that really speaks to the importance of just good communication. Whether you're dealing with
someone who's unwell or not, it's just general foundational block of a family unit should be
(16:21):
having those open conversations sitting down like I know we always talked with our girls as early on
as we could in an age appropriate way each time as they got older just to really ensure that they
felt like they could come and talk to us if things were not okay. I mean the obvious things like
talking about sex or talking about drinking or talking about peers or you know all of those things
(16:42):
as well. But I think we also have to be having the conversations about the mental health piece too
and integrate that. If we want things like mental health and wellness and mental illness to become
mainstream then we need to start integrating those conversations into our day to day so that
people are used to hearing it so that people don't feel put off or unprepared to have a conversation.
(17:04):
But I think Lisa you're so right there but it also depends on the family structure. I mean some
families don't theme these topics to be discussable. You know some families have different sort of
it might be a religious thing it might be I don't know whatever it is they're just not that open.
And then you have the single parent family and I think this is where the village I would say
(17:25):
takes a village to raise a child. I've come into play because and I think here like we're transparent
you know we came from South Africa so I don't have my sisters and my brothers and the aunts and
the uncles and the cousins here who often pick up things when the parents don't see things or even
you know my sister might notice something about me that my husband may not. Or if I'm alone at least
(17:47):
you know you have cousins who you might pop into who check in on you that village I think is so
incredibly important in managing mental illness because you need more than one person. It takes one
person to help initially but you need more than one person you need a little village to rally around
you when you need to bring you the soup when your leg is broken or to you know offer to walk the
(18:09):
dog when you're too tired. Those little things are so important because that is where you feel like
you belong. Yeah in a slightly different context I understand that I'm all I'm thinking about as
my own childhood and the way that he was raised by a single mother I mean I lost my father he took his
life when I was 10 years old I didn't know that he had taken his life my mother did so my mother not
(18:31):
only had to keep that secret chose to keep that secret of his suicide from me to save me from that
pain but she was also dealing with the loss of her husband and dealing with raising a child and
dealing with everything that all of a sudden now was on her plate which was the entirety of our
life and I think about that I of course couldn't see it for what it was then because I was a 10-year-old
(18:54):
kid and I just didn't have that perspective but as I've grown up as I've as I've formed my own family
and and understood what it takes to be a mother be a wife to to be all of the things that all of us
have to be every day I'm astounded and dumbfounded at the same time that my mother did what she did
but she did it because she like what you said she had community you know my grandmother came and
(19:17):
lived with us and our house was always full we we always had some part of our larger family unit
there and I don't know if my mother would have been able to just manage the day to day were it not
for that extra support you could understand mentally illness creeping in day if you're on your own
and dealing with that yeah and in the healthiest individual that's a lot to to manage yeah and at
(19:41):
that time I mean we're we're talking about the 1970s and 1980s people were not regularly visiting
with their with their therapist not not in the mainstream type of way that it is now my mother would
always laugh about it after the fact but whenever I would get frustrating or a situation would become
frustrating my mother would get in the car and she we had a loop we lived with a let me you know
(20:03):
in a circular neighborhood so she would get in the car and drive loops around the neighborhood
and just talk it out to herself she would just have a conversation with herself and that's how she
worked her way through whatever the issue or the problem was and then there were also the days
when my mother would be the first to say this that when I was really getting under her skin she would
get in the car and she would scream her way all the way around the block just to kind of you know
(20:27):
avoid doing that to me but I just I think about how remarkable it was in my mother's case that she
maintained a balance in spite of all of those things and I think about the fact that she had
people in her life and she had a community and she went back to college late in life and so she had
those those purpose her exactly exactly I mean that she did that six months after my father
(20:49):
good for her as a way at the age of 40 years old decided to go back and get her college degree that
took her five years and she did it and she did it she just excelled in every way and and I think about
we we talk about that all the time how not only was that just such a highlight of her life but it saved
her life in so many ways to be able to do something that was just for her in that way I think I think
(21:10):
maybe it makes sense to to dig a little deeper into the what what can we do part of this conversation
what can people do like let's let's put therapy aside and talk about kind of the the purpose and
community and you know positive self-talk what can people do like when they stop listening to this
podcast today if they're feeling overwhelmed if they feel like they need some kind of support
(21:34):
additional support what do they do where do they go do they do they turn to mindfulness apps
it's on the person I think and where they're at you know some people on such a dark space they
cannot do anything they're almost paralyzed like Gritun was saying she couldn't communicate
she didn't know what to say she didn't know how so it's something just had they just it's so dark it's
(21:56):
so they so deep underground that they don't know how to put their hand up and I think that in that
case somebody needs to reach out but somebody who is feeling overwhelmed who's feeling really like
they are not coping right now reach out reach out to anybody and for anybody who's listening to this
podcast if someone reaches out take their hand and just walk with them you don't have to tell them
(22:20):
what to do you don't have to solve the problem just be there and know that they have someone that
they can actually turn to if they win when they're ready to when they want to speak be there support
don't judge those are two very very powerful pieces of information and I would add one thing that
(22:40):
GM sure you're getting ready to add this to about 988 calling the lifeline like we talk about
okay there are people who have insurance and they have access to therapy and then there are other
people who may not have the insurance piece but they have the means to do tele therapy and they have
a community but okay who about how about the people who don't have any of that where did they go what
(23:02):
did they do they always have a resource there is always someone on the other end of the 988
crisis lifeline and it can't say this enough especially speaking as a counselor who often takes calls
