Afghan Refugee & Mental Health Startup Founder - Sophia Mahfooz

Sophia Mahfooz is a survivor, she is a role model and she is one of the most inspiring people I’ve met.  She was born pre-maturely, as her village in Afghanistan was bombed while her young parents fled to a refugee camp.  This trauma shocked her mother into labor and left Sophia with very little chance to survive.  Shortly after this, her family quickly fled the war-torn village where she was born after their home was destroyed. 

Sophia spent many of her formative years living as a refugee in Afghanistan, and later in England.  In our conversation, she tells the story of her family fleeing Afghanistan, making their way to England, and eventually how she moved to San Francisco to become an entrepreneur.

She originally traveled to the U.S. to care for her brother who struggled with bipolar disorder.  She couldn’t afford to seek treatment for him within the U.S. healthcare system, and she couldn’t send him back to England, so she decided to figure out another way to treat him.  Her efforts resulted in a solution that she hopes to replicate and commercialize for others who are trying to help their loved ones find relief from serious mental illness in a cost effective, and natural way. 

She is building a startup to bring her vision to market to help others.  Her business is called NeuroX.

You can connect with Sophia here: LinkedIn, NeuroX Website, Facebook, Twitter, Email, Instagram

HERE ARE SOME OF THE THINGS WE TALKED ABOUT:

1)  Sophia details her early childhood experience.  She tells a harrowing story of survival, escape, and how her family found their way to safety after her village was bombed. 

2)  She explains the difficulties of being an immigrant / refugee.  Sophia talks about some of the difficulties refugees and immigrants face that I had never thought of before.  One specific thing she explains is that she never got a birth certificate which makes it nearly impossible for her to navigate parts of life that we take for granted (identification, travel, visa, etc.). 

3)  Sophia shared about growing up in England and living what felt like two separate lives.  There was the life she lived at school where she spoke English and pretend to be a “normal” child who fit in with others.  Then there was the other life she lived at home where she spoke a different language, at different food than her friends and often felt isolated because of her race, and heritage.

4)  She talked about her family’s history of mental illness.  Her father had bipolar disorder, and she talks about how she believes it to be a byproduct of the stress he had to endure to survive.  She also shares that her brother later suffered from bipolar disorder.

5)  Sophia traveled to the United States to take care of her brother when he was struggling with manic episodes from bipolar.  She said that they couldn’t afford to admit him to a hospital in America for treatment, and it wasn’t feasible to send him back to England for help.  This led her to try to find a solution on her own.

6)  The idea for her startup, NeuroX came from this pursuit of a solution for her brother.  She researched non-medical treatments for bipolar disorder and found evidence that such treatments existed.  Sophia started to try different techniques from diet, to meditation, exercise, and other wellness routines with her brother.  He showed signs of improving and over time he was able to live a better life.

7)  Now Sophia is working to build a program based on what she learned, helping her brother, to facilitate other family members of people struggling with mental illness.  Her platform is designed to be a resource for people suffering from mental illness and their loved ones as they try to find natural, cost effective solutions. 

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn, Email

Connect with host Stephen Hays here: Stephen Hays Personal Website, Twitter, LinkedIn, What If Ventures (Mental Health Venture Fund)

Streamlining the Pathway to Mental Health Care with Strong365 Founder, Chantel Garrett

Chantel Garrett, Founder and Executive Director of Strong365 joins me for a conversation about psychosis, schizophrenia, and how we can help people when they first start to struggle.

One of the biggest problems we face in helping people who struggle from mental illness is reducing the “pathway to care” from the first symptoms until treatment. The average duration from symptom to treatment in the U.S. is 15 months when the World Health Organization says it should be under 3 weeks.

Strong365, is a non-profit, and a subsidiary of OneMind. Chantel and her team are on a mission to connect people who need help, and the loved ones of those people, through online education, 24/7 peer support, and connection to specialized care centers across the U.S. in order to reduce the time to care for those who need it.

Chantel has a degree in applied economics from UC SF and lives in SF with her husband, 2 daughters, 1 dog and 5 chickens!

You can connect with Chantel here: Strong 365 Website, Chantel’s Twitter, Chantel’s LinkedIn

HERE ARE SOME OF THE THINGS WE TALKED ABOUT:

1. What is Strong365? Strong365 was created in 2014 to shorten the pathway to care for young people facing their first episode of psychosis. They use digital channels to connect with teens and young adults about what psychosis is, provide educational information, and humanize their stories to reduce stigma. They also provide a directory of care centers around the US of which there are about 300 today (when in 2014 there were only 50). The federal government has helped support that growth.
   
   

2. Why did she create Strong365? The idea came from a personal experience. Her brother was diagnosed with schizophrenia when he was 20, and he is now 40 years old. It has been a long road, and he’s doing well, but it took about 15 of those 20 years to find quality and effective care. There is a huge gap, particularly for young people, that are experiencing mental health issues outside the realm of what most people usually talk about.
   
   While on sabbatical in 2014, Chantel researched this topic of how to find care for psychosis. She realized the lack of options for help and wanted to create something. So, she started Strong365 to use her marketing background to promote a new model of care. This care is called “Coordinated Specialty Care.” The National Institute of Mental Health (NIH) did a study on this model leveraging more than 20 sites. The outcome of this study is that young people do so much better if they get care early in their mental health journey than waiting until some sort of disruptive crisis sends them to the ER or inpatient care.
   
   

3. The average time that passes between the first episode of psychosis and getting care is about 1 year and 3 month today in the United States. The World Health Organization has set a goal for that to be 3 weeks globally. ‘The time to care’ is the biggest lever in the long-term health outcomes of young people with early psychotic disorders like schizophrenia.
   
   

4. How do people find you? People typically don’t come in for help on behalf of themselves. Typically, it’s a parent or some adult that helps a young person come to care. The number one referrer of people to care are inpatient units in the U.S. We consider this failing because most people are coming for help after a very traumatic event that leads them to the ER and or inpatient treatment.
   
   

5. How can we reduce the time to care gap? Strong365 is piloting a project in NY state to test their approach. They have partnered with 23 clinics (all are coordinated specialty care clinics that treat young adults with psychosis). They are trying to figure out “what role digital media can play in meeting a young person directly where they are at the right time, with the right information and support.” This pilot program is funded by the NIH and is a 3-year grant.
   
   

6. How soon can we solve this problem? We talked about how solutions in this space move at a snail’s pace. While Chantel has a very entrepreneurial spirit and wants to see solutions in market ASAP, she must work around funding concerns, clinical concerns, finding the right partners, and building a team to execute once all those hurdles have been overcome.
   
   
   Today, the care system for young people experiencing psychosis is a very manual, fragmented system. Usually, someone comes into an ER, and the ER looks them up in an EHR (database) to see what specialty provider to call. It’s a manual, slow, and impersonal process that is not working for young people.
   

7. Chantel and Strong365 have partnered with several organizations. As mentioned above, the NIH has funded their latest work, but they also work closely with Mental Health America (MHA), which has a mental health screening tool on their website that screens for psychosis. However, MHA has admitted to Strong365 that they struggle helping someone after the screen results are presented. A lot of the times, people just disappear from MHA once the screen is completed. This is the problem that needs to be solved.
   
   

8. Funding for Strong365 is primarily provided by family foundations. Some money is also provided by NIH research grants as mentioned above in the specific use case we discussed on the podcast. We talked a bit about her fund-raising challenges and how hard it was to get funding in the first few years as a “startup” non-profit.
   
   

9. Personally, Chantel spends her time teaching yoga and mindfulness in underprivileged neighborhoods to people who may not normally have access to yoga studios and mindfulness apps. She explains that mindfulness is something she discovered by the function of needing to take care of herself and now she looks to share that experience and the positive benefits of mindfulness with others.
   

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn, Email

Connect with host Stephen Hays here: Stephen Hays Personal Website, Twitter, LinkedIn, What If Ventures (Mental Health Venture Fund)

Lindsey Boylan (D-NY): Running For Office On a Mental Health Platform

In a recent podcast recording, I had the chance to speak with congressional candidate Lindsey Boylan. She is a candidate for congress in NY’s 10th district. Listen now.

I found myself getting emotional a few times during my conversation with her. She has a very personal reason for pushing a mental health agenda as part of her campaign. If you do nothing more than watch her short video on why mental health is such a big part of her platform here.

In this episode Lindsey explains how the people in her district are spending more time searching for things like mental health, depression and anxiety on Google, versus gun control, climate change and plumbers. Not to diminish those other issues, but her constituents need a candidate who cares about what they care about. Americans needs politicians who care about what we struggle with because they have experienced it personally.

Lindsey is a New Yorker, a lifelong public servant and has done some great work in her service efforts to help secure hundreds of millions of dollars for underfunded public housing in NY, she’s worked to generate job growth in NY state, and she was heavily involved in the fight for a $15 minimum wage in NY.

She is a Board Member at the Design Trust for Public Space, she is on the Powerhouse Committee at “Run for Something” which is a group that encourages young progressives to run for state and local office, and she spends time advocating for NAMI-NYC (National Alliance on Mental Illness).

You can connect with Lindsey Boylan and learn more about her work here: Campaign Website, LinkedIn, ‘Mental Health is Personal’ Video, Twitter

SOME OF THE THINGS WE TALKED ABOUT:

1. What made you decide to run for congress? Lindsey talks about how she’s spent most of her career focused on solving problems to make systems better for people. She’s always been very driven to help other people.
   

2. In Manhattan, more people are googling “depression, anxiety and therapy” than “gun control, climate change and plumbers.” Not to minimize the latter issues, but our leaders aren’t really focused on the issues that the people are most concerned about. People want to see politicians focused on mental health, and Lindsey is laser focused on it from a policy perspective. Lindsey is running for congress to help bring these very personal issues around mental health, to the forefront in government.
   

3. Lindsey talks about how mental illness has impact her and her family. She is very passionate about changing the mental health system. Mental health is a core component of her campaign and it drives her personally, as well as professionally.
   

4. Lindsey produced a video called “Mental Health is Personal” –in the video she explains that we don’t have a mental health care system in this country. Instead, we have a patchwork of resources for those who can afford it. We talk about why there is no real mental healthcare system. Lindsey gives an example about how in NYC it’s almost impossible to see a therapist that is paid for by insurance. We have this archaic barter system of a scale of payment that is very opaque. If you’re experiencing a crisis, or a hardship, and you don’t know where to go that is affordable, then it’s extremely daunting.
   

5. We don’t treat mental health the same way we treat physical health in this country. We talk about the pool of resources that are out there to help people with various ailments and disease. We also talk about how many research dollars are available for things like diabetes and heart disease versus dollars available for mental health research. Legislation is required to get more funding flowing to mental health research.
   

6. We talk about this forced narrative that exists around violence and mental health. Most people with mental health concerns are not perpetrating violence. People often want to only talk about mental health around tragedies and gun control. It’s frustrating that the only time the mental health conversation comes up in some circles is around tragic gun violence situations. Lindsey explains how frustrated she gets when people force the gun conversation and the mental health conversation to take place sin the same breath.
   

7. We talked at length bout political appetite for mental health bills in congress. Lindsey explains that when she decided to run for congress, she spent a lot of time thinking about how we can move policy forward with regards to mental health. At first she wondered who the members of the mental health caucus are, and if any are from her state of NY (as it turns out, only one congressman from NY is apart of the mental health caucus — it is Rep. John Katko from the 24th District of NY — a republican). She realized that the people in NY are concerned about mental health and the elected officials from NY are not focused on this problem.
   

8. We talked about what inspires her as a politician. Lindsey explained that she decided to run and was most inspired by leaders who have made politics personal. Personal experience with the problems we are trying to solve help us inform the debate. She is personally motivated to solve problems around mental health and once elected, can use her personal experience to help drive real change on this topic.
   

