For the second installment of our mental health series, Stan, Clarence, and Dr. Mike Trangle explore mental health through different population and age groups. Join the conversation at healthchatterpodcast.comBrought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships. More about their work can be found at http://huemanpartnership.org/
Hello, everybody. Welcome to Health Chatter and today's second show of a trifecta with our great guest, Mike Trangle, who will be addressing mental health more from a clinical component and also the effects on certain populations. Mike has, you know, wealth and knowledge behind this. So we'll get to that in a minute. We have a great crew that keeps our show hopping all the time.
And that includes Maddie Levine-Wolf, Aaron Collins, and Deandra Howard, who do our great background research for us. Matthew Campbell is our production manager. Sheridan Nygaard also helps with research, but also with our marketing. And then, of course, there's I couldn't do this at all without my great colleague, Clarence Jones.
We had a great lunch just last week and it was really, it's always special to get together face to face, but we do talk and we do chat and we have done that well these years. So thanks Clarence to your great, great expertise. So today, mental health clinical by population and age, we got Dr. Mike Trango with us once again,
He served as a health partner, senior medical director for behavioral health, president of the Minnesota Psychiatric Society. He's a lifetime fellow of the American Psychiatric Association. He's a member of the National Quality Forum on Standards for Behavioral Health.
serves as a clinical assistant professor of psychiatry at the University of Minnesota School and Department of Psychiatry, and also works on Governor Walz's in the state of Minnesota advisory panel for mental health. So he comes with a wealth of knowledge.
I did my term there and I'm no longer on that.
Well, you're no longer, but we'll still claim that you were.
Well, I was. I was the chair.
Yeah, yeah, right. So thank you. Thank you. Thank you for being with us. Mike's been a longtime friend, know each other for years and has some great insights into the mental health arena. So today we're really going to get a little bit more into the clinical aspects of mental health. And, you know, it's interesting.
Years ago, I was a psychiatric technician at Fairview on Riverside Avenue as when I was going to school. And it's really interesting that the types of patients that we saw and like paranoid schizophrenics. We saw paranoia in general. We saw what was called behavior problems. socialization problems, anxiety, depression. And this was just, you know, we were dealing with adolescents.
some of these kids had severe mental health issues. And well these years, it has stuck with me how any of us can be affected so dramatically by mental health issues. So let's get the show going here by saying, all right, can you give us kind of Mike, the gestalt of all the clinical aspects or the clinical diagnoses of mental health that certainly you've seen in your career?
Let me back you up a step. Sure. People talk about mental health. Some people talk about behavioral health.
Correct. And if we go back a step, if you start with behavioral health, it's a bit broader. And the two subcategories that are generally thought of as part of it are mental health disorders and or substance use disorders.
I think there's so much overlap between the two that it's a little bit arbitrary to say, let's just talk about one and not the other, as they sort of interact between and influence each other. And sometimes they're comorbid, sometimes one causes another, et cetera, and so forth.
I think that was why I was going to start off my questioning by asking this question, because I thought what you just said speaks so well to it, is that according to the research that we have, that there are more than 200 types of mental health disorders. And I think that most people, when they think about mental health, they only think about maybe one or two. What are your comments about that?
I mean, you're speaking to the fact that there are a lot that we don't even think about.
Right. And to some extent, I'm going to go back to my major as an undergrad, which was philosophy. And how do you when do you say it's a discrete, separate entity? And when is it sort of one thing merges into another? To some extent, the guiding light is folks in the American Psychiatric Association who come up with the definitions in something called the DSM. Now it's five text revised.
But research is being done to sort of say, does this sort out separately than that? Is one at later stage of it? or just sort of a subtype. And you actually can do studies, both genetic studies, epidemiological studies, to sort of figure out what is the latest that we've learned and we're constantly learning. So it's not like somehow the world,
came about, whether you're religious, you can say one way, if you believe in evolution, a different way, but somehow that it's fixed that way. My point is things continue to evolve both in our bodies and in the world around us. And our understanding of that continues to evolve as we learn more. So don't view it as like, here are the 10 commandments and they're never going to change, you know?
So is it true that, that it just seems to me that today we hear more about anxiety and depression more than maybe some of the other clinical manifestations of mental health that I heard about for sure over the years. Is that a fair statement?