from people who say should I even really be calling and using this lifeline I'm really not sure because
I'm not suicidal and I stop them right there and I say are you feeling like you're struggling don't
(23:25):
even need to tell me right in this moment what it is that you're struggling with but are you struggling
and the answer is yes it's all relative it doesn't matter what you're struggling with because if
that's enough to affect your mental health and wellness then that's enough to pick up the phone
into call counselor and any of us on these lifelines are here to listen 24 hours a day every day of the
(23:46):
week to whatever it is that's compromising your mental health and wellness so I think that as we
identify in this conversation what those pieces are like go go seek some purpose in your life go find
community go explore therapy keep things like the 988 lifeline on the top of your brain and make
(24:08):
those phone calls when you need that help so my question to both of you is like what do we do for the
homeless community that doesn't sometimes don't have phones right are there people that can actually
go out to those encampments and talk to these people because a good portion of the homeless are
mentally ill but they don't have the resources they don't have somebody to talk to and it's just an
(24:32):
endless cycle right so yes they won't end up going to the hospital go into emergency getting kicked
back out into the world and nobody to talk to so as a community what can we do to help those
population because for the population like you and I and Jeanine we all have resources right we have
(24:52):
so full we get friends they have a roof over our head but I feel bad for the homeless and for those
people that really don't have the resources that we have so I'm trying to think of how we can use
our platform to so that people can understand what's going on yeah I think that's a hard question
and I and I think it's such an important population to focus on in this conversation I think that
(25:19):
it just speaks to how much more we need to build into our infrastructure the fact that unfortunately
it's not designed right now to support such a vulnerable population but we do have homeless
shelters there every city has a community of homeless shelters where people can go and can receive the
basics to to sustain them and to get a roof over their head and food and their stomachs and whatnot
(25:44):
it's it's a really hard problem to solve I wish I had the ready made answer it's interesting because
I um I was in San Francisco to conference recently and the city was clean I was there previously when
I dropped my son of a college and it was overrun with homeless people it was so sad the next time
I like the scheme because they moved to homeless people because there was a big delegate from some
way from foreign country came to visit so they housed him temporarily so they there is a post they
(26:08):
can do it the states can do it the infrastructure needs we need to push for that to happen because yes
a homeless person go get food tonight and if the shelters are not full they may have a bed but if
the shelters are full they don't they sleep in the station or wherever they can find some place warm
because it's very cold in most of the cities in the US and the North so they need warmth and then
(26:30):
but when they get out the next day where do they go they don't have a purpose and they have mental
illness which needs to get treated and they don't get that in the shelter so I think that it needs
to become a federal mandate that we take care of the people and the second thing is I think more
of us need to volunteer because if we all help they're more hands they're more with it's more support
(26:54):
and I think that it will do us all the world of good to to understand that again this could be
happen to anybody it's a problem that if you don't have a job and you have not say what do you do
it's very easy to land on the streets so let's let's all help yeah I think as a way to to wrap up
this beautiful conversation just I think it's worth making reiterating the point that we all need
(27:19):
to be not only taking care of ourselves the whole oxygen mask put that on you first to ensure that
you're capable of helping yourself and helping others but we just need to be paying better attention
to people we need to I mean G say it all the time we need to show more compassion to ourselves
and also to the people around us and it's once we start doing that once we really start checking
(27:44):
in on each other regularly then I think things will start to shift things will start to change and
you'll see see you know a lot more people feeling supported and feeling capable of reaching out for
support and understanding that mental illness is not a life sentence people can recover it's like
having you know heart disease or having diabetes for example if you leave it untreated it has a lot
(28:08):
of negative complications and side effects but if you're able to address it and treat it and
management and again something like diabetes is not just about medication you know it's about
the right food and the right lifestyle and the right support well mental illness is the same
you need to have the right very good thing you need the right support around it as well and 100
(28:28):
percent you can recover so why do we let it become this epidemic when we know that that
key part of of hospitality not hospitalization as Tom I'm quoting again is part of the theory is
let's to trace that part of the cure and make sure that people have access to it absolutely and
let's start here let's start today let's start now and anyone listening we hope that you'll you'll
(28:52):
do the same we hope that you'll you'll move through your your day and and have a little bit more
intention in the way that you look after the people around you yeah I'd love this conversation this
was so awesome thank you Janine you are just so lovely you know I actually get more out of this
than anybody because every time we speak I realize how deep this problem is and that people have
(29:19):
governments people psychiatrists ecologists states have been trying to solve this for so long but
we're just not getting it right so it actually fires me up to do more good and it fires me up too
and I know here's you she look at her I'm all fired up today she's all fired up um Janine will you
will you come back someday soon yes we'd love to chat again wonderful thank you so much for
(29:41):
just your wisdom and your insight and just for spending a little bit of time we appreciate you
I appreciate you too thank you thanks for joining us on the survivors remember no matter how tough
things feel you are enough and the world needs you just the way you are you're not alone in this
journey there's a community here and every step forward counts we're so grateful you took the
time to listen and we hope they'll take one day at a time just know there's always more right ahead
(30:05):
thanks for being here friends just remember help is out there in so many different places
so if you or someone you know is struggling please call 988 and a trained crisis counselor like me
will be there to help you can also find an inclusive and comprehensive directory of mental health
resources tools and content at the help hub dot CEO just remember that help is always just a call
(30:29):
or a click away. We'll catch you next week. In the meantime, keep surviving.
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