May is Mental Health Awareness Month and to kick things off, earlier in the month, Marin Community Clinics’ Chief Behavioral Health Officer Elizabeth (Lizzie) Horevitz, Ph.D., LCSW, joined radio host Brenda Camarena (Cuerpo Corazon Comunidad, KBBF 89.1FM) to discuss some of the resources, health services, and financial assistance available to anyone struggling with mental health issues in our community.
At Marin Community Clinics (MCC), treating mental health and behavioral health issues is an important part of the comprehensive services offered to patients, and it’s something our primary care providers and experts do on a daily basis. MCC is also able to provide specialized treatment using a multicultural and multilingual approach. But due to the stigma our society has historically held against such mental health conditions, too many are not getting the support they need, or simply don’t know when to seek help. In addition, the COVID-19 pandemic has taken a serious toll on the mental health of people of all ages, so it’s crucial that we ditch the stigma for good, open up a dialogue, and continue getting support to those that need it.
The good news? At MCC, there is no stigma. We know that most of us will experience a diagnosable (and treatable) mental health condition in our lifetime – and it’s important that we bring attention to it. To keep the conversation going, we sat down with MCC’s Dr. Horevitz and Kristine Kwok, LCSW, to talk more about it.
marinclinic.org: When we talk about mental health issues, what are we referring to or what does that mean? What are some common types of mental illness? Who is affected?
Dr. Horevitz: Mental health refers to the state of our emotional and psychological well-being. Actually, I prefer the term “behavioral health,” as it encompasses not just mental health, but also substance use/addiction and health behaviors (it’s one of the reasons our department is called Behavioral Health – because we address all three of these critical components of overall health and well-being in our program.
When we talk about mental illness or mental health concerns, we are really talking about problems affecting the state of our emotional/psychological well-being. These problems affect our mood, behavior, and our brain chemistry. Mental illness, like physical illness, can run the spectrum of being mild and manageable, to something very severe in need of intervention, medication and in serious cases, hospitalization. Sometimes mental health problems are in response to stressful life events (say, for example, living through a pandemic, losing a job, or death of a loved one), and sometimes they are caused by a genetic predisposition to a specific mental illness (such as, say schizophrenia). Much of the time, it is a mix of factors—stressful life events combined with our genetic make-up.
Dr. Lizzie Horevitz: “It is so important for all of us to remember that we are not alone”
Mental health – and, more broadly, behavioral health – issues are very common. Most of us will experience a behavioral health problem at some point in our lives. Most of us also know someone living with a mental health issue or addictive disorder. Depression, anxiety, post-traumatic stress disorder are all common mental health concerns we see in-clinic on a day-to-day basis. Before the pandemic, we estimated that 1 in every 10 Americans was living with a diagnosable mental health condition like depression. Since the pandemic started, that number has sky-rocketed to 1 in 3 individuals living with diagnosable symptoms of depression, anxiety, and insomnia. We have also seen a significant increase in addictive disorders, as well.
marinclinic