Yes. And you're hearing about it more now because during COVID and the pandemic and the shutdown and the impact on schools and people being home and not just that, but the rise of the internet and how that impacts people, the prevalence of those have increased. You know, so traditionally, I would say before, several years ago, if you say, what's the basic 12-month prevalence of depression?
You know, most people would say it was about 7%. And it tends to be higher in people that are younger, like 18 to 24 years of age, like three times higher in that range.
A little bit higher in females and males.
you know, about twice as high, and it's increased lately, just as anxiety has increased. You know, if you look at the statistics of anxiety, in the U.S., some of the studies before the very most recent ones show that a little less than 3% of adults had anxiety problems, generalized anxiety. In the world, it was sort of listed as about 1.3%.
prevalence in the world, but how much of that is affected by cultural norms and whether you, in certain cultures, you don't have good words to describe it, or there are taboos against acknowledging it that, you know, which is probably true everywhere, but it could be greater in some civilizations and some societies than others.
So the thought is that there's less reporting and less acknowledgement of it in some other third world countries kinds of things.
Um, so let me, you know, it seems like there's like these components, um, let's talk about, um, your, your experience with, um, mental health hospitalizations or mental health therapy or, and, or mental health, um, uh, medication. Okay. Um, Can you kind of talk about those three a little bit? Are we seeing more people, for instance, being hospitalized today than we did yesterday?
Are we seeing more people today being in therapy per se than we did yesterday? Put it in kind of a perspective for us a little bit.
There are rate limiting steps for all three of those, you know?
Yeah. So first of all, if somebody has a problem that comes up, you got to sort of figure out what's going on with me, you know? And I would say because of the stigma and lack of knowledge, and if you go back a ways, more often than not, people might have a mental health disorder, but not be aware of it.
not recognize the symptoms, the cluster of symptoms that sort of lead one to think maybe this is more depression, or maybe this is more anxiety, or maybe it's not generalized anxiety, it's a panic attack. So you have to recognize it, you have to get diagnosed, and then you have to have treatment available and accessible. All of which, for mental health issues in the U.S. or in other countries,
have been sort of problematic. I think in the last 30 years, 20 to 30 years, there's been enough education and public service announcements and stuff so that the stigma about acknowledging to yourself or to others, maybe they have a problem that's a mental health problem is a bit less than it used to be. So there's probably a more likelihood someone would say, yes, I have it.
At the same time, traditionally, there was a lot of discrimination against uh paying for and treating it you know so example just take in the us um if you had a physical problem and you were old and had medicare or experience depending on uh how sensitive you are to the word old experience and have medicare um
Medicare paid 50% of the cost for physical things and only, I'm sorry, 80% of the cost for physical medical problems and 50% for psych problems, behavioral health, mental health problems. Now, maybe about 10 years ago when parity came up, that got rectified, or 15 years ago, I don't remember the exact time. So there's already sort of a barrier to accessing it.
As a patient, you would have to pay more. And that's been true up until just very recently, you know, and maybe 10, 13 years ago, the U.S. passed the first Wellstone Parity Law, but it was never enforced. In fact, there were rules about how to even enforce it and what it meant, how it was defined for years, for a number of years after it was passed by Congress.
And even then, they then passed rules, but it was ignored and not enforced. And even until like a year and a half ago, there was a study done by a joint study by HHS, federal level, labor. And there was a third department there, which I can't remember what it was. Labor, health and human services, and another department, commerce maybe. And they saw that health plans were enforcing it.
Nobody was making them enforce it. So there was another more recent version passed. There was one in Minnesota that passed. It also wasn't enforced. There was another one passed. It's starting to get enforced a little bit, but it's way lagging.
And that's true for outpatient resources, whether it's for a therapist or to see a psychiatrist to get evaluated and do medications, or whether it's to get into a hospital. These days, there was a study that just came out in Minnesota about what percentage of patients that are showing up in emergency rooms can't get access to needed treatment.
And there was a law passed called EMTALA that started out because of women in labor getting turned away if they didn't have insurance. And it obligates hospitals that have emergency rooms to evaluate and treat and stabilize patients that show up in their ERs.
So it's interesting, you know, one of our last shows, actually, I think it was after our first show with you, we had Dr. Jeff Louie, who is an emergency room physician. And we talked at length about. You know, kids, because he's a pediatric ER specialist, kids showing up in ERs with mental health issues and they're just dropped off there and left there.
