Summary

In this episode, host James Ramos and Dr. Rachel Riphagen discuss mental health awareness and the importance of breaking down stigmas surrounding mental health. They address common misconceptions about mental health, the evolving understanding of mental health disorders, challenges in mental health care access, the impact of social media on mental health, the effects of the pandemic on mental health, and the need for cultural inclusivity in mental health care. Dr. Riphagen also shares promising breakthroughs in mental health treatment and emphasizes the importance of open conversations about mental health.

Keywords

mental health, awareness, stigma, misconceptions, disorders, challenges, access, social media, pandemic, cultural inclusivity, breakthroughs, conversations

Takeaways

• There are many common misconceptions about mental health, such as the belief that kids don’t experience mental health issues or that therapy is a waste of time. It is crucial to address these misconceptions to break down stigmas.
• The understanding of mental health disorders has evolved in recent years, with a shift towards viewing them on a continuum and focusing on individual experiences. This has led to improvements in service delivery, programs, and policies.
• One of the significant challenges in mental health care access is the shortage of mental health professionals, including clinicians, behavior specialists, and psychiatrists. Funding and resource allocation are also ongoing challenges.
• Social media has both positive and negative impacts on mental health, providing opportunities for social interaction but also presenting challenges. The effects of social media on mental health vary depending on how it is used.
• The pandemic has permanently altered the mental health landscape, with positive changes including the increased use of telehealth and a greater openness to discussing mental health. However, there has also been a surge in demand for services, leading to long waitlists.
• Cultural inclusivity is essential in mental health care, and interventions should be tailored to individuals based on their cultural background, age, gender identity, family background, language, spirituality, and physical abilities.
• Promising breakthroughs in mental health treatment include a better understanding of trauma and the importance of regulating the body, as well as research on the impact of sleep on mental health.
• It is important to ask tough questions about mental health and break down the stigma surrounding it. By asking questions and seeking help, individuals can contribute to a more open and supportive society.
• In the future, it is hoped that there will be a world where people truly see and understand each other’s mental health challenges and strengths, leading to greater empathy and support.

Sound Bites

• “Kids have mental health issues. Our elders do. Every culture, every ethnic group, all genders, there’s not a population that’s not affected by this.”
• “We’ve really started to view mental health disorders much more on a continuum.”
• “One of the biggest challenges is workforce retention. There’s a massive workforce shortage in mental health right now.”

Chapters

• 00:00 Introduction: Shining a Light on Mental Health Awareness
• 02:06 Addressing Common Misconceptions About Mental Health
• 05:23 The Evolving Understanding of Mental Health Disorders
• 08:34 Challenges in Mental Health Care Access
• 12:41 The Impact of Social Media on Mental Health
• 14:34 The Effects of the Pandemic on Mental Health
• 17:55 Cultural Inclusivity in Mental Health Care
• 20:19 Promising Breakthroughs in Mental Health Treatment
• 22:12 Asking Tough Questions: Breaking the Stigma
• 28:19 A World Where Mental Health is Truly Seen and Understood

Transcription for Dr. Rachel Riphagen Podcast 4-5-24

Hello everyone. This is James Ramos, your host on Empowering California. Thank you for joining us on this episode. We are here to shine a light on mental health awareness. With me here today is Dr. Rachel Riphagen, a clinical psychologist with profound insight into mental health challenges and solutions. Stay tuned as we explore the critical issues surrounding mental health, aiming to break the stigma and open up conversations.

Let’s dive into a discussion that matters to us all. Today, we are focusing on the topic that silently affects millions, millions with mental health awareness. Across our state and beyond, countless individuals face mental health challenges, many of which go unseen and unheard. It’s staggering how much remains unknown, and yet understanding and compassion can make a world of difference. As a community,

we can offer support by educating ourselves, breaking down stigmas and fostering open dialogues. Let’s explore together how we can contribute to a healthier, a more empathetic society. Now let’s shift our focus and dive deep into today’s vital conversation. I’m thrilled to welcome Dr. Rachel Riphagen, a dedicated clinical psychologist.

with profound insights into mental health awareness. Dr. Riphagen, thank you for joining us. Happy to, happy to. Thank you for inviting me. Your expertise is especially crucial as we navigate through complex mental health landscapes, aiming to enlighten our audience with knowledge and actionable advice. Let’s kick off with some questions that I believe will open up new perspectives for our listeners about mental health.

its impacts and how we can all contribute to better mental well -being in our communities and in the state of California. Absolutely. I agree. We need to talk about some of these things for sure. Dr. Riphagen, can you describe a common misconception about mental health that persists in society and why it’s crucial to address it? Sure. There’s so many, as you know, misconceptions about mental health.