9. We talked about the bipartisanship we saw in 2018 around Tyler’s Law. We talked about what can get done, and how much willingness there is to pass mental health legislation in congress. Lindsey explains that with the Affordable Care Act,we were able to move the conversation forward. Parity laws were important as well. Lindsey is a proponent of Medicare for all which would help drive more money and more coverage to more people who need mental health care as well. Lindsey explains how we have had several decades of lackluster investment in research.
   

10. As we start to revamp our healthcare system in the country, we need to make mental health a central part of whatever system we have in the future.
    

11. We talked about how there isn’t really a great way to deal with crisis in this country when the problem stems from a mental health problem. There are so few resources available that most people call the police whenever there is a problem. Police often escalate a situation that doesn’t need to be escalated. This can make a situation more severe than it needs to be. We need to reform how we treat moments of crisis. Most people facing a mental health crisis are mostly potentially harmful to themselves, so we need to re-think about how we resource the emergency management system in this country. The current system moves toward hospitalization, and police involvement. We can do better.
    

12. We talked about prison reform at length as well, which in our opinion, has a lot to do with mental health. Lindsey told me that 40% of the people in Riker’s Island jail have a serious mental illness. Are we dealing with people in a way that is putting these people in prison who used to go to mental institutions? Are there more humane ways to deal with these people? Could we all live more productive lives if we get this right? We need to spend money researching this so we can have the answers and reform these systems.
    

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn, Email

Connect with host Stephen Hays here: Stephen Hays Personal Website, Twitter, LinkedIn, What If Ventures (Mental Health Venture Fund)

Political Activism and Addiction Recovery with Ryan Hampton

In this episode Stephen Hays chats with Ryan Hampton about Ryan’s personal addiction journey that has led Ryan to the forefront of our national conversation on addiction and recovery. Ryan shares his story and talks about where we are as a country on combatting addiction, fostering recovery, and defeating stigma. Ryan really tells it how it is, and if you are at all concerned about how the government is dealing with (or not dealing with) drugs or addiction, you will feel better when you hear that Ryan is on our side (and when you hear what he’s doing).

Ryan is a former white house staffer (Clinton Administration) and is leading the national conversation about addiction and recovery. He is the author of the book, American Fix – Inside the Opioid Addiction Crisis and How to End it. He’s also part of a team that released the first-ever U.S. Surgeon Generals Report on Addiction (2016) and has been called a “top social entrepreneur” by Forbes. He’s appeared on countless broadcasts on Fox News, CNN, NPR, HLN, and in the Wall Street Journal, The Hill, Vice, HuffPost and many other publications. He is an authoritative figure on addiction and recovery in America.

Ryan has been instrumental in getting addiction legislation drafted, and passed both in California, and at the Federal level including HR 4684, also known as “Tyler’s Law” or the “Ensuring Access to Quality Sober Living Act of 2018.”

You can connect with Ryan Hampton and learn more about his work here: Ryan Hampton’s Website, Book: American Fix, Ryan’s Twitter

SOME OF THE THINGS WE TALKED ABOUT:

1. Ryan tells his story of addiction, and recovery. Just after Thanksgiving of2014 Ryan was in drug treatment. It was a place he never thought he would end up. Certainly not after being stranded and homeless on the streets of Los Angeles. Ryan had a very promising future career in politics, he worked in the Clinton White House, then worked for the Democratic National Committee through 2003. After a hiking accident in 2003, he was prescribed an opioid based pain killer which ultimately led him to addiction to not only pain killers bur heroin and other addictions.
   

2. Addiction journey: From 2003 to 2014, Ryan spent years living in addiction to opioids and later heroin. After multipole attempts at treatment, rehab, sober living, and struggling with uncertainty about what to do, he found himself homeless in Los Angeles at Thanksgiving of 2014. Ryan spent Thanksgiving Day of 2014 on the corner of Hollywood Blvd and Highland with no food, no place to sleep, and no insurance, begging for help. That week someone helped him and got him to a treatment center.
   
   After treatment, he moved into a sober house, and plugged into a peer community that lifted him up when he couldn’t lift himself up. He focused on his recovery, went to meetings every day, drove Uber, and worked odd jobs. He was still incredibly ashamed though. He didn’t want to talk about addiction and recovery outside of the recovery community.
   

3. What made you start speaking out, taking action, and coming out of the shadows? 13 months into recovery, while still living in a sober living home, Ryan experienced the death of several of his friends in the recovery community. These were people he lived with or went to treatment with. These were people who got sober, but then relapsed, and could not get care, some of which went to hospitals and were denied care or left out on the street and died as a result.
   
   Ryan soon started to look outside of his local recovery community to see why people were dying and why nobody cared. This is when he started to get more involved and connect with the recovery community and recovery movement nationally. Leveraging his former political activist roots, he started using the cause of addiction to organize people and get people registered to vote, call their congress person, etc.
   

4. Comparing the AIDS crisis to the addiction crisis: 1/3 of households in the U.S. are impacted by addiction. This is a larger constituency than the gun lobby, the pro-life lobby, it’s larger than the LBGT community. Why is nobody talking about it at scale? Why have there not been changes? We don’t need everyone to bang on their legislators’ doors but if a couple thousand people would do it, then we could see huge changes.
   
   When the AIDS crisis was at its height, not every gay person in America got up in arms to change funding but a few thousands did. The result was billions of dollars of investment and research in science, which led us to a point where today, AIDS is a manageable chronic disease.
   

5. How can someone go to the ER for help and not get it? Ryan explains that close to 95% of hospitals can’t treat substance use disorder in the ER. There’s a huge stigma and bias against drug users when they walk into an ER. ER doctors want to get “those people” out of their ERs as fast as possible. These “dirty junkies.” People die because of this stigma (stigma is the wrong work, it’s really discrimination).
   
   Recently we have seen more hospitals start to have Naloxone (Narcan – an opioid antagonist) on hand. Naloxone is a medication used to counter the effects of opioid overdose. However, most ERs still treat SUD as “catch and release” instead of offering or facilitating access to overnight care until a stable plan can be put in place for the individual to move into recovery or sober living.
   

6. Why don’t hospitals have a plan to send people to sober houses? In a perfect world, if someone walks into an ER, overdosing, it should be the same as a heart attack. We should not only triage but offer a continuum of care (like we do for any other medical condition). But we treat it more as catch and release. We would never do that with a heart attack. There should be a warm hand off from the hospital to a peer recovery coach, community organization, sober living, etc. – there should be some sort of continuity of care (as opposed to zero). Most of the time the ER is releasing these people onto the street after doing basically nothing, and just giving them a sheet of paper with some 800 numbers to call in the event of emergency which is totally useless to an addict in crisis mode.
   

7. What should hospitals be doing? Look at what they are doing at Mass General. They are taking a very disruptive, recovery informed approach. They are making warm handoffs with “recovery coaches.” This is taking place in Alaska, and Las Vegas as well. We will get there nationally, but hospital ERs are drastically behind where they need to be on treating Substance Use Disorder.
   

8. How do we get the federal funding to follow the campaign rhetoric with regards to addiction and recovery? How do we get the hospitals to get in line?
   It’s important to attack the funding issue from the top down (congress, senate). The federal government needs to provide money to the states, then the states need to have a plan in place to organize and distribute the money to the communities where it is needed.
   
   During the height of the AIDS crisis, there was an act passed called the “Ryan White” act. This law really changed how we got money from the federal government into AIDS research, care, etc. at the state level. We need something like that law for addiction.
   
   Here are a summary of thoughts Ryan discussed on this topic:
   -AIDS gets $25bn a year from the federal government
   -Addiction / recovery gets $2bn a year if we are lucky
   -Addiction / recovery funding should at least be on par with AIDS when you consider the size of the problem
   -Addiction / recovery funding should at least be on par with AIDS when you consider the size of the problem
   -Funding should be at least $20 bn per year if we want to combat the problem
   -The CARE act is in congress now, and it would grant $10bn in grant money to local governments and states – but it just needs to get a hearing in committee, and it isn’t happening. It’s a democrat written bill, in a democrat-controlled house, and it can’t even get a hearing. This makes you think it’s just lip service.
   – Presidential candidates are laying out robust proposals on par with the $10bn a year commitment.
   

9. How do get bills like the CARE act to move beyond stalling out in committee?There’s no outraged advocates demanding a hearing. Therefore, we need to build civic action and civic capacity to build direct engagement and put pressure on politicians.
   

10. So, what if we pass the CARE Act? Then what? There’s another fight after that. We will need internal controls to make sure money finds its way to front line services and that it just doesn’t all go to treatment centers. As a country, when we spend money on addiction, we normally spend money on law enforcement, treatment, and interdiction/prevention. You don’t hear much about long-term recovery supports. You don’t hear much about peer recovery supports. We don’t hear about harm reduction. Harm reduction is a pathway toward recovery and saves lives. It creates trust between the drug user and the system.
    

11. How can individuals help? Who can help?
    You don’t have to be a policy expert, doctor, scientist etc. People with ‘lived experience’ have a much more unique and valuable perspective on what needs to happen in our own communities than these “experts” who see us through the lens of data and science. We can put names and lived experience to what is happening and impact our legislators together. Anyone who has been touched by the addiction problem should make an appointment with their state representatives, and federal representatives and tell the story of the barriers we experienced in seeking help for ourselves or for our loved ones.
    
    There are Organizations you can get involved with:
    recoveryvoices.com
    Faces and Voices of Recovery
    Shatter Proof
    Young People in Recovery
    Google ‘Recovery Together Initiative’
    

12. The story of Tyler’s Law: Ryan was sponsoring a young man named Tyler at a sober home Ryan managed in Pasadena.Tyler was Ryan’s first sponsee. Tyler’s parents were paying $2,000 a month to have him live in the sober home. Tyler came home one night and said he was using again. The house manager let Tyler stay one more night, but Tyler had to leave the next day. Tyler slept on a sofa in the living room, not his bed, per the house manager, and that’s where Tyler died. The house manager came down at 6 AM to check on him. He was blue, but still alive. Clearly overdosing. House manager called the owner of the sober home and had no idea what to do to help save Tyler form overdosing. There was no Naloxone on site, nobody knew how to react. They called 911 and he died while the EMTs were on the way. How could a sober home charge $2,000 a month and have nobody on site with the skills to revive Tyler and no Naloxone on site? This was a preventable drug death.
    
    
    The next day, the Owner told Ryan not to be upset at the sober home. The owner blamed Tyler saying Tyler didn’t really want to get clean. Instead of taking a baseball bat to the sober living home windows, Ryan said, “this is wrong” and he acted.
    
    Ryan and a couple friends in recovery went to state see their senator, state representative and their member of congress. Ryan and his friends shared about Tyler’s story and how many community members are suffering and dying.
    
    Those conversations led to a law being passed: HR 4684 in US Congress. Tyler’s Law. Ensuring Access to Quality Sober Living Act of 2018
    
    This law provided published standards on sober homes (for the first time) including requiring Naloxone on site and drug overdose reaction training for employees as well as an overdoes reaction plan. Passed in congress unanimously. 1 vote against in the Senate. Trump signed in late 2018. Lives will be saved because we told this kid’s story. We have a story to tell. That’s the power of lived experience. That’s how people can get involved.
    

13. Which of the current presidential candidates are the most recovery or mental health friendly?
    
    They are all saying a lot about it. What they are saying and how they plan to pay for it is equally important. They are all talking about it.
    
    Warren – CARE act
    Sanders – Medicare for all.
    
    You can’t really end these crises without a massive expansion. A total revamp of the healthcare system is needed.
    
    Ryan has endorsed Pete Buttigieg and his plan (an 18 page mental health plan that includes $10bn a year for addiction, a specific focus on peer work force, service, long term recovery support services, and harm reduction).
    
    Doesn’t matter who you vote for or support. Please get involved. Help inform your favorite candidate and impact their policy on this topic. One of them WILL BE president and its important that we inform all the campaigns on this topic.
    

14. What can we built privately that could help or be for profit?
    Peer to peer and peer recovery support is THE way to close the recovery gap. Even if we had treatment centers on every corner in the country, we would still have a huge treatment gap (financial barriers, insurance, cultural barriers, and other things that prevent people from getting into treatment). We need peers, warm hand offs, expanded peer work force.
    
    Innovation from people with lived experiences are needed. On-demand services are also needed. We must figure out how to combine tech and traditional on-the-ground services together. Private investors can play a role there. There are many people living in parts of the country where help is not accessible with in 50 miles or more.
    

15. What can we do to reduce Stigma?
    We need more people to speak out. We need to normalize this problem by increased sharing. But stigma isn’t really the right word. Stigma is just a nice way of saying what is really happening. The problem is systemic discrimination and bias against people with a medical condition.
    We are on the way to combatting this problem. This is a historical problem. The drug crisis in this country isn’t just 5 years old. There have been decades of “wars on drugs” and “wars on people who use drugs.”
    
    Specifically, the medical profession needs help – there is still a lot of education to be done. Medical schools are still not providing the training necessary on addiction. Doctors who have been around for a long time are averse to learning anything new. It’s going to take a new generation of doctors who are wiling to learn and educate themselves to provide compassionate care to people with SUD.
    

16. “War on people who use drugs” – what does that mean?
    
    The war on drugs at its heart is a war on race, class, poverty, etc. It’s disgusting. We are locking people up for simple possession. These drug induced homicide laws are ridiculous (2 people using drugs, one dies, and the survivor gets a murder charge). Decriminalization of drug use, and possession is a step in the right direction. It will have to be taken on state by state. It will be very hard to do this nationally.
    

17. Should we legalize drugs?
    Ryan talks about how he is still unsure when considering all the facts right now. It’s worked in some countries. How will that play out in the U.S.? Not sure. Still weighing the pros and cons of that. But we do need to make more of an effort on decriminalization.

People are working hard against us. Status Quo is public enemy number 1. Lot of moral entrepreneurs who have planted a flag and don’t want to see change. They want to see prevention and treatment remain the focus without looking at the other tools that we could deploy. The fight for change is disruptive to these people.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn, Email

Connect with host Stephen Hays here: Stephen Hays, Twitter, LinkedIn, What If Ventures (Mental Health Venture Fund)

Walk and Talk Therapy

In this episode Stephen Hays chats with Clay Cockrell.  Clay is a therapist in New York, NY and has gained quite a bit of notoriety for the medium through which he meets his clients.  He meets his clients for walks.  Clay started Walk and Talk Therapy in NYC after realizing many busy professionals simply don’t have time to transit to therapy sessions. 

Clay has been featured on numerous TV shows, and in many publications including Good Morning America, CNN, The Wall Street Journal, The Times of London and the NY Times for his unique approach of walking with his therapy clients instead of meeting in an office.

Clay is also the host of the podcast “Finding Therapy” where he takes listeners through a step by step process of finding the right therapist and he hosts another podcast called “The Online Counseling Podcast” where he educates therapists on the ethical and effective ways to use technology to connect with clients.

You can connect with Clay Cockrell and learn more about his work here: Walk and Talk Therapy,  LinkedIn, OnlineCounseling.com,  Podcast: Finding Therapy, Podcast: Online Counseling.

SOME OF THE THINGS WE TALKED ABOUT:

1. Clay Cockrell is a therapist in New York City who has always been attracted to stories about humans and how our histories impact us.  He built his Walk and Talk Therapy practice in NYC on the idea that clients often are busy, stressed out, and rarely willing to make transit across the city for a therapy meeting in the middle of their busy day. 
   

2. Clay was born and raised in Kentucky, and his wife is an actress in New York.  Clay noticed his clients had a hard time getting out of the office to come to meetings with him.  He wanted a way to make it convenient, so he decided to come to his clients, and host meetings while walking and talking.  Clay credits the idea to his wife suggesting that he make meetings more convenient, and she was right!
   

3. Clay noticed that as he walked and talked with clients, that his clients opened up more, and the sessions were more effective.  He also meets with his clients remotely online now as well and we talk about the effectiveness of remote therapy via voice, video or text in this episode.
   

4. One observation Clay made during walking meetings is that clients are often uncomfortable sitting on a couch, staring a therapist in the eyes, and revealing their deepest darkest secrets.  However, if you get the clients moving, there seems to be more of a willingness to be vulnerable.  Maybe this is due to the movement, maybe it’s a more comfortable environment, maybe it’s the eye contact.
   

5. Clay’s clients are primarily men, and we talked at length about men’s mental health broadly.  Men are resistant sometimes to talking about emotions.  It seems to Clay that men are resistant to sitting down and reflecting. In our society, it hasn’t been considered “masculine” to go to a therapist.  However, that is changing, and Clay believes that men are seeing the value of therapy more and more today as stigma decreases.
   

6. Why does this idea of masculinity keep men from getting help?  It’s the media, John Wayne imagery, being vulnerable is considered bad.  We are complex beings.  It’s hard to live with intention and often we find ourselves operating whimsically under the influence of what the media tells us we have to be.
   

7. What makes men willing to come into therapy for the first time?  Desperation and pain, Clay explains, for the most part.
   

8. We talk about the value of community in our lives.  There are millions of people in NYC but everybody is lonely.  Isolation is dangerous and we must proactively fight against it.
   

9. How can technology be leveraged by therapists to help their clients? Clay encourages people to use meditation apps such as Calm and Headspace.  He also talks about how many therapists don’t even have a website or know how to market their practice.  Teletherapy is also a great tool – while it does change the dynamic, both for good and bad, there are many positive benefits to teletherapy.  However, there is a need to focus on using technology ethically and legally when providing care remotely.  We must also make sure the client is suitable for online counseling (someone with suicidal ideation, psychosis, etc. may not be suitable for online therapy).
   

10. We talk about the legal rules around therapy and how they impact online counseling.  The current laws prevent a therapist from crossing state lines unless they are licensed in the state where the client is located.  Originally states wanted to protect patients and the licensing boards need to make money so they require licenses in each state for now.  This isn’t an issue outside the United States.  Some states are coming together to create reciprocity, but this is an issue that needs to be taken up politically.  This needs to be addressed at the federal level. 
    

11. Clay built a platform for finding a therapist (both in the U.S. and globally, in any language): OnlineCounseling.com.  Clay’s site investigates the therapists and validates them on behalf of the potential clients.  They spend a lot of time educating and training therapists on their platform as well.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn, Email

Connect with host Stephen Hays here: Stephen Hays, Twitter, LinkedIn, What If Ventures (Mental Health Venture Fund)

What is the Role of Tech in Mental Health Treatment?

In this episode I chat with Dr. Stephen Schueller about the role of technology in treating people for mental health conditions as well as the landscape of existing technology solutions, and those that are yet to be built.

Dr. Schueller is an assistant professor of Psychological Science at the University of California in Irvine and he is also the Executive Director of PsyberGuide, which is a non-profit functioning as the ‘consumer reports’ agency of the mental health technology world. Dr. Schueller has a team of people who evaluate technological tools (such as apps, and other tools) used in the treatment and improvement of mental health.

You can connect with Dr. Stephen Schueller and learn more about his work here: Stephen’s Twitter, PsyberGuide Website, Stephen’s LinkedIn, Facebook (PsyberGuide), Press on Dr. Schueller

SOME OF THE THINGS WE TALKED ABOUT:

1. What is the role of technology in mental health? Can we use technology to treat and or diagnose people suffering from mental health conditions, addiction, etc.? Dr. Schueller shares his thoughts about how technology is unavoidable in our daily lives to some degree and how we can leverage that for the improvement of mental health within society. This will include the use of some apps, websites, devices, etc. that were intentionally built for mental health purposes as well as some that were not. Ultimately, access to treatment is one of the biggest hurdles to getting people help who need it, and technology can help remove some of that access barrier.
   

2. Is technology useful in clinical treatment of mental health conditions? Dr. Schueller talks about how traditional services (face to face therapy, etc.) are great, and they work for many people, and some people want traditional face to face services. However, not everyone feels this way. Technology expands the available options so that different people can get exactly what they want or need in the mental health resource space. In the event that someone is not receiving care for one reason or another, and where a technological solution can bridge that gap, then technology is certainly useful not only then, but in many other applications as well.
   

3. Can we use technology to test, measure and diagnose mental health conditions? Dr. Schueller explains how he thinks about the clinical utility of technology in this space. He uses 2 questions to being to test the effectiveness of an app, or technology.
   
   a) First question – Is the input useful?
   b) Second question – is data or the translation of that data a clinically meaningful insight that can help a client or patient improve their life?
   
   We must think about where we get data, and how we interpret it. There have been many great developments and inventions in the data gathering area, but we still have a long way to go when it comes to interpreting the data that we gather from all these wearable devices.
   

4. Should we be relying on surveys or measurements for analysis of our mental health status? Dr. Schueller talks about how mental health assessment is fundamentally broken. Surveys like the PHQ-9 are not as effective as passively collected data when it comes to things like sleep patterns and quality, however when it comes to thoughts of self-harm survey data is likely better than some passive measurement. Dr. Schueller explains that, “we need to think about how to optimally bring together data streams to give a full picture, or triangulation of what a person is going through.”
   

5. Should startups in the mental health tech space be focused more on technological innovation or clinical accuracy? A tug of war, of sorts, exists between clinicians and technology focused entrepreneurs. We have to make sure that in the process of helping people, that we do not harm people. There is a fine balance to walk between “moving fast and breaking things” and helping people with their mental wellness. Some of the challenge around innovation in this space is that often technologists don’t have an understanding of what standards of clinical care looks like. We must innovate from a place of understanding standards of care and standards of practice. There are lots of places we can innovate while being responsive to minimizing harm, while maximizing benefit for patients and individuals suffering from mental health problems.
   

6. What is PsyberGuide? It is the consumer report of digital mental health products. This is a non-profit that Dr. Schueller helps to run with the support of numerous partner agencies such as:
   
   a) Anxiety and Depression Association of America
   b) International Obsessive-Compulsive Foundation
   c) American Institute for Stress
   d) Mental Health America
   
   Dr. Schueller explains how there are thousands of digital mental health products out there. There could be somewhere between 10,000 and 20,000 apps or tools out there from his estimate. Very few have any evidence-based support behind them – he estimates that about 3% of those apps have any kind of evidenced based support behind their approach.
   
   PsyberGuide focuses on separating the good from the bad in this space.
   
   Their reviews provide structured, consistent frameworks for looking at critical aspects of a product. Their reviews focus on these key areas:
   
   a) Credibility of the product or platform (or the science behind it)
   b) User Experience (engagement, likeability, etc.)
   c) Transparency (Data security / Privacy ) – They review the policies of the company or app, but they do not do a full technical audit of the privacy practices
   

7. We talked about data security in the space among the apps in the industry. Recently Dr. Schueller’s team looked at 120 apps focused on depression. He indicated that half of those apps didn’t have any data security policy at all. Of the ones that did, only half of those (25% total) had policies that are acceptable by industry standards. Dr. Schueller goes on to explain that there isn’t a lot of transparency on what many products are doing with your data. This must be addressed and resolved in this industry.
   

8. How many apps or startups are out there in the mental health space? As mentioned previously, there are somewhere between 10,000 and 20,000 mental health apps on the market (depending on how broadly you define the search criteria). The barrier to entry to build in this space is very low.
   
   Many of the apps are one-off apps that are not maintained or supported or have “failed” or been abandoned in an app store somewhere. A large portion of them are just put up by people with some programming experience but no science or clinical team behind it. This is why PsyberGuide exists.
   
   Some of the apps are built by entities that have dozens of apps out there. One group that Dr. Schueller references has about 20 apps of their own. So, when you consider this, the number of abandoned apps, and the low percentage of apps that have any clinical evidence behind them, there seem to be about 3% to 5% of the 10,000 to 20,000 that are viable. This would imply a market size of maybe 500-1,000 startups or companies and that is consistent with my (Stephen Hays) prior analysis on this industry.
   

9. How do you pick which apps PsyberGuide reviews? There is a little bit of art and a little bit of science to this. Dr. Schueller explains that they track the app store, as well as the research world and keep track of what’s being researched, and what’s being built. They also have partners (mentioned above) that often come and ask for help reviewing a technology. Additionally, they track traffic on their own website to see what consumers are interested in learning about and use that to manage workflow and prioritization as well.
   

10. Why do we need something like PsyberGuide? Dr. Schueller talks about how there isn’t anyone out there policing or patrolling this space. The mental health care industry could be one of the largest industries in the world with billions of people in need. The FDA can’t possibly review everything. PsyberGuide hopes to become the gold standard of independent reviews for digital mental health solutions
    

11. Why are technological solutions to mental health are needed? I asked Dr. Schueller about why we need teletherapy and some of these other solutions. He explained to me that 1 in 3 counties in the US do not have a licensed psychologist and that 70% of counties in the US do not have a child psychologist. The access problem around mental health is huge. Technology will be required to fill the gap. He goes on to describe that in a perfect world, technology is used to supplement therapy and to make it faster, better and more efficient. Technology can help us transcend time and space to reduce the access issues we are facing today.
    
    Dr. Schueller also talks about how technology can take insights from daily life and help make the information gathered from our daily lives actionable when it comes to our mental wellbeing.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn, Email

Connect with host Stephen Hays here: Stephen Hays Personal Website, Twitter, LinkedIn, What If Ventures (Mental Health Venture Fund)

Subscribe to the Stigma Podcast Newsletter

Let's Talk About Sex (Addiction) - With Dr. Alexandra Katehakis

Dr. Alexandra Katehakis is a pioneer in the study of sex addiction, and healthy sexual behavior. In this episode we talk about what sex addiction is, where it stems from, how to treat it, and how to know if you need help. It’s a provocative conversation on one of the most stigmatized addictions we face.

Dr. Katehakis is a Marriage Family Therapist, Certified Sex Addiction Therapist/Supervisor and Certified Sex Therapist/Supervisor, and Clinical Director of the Center for Healthy Sex in Los Angeles. Dr. Katehakis has extensive experience in working with a full spectrum of sexuality; from sexual addiction to sex therapy, as well as and problems of sexual desire and sexual dysfunction for individuals and couples. She has successfully facilitated the recovery of many sexually addicted individuals and assisted couples in revitalizing their sex lives.

She has written numerous books on the topics of sex addiction, erotic intelligence, the neurobiology of sex addiction, intimacy, and other topics related to this space.

You can connect with Dr. Katehakis and learn more about her work here: Twitter, Center for Healthy Sex, Her Books on Amazon, Her Books on Her Website

SOME OF THE THINGS WE TALKED ABOUT:

1. We spent some time in our conversation talking about what exactly addiction is more broadly. Dr. Katehakis explains that addiction generally is a strong predilection for something. It doesn’t really matter what that thing is.
   
   

2. We discuss the “history” of sex addiction including when people started talking about sex as an addiction, the early research as well as current research and how society views the topic of sex addiction.
   
   

3. Dr. Katehakis talks about some of her work with Dr. Patrick Carnes on the topic of sex addiction as well as some of the discoveries he has pioneered since he began studying the topic in the 1980s.
   
   

4. Dr. Katehakis explains that shame is the driving force behind a lot of our unhealthy sexual practices including sex addiction. She says that, “Shame is built into the autonomic nervous system. It’s in the gut. It’s in the enteric nervous system.” And that “Human beings are biologically coded for shame.” Shame is a pro-social function that drives a lot of how we develop as humans.
   
   

5. We discussed what a sex addict is, when they become one and how to know if someone needs help. Some of the criteria she mentioned for judging whether you may need to seek help include:
   a) Spending more time than you intended on a sexual behavior
   b) Privileging sexual behavior over other obligations
   c) Continuing behavior despite negative consequences
   d) Preoccupation with sex
   
   There are assessments people can take, one of which is located on her website here: https://centerforhealthysex.com/sex-therapy-resources/sex-addiction-test/
   
   There is a section on her website dedicated to figure out if someone is a sex addict or not and you can find that content here: http://centerforhealthysex.com/sex-addiction/
   
   

6. We talked about the history of sex addiction treatment and the work of Dr. Patrick Carnes. His model is one of abstinence, not forever, but for a period of time so you can get a read on what’s happening with your mood when you take that break from whatever you are addicted to. This helps you figure out what is driving “this thing” that may be addiction (could be a mood disorder, or something else). Sometimes someone has a mood disorder, then they get on medication, and their extreme sexual behavior becomes less common.
   
   

7. We talked about what recovery from sex addiction looks like. Dr. Katehakis explained that not all sex addicts are alike. She explains how in her workbook called, “Sexual Reflections,” people can create a sexual health plan as part of a recovery process. She explained that anything can go on that plan as long as you don’t feel shame about it, and it is not secretive.
   
   

8. We talked about how men are in an identity crisis of sorts today. Men are socialized from an early age to be in competition with each other, to measure everything and this translates into unhealthy behaviors early in life as well as later in life. We also discussed how in the recovery community, you see the opposite, where people are helpful to one another and it radically changes how we get along both as individuals and collectively with society.
   
   

9. How do you recover from sex addiction? We talked about 12-step recovery programs, websites, resources, etc. Some of those resources are listed here for both porn and sex addiction:
   https://www.yourbrainonporn.com/
   https://saa-recovery.org/
   https://centerforhealthysex.com/
   
   Dr. Katehakis explains that, “People change their attachment styles when they attend 12-step meetings over time. She goes on to explain that attachment issues have to do with “regulation” of the nervous system. In a 12-step program you start to realize you can get your needs met from other people (as opposed to only getting them met from yourself, through destructive behavior). During this process, another human is helping to regulate your nervous system. Sex addicts have been doing this through unhealthy sexual behavior. Eventually you start to learn to trust other people, and then your nervous system starts to seek other people when it needs help rather than engage in unhealthy sexual behavior.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn, Email

Connect with host Stephen Hays here: Stephen Hays Personal Website, Twitter, LinkedIn, What If Ventures (Mental Health Venture Fund)

Subscribe to the Stigma Podcast Newsletter

Getting Sober with Alex Wilhelm of TechCrunch

In this episode, my friend Alex Wilhelm joins me to talk about our shared experiences in recovering from addiction.  Alex was most recently, the editor in chief of Crunchbase News, and is currently the host of the Equity Podcast on TechCrunch.  He’s been covering the tech world as a journalist for many years and has had a wide variety of experiences in the entrepreneurial and startup ecosystems. 

Alex had a huge impact on my decision to get sober, and my decision to get help when I got to the point where I decided I wanted it.  In this episode Alex shares why he got sober, when he realized he needed help, how he got help and then what he has done to maintain 3 and a half years of continuous sobriety.

We also talk about how society views addiction, and how stigma plays a role in that societal perception as well as when and how some people get help.

Here are some ways you can connect with Alex: Twitter @alex, Alex’s Personal Blog, TechCrunch Equity Podcast

HERE ARE SOME OF THE THINGS WE DISCUSSED:

1. Alex Wilhelm shares with us about why he decided to get sober. He talks about when he realized he needed help, and all the times he attended AA, only to go home and drink immediately after. He then shares how he finally realized he needed help, which came when he ended up in the ER because of alcohol – which was 3 and a half years ago.
   
   
   

2. We talked about how rehab, and then specific life changes, and support systems positively impacted Alex’s recovery. We both share some of our experiences living in recovery and some of the actions we took to foster our recovery in the early days.
   
   
   

3. Alex shares about why he is intentionally being public about his recovery story. We talk about “stigma” and how society often views addiction and addicts themselves. Alex explains how addiction is a disease, and how it should be viewed and treated as one as well as why it has not been until recently.
   
   
   

4. Sometimes life changes are required to set ourselves up for success in recovery. Alex talks about some of the changes he has made in his life, some large, some small. Some of those changes include not using mouth wash with alcohol in it, or not having alcohol in the house, nor eating foods cooked in alcohol.
   
   
   

5. One of the most critical things Alex found that helped him with his recovery was learning to be of service to other people. Addicts can be very selfish individuals and when you remove the time wasted on your addiction from your life, you have more time to do healthy things. One of the things Alex fills his time with is being helpful to others. He even wrote a blog post about how serving others is “self-care” which you can read here.
   
   
   

6. I asked Alex how sobriety has changed his life and he shares with us how he would have never gotten to marry his wife if not for his sobriety. He talks about how he dated her in college, then didn’t speak for 4-5 years then reconnected when he was 5 months sober. Without his sobriety, their relationship would have never worked, and he would have missed out on that incredible blessing.
   
   
   

7. We talked about some of our habits that we have formed during our recovery and Alex listed a few of the things he focuses on that helps him with recovery including: exercise, meditation, diet, a social calendar with people who are sober or accepting of his sobriety, and a lifestyle built around sobriety.
   
   
   

8. If you want to quit what is your first step? I asked Alex to advise anyone who may be listening on what to do today, if they think they may want to quit. He gave us a bit of a check list of things to do to see if you need to quit, and how to start that process.
   
   
   

   Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn, Email

   Connect with host Stephen Hays here: Stephen Hays Personal Website, Twitter, LinkedIn,  What If Ventures (Mental Health Venture Fund)

Subscribe to the Stigma Podcast Newsletter

Suicidal Ideation and Self Harm - What to Do When It's Your Child

I had a raw, personal, and honest conversation with Robbie Millward about mental health, suicidal ideation, self-harm and how he struggled with these things in his life, and what he’s done to overcome them.  

Robbie is a military veteran and now serves on the Board of Directors for NAMI in New Hampshire where he has taken part in drafting materials that guide how New Hampshire’s state level first responders handle mental health crisis situations.  Robbie has overcome a lot with respect to his own mental health and he has used that as a platform to help others.  

I was moved by Robbie’s story of his experience with thoughts of self-harm, how he has gotten help and the action plan he has in place to prevent any future self-harm.  He also shares about how his daughter has struggled with these thoughts as well and how he has worked with his daughter to overcome those struggles.  We go into detail on how to develop an action plan, what to look for and how to respond when a loved one is struggling with suicidal ideation or thoughts of self-harm.

You can connect with Robbie here: LinkedIn, Twitter, Website, Video of Robbie Telling His Story

HERE ARE SOME OF THE THINGS WE DISCUSSED:

1. Robbie shares about his mental health journey from the time of his childhood, and how some of the things he struggled with as a child evolved into mental health struggles later in life.
   
   

2. He shares about how he was misdiagnosed with a personality disorder in the military, and it wasn’t until after several more years of struggling and an anxiety attack at work, that required hospitalization, that he was appropriately diagnosed with severe depression, anxiety and PTSD.
   
   

3. After a while, he thought he was good, so he relaxed on taking medication and seeing his therapist. He began to rely on self-medication which led him back to the hospital in a severe episode of depression.
   
   

4. One weekend, he went to go snowboarding and got a call that his 14-year-old daughter was in the school counselor’s office struggling with thoughts of self-harm. Robbie raced to get to her and when he did get there, he spent time sharing all his struggles with the same thoughts and problems in his life which seemed to have a profound impact.
   
   

5. We talked in detail about how both he, and his daughter have developed written action plans for times when they are struggling with thoughts of self-harm. These plans include daily action items such as checking in with a specific handful of people, daily actions and fail-safes for days when he doesn’t check in with those people. Robbie walks us through his safety plan as an example of what one looks like.
   
   

6. We talked about the signs to look for as a parent to know when your child is struggling with self-harm, or suicidal ideation as well as what to do about it when you do see those signs.
   
   

7. I asked Robbie where people can go to get help with building a safety plan or finding community support around ideas of self-harm and suicide. He emphasized that the National Alliance on Mental Health (NAMI) has free resources available online and in most communities that can help.
   
   
   If you are in a state of distress or emergency and need to talk to someone, never hesitate to call the Suicide Prevention Lifeline at 1-800-273-8255

Opioid Addiction Prevention - with Yossuf Albanawi Founder of Pilleve

In this episode I speak with Yossuf Albanawi, co-founder of Opioid addiction solution, Pilleve.  Yossuf is a graduate of Wake Forest University, he is a fellow at the Halcyon Incubator in Washington DC.

This conversation is about the Opioid crisis.  This is such a huge problem in our society, and we need solutions faster than we are bringing them to market.  While there are traditional resources available for people once they become addicted, there are no solutions on the market focused on preventing addiction effectively. That’s the focus of Pilleve – to prevent addiction to Opioids while still allowing doctors to prescribe these drugs, when necessary, with reduced risk of addiction. 

You can connect with Youssef and learn more about his work here: Pilleve Website, Yossuf on LinkedIn, Pilleve on Twitter,

HERE ARE SOME OF THE THINGS WE DISCUSSED:

1. Yossuf shares his experience with addiction at an early age to prescription drugs. He talks about how his loved ones noticed very early on and sought the help of a professional to intervene. He gives a great example of how we can help our loved ones if we notice that they need help.
   
   

2. What were some major parts of recovery for you? Yossuf explains that spirituality, and awareness were the two biggest components of his recovery from addiction.
   
   

3. How did he learn about the scale of the Opioid Crisis? Yossuf took an entry level job after school at a rehab center. He did this to learn about what was being treated, why, and how. He found his purpose there. He explains how about 10 years ago most of the patients in treatment centers were there for alcohol. Then it flipped to be mostly Opioids in recent years.
   
   

4. Can Opioid addiction be prevented? While working at a treatment center, Yossuf wondered about this. Why can’t we screen for this or treat this like other physical health problems? Is there a preventative measure we could put in place? Yes, but he had to build it. And he has. Pilleve.
   
   The healthcare model in the United States is a fee for service model which means we typically treat people once they are sick or need treatment. Whether or not that’s a fair or good model is up for debate, but in this system, we have to look for innovation in order to “prevent” problems and that’s what Yossuf has done around the Opioid crisis.
   
   Heroin addicts traditionally (60%+) begin with a prescription drug abuse. There is such a huge opportunity to identify this before it happens and then prevent the long-term cost on the person, on companies, on the economy, and on loved ones of that future addict’s problems (death, destruction, in-patient treatment, etc.).
   
   

5. What is Pilleve? Pilleve is a smart, secure pill bottle that adapts into existing pharmacy and physician workflows. The Pilleve bottle and platform tracks, monitors and reports real-time use data to physicians allowing physicians to identify potential addictive behaviors very early. The Pilleve device makes it safer for doctors to prescribe Opioids to their patients.
   
   

6. What is the high-level mission of Pilleve? The Company’s mission is to become the controlled drug standard for prescribing, dispensing and using controlled drugs.
   
   Pilleve Focuses on Three Main Things:
   
   Compliance – Making sure people don’t take too much of their medication. This is very different and needs to be distinctly differentiated from “adherence.” Adherence is the focus of most who have built solutions in the “prescription pill” market. Adherence means making sure people take the medications they should. We are focused on preventing people from taking too much. Is someone taking too much, or abusing the pills (this is the unique Pilleve focus).
   
   Reduction – Focused on getting people “off” of the Opioid medication as soon as possible. This is an application of the data they gather on each patient while they use the medication.
   
   Diversion – Get the excess pills back to the pharmacy once the patient has recovered. Today, many pills remain in the medicine cabinet for misuse at a later date, often by someone else in the household.
   
   

7. Are there other smart pill bottles out there? There are a few smart pill bottle caps and such that are used for monitoring opening and closing by the patient. These are more focused on adherence, whereas Pilleve is focused on compliance (as described above). We are focused on taking too much, versus these other solutions, that are focused on whether you take the medication at all. These are very different behaviors, mindsets and use-cases.
   
   

8. Should drugs be illegal? A favorite topic these days, we talk about how in some countries (Portugal and Netherlands) the legalization of drugs led to lower crime, lower addiction, and fewer people going to treatment centers. However, we also talk about how those countries have different dynamics than what exist in the U.S. (different people, different healthcare system, different culture, etc.) so you can’t look at them as a 1:1 comparison on whether or not certain drugs should even be illegal.
   
   

9. How can we de-stigmatize addiction? This is a huge part of the solution. It’s our responsibility to make sure addicts get treatment. We must differentiate between addicts and criminals. If you are an addict, you are not a criminal (well not by default).
   
   We find that when we share our experiences, others react by sharing theirs. The more this happens, the more stigma reduces and the easier it is to change this perception that an addict, is a criminal by default.

Children's Mental Health and the Role of Educators

In this episode of the Stigma Podcast, I had a chance to speak with Mandy Froehlich.  Mandy is an educator, and personally, opens with us about overcoming PTSD, depression, and anxiety. 

Mandy is an experienced educator who leverages her professional experience, and her passion for learning, to teach, train, and inspire other teachers to renew their excitement for teaching, and re-engage with their profession in an innovative way. 

Currently, she spends her time consulting school districts and post-secondary institutions on effective use of technology to support teaching, mental health support for educators, and how to create organizational change within educational institutions.

Mandy has published a couple of books.  The first was titled “The Fire Within: Lessons from defeat that have ignited a passion for learning” – where she discusses the idea of mental health awareness within schools. Her most recent book, titled, “Divergent EDU” is based on an organizational structure concept called “Hierarchy of Needs for Innovation and Divergent Thinking” which was developed to support teachers in innovative and divergent thinking.

Mandy is also the host of a podcast, called “Teacher’s Aid” – which focuses on provided social and emotional support for the very personal challenges that teachers face. 

You can connect with Mandy and learn more about her work here: Her Website, Her Twitter, LinkedIn

HERE ARE SOME OF THE THINGS WE DISCUSSED:

• Teacher burnout – We talked a bit about how she became a teacher, and how over time she struggled to stay motivated. This led to a conversation broadly on teacher burnout and why teachers disengage, burnout, have a high attrition rate, etc. This impacts the children and we dig into why on this podcast.
  

• The role of the school, teacher, and parent in acknowledging a child’s mental health issues – We talked about this concept that as parents have begun to work more, with both parents having full-time jobs, the school has been forced to become a de facto parent for 7-8 hours a day. We discussed what role the school, the teachers, and the children themselves play in observing and helping those who have mental health needs within the school system.
  

• Should teachers be talking about their own mental health concerns? It depends on who they are talking to. Although teachers should be able to be vulnerable with their students, oversharing can be bad. It’s ok to admit when you may be dealing with something difficult. Kids need to know they are not alone. It’s also ok for teachers to admit their struggles to other teachers. In a lot of ways, teachers are the only ones who really understand other teachers.
  

• What will mental health help look like inside of a school? Some schools are implementing social and emotional learning as well as mindfulness into regular curriculum. The schools that are doing it well are integrating these things into regular content, so kids are learning to self-regulate and read at the same time, for example.
  

• What if the parent or teacher isn’t pulling their weight? This is very common. It’s more common than everyone being on the same page. Sometimes the MH issues are caused at home. Not all MH issues come from the parents, there are other things that cause MH issues and trauma, but sometimes it does come from something going on at home. Alcoholic parents, abusive parents, etc. This makes it much more difficult for the educator. Any headway the schools can make is erased by the child going home at night or over the summer. We talked at length about this.
  

• Peer to peer support systems within schools – and at what age can it work? We talked about peer to peer support networks within schools and how effective they can or can’t be. We discussed at what ages it can work or makes sense to try. We talked about how peer to peer solutions are good but are only one part of a bigger implementation of solutions. We find that many kids have a stronger connection with their peers than adults, and when you consider that teachers have to report a lot of what they hear kids talking about, it is safer for kids to talk to their peers (and better than not talking at all). On the topic of how early is too early, she says she has seen peer to peer networks work as early as 2nd grade (with adult monitoring and facilitation of course).
  

• We talked about stigma and compared the way children and adults stigmatize mental health issues. Based on our conversation, it appears that children are less likely to stigmatize themselves or others and are more open to talking about their problems than many adults. However, at younger ages, they don’t have the coping skills to deal with the issues that come up so they have to be in the right environment with the right oversight to have these conversations.
  

Mental Health Biomarker - Heart Rate Variability

What do monks, startup founders, and Ph.Ds in cognitive neuroscience have in common?  They all have a heartbeat.  Today’s guest, Rohan Dixit, founder of Lief Therapeutics joins us to talk about how our heart beat, can tell us more about our mental health, than any other biomarker, and how we can learn to use it to self-regulate our mental well-being.

Rohan explains how Heart Rate Variability (HRV) data can be used to help us learn to self-regulate our emotional state by taking biofeedback and using it to train ourselves to regulate our mental state.

Rohan explains the science behind it this.  He has a degree in cognitive neuroscience from Northwestern and has done a lot of interesting research around neuroscience at both Stanford and at Harvard and around the world when he spent a year measuring the HRV in Monks who have mastered the art of self-regulation.

You can connect with Rohan and Lief Therapeutics here: Website, Twitter, Rohan’s LinkedIn

HERE ARE SOME OF THE THINGS WE DISCUSSED:

1. Rohan Dixit is an expert in Cognitive Neuroscience and he joins us to talk about neuroscience, heart rate variability, his startup Lief Therapeutics, and his story of recovery from depression and anxiety. He began his own mental health journey as a teenager. Solving problems in this space is very personal to him. He talks about how mindfulness and meditation changed his live by helping him manage his mental health struggles and ultimately led him to this space.
   
   

2. Cognitive Neuroscience is how the brain thinks and how we perceive who we are. We can use it to help people who are sick (with mental illness). Rohan talks about having spent a year studying the biofeedback data from monks and noticing how masters of self-regulation present when analyzing brain waves and heart rate variability biofeedback.
   
   

3. We talk about the Default Mode Network, a large scale brain network of interacting regions that controls our perception of ego. If we tweak that network, then some parts of what we think about our self, can be turned off or managed. Rohan explains how using biofeedback to improve our ability to self-regulate can help us do just this, tweak our Default Mode Network.
   
   

4. What is biofeedback? Have people been using it for a long time? Biofeedback testing started in the 1970’s. One of the earliest studies included a group of students where half were asked to consciously raise the temperature of their fingertip, and the other half asked to lower the temperature of their fingertip. If you give those students an accurate enough sensor, then they could do it. With the right biofeedback, you can train your body, and your mind. Heart Rate Variability (HRV) is the best biomarker to use for biofeedback when it comes to mental health.
   
   

5. What is Heart Rate Variability (HRV)? It is the most accurate biomarker for tracking the body’s response to a variety of mental states, stressors, and moods. This is all found in the variability of one heartbeat to the next. You can track this with an EKG or some very good sensor. If you track it enough, and practice regulating it, then you can effectively manage your mental wellness by actively controlling HRV. You can practice how to make that biomarker (HRV) improve through breathing and biofeedback.
   
   

6. Why did Rohan become an expert on HRV? Rohan found relief from his struggles in meditation and self-regulation practices. He started to have better emotional responses while engaging in these practices. He wanted to know why it worked, so he went to Tibet for a year and studied the biofeedback in Monks who are experts in self-regulation.
   
   

7. What is Lief Therapeutics? Rohan aims to integrate those ideas into the mental health system that is currently failing millions of people. The system failed him, as he states. He has found a way to use science, to measure the effectiveness of a person’s self-regulation and turn it into something that insurance companies will pay for.
   
   

8. Why do biomarkers matter for treating mental health? Imagine if your doctor was trying to treat you for diabetes without using any blood tests. Maybe they only asked you how tired you were after big meals and diagnosed you that way. That’s how we diagnose mental health issues today.
   
   

9. What about other biomarkers like voice, facial recognition, etc.? Those biomarkers can’t really be called biomarkers. They are behavioral assays. They are not the best with respect to teaching people how to get better either, but HRV is, and that’s the focus at Lief Therapeutics. Let’s say you use voice to diagnose depression, then you’re telling people it’s a behavioral issue that’s in your head and if you talk a little peppier, then you’re well, and we all know that’s not true. Depression is a physiological problem. It’s not just “in your head.” HRV is easy to measure accurately. You can teach people to improve HRV using the biofeedback.
   
   

10. How to measure HRV? How Lief works. To measure it in a clinically accurate way and provide biofeedback you need hyper accuracy. The only way to do that is with an EKG. Lief built an EKG smart patch. You put it on your body, it’s very discrete, and measures with hyper accuracy. Then it gives you vibrations through the patch, that teach you to breath in a pattern that improves the HRV and in turn your mental health. Eventually, you know what you’re doing and you can take the training wheels off and not need the patch any more.
    
    The goal is to be like training wheels on a bike. Lief teaches people how to be aware of what’s happening inside them. Lief gives them skills to get better. Eventually, people don’t need the advice. The solution is a short-term training program. Once you know how to self-regulate, then you don’t need Lief anymore, and that’s a victory.

How Psychotherapy Can Become Mainstream

I had the most educational, and enlightening conversation with Dr. Cameron Sepah and I’m lucky that I captured it digitally and can share it with everyone!  We talked about a range of topics from his education at Harvard and UCLA, to his time growing a digital health tech startup from 6 to 300 employees and now his efforts running his own private practice while advising multiple venture capital funds on their investment strategies in and around digital health investing.

Dr. Sepah is a venture capitalist, an investor, an executive psychologist, an assistant clinical professor at UCSF Medical School, he’s a founder, a CEO and someone whose public commentary on mental health, and human performance to be very educational and insightful.

In his private practice, he helps CEOs, and VCs optimize for health and performance using evidence-based approaches.  We had an incredible conversation about evidence-based treatment, stigma, and psychotherapy will have to evolve in order to become mainstream (just like jogging or physical fitness).  The answer is in and around the idea of how we select our sexual partners and goes back to Natural Selection.

You can connect with Dr. Cameron Sepah directly via his Twitter and LinkedIn, and keep up to date on his work via his newsletter which I highly recommend. 

HERE ARE SOME OF THE THINGS WE DISCUSSED:

1. Dr. Cameron Sepah talks with us about growing up in San Diego, then attending Harvard for his undergraduate degree and UCLA for his Ph.D in Clinical Psychology (Psychoneuroimmunology). We talked about his love of people and passion for understanding them from a very early age and how that drove him toward his educational focus and profession of choice because he wanted to apply his learning to helping people.
   
   
   

2. While in college at Harvard, he worked in a cognitive neuroscience lab doing research with Stephen Kosslyn. Their research included looking at how Buddhist monks can control their emotions, one of them to the point where he could avoid reaction to a gunshot next to his ear. We talked about this study of learned emotional responses in our conversation in this episode.
   
   
   

3. While in graduate school at UCLA he focused on several areas including anxiety disorders, and behavioral medicine / health psychology. He did a lot of work around using behavioral interventions to manage chronic illnesses including obesity and diabetes. We talked a lot about some worrisome and fascinating statistics and facts around these diseases including:

   1. Only 12% of people have zero metabolic issues (blood sugar issues, diabetes, obesity, etc.).

   2. This is the first time in history that most adults have abnormal blood sugar levels.

   3. We live in a profoundly sick society.
      
      
      

4. Diseases of lifestyle kill more people now than diseases of infection do. We as humans are dying mostly from diseases of excess. We talk about why, and how this is relevant to the mental health struggles of many people who Dr. Sepah has treated over the years.
   
   
   

5. Individual or group therapy isn’t set up to solve the breadth of the mental health problem set in society. It’s not that it isn’t effective, but most people can’t afford it, don’t have the time, or don’t have the energy or resources to show up in person and do what they need to do. So why should providers expect people to come to them, when providers could come to patients, digitally and conveniently? We talk about the emergence of digital access to care at length and Dr. Sepah’s contribution to developments in that space.
   
   
   

6. Dr. Sepah moved to Silicon Valley right after getting his license to practice. He wanted to help people with metabolic diseases, so he joined the founding team of Omada Health where he was able to help far more people than he could in an individual practice. Their business helped over 250,000 people lose over 2,500,000 pounds while he was there.
   
   
   

7. We talked about the mental health crisis in the university school systems and how colleges are not prepared to handle it or deal with it. Even at his college, Harvard, where he was surrounded by wealthy kids with tremendous privilege, there were many mental health issues and struggles. He estimates that at least half of the students there struggled in some way with mental health.
   
   
   

8. What contributes to human flourishing? If you go to your doctor for a check-up and the “check engine light” says you’re ok, are you really? Is there really nothing you can do to improve? Is the absence of illness necessarily the presence of health? We dig into this from a mental health perspective.
   
   
   

9. When will psychotherapy be mainstream, like jogging or going to the gym? You must look at it from a sexual mate selection perspective. Let’s look at fitness as an example. Fitness is a growing market, and it hasn’t always been that way. 50 years ago, fitness was not a big thing. It wasn’t that long ago that the only people who jogged, were athletes almost exclusively. Fitness is a relatively recent phenomenon as it has become a status symbol, or a signal for sexual partner attractiveness. On the contrary, therapy and mental fitness efforts signal that you are mentally ill or a potentially unstable partner to potential mates. Mental health will never be at the same place as physical fitness until it enhances your potential value as a partner to other people. This will require stigma reduction.
   
   
   

10. How do we de-stigmatize psychotherapy? We have to re-brand it all together. The term “therapy” has too much cultural baggage for us to reclaim it. We talked about the need to move away from pathology and stigma toward performance and prestige. Take having a personal trainer or personal chef for example – they are status symbols indicating that you prioritize nutrition and fitness. We must find a way to re-brand psychotherapy so that people can view it as a positive tool in your life.
    
    

11. Calm and Headspace have nailed the consumer marketing aspects of mental health. They brand themselves as sleep aids or meditation apps, but when you look at the reviews of the apps, people are using these apps to improve their mental health. The best mental health companies don’t use the words “mental health” to brand themselves or what they do.
    
    
    

12. The best athletes in the world, have coaches, they could probably coach themselves. They know that playing is not the same as coaching. There is unique value in someone who is focused on theory and strategy on your behalf. You also need clear objectivity from an outside observer when you train as an athlete. Finally, you need someone who curates all the potential techniques and approaches to help you decide what’s best for you. Coaches help athletes with these things so the athlete can focus on execution. We need this in our lives from mental health professionals. The term “life coach” or “executive coach” hasn’t taken off because of how the non-licensed life or executive coaches have treated the industry. It all comes down to tracking and ranking performance outcomes. This works in physical training and needs to be applied to mental health and wellness.
    
    
    

13. How do we reduce stigma around therapy? If therapy is always associated with coping with job loss or coping with a breakup or coping with low self-esteem, then it’s always going to have stigma associated with it. Maybe we should re-brand it as “performance psychology” and focus on what people want such as making more money, attractiveness to potential or current partners and increased confidence.
    
    We should be more focused on the positive. Focus on producing outcomes that people want and things that make you an optimal person or partner in every way.
    
    
    

14. How do I find a therapist or a performance coach? We talked about who to look for, what to look for and how to do it. Dr. Sepah emphasizes that you should find someone who is licensed to do this kind of work (there are many “life coaches” and others out there who have no licensing or very minimal training). We talked about resources for finding therapists and some things to watch out for in how providers describe themselves and their areas of expertise (too many therapists list their expertise too broadly).
    
    
    

15. We talked about the mediums over which therapy can be delivered from texting, phone calls, video calls, and in-person meetings. Dr. Sepah talks about the effectiveness of each way of meeting with people and which ones are effective in his opinion as well as how each of those methods can be used in a holistic treatment plan where continuity of care is important.

You Are Not Alone with Mxiety

Marie “Mxiety” Shanley joined me for a conversation about mental health, depression, streaming on Twitch/Mixer, and how to get help when you are struggling. She shares her own story of overcoming debilitating depression, PTSD, and anxiety.

Since getting help, Marie felt compelled to create a place that connects people who are currently struggling with people who have struggled, so nobody ever has to be alone in their time of need.  

She has built a community on streaming platforms Twitch, and now Mixer, where she talks with her audience about mental wellness two nights a week.  In addition to this, she’s written extensively about her mental health journey and experiences on her blog here.

Please do check out Marie’s website, stream, and social channels, which you can find here: Website, Twitch, Mixer, Twitter, IG, YouTube.

Here are some links to a handful of her very helpful blog posts on a range of mental health topics:

3 Things you can Do Right Now if You’re Anxious

List of Things to do When You’re in a Depression Low

List of Warning Signs that You Might be Falling Back into Depression

Marie’s current streaming schedule is every Wednesday and Thursday night at 7 PM ET.

HERE ARE SOME OF THE THINGS WE DISCUSSED:

1. Mxiety is a streamer on Twitch and Mixer. However, she doesn’t play video games like you may expect. Her show is about mental health and wellness. She’s apart of a surge of content creation meeting demand for mental health and wellness on streaming platforms by creating community around the topic and sharing personal experiences.
   
   

2. Marie tells us about her mental health journey. One day Marie found herself sitting in a corner, struggling, rocking back and forth because of the the pain she felt due to debilitating depression, anxiety, and PTSD. She shared with us about how she got to that point, and what she did to get better.
   
   

3. We talk about how we label ourselves by our weaknesses and struggles. We talked about how and why we came up with labels and why we continue to use them both for the benefit of ourselves (or detriment) and because of how others expect us to label ourselves.
   
   

4. Is there anything that could have led you to get help sooner? Marie talks about trying therapy, and going to a school counselor, which didn’t seem to work for her at first. She tells the story of experiencing suicidal thoughts and going to see the college counselor, who couldn’t help her in her time of need.
   
   

5. We talked in detail about the extreme stigma around suicidal ideation. We discuss how hard it is to be open about this topic. Marie talks about how after 7 years of therapy, finally had a therapist who seemed to handle it appropriately and talk through it, instead of upending her life. We agreed that there is some work we must do as a society around how we respond to people who have these thoughts.
   
   

6. Marie shares with us about where she finds support and what her support network looks like for her struggles. She talks about this by framing her current network against her old network, which was basically no support at all. She gives a list of things she tries to do daily, weekly, monthly, etc. in order to manage her mental wellness, which she has also discussed on her blog here.
   
   

7. We talked about how she got into streaming and building a community of people interested in mental wellness. Once she found support in a local community, she wanted to create a place where people could find a sense of community when they are struggling.
   
   

8. Marie talks about her streaming community and how many different people, with so many different struggles from all over the world have joined her community and engage in the conversation she creates space for several times a week on her stream, which you can find here on Mixer and here on Twitch.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn

Automated Mood Tracking with Dan Seider, CEO of Misu

In episode 10, we have a conversation with Dan Seider, founder and CEO of Misü. Dan talks to us about his experience living with bipolar disorder, getting diagnosed, how he thinks about his mood states on a regular basis and taking medication (Lithium). We also talked about how Dan became very aware of his mood state after his diagnosis. Dan’s personal desire to track his own mood state over 100,000 times, drove his efforts to try to automate the mood tracking process.

Dan’s startup, Misü, is solving a problem that many people struggling with mood disorders, and people who seek to be aware of and improve their emotional wellness have.  He has developed the first automated mood tracker.  No hardware required.  

Dan talks to us about the product he is building, and we talk more broadly about the mental health tech ecosystem as well.  Dan is one of the most connected people I’ve met in the mental health tech ecosystem.  If the idea of technology applied to mental health problem sets is interesting to you, then you should reach out to Dan.

You can connect with Dan on social media via Facebook, LinkedIn and on his Company’s website or over email at dan@misu.app.

HERE ARE SOME OF THE THINGS WE DISCUSSED:

1. Dan talked to us about his diagnosis with bipolar disorder 8 years ago.
   
   

2. He shared how he realized that he needed help, how he found help, and where he went to get it. Dan has a psychiatrist in his family, so that made it a little bit easier, but he, just like everyone else, started his journey by going to the emergency room and eventually found his way to medication, support groups, etc.
   
   

3. We talked a lot about how important it is to track and measure mood states, and how he found his way to building a business around doing so. Dan shared about how he’s building a tool that will automatically track mood for people using the technology in our everyday lives.
   
   

4. Dan has extensively researched the policy, legal and regulatory environment around mental well-being as it pertains to how things impact us (social media, tech, etc.). We talked about Dan’s excitement to see major platforms like Facebook, Twitter, Reddit, and others work to be able to measure how content impacts consumers’ long-term mental well-being and start optimizing for that. Some of this is driven by a desire to help humans, and some is driven by policy and legislation that is coming soon that will force some changes in this area.
   
   

5. Dan gave an overview of his startup, Misu, that analyzes emotional state through the webcam on your computer and detects emotional state automatically. There are many applications of tracking this data, and Dan goes into them in detail. Dan shares how he came up with this for his own personal use and how he uses this tool himself.
   
   

6. Dan explained that he sees a future where there is a derivatives market that collects payouts paid to certain companies for positive impacts on consumer’s mental health. The key to getting there is automatic mood tracking, like what Dan is building at Misu.
   
   

7. Dan gave an overview of the mental health tech startup ecosystem. He is one of the most connected people in this nascent market. Dan talks about what tools are out there now, what could be developed realistically, what he uses, and what he would like to see developed.
   
   

8. We talked about the technology capabilities that are leading to this boom in the mental health tech market such as machine learning, voice recognition, bio-markers, etc.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn

Cornbread Hustle – Recovery & Second Chances with Cheri Garcia

In this episode I had the chance to speak with a friend of mine, and someone who was very compassionate toward me in my early days of recovery, Cheri Garcia.  She is the founder of Cornbread Hustle and our conversation was very raw, very vulnerable and opened my eyes to the movement around second chance hiring that’s growing quickly here in America.

Cornbread Hustle is a staffing agency for second chances (people getting out of prison or living in recovery).  Cheri is passionate about helping felons, and people in recovery find transformation through employment or entrepreneurship.  

Cheri’s story of addiction to methamphetamines, and alcohol resonated with me and her story of finding sobriety is going to be helpful to many people.  Cheri talks about how she educated herself as to exactly what the alcohol was doing to her body, and when she realized that it was increasing her anxiety, instead of numbing it, she quickly found the necessary motivation to get help in AA.

Cheri found her own transformation and recovery through starting a business and eventually building a career in the TV news industry.  As she progressed along this path, she developed a number of skills in marketing and PR. She now uses those to help individuals getting out of prison re-brand themselves to become the person they want to be and get noticed by the people they want to meet.

Cheri is also a PR consultant for Mark Cuban companies, and provides strategy plans and media opportunities for a variety of Shark Tank companies.  

Links: Cornbread Hustle, Cheri’s Twitter, Cheri’s LinkedIn

Here are some of the things we talked about:

1. Cheri tells her story of getting over her meth addiction in 2007. She talks about how she didn’t really get into the recovery community but replaced her addiction with a love of success and money which led to a whole set of other problems for her.
   

2. She talked about why she felt a need to use drugs and drink, and what she was trying to escape from with that numbing. Many things led to her falling into addiction including lacking healthy boundaries, people pleasing and wanting people to like her because she didn’t like herself.
   

3. Cheri opens up to us about what she felt like when she got a DUI, how she found herself in that situation, and what it meant as the founder and CEO of a second chance hiring business.
   

4. We talked about why she got help and sought sobriety. Cheri talks about how someone reached out to her and mentioned their concern. She downloaded a book on trying to control alcohol. As she learned about what alcohol withdrawals look like, she learned that a lot of the anxiety in her life was because of the alcohol, not relieving her from the anxiety.

5. Cheri’s business is, “Cornbread Hustle,” a staffing agency for second chances. Cheri’s team helps people getting out of prison and people who are living in recovery, find jobs. We talk a lot about what kind of jobs she helps them get, where those jobs are, and how she places them. Her work is truly inspiring and she’s doing amazing things.

6. Cheri talks about how it wasn’t popular to be helping felons a few years ago when she started. Recently, with celebrities like Kim Kardashian and others talking about this cause, it’s become more mainstream. She talks about how a lot of people discouraged her from creating this business.

7. She talks about how she doesn’t go out and pitch companies to hire her people, but that companies are proactively coming to her. She does spend a lot of time hearing employers talk about how they want someone with a non-violent background, and Cheri talks about how she gets those employers to be more open-minded about who they will and won’t work with.
   
   

8. What kinds of jobs do you place second chance hires into? We talked a lot about the types of jobs she is placing felons, drug dealers, former doctors, and others in.
   
   

9. We talked about how many of the people getting out of prison may be very well suited to be founders of startups. Cheri talks about her vision for where this idea can go and how this could turn into an entire ecosystem of its own adjacent to what she’s doing with the staffing business.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn

Episode 8: Stigma is a Squirrel. Run at it Shouting!

I’m excited to share my conversation with Mark Freeman. Mark is an author (Book: “You are Not a Rock”), mental health coach, workshop facilitator and someone that I follow closely as his frequent tweets and public commentary on mental health and wellbeing are helpful for me as I live in recovery from addiction and live with bipolar disorder.

In addition to talking about stigma, mental health care and treatment for anxiety, Mark discusses his own struggles with addiction, anxiety and OCD.  We were able to relate quite a bit about our past struggles and paths to recovery.  We also dig into how the mental health care system is designed to foster increasing stigma.  In the same way you don’t have to have a diagnosis to get a gym membership, you shouldn’t have to have a diagnosis to get help with mental health.  The solution to this broken way of thinking is an entirely new mental health care system, which we talk about in this episode.

Mark currently lives in Toronto and focuses his professional efforts on change management workshops for Fortune 50 companies, peer support for people suffering from anxiety disorders, and creating books and videos to fill the gaps in our healthcare system. 

More about Mark:  Website, Book, Brain School

You can connect with Mark directly via twitter @thepathtochange

Here are some of the things we talked about:

1)      Stigma is a Squirrel.  Run at it Shouting.  Mark makes this analogy about we fear stigma, and let it prevent us from getting help and how similar that is to the squirrels in Toronto that will steal from you, but if you are aggressive toward them, then they run away.  Stigma is very similar. 

2)      We talked about Mark’s personal experiences with compulsion and OCD.  He talks about how he didn’t think he was struggling with any mental health issues.  He started to feel separated from reality and would start to do things like standing in front of his stove for a long time just to make sure it was not on.  His compulsions and OCD tendencies gradually took over his life.  Although he viewed none of this behavior as strange, because he thought he had perfectly good reasons for doing it. 

3)      What led you to seek help?  Depression, addiction and sexual compulsion issues led him to speak with a counselor.  He thought everything else was fine and totally healthy, and that’s when he learned that he needed to work on the compulsion and OCD. 

4)      We talked about the intersection of mental illness and sex.  If you are running into any kind of mental health challenges, they are likely affecting your sex life as well.  Sex is so much about out intimacy, being ourselves, uncertainty and vulnerability.  So, if you’re struggling mentally, it’s going to be hard for you to experience intimacy and be vulnerable.   

5)      Mark talks a lot about holistic mental wellness.  I asked him where people should start to get help if I haven’t gotten help before.  Do you start with cutting out social media, dealing with addiction, therapy, or church, or some other place?  Mark talks about this and gives some examples based on his experience.  He talks about how he encourages people to start learning to interact with the thing in our heads differently.  For example, resisting urges to check your phone or email.  Learning to know that you have an unread message, but not opening it and controlling that urge for some time. 

6)      How do we make changes in our lives before we crash and burn from addiction or mental illness?  Will we lose our edge if we go ask for help or seek treatment?  We talk about how we can be more proactive and where to start if we have never sought help before. 

7)      Often with physical health, we get proactive because we see somebody doing something we want to do.  In mental health, because people keep it quiet, we don’t see those examples as often. So, there isn’t as much of a sense that we can be doing something to improve.   We are still in the early stages of people talking about mental health, even though, we have had brains for a very long time. 

8)      A lot of the things we call mental illness could maybe have been considered great survival tools back in the caveman days, but in today’s world, it’s hard to fit in when you demonstrate those traits. 

9)      Swimming is not about “avoiding drowning” it’s about “learning to swim.” We don’t label ourselves as having a drowning disorder because we want to learn to swim.  It’s about the thing we want to learn and build.  We need to approach mental health this way.  IF you think of anxiety as a lake, you don’t have to “fix the anxiety lake,” rather you want to figure out how to swim across it instead of stopping and seeing it as a barrier.  We need to learn how to go where we want to go. 

10)   Where do I start if I want to deal with my anxiety?  Start with smaller uncertainties.  Things like not checking your phone. You notice a simple uncertainty, and you don’t react to it.  Then you can progressively level up from there. 

11)   How do we learn to sit with uncomfortable feelings?  Just like exercising the first time.  If you went to the gym and tried to lift a weight, and failed, you wouldn’t just never go back to the gym.  If you go to therapy and have a painful experience you must keep going back.  You must push yourself just like you would physically. 

12)   We talk about where stigma comes from and how we can address it.  The mental health care system was designed around stigma.  Nobody would exercise if you could only get a gym membership by admitting an illness or have a diagnosis.  The mental health system works this way where we have to admit we are ill or be diagnosed before we get help.  We must change how the system functions. We should view getting help for mental health the same way we do a gym membership.  We should view it as doing something good for ourselves.  It’s going to take consumer led services led by people who are living in recovery to fill the gaps.  It will take a new system all together.  Then we can hope to see stigma reduced.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn

Episode 7: Bea The Difference

Bea Arthur is a Columbia University trained psychotherapist, founder and CEO of The Difference, and an author who works with high performance individuals.  Bea was the first African American female founder in Y-Combinator and was named as an Entrepreneur to Bet On by Newsweek Magazine as well as one of Bumble’s 100 Most Inspirational New Yorkers. 

I had a blast during this conversation, and I learned a lot.  Bea is just all around amazing and I learned a lot from my conversation with her.  She knows the history of mental health care, and the mental health tech landscape better than anyone else I’ve met lately.  This conversation was educational and informative for me.

You can connect with Bea on her websites and social media.  Her twitter handle is @BeaArthurLMHC and you can find her online at her personal website, The Difference website and on LinkedIn.

Here are some of the things we talked about:

1. What led you to get a master’s degree in Psychological Counseling? Bea talks about how psychology “fell into her lap.” She talks about how she found her ability to connect with people by being nosey, and she found that people would open up to her while she was a real estate agent digging into her clients’ backgrounds to see if the home they were viewing was a fit for them.
   
   

2. How did you find your way into entrepreneurship? Bea talks about her journey from multiple jobs including being a real estate agent and finding her way to a counseling degree and into the entrepreneurship community.
   
   

3. Bea talks about how she came up with the idea for The Difference, which is a startup that provides on-demand access to therapy as Amazon’s first mental health Alexa skill. We talk about how hard it is to find a therapist. Bea explains how the primary reason people aren’t getting help is because of access. She talks about how the suicide hotline (a non-profit) is the only platform that has always been around and always had volume and impact. The reason is because it’s accessible. So, she is building a tool to give people better, immediate access to therapy.
   
   

4. History of the therapist, patient, and payer relationships since the 1980s. Bea explains how we got to where we are today in the mental health market. She explains that there is a misconception that therapists charge a lot of money based on their worth. The truth is, therapists charge that much because they must.
   
   
   People used to get 20 free therapy sessions a year from their insurance companies. Then in the 80s and 90s, when mental health started being categorized as disability, employers started using this against employees to fire them. This was before the disabilities act. In the 80s and 90s when there was free therapy, people started paying out of pocket so their employers wouldn’t know. Also, when submitting a claim, a therapist must wait 2 months to get paid $60 when they can just get $200 now private or cash pay. Since then we still haven’t figured out how to get clients and counselors connected in a good way, and that’s what The Difference is trying to solve.We talked about corporate leaders having a responsibility to take the lead on mental wellness. Bea explains that most companies are quick to nod their head and say they want to help or be supportive of employee mental wellness but are not quick to write a check to do so. Companies are still in a place where they need to be convinced of how that spending will positively impact their bottom lines.
   
   

5. We discussed men specifically struggling with mental health. Bea talks about some of the statistics on this issue and how much worse mental illness is among men than women. She talks about the way men make social connections, and how men spend their time socially (watching a game, golf, gun ranges, fishing) doing things that don’t foster face to face sharing and vulnerability. This type of “manly” social connectivity is harmful to men and their mental well-being.
   
   

6. Isolation can kill you. We talked about how humans have always been tribal creatures, but recently we have become such an individualistic, kill or be killed alpha-male society. Going back to the topic of men’s’ mental health, a lot of men think of themselves as leader of the pack . But back when we were in packs, we all had to rely on each other, even the leader. We had to admit our fears and work together. In an individualistic society, only “you” need to survive, so you worry about yourself and keep all the fears inside.
   
   

7. We talked about this idea of a “mental health baseline” and how we have to be self-aware both physically and emotionally. Our bodies will tell us when something is wrong, so when things don’t feel right, you need to talk to someone and not just think it will go away.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn

Episode 6: Mental Health, Stigma, and Vulnerability with Jordan Brown of AnswersNow

In this episode of the Stigma Podcast, I spoke with Jordan Brown, an advocate for mental health, a social worker in the mental health field, writer, poet and key member of a mental health related startup. He has also spent time volunteering with the National Alliance on Mental Illness as well.

He’s a part of a team helping to build “AnswersNow” which is a solution that helps parents raising children with autism by providing access to board-certified clinicians via desktop and mobile devices for guidance to help the parents through day to day concerns they face. 

Jordan has written several articles on many topics surrounding mental health.  His writing can be found on his website, nerve10.com.  He also has a newsletter where he distributes some very meaningful and authentic mental health information.  

Jordan’s Website: nerve10.com

Jordan’s Twitter: @JPBrown5

Jordan’s Newsletter: https://pages.convertkit.com/d4d10d3480/e64a43d759?src=twitter_profile

Here are a few highlights of what you can expect to hear in this episode:

1. We talk about Jordan’s background and how he found his way into the mental health space. Jordan did not begin in mental health. He got involved because of a personal connection to a family member who had a mental health issue. Many of us can relate to that.
   
   

2. Jordan shares about how he underwent open heart surgery in 2012. He has written about, and shared on our podcast, about how much harder the mental and emotional recovery was than the physical recovery from that surgery. Jordan talks about that and how he dealt with the mental health component of that recovery. He shares about how after surgery he struggled to sleep, which led to mental health issues.
   
   

3. We talk about OCD, anxiety and compulsive struggles including skin picking. Jordan shares how he overcame his own struggles with each.
   
   

4. Jordan talks about after getting some less than desirable help from mental health providers, he was admitted to a mental health facility in Montana after having concerns about harming himself. He discusses how treatment providers he worked with before being admitted were not helpful, and then when he was admitted, he was helped by a psychiatrist who really understood him and his needs which made all the difference in the world. It took quite a bit of courage to stand up and say he wasn’t getting any of the help he really needed and checked himself in to a mental health facility.
   
   

5. We talked about how to proactively manage mental health. Jordan gave a list of things he does to proactively manage his mental health. That list includes:

   1. Getting enough quality sleep

   2. Good sleep hygiene – consistent sleep and wake times, etc.

   3. Turning off tech an hour before sleeping

   4. Meditation – he calls the mindfulness he gets from meditation, a superpower he has

   5. Getting enough exercise – such as walking and hiking

   6. Avid reader (50-80 books a year)
      

6. Jordan has mentioned publicly that we have an ethical responsibility to talk about mental health. I had a chance to get more of his thoughts on what that ethical responsibility means. He makes the point that mental health issues can’t be allowed to “slide” – for instance, if someone has cancer, we rush to their side. So, when someone has a mental illness, we need to support them the same way.
   
   

7. We talked about ways to defeat or reduce stigma. We have to talk about it. We have to tell uncomfortable stories. We don’t really give people a voice who are dealing with serious mental illness. We go into the co-occurrence of mental health and addiction as well as the presence of trauma when addiction is also present in people.
   
   

8. We need to drastically reform the mental healthcare system. What we are doing right now is not working. Different parts of the health care system don’t talk to each other and the care isn’t what it should be. HIPAA, even though it has good intentions, makes it very hard to communicate about mental health issues.
   

9. We talk about the culture of “toughness” and specifically how it pertains to men in society today. We talked about how men are not encouraged to be vulnerable, share their emotions, and open up and how that impacts boys later in life. This culture is prevalent not only in “sports” for young kids, but it’s prevalent in many industries, like startups where the culture of working harder, longer, and sleeping less is seen as a badge of honor. The mentality of “suck it up” has destroyed the fabric of humanity.
   
   

10. Finally, Jordan shares more about what he is working on at AnswersNow and how his business is helping parents of children with autism.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn

Episode 5: 'Asking for Help' is not Weakness. It is Strength. - Micah Baldwin

Micah Baldwin is a serial entrepreneur and founder of Graphicly which was acquired by Blurb in 2014. We are very fortunate to have him come on the show and be very vulnerable with us about his experience recovering from addiction, and dealing with mental illness since childhood. He has a lot of wisdom and experience living in the recovery community and helping others to find help and hope.

Micah grew up in Silicon Valley and started his first company at the age of 9. After selling Graphicly, he spent time at Amazon where he led a team dedicated to helping startups growth their businesses by connecting with large enterprises and business units. Currently, Micah is the founder and Executive Director of Create33 in Seattle which he describes as a labor of love, providing resources to founders such as advice, fundraising access and other resources he would have loved to have when he was starting out as a founder. 

He is also an experienced startup investor, and a trusted adviser to many startups as well. He’s a mentor and adviser at 500 Startups, Techstars, CrunchFund and others where he helps early stage companies with fund raising, business development, product development, marketing and growth 

You can connect with Micah on twitter @micah. You can read more about his background and find a link to all of his socials on his profile at about.me/micahb.

Here are a few highlights of what you can expect to hear in this episode:

1. Micah talks to me about his personal entrepreneurial journey. He talks about growing up in the heart of Silicon Valley and how his father worked at Stanford and was asked to be the 4th employee at Cisco. Micah grew up around entrepreneurship.
   

2. I asked Micah what comes to mind when he thinks of mental health and he shared about how stability comes to mind first and goes on to explain his lifelong struggle battling mental health issues. He discusses his mental health diagnoses which include bipolar 2, anxiety and bipolar depression, all of which are medicated, and he is currently in a stable state. He talks about how when he was growing up, nobody really knew what mental health was and that people just viewed him as “the crazy kid” who was sad all the time, or the little “genius kid” that was like a little energizer bunny all the time. Micah goes on to explain how when he talks to his mom to this day, about mental health, her response is just about always the same. She says she she wished she knew this was going on when he was a kid. This brings up a very interesting point which is that mental health was not talked about when we were kids. It was something you kept quiet. He gives an example about how if he had gotten in a car wreck and become a paraplegic there would have been a conversation about how to deal with it, but mental health just wasn’t talked about.
   

3. We talked about how addiction interacted with his mental illnesses throughout his life.Micah talks about having an addictive personality, and how moderation has been something he struggled with. His very first drug was food. He became a big kid and he talks about how he used his role as the “funny fat kid” as a defense mechanism. Later in life that translated into drug and alcohol addiction. He talks a lot about how he bottomed out and when he decided to get sober, as well as his process to gain sobriety and maintain sobriety.
   

4. I asked him to talk about the difference between “white knuckling” it with regards to addiction recovery versus going through a program like AA. He talks about how he first attended AA after being court mandated after a DUI in the early 2000s. When he went he expected it to be full of fake people pretending to work a program but, he realized how nice everyone was, how different everyone was, and how every single one of these very different people were full of pure love for one another. The sense of belonging was the biggest wake up call for him.
   

5. We talk in depth about the spiritual component of AA (or 12-step programs). He talks about how at one point he was turned off by the mentions of “higher power” in AA. He talks about how he would listen to all these people turning their lives over to a higher power and that it didn’t’ make any sense to him. He talks about how for him higher power has evolved into the broader AA group and how each friend he has made in the program represents a piece of this higher power.
   

6. I asked how stigma has impacted his journey with his mental health and addiction. He talks about how there is always this image of “perfect” in certain fields, like venture, or startups with respect to how you look, or who you are. He doesn’t fit the mold in many ways, and his fear of adding his mental health issues to his reasons why he doesn’t’ fit the mold kept him from wanting to get help or talk about it. Eventually he made the shift from worrying what other people think to not caring if someone judges him because he’s not like everyone else or because of what he’s done in his past.
   

7. We talk about how we can address the problem of stigma. Micah outlines three things that need to happen:

• Each of us needs to be open to admit that we all have biases and we have to work to be compassionate, accepting, and willing to listen to a person’s whole story instead of judging them based on part of the story.
  

• We need to talk about mental health as a medical condition, because it is one. My brain works differently than other peoples’ brains. That’s ok just as it’s ok for someone’s legs to work different than other peoples’ legs. Furthermore, education is key. There needs to be more opportunity to learn what it means to live in unstable versus stable mental states. We need to educate people on how they can be helpful to us when we are struggling whether it be in a crisis or in a depressed state or whatever it may be.
  

• We need more people who have succeeded in spite of mental illness and addiction, to come forward and share their stories. We need to make it well known that many people achieve a great deal of success while struggling with instability or addiction.

Connect with the Stigma Podcast in the following ways: Website, Twitter, Facebook, LinkedIn