And then the ERs become holding tanks for these kids that have mental health issues and they have nowhere to put them. And so there's policy implications for this, and it's being addressed at the state legislature as we speak. Clarence, you got a question?
Yeah. Dr. I, you know, as you were talking about some cultural things, one of the One of the conversations that's happened a lot in my community is this issue around trauma and intergenerational trauma and cultural trauma. Is that something that... What are your thoughts? I mean, because I think a lot of people are using trauma as a catch-all for everything that's happening.
Is that something that you think is occurring as a result of the shutdown? Or is it just that people have decided, as you said, to just group everything as one thing?
I mean, I think trauma has always existed as long as there have been people, and people that have been mistreated, neglected, and treated poorly. Whether it's you're a child in a classroom and you get ignored, but other people get called on because of your skin color, or because you have ADHD and you're annoying to the teacher.
Or, you know, you get pulled over for a taillight and then awful things happen when the police check you out. I mean, or there have been wars and fights and people get traumatized by that. Or there is abuse, physical or sexual abuse. There's always been trauma, I think, throughout civilization. I think... It's sort of probably a little bit more of a more recent thing that people say that's awful.
It's not OK. We have to try and stop it and we have to try and sort of help nurture and heal the people that have been victimized by it. But I'm not sure that's what you're asking.
You know what? I'm trying to figure out what I'm asking. And the reason why I'm saying that is. is because whenever I am in the community and I'm talking to people about always having these kinds of conversations like this, that word always comes up. I mean, it's kind of like a catch-all for many, many things. I'm not saying for everything.
but for many things in a way and why people are behaving in a way that they do, why people are responding to certain things. And so I'm just, we talk about mental health by populations. I'm just saying that this is a more common word now in my community than I've ever heard before.
Sure. So it's one being recognized. in your community and broader communities. And I think you're also saying that not only is it being recognized, but it's sort of like being normed that it's totally not okay, and we gotta prevent it, then we gotta do something about it. I think that's what you're saying, right?
Yeah, but the question is, what are we going to do about it? I mean, it seems like the conversation keeps coming up, well, we're traumatized, and so what are the ways in which to address this? It's really kind of, when we talk about these kinds of topics, people don't know how to articulate, is it a mental health issue? You know what I'm saying? So we're in that area of...
Let me help you with this. I think what you're saying is there are different sequelae caused by trauma. The classic one that gets talked about is post-traumatic stress disorder, PTSD. You've heard of it? Yes, I have. If we're talking about what are the criteria of that, one, you have to be at least six years of age or older and you've got to be exposed with actual or threatened death
serious injury, sexual violence in one of a number of different ways that the threat could be. You could be directly experiencing it or a series of those kinds of events yourself. You could be witnessing it in person as it occurs to other.
You can learn about it that a close family, a relative or a close family friend has been threatened or maimed or whatever it is by violence, whether it's accidental or whether it's intentional. There are even studies that if you're a police or fire responder that are exposed to it repeatedly, you can get post-traumatic stress disorder. But you said age six. Tell me more about that.
That's the youngest. If you're younger than six, by definition, you might be traumatized, but somehow it's not clear that it really causes PTSD. You know, like I said, we're always sort of learning more, and I don't think it's been studied in the youngest group that much to know for sure, you know?
Okay.
So what happens is, so you get exposed to it, and then you have recurrent things that are not kind of like memories of the traumatic thing and reactions to it that you can't control. And you have distressing dreams. You might dissociate. You might have flashbacks.
um and for a brief moment you feel like you're back there again if it's a flashback and you're totally in the moment re-experiencing the terror and the hopelessness and the powerlessness that are typically associated with it you know and um You even have things that remind you of when you were traumatized and abused or whatever it was. You try to avoid it. You can't stop thinking about it.
And it continues to sort of torture you psychologically. And you have like adrenaline surges and anxiety. You know, it affects how you think. You become vigilant. You become insecure, kind of scared. And, you know, you build up sort of like exaggerated responses, both physiologically and psychologically at exposure or things that would remind you about it.
You know, sometimes you personalize it and blame yourself, even though it wasn't your fault.
You know, it's funny you're saying all these things because, you know, I'm not asking to be analyzed here, okay?
Okay.
I just want to have this conversation, all right? But I remember things that happened to me before I was six, you know, that traumatized me. I mean, you know, I remember my fear of heights becoming very, when I was real young, I remember specifically, when I became very, very afraid of heights.