Some real common ones are that kids don’t experience mental health issues. Another common one we’ve run across a lot is the assumption that people with mental health conditions are violent. That therapy and self -help is just a complete waste of time and it’s impossible to prevent mental health conditions. You’re crazy if you have a mental health condition. And it’s so crucial to address it because these things just persist if they’re not addressed.

many of these mental health issues they don’t resolve on their own without professional help. And I think some people kind of assume that they do. Some may, but many really need mental health interventions for that. Some major, major issues like suicidal ideation, those can actually go undetected for a while. People often think that, this is a big deal. It’s gonna show they’re gonna get the help. But you and I know that people can hide that all the time.

And suicide’s absolutely preventable. So that’s another huge one. Hidden means that the issue doesn’t get addressed, people hide it. If I just kind of describe one symptom of a very common diagnosis, so trauma is something that many, many, people struggle with as you know. One of those symptoms is hypervigilant or really jumpy. There are many symptoms with trauma, but that’s just one of them.

But if I paint a picture about how it affects their world, if I think about employment and this person is hypervigilant or jumpy at work, their boss may perceive them to be defensive, to be not approachable on certain topics. So that right there affects job, that affects performance, that affects their evaluation at work, that affects their promotion potential at work. So, and in relationships.

So if you’re hypervigilant jumpy, some people may perceive that person to be avoidant, to not be open. And so then they’re feeling disconnected. They’re not feeling connected in relationships. And then just thinking about if that person has a kid, that kid is watching their parent be worried and reactive about a certain topic. And that kid learns to be scared and avoidant of those things as well. So we can see how much this really affects the different areas of a person’s life. And I’m just talking about one symptom there of a very common issue.

So yeah, it affects so many different things. Kids have mental health issues. Our elders do. Every culture, every ethnic group, all genders, there’s not a population that’s not affected by this. And so it’s there. The question is just whether or not we admit that it’s there. Well, thank you. Thank you for that. How has the understanding of mental health disorders evolved in recent years within the clinical community?

Sure. So if I’m thinking about diagnosis itself, and I’ll go a little bit broader for a second. So really common ones are major depressive disorder, generalized anxiety disorder, post -traumatic stress disorder, oppositional divide disorder. Those are really common ones. We’ve really, as professionals, started to view them in recent years much more on a continuum.

we have a much more broader understanding about how it presents to various people groups, to individuals. And so it’s not just a slapstick diagnosis there. And so really with that, we do a lot more psycho -ed with our families about the disorders, about it being a description about what’s going on, a way of communication and language between people about something to describe something. If we didn’t have a word for chair, we need a word for chair to kind of describe something back and forth.

So similar to diagnosis. So it’s not viewed as much as something permanent. You’re gonna have this forever. This is a label. We’re really trying to pull away from that a little bit. And as understanding about mental health disorders has increased, that’s really affected. So talking broader now, service delivery has been impacted. Programs have been impacted and grown. Policies legislation definitely impacted and grown. And so when

providers and managers of programs, because that’s one of my jobs as I manage a mental health program, as we understand the disorder and how it presents and plays out, we can enhance our service delivery. So how we provide services, what services we provide to who and where we’re providing them. We’re able to implement evidence -based practices that we know are effective. And what that means is better outcomes. That means better success rates for those individuals receiving the services.

And when I think even broader than that, so individuals that are making decisions, that are running public programs, when they understand mental health disorders, and so I’m thinking broad, I’m thinking teachers, I’m thinking directors of community services, I’m thinking about lawmakers, when they know, then this means that attention and funding gets directed to places where it’s needed, where it would be effective. It means policies are in place to support those programs, to establish those programs.

and bring in awareness and need of the programs that are available. It also means when we’re having these conversations bigger, it means that we’re collaborating really at crucial intersections. So departmental behavioral health, they collaborate with faith communities. This is something that happens right now. Mental health agencies connecting with our local schools, because mental health isn’t a standalone. Multiple areas of life affect mental health, mental health affects multiple areas of life. So then,

by those intersections, we’re able to have those conversations. And it makes sense for those conversations to happen. Well, thank you. Thank you for that. And from your experience, what are some of the most significant challenges in mental health care access today? There’s a lot. There’s a lot. So speaking from my perspective, I’m a program director. So I direct a big program.

One of the biggest challenges that I’m running into is workforce retention. There’s a massive workforce shortage in mental health right now. There’s just simply not enough workers to provide the mental health services and the demands at an all time high. So it’s hard to find professionals like clinicians. It’s hard to find paraprofessionals like behavior specialists and parent partners. And you probably know this, there’s been a long time shortage on psychiatrists. It’s just kind of across the board.

Funding and resource allocation, that’s always a challenge. It’s an ongoing challenge, you know this, even for programs that have been shown to be helpful and effective. And you know that I managed a pilot project a few years ago, really toward the beginning of COVID, which that provided short -term intensive support to adults with suicidal ideation or who experienced intimate partner violence.

And that was funded through SAMHSA for 16 months. And our agency worked to sustain that program longer. did for a few months while we were looking for other additional funding. It filled a gap in the community that no one else was doing, but that funding eventually came to an end because we needed to end that program because it wasn’t funding that we found for that. And stigma is huge. It’s one of the reasons why we’re having this conversation. It plays a huge part as well.

We do intakes, I’ve done intakes, numerous ones, all the time for clients and families who’ve never been to a mental health clinic before. And not only that, but when I’ve done intakes, I’ve said, hey, do you know anybody that’s been to mental health? Do have friends, family? And they’re like, no, I run intense programs. And so what that means is that the kids that we’re seeing, they’re already having suicidal ideation, they’re already missing a lot of school, they’re detached from their social support systems.

they’re having intense problems. And so that means that they’ve delayed seeking services when they were smaller problems. And they’re waiting for different reasons, right? I think stigma plays a big part in that. They’re waiting until they can no longer contain it to then seek services. And we know that the earlier that we can jump in, the earlier that we can do and the better that we can do at preventing these problems, at them getting this big.

So dealing with the educational system, how can that impact someone’s early life when they have the mental health component that’s there? Do we need more training? Do we need to be able to identify? Do we need to start to come together as a community and break down the stigma of asking for help with mental health? All of the above, all of the above for sure, because

Right, if early intervention is the place where we can prevent it being bigger, if we can solve the problem quicker, if we can do it quicker means that we can spend less money doing it. It means that we can prevent bigger problems. We can do it with less costs. We can do it with less time. And our school admin, our educators, they’re there every day with the kiddos. They’re working closely with them. And so for them to be able to see, to notice when a kiddo can benefit from mental health, that’s a crucial juncture.

that we have right there. And so yes, with continued training, with continued awareness, bringing this to the forefront, we can jump in earlier and really give them the best chance to live a healthy life. We’ve seen where the state and the local communities have to come together and break down the stigma. We ran a bill in 2021 that for the first time in the state’s history created the Office of Suicide Prevention bringing to forefront the ability to talk about mental health components. I think it’s time that when we talk about economies recovering, when we talk about the status of the state of California, we have to start talking about the mental health wellbeing of all those in the state of California. Also, can you talk a little bit about the psychological impact of social media on various age groups and ways to mitigate  negative effects. I actually have a colleague, a staff that I supervise, who’s actually writing her dissertation right now on this very topic. This one’s tricky. There’s a lot of research that’s still left to be done to conclude on the topic. And so I can say a couple things on that. It’s definitely been a way for youth to engage and interact socially for sure. But this became much broader during the pandemic for all ages.

Right, everybody was looking for ways to connect with each other and social media and video chats and different things were really a big part of that. And yes, right, when more people use that there’s challenges that becomes much more aware. But also at the same time, what people might miss is that this also has a benefit. It’s an opportunity to find and identify community. So not just for our young ages, but all ages.

I don’t expect research to conclude social media is all bad, social media is all good. I don’t expect it to have that kind of a conclusion as with many things. I really expect it to really say, hey, it really comes down to how we use it, how we’re intentional about social media. That’s my guess as to where I expect the research to go on that. Thank you for that. Social media continues to play a vital role in our communities. What ways has the pandemic permanently altered the mental health landscape, both positive and negative? Yeah, there are a lot of ways. One, I’ll start with a great way. One really great way that the pandemic affected mental health is telehealth. So being in a video call with your mental health professional. This was actually before the pandemic minimally used.

And the attitude in the mental health field is it’s not very effective, face -to -face is really how you should be providing mental health services. But enter COVID, that’s the way we had to provide services to individuals. was either that or no services. So that was the way for them to get the support that they needed. And this also then, because so many providers were using it, this was a great opportunity for researchers and data analysts to test how effective telehealth really was.

since so many people were using it. And we have an outcomes and evaluation department in Pacific clinics. This is the agency that I work at. And our initial data shows that in -person telehealth, we’re actually very similar in outcomes for kiddos. And this was very surprising for, think, for a lot of mental health professionals. So telehealth continues as an option for several of our programs. It gives access to services and in several ways

In -person might not even be possible, like somebody sick or something like that. They’re well enough to participate, but don’t want to pass around that. Another huge positive during COVID is that it opened up the conversation about mental health. This was needed all along, right? So there were mental health issues there the whole time. And so it opened up that conversation because people were worried about all of a sudden the mental health of people when they’re in isolation. And so it wasn’t just the long -time issues that were being talked about, but the emerging issues that were being talked about. So this conversation needed to happen the whole time. So then after all of this mental health awareness happens, what then happens in mental health, and this is positive and negative together, there’s a surge for mental health services, a huge surge in demand for services. And this happened quicker than providers were able to be hired or to be able to be there to provide services. So wait lists everywhere were crazy long.

And this actually discouraged a lot of people from seeking services. And even individuals, I talked about how I manage programs that are more intense, individuals that were having a lot going on were waiting a while to be seen, even with some pretty intense issues. And if I were to offer one thing back to the community about that is I would encourage them that for those individuals that got discouraged, that really put that off, I’d encourage them to check back in with yourself and what you need.

to keep exploring options, to keep talking to others about what’s available, what’s the best fit for you, because mental health is still worth it, for sure. And we know COVID was just a lot all at once. Loved ones passed away, individuals were isolated for a long period of time, kiddos had modified school and so now they’re trying to catch up and they weren’t able to get all the attention that they really needed. And so this is an area where I expect research to continue. There’s still a lot more to be researched and looked about the long -term effects of the pandemic and of COVID. And so then again, that gives us mental health professionals info on how to respond to our community. Thank you. Thank you for that. And we know that cultural backgrounds do play an influence, some of the decisions and even those reaching out for support. Sure. Cultural and the approach to mental health treatment. How can you care by adapting to be more inclusive within the cultural components of our community?

Yeah, mean, cultural background influences everything about care, or it should, it totally should. We know from research as mental health professionals what interventions are effective, but there’s a hundred ways that we can tailor those interventions to the individuals that we work with. Depending on age, that intervention may look different. Depending on gender identity, family background, that intervention may look different. Culture, nationality, what language they’re speaking, spirituality for sure.

physical abilities. I can keep going on about all of the different things that impact how we might do service delivery, but we can tailor service delivery and interventions around those things. There are many agencies that do a lot to really adapt to culture of the community. I can talk a little bit about what we do at Pacific Clinics. We hire individuals that speak the language of the community that they’re in. We are continually training yearly.

our staff to be culturally sensitive and respectful. We have supervision for our staff and consultation for our staff. And culture is something that we look at that we talk about very regularly about how do we adapt this to this kiddo, to this family, to be the most effective that it can be. And with each new case that we’re taking on, we’re asking the kiddo and the family, what are their wishes? What’s their vision for health and wellbeing? And that’s getting incorporated into our treatment plans.

And so it becomes this collaborative thing rather than something that is just kind of handed down by the mental health professional. Sounds good. Getting more to that centric of a peer to peer understanding truly how the individual that’s being impacted by mental health, what it is they want to see as something that would help them get through the struggle that they’re in right now. Right. And they’re going to know the best about what they need, way better than we are. And we fully recognize

So we wanna be able to hear that from them. What does that look like and how can we support? Great, thank you. What is one breakthrough in mental health treatment or understanding that you find particularly promising? There’s been some phenomenal researchers recently who’ve brought to light new understanding zone trauma because it’s something that affects so much of our population in such a huge way. A couple of prominent ones out there are Bruce Perry,

Bessel van der Kolk did a lot of great research recently, really speaking to the need for individuals with trauma to learn how to regulate their bodies. Talking about trauma in the body, not just as something in talk therapy that you can talk through and be aware of, kind of with your brain, with your emotions that way, but talking about how trauma affects the body and the effects in the body that sometimes are a little bit beyond mental health, your mental awareness. And some kind of gives us professionals some ideas about where to go in working with trauma.

Another topic that I particularly love is Matthew Walker’s research on sleep. Sleep is write something, it feels really basic, but it’s actually a very under -researched and has a huge effect in mental health, physical health, healing, how we heal. And it’s not talked quite enough in either medical school, psychology classes. So it’s some really, really great stuff.

But thank you. And I know that early intervention is important, mental health components, but also is mental health in that behavioral study, does it also include the autism spectrum, which we’re seeing a bigger concern also in that community? There’s a lot more talk about that. I am not quite as expert on autism specifically. I’m more of a general awareness in my work.

but there’s a lot more coming out because that conversation is coming out too. There’s a lot more research coming out when interventions are effective that gives us mental health professionals opportunity to work with these interventions, what’s been proven to be effective. So that’s a great, great field as well. Well, thank you. Thank you so much for that. And finally, what tough question about mental health do you wish people would ask more often and how would you answer it?

One thing, so thinking about society bigger, and we talk about just the need for this conversation about mental health. One thing that I wish is that individuals would do a check -in with themselves and see what worries them about mental health. What’s the worry? What’s the concern? What’s the thing that makes them anxious? Whether it’s their own mental health, looking at the mental health of individuals around them, or just mental health in our society in general. And that they would take that thing that

they’re worried about, anxious about and bring it up. Start asking about it. Find a professional. Even search the topic. There’s some really great, well -known, respected websites. There’s NAMIs, the National Alliance on Mental Illness. There’s SAMHSA, the Substance Abuse Mental Health Services Administration. There’s nonprofits like Mental Health America and the National Institute of Mental Health. Like these are great websites to start to get exposed to and ask these questions, get curious about

If we’re curious about it, brings up the conversation more, right? And it’s not just about us, but when we talk about it, our kids, our neighbors, they know that it’s okay to talk about this. And then they know that what they’ve been struggling with in silence, what they’ve been struggling with in private, they become a little bit braver in asking for the help that they need. So it’s by asking more of the question, breaking that stigma down so people feel more comfortable asking.

for help in these resources. Well, look at the stigma, ask about it. It’s big. And I wanna thank you, Dr. Riphagen, for such an insightful discussion on mental health awareness. It’s clear from our conversation that there’s much we can do to support mental wellbeing in our communities. And in many times, just listening to those that are going through a challenge could be all that someone needs. Yeah. Now, before we wrap up, we’d love to learn a bit more about

Can you share something with our listeners that they find surprising or particularly interesting about your journey or experiences in the field of mental health? boy. One of the things that I continually learn is I’m challenged in so many different ways. Personal growth is one of my things. It’s one of just my values as a person,

how many different ways I get challenged to see things differently, to have to learn, have to grow myself, to be able to be what my staff need, what her clients need. I think that’s not quite the same in other fields of study. You know, you’re a plumber, you kind of get exposed to a few different new things, but you know, it’s very more routine, I think. But my study is people. And as we evolve, as culture evolves, as we learn more,

it makes us as professionals grow ourselves, we have to. And so there’s a demand on us to step up to the plate every day, all day, to be able to do what we do. And I think that’s not always known, but when we’re doing our job right, we are continually working to learn and continually working to grow.

Thank you. Reflecting on your impactful journey in mental health, could you share with us a pivotal moment or discussion that has profoundly shaped your path? Perhaps a turning point that deepened your commitment to mental health advocacy or reshaped your approach in this crucial field? boy. You know, my journey is a lot more of the little ones rather than one big pivotal one.

I went into the field initially because I saw so much opportunity in the community around me and the people that I was running into day to day as a kid, I just saw such a need. I did not grow up with mental health being a conversation. I didn’t. And so I definitely get it about what it is for mental health to be in silence, for it to not be talked about, for emotions to not be talked about or okay to talk about. So I grew up understanding that and

It was a lot of little moments for me, what I saw in the communities that I worked with, what I saw in the people. I worked a lot of community mental health. I worked a lot of inpatient psych as well. And so a lot of the stories shaped me. They shaped what I care about. They shaped how I work to learn and grow myself. Listening, listening to the people around me has really challenged me in many ways. It shows me not only what’s working in effective, but it makes me look at what I need to grow into.

what our field needs to grow in. What are the challenges of our society and where could I play a part in it? It’s definitely true. Society plays a big part in community and even reaching out. mean, growing up when we had mental health challenges, we were told when you’ll grow out of it or things will change and you’re just growing up, you’re going through certain things in life. Things are still with us.

The reason we do what we do is so the next generation doesn’t have to be told those things, that there’s truly resources that are out there for them. Yeah. There’s a lot of kids that are told by their families, you don’t need mental health because you’re not crazy. And it’s a literal statement that a lot of kiddos are told, but mental health doesn’t mean that you’re crazy. That’s why we have to break. It’s like getting a broken leg and going to the doctor doesn’t mean that

functional. I just me, do you need to work on your broken leg? I think it’s time that we break that stigma in our community where people are open to reaching out about what they’re challenged with within their health resources that are out there. And a thought provoking, fill in the blank question. Let’s look ahead in 10 years from now and fill in the blank. I hope to see a world where fill in the

I hope to see a world where people see each other and who they really are. Mental health, the challenges, the strengths, where people can really see each other. And that’s one of the big reasons why I do what I do. Wow. A world where people can see each other. Really see each other. That’s powerful. I want to thank you, Dr. Rippagen, for joining us today and sharing such an invaluable insights on mental health awareness. Your expertise has truly enlightened

our discussion and given us a lot to think about. To our listeners, we hope this conversation has shed light on the importance of mental health awareness and inspired you to learn more and support those around you. Don’t forget to tune in to future episodes of Empowering California with James Ramos for more engaging and informal discussions. Together, we can make a difference. This is your host, James Ramos.

Until then, stay informed, engaged, and empowered. Pahika te ni, until another

Yeah. Yeah. Thank you, assembly member. Appreciate it. it’s so true. mean, growing up, I mean, that’s breaking the stigmas, right? And, know, different generations, different things, right? mean, growing up on the reservation, right? Everybody could see who was going into the Indian clinic and which department they were going into. And some just disengaged altogether. And so it is important across the across the whole community’s cultures to be more open to

to start to talk about these issues. Absolutely. Absolutely. would change our society, right? Just didn’t have to change our society. Breaking it down. Every time you would go, you brought it up, right? If you go see a mental health person, then a counselor, however you want to call them, people thought you were crazy a little bit, right? And at times, community wasn’t there to support you. the person acted out and became probably the most vocal in the community.

Right. And then they do become, because their symptoms increase, what other people call crazy. That’s not who they are. We’ve got to get back to listening to one another. And I like a world that sees each other in this world that we’re in. That’s a good question. But yes, absolutely. I’m curious what your other podcast speakers will say to that one. Well, thank you so much for everything. And as always, we’re here to support Breaking That Stigma.

I mean, moving forward on that Office of Suicide Prevention in the state of California opened up that whole dialogue. And autism is taking a big discussion now with statistics like one in 22 people, right? But mental health components, we have to put all that together. We can’t talk about a deficit or let me moving forward if we don’t have the mental health stability of.

And it didn’t bring it up in this conversation, but you also know that just developmental supports and mental health supports, they could work so much better together than they currently do. But I think also our trainings could be a little bit better than they currently are. So that’s a place where that intersection could be a little bit more seamless for our families, especially. Definitely, definitely. Well, thank you so much for taking time. Thank you, Mr. All right. Have a good afternoon.