I remember very specifically when people, some of my relatives were playing with me about, and they stepped a pillow over my head and I remember not being able to breathe. And so it's been very, very, whenever I can't breathe, I freak out.
So I'm saying those kinds of things because I think that what you're saying is very helpful in the sense that we have these experiences that causes us to respond a certain kind of way. And other people might look at it and say, well, that's not okay, but it is our experience.
So let me, there's a couple of things I want to, you know, kind of touch on a little bit historically, then also where we are today. Like I remember, and you know, perhaps you do too, Mike, where shock therapy. was used. So comment on that.
I don't even know if it's, if it's, if it's being done anymore, frankly, if you're talking about like for depression or other kinds of things in a hospital or in an outpatient setting, it is still being used and it's still being more effective things that for people that have sort of intractable non-responsive depression.
Okay.
All right. Um, but, and even before that, when it was more barbaric, they, they gave, uh, you do insulin. So people would get into kind of have a, have a little seizure insulin. Wow. Because diabetic kind of like another seizure kind of thing. Yeah.
Yeah.
Um, but, but, um, Clarence, you were saying something that I neglected to mention, but typically if you have a post-traumatic stress disorder, whatever you experienced takes on a life of its own and you almost like continue to re-experience it as you go through your life and in following months and years, you know, and yeah.
You know it's like your thoughts and your beliefs and your reactions to things that remind you of it became strong become stronger. kind of persistent it distorts how you think about things and how you feel about things and you might like just lose your interest in doing things your normal enthusiasm. your normal ability to sort of just be calm and serene.
You might get detached and estranged from other people. And sometimes if it's a really bad case, you sort of like lose your ability to experience positive emotions, you know, happiness, satisfaction, loving feelings.
and your arousal almost becomes super sensitive you get exposed to it and you're gonna and over time you react stronger and to less uh stimulation that reminds you of it it like grows if that makes sense it does and i think you've been doing that because that's part that's part of the reason for the conversation is that i know that there are
We started talking about age six. We started talking about the post-traumatic stress. And I think it's just important to have this kind of conversation so people can understand that it's not necessarily sometimes what they think it is. Oftentimes it isn't, yeah.
Or at least people come up with idiosyncratic but scary and upsetting ways to explain it to themselves. And sometimes they sort of if it's a chronic or repeated exposure, it's not at all unusual for people to dissociate and feel like I'm numb, I'm not really there, or to feel like it wasn't me. I'm so detached, I have no reaction to it, you know?
Or I feel like it's just not real, that it's just a dream I'm having, you know? powerless and trapped in a situation that's just awful. Okay. Thank you.
So let me give you a couple of things here. And I want you to react to a panic attack. So I can, I can, I'll relate one specific. I had a panic attack when I had a detached retina in my eye. Okay. And to the point where I felt as though I couldn't breathe. Okay. It was that bad. So I bring that up as it relates to mental health, acute conditions and more chronic conditions.
Like fortunately in the case where I had, it was acute. Okay. So it happened and I got over it and Fortunately, but is there what you would consider to be categorized as acute conditions and then more chronic conditions in mental health?
Yes. Yes. That's definitely true. Let's describe it. Let's just clarify what a panic attack typically is.
Yeah.
If someone's having a panic attack. Yeah. it's an abrupt onset, usually within just seconds, but certainly it tends to reach its peak within just a few minutes. And during that period, so it's an abrupt onset and you have your heart speeds up, you have palpitations, it's pounding, you might sweat, you might shake. If you're hyperventilating as part of it, you feel short of breath.
and feel like you can't, maybe you're smothering. You may have chest pain, not at all unusual. You could have nausea or vomiting, dizziness, lightheadedness. Sometimes some people feel hotter or colder than normal. Numbness and tingliness when you're hyperventilating goes along with that, typically in your fingers or toes.
And you might, once again, feel like it's not real, but it's also very common for people to feel like, oh my God, I'm having a heart attack, I'm dying, you know?
and you have to have uh at least a month of a lot of worry about this is this going to happen again oh my god you know losing control uh and you it has to be severe enough that it's starting to interfere with you doing your normal occupational or social sort of activities
you know it's got to be that bad and so disruptive of your ability to function that we wouldn't call it a panic disorder as opposed to a panic attack you know interesting okay um well it's not fun you know when you have them that's for sure i can tell you and you know when you get over it quickly you're you're you're you're very um thankful um Let's talk a little bit about therapy, okay?
Has there been, you know, over your illustrious career, have you seen mental health, shall we say, morphing more into therapy-oriented treatment, quote-unquote? Yeah. whereby it's family therapy or the loss of somebody therapy, whether it's through perhaps death or the loss of a loved one or a boyfriend, a girlfriend, what have you.
Are we seeing more therapy-oriented treatment per se in the mental health arena, or is it really a mixed bag?
I think your latter comment about a mixed bag is much more accurate. Okay. But take a step back and think about, we're talking about individuals experiencing something, right? And how do I want to say this exactly? if you like, sometimes people interview other people, especially on TV or news shows, and they say, are you an angel or are you a devil?
And it's like a dramatic thing, you know, one extreme or the other.
It depends what day.
Yeah. But, but I think in reality, if you take any individual walking around and, You know, they have certain kind of genetics going on inside their bodies, which, you know, increase certain tendencies to have certain issues come up and spare them from some risk for other issues. At the same time, they go through their life and they're growing up in a family where they learn certain attitudes.
And ways to react that are somewhat biological, but also learn from how your parents react to you or siblings or your teachers. You may get abused and have other things you're reacting to, you know, as life goes on. you may excel in certain areas and develop confidence and a sense of how good you are enough that way.
But everybody sort of is affected by a whole array of biological, genetic, psychosocial, and other things going on around them. And so you could say that, Mr. X is going through life and his wife just tells him, I want a divorce after 30 years. If he doesn't react with being shocked or upset or bummed out, assuming he was happy with the marriage, even if she wasn't.
And that's a normal adjustment reaction. It's not necessarily a mental illness or a problem. If it persists and it becomes prolonged and it interferes with his ability to sleep and function, you know, and it lasts for a certain amount of time and the amount of time depends on what the diseases that you're talking about.
I thought the chat show up and I lost my concentration in the screen.
But it's a multitude of factors that go on, all of which affect how you function, how you cope and how you think and how you feel. Depending on the situation, in certain of those cases, you could say, oh, my God, this is a, you know, 70% chance that it's biological and genetically determined. Or another one, we don't know, but it's probably less of a chance of that.
So depending what it is you want to change from your armamentarium, if somebody just got found out about divorce, I think talking it through with somebody and having some therapy and some context is probably the preferred method.
You know, if it's all of a sudden there was no medical thing and you weren't using drugs, but all of a sudden you have a manic episode, that's probably biological and genetic. And you want to approach that by doing sort of a workup to make sure it's not a physical and that drugs, you know, either they're taking certain things or withdrawing from them that could cause manic reactions.
But it's still more in the medication realm. If it's, oh, my God, this person has been using meth and other amphetamines constantly, and now they're deeply depressed, it's probably withdrawal. And it's sort of how are you going to get them through withdrawal and get them to sort of get off the meth? And it's still sort of more medical, but it's not medications per se, you know.
So I guess to answer your question is yes to all of them because it depends on the individual and what's going on with them. And they're all necessary. And the bigger issue sociologically these days is people have a hard time accessing mental health, substance use, medications, therapy, inpatient beds or treatment programs in the mental health realm, you know.
A couple of things that come to mind. Can you talk a little bit? One sec, Clarence. It's how you have perceived, Mike, the field of mental health connecting with other fields in medicine. Like, for instance, mental health issues and sleep. There are a lot of sleep specialists. Or post-surgical mental health issues.
For instance, somebody has, or even a medical issue, somebody's had a heart attack and now they've got some mental health issues to deal with. How is it that the field of mental health has, I guess, integrated itself with other medical fields over the course of your career that you've seen? I think maybe not, or maybe not.
I think you're right. I mean, as we learn more and, and, and more research comes out, you find those connections and realize it's an integral part of what you need to work up to see if it's an issue of causing things, uh, or treat. So like sleep is a great, is a great one, you know, where, um,
lately we've been seeing sort of how the effects of lack of sleep and significant insomnia affects your mood, you're much more irritable, potentially higher risk of depression, higher risk of cardiovascular problems and strokes. But even it's not just that, I mean, you could say that if you have very poor gums and teeth,
that increases risk for certain kinds of things that we didn't know about before 15 years ago, you know?
Yeah, or even pain, just relative pain, you know, whether it be, you know, a toothache or, you know, tennis elbow or whatever, you know, pain can have some mental health issues, I can imagine, especially if it's chronic oriented pain.
Yeah, you know, and once again, it's like, if you take pain, you know, how much of it is genetic? How much of it is learned in your family? You know, if you would be a... old bachelor farmer that's Finnish or something, you know, and it's very stoical, you were taught to ignore that and don't complain about it. You know, if you grew up in a different family, it might be the opposite.
You know, it's a huge thing. You can't stop talking about it. I need to leave. Give me those pills. I don't care if I get addicted, whatever, you know. Yeah, yeah, yeah, yeah.
Clarence.
So can we talk about treatments? I mean, we talked a lot about mental health disorders and things like that. We talked about trauma, those kinds of things. How do we treat these issues once they are identified? Could you talk a little bit more about those things?
Well, it's kind of like I'm saying, you got to give me a context and a situation and I can tell you how we would treat it optimally. But if you say mental health in general, kind of what I'm highlighting is sometimes it might be therapy because I just learned about my divorce and I need to kind of think it through. Sometimes it might be I'm manic and I need to sort of decrease stimulation.
I need to make sure I'm not withdrawing or using different chemicals, but then I might start somebody on a mood stabilizer, you know? It depends on which issue you're talking about.
And it's interesting because I know Stan brought up the whole issue around shock therapy and stuff like that. I mean, it's just so many different things that are around this topic that I think is so interesting and so many different ways to address what's going on. I think in my case, you know, I'm thinking only about...
you know, mental health, we think about going, seeing the doctor and getting some meds. And that's just basically it. But I think that you're saying that there are other things like it could be a, you know, a genetic imbalance or whatever. So there's all these different ways in which to look at these things.
People need to, to not be fixed in terms of how things are going to work, but to open, you know, to different alternative, uh, uh, Am I correct?
You know, and in a lot of ways, you're putting your finger on a really important issue. It's like we have such a sprawling, complex sort of not even it's not a well-functioning system, but system of care. And people don't know how to get in. They don't know where to start.
You know, and the resources are such that the people that sort of have a good broad base and what's going on psychologically with therapy, with genetics, with medications, with drugs. But there's such a shortage of those people and it's hard to get in. It's like, we don't really have a system where you have somebody comprehensively looking at somebody and saying, this is who you should see.
You know what I mean? It's word of mouth. Can you go to your primary, you know, if you have a primary care doc, a good strategy is go to that doc and say, can you get me in to see somebody in your system? Assuming they're not at a small boutique private practice, you know?
uh but uh because the lack of resources and it seems like a lot of the systems of care the wagons have uh it's like a wagon train and they've circled the fire yeah protect themselves and if you're in the circle you can get in if you're not you're at a lot you know um
and uh yeah you need to sort of go to see somebody who's whatever it is i'm i'm a devout freudian psychoanalyst or something you know and everybody i see needs analysis you know you want to see somebody that has a perspective and an open mind and can think about uh what really fits and best matches this particular patient you know yeah yeah yeah you know it seems like it's um
To a certain extent, it almost seems like a swamp of so many things in the mental health arena. Yet, we're getting better, which is encouraging. And I should underscore that for our listeners. It's getting better in the sense of how we identify it, how we treat it, how we connect it with different providers of care, etc.,
regardless of the fact of access, which we will get into for sure in our third show with you, Mike. One of the things I do wanna bring up is some of the incredible statistics that our research crew has done. So just to give our listening audience a little flavor here, from February 1 to the 13th, so two week period of time,
in 2023 so that was recently yeah 28.3 percent of adults in Minnesota reported symptoms of anxiety or some kind of a depressive disorder compared with 30 32 percent of adults in the United States regardless that wow okay so you know and Mike you brought this up you know Certainly during the pandemic, we saw a lot of differences in depression, et cetera.
The pandemic has coincided with an increase in substance use and increased death rates due to substances. In May of 2022, among adults in Minnesota who reported experiencing symptoms of anxiety or depressive disorder, 30.6% reported needing counseling or therapy but not receiving it in the past four weeks, compared to an average of 28.2%. Still, incredibly sad stuff here.
Mental health in the United States, the vast majority of individuals with a substance use disorder in the United States are not receiving treatment. 15.3% of adults had a substance use disorder in the past year. Of them, 93.5% did not receive any form of treatment. Some of them probably didn't even realize they had a problem. And so they didn't present themselves
But you should repeat that again. That is such a startling figure. 10% of people that acknowledge and think they have a problem can get in and get help.
Correct.
I mean, it's just... You know, if that was happening with people with heart attacks, there really would be an uproar around it.
No kidding. No kidding. Suicide, you know, we had a previous show that we dealt with suicide. You know, gay transgender populations, I'm sure, are seeing much more stress and anxiety just in living in general. And so these are incredibly sad. Depression is a leading cause of disability worldwide.
The United States has some of the worst mental health-related outcomes, including the highest suicide rate and second highest drug-related death rates. These are things that really, really lend themselves to some policy changes so that we as just human beings in a country that should be taking care of each other should address.
And hopefully we'll get into many of those aspects in our next show on policy. Yeah, Mike, thoughts on all of these?
It's kind of like what I was saying that the problem is worse and the access has been worse too. Exactly. And there's a whole host of reasons for it, ranging from underfunding the resources needed to evaluate and treat folks with mental health problems and substance use disorders,
um it uh it's changed a little bit now but it also you wouldn't get paid as a psychiatrist like you would as a cardiovascular surgeon right right the esteem isn't quite there so it's like uh and the payment wasn't there so it's like um and now we have a
Because of the economics of it, there are less inpatient beds, there are less clinicians out there, but the population continues to grow, the need continues to grow. People are beginning to do some stuff in the legislature about putting some money into maybe increasing resources for training programs.
increasing resources for training programs so we can get people from diverse communities trained and supervisors to train other people from those communities. That'll take a while. And they still they've done some token things, but the rates haven't gone up to really attract people to the field as much as other areas.
but it's been sort of neglected and underfunded and increased the amount, the degree the underfunding has kind of accumulated over the years. That's a long way to go. So it's starting to change, but unlike Virginia Slims, we have not come a long way, baby.
Right, exactly. Well, listen, we could go on and on. about this. Last thoughts on this, Clarence?
Yeah, thank you, because I was going to say, I thank you for entering this conversation with us. I mean, it's been... There have been a lot of things that you said today that have really... been enlightening to me in terms of what we're really experiencing.
And saying you're absolutely right, I thought that the research that was done was phenomenal in terms of being able to understand this issue a little bit better. But the more you talk, Mike, the more I think we need to talk. about this. I mean, we need to enter this conversation because there's so many things that are going on.
And as Stan said a little bit earlier, is that it just seems like the issues are increasing and increasing. We don't have the necessary professionals to help. And so How do we enter this conversation? How do we chat about this in a way? And how do we give people the information that they need in order to make informed decisions? And that for us is really what's important.
So I really want to thank you for helping to kind of sort through something even for me today. And I'm sure that our listeners will get the benefit of that.
You know, and I think that whoever's listening, if you think about, if you know who you're legislatures are in the Senate, in the Minnesota Senate and House. And if you have any communication or if you don't, maybe you should strike up some and say, we need to better fund mental health and substance use resources. You know, please do so as issues come up in the legislature.
You know, we had Senator John Marty on the show a couple of weeks ago, Mike, and he underscored that. He absolutely underscored that. And I hope it truly, truly, truly happened. So, Mike, once again, thanks for your incredible insights on this. hopeful. There's some sadness to it, but there's some hopefulness to it.
And we'll get into another show with Dr. Trangle on policy implications, which I think will be real timely, certainly for our next legislative session coming up. So thank you once again for everything. By the way, for our listening audience, all the research that we have on all our shows, but certainly this one will be attached to this show on the website.
So you'll be able to see it and also some of the sites that we use in order to gather this information. And Mike, of course, if there's other information that you want to share with us that we can get on our website, be happy to do that. So for our listening audience, keep health chatting away.
Hi, everyone. It's Matthew from Behind the Scenes. And I wanted to let everyone know that we have a new website up and running, HelpChatterPodcast.com. You can go on there. You can interact with us. You can communicate with us, send us a message. You can comment on each episode. You can rate us.
And it's just another way for everyone to communicate with Stan and Clarence and all of us at the Help Chatter team. So definitely check it out. Again, that's HelpChatterPodcast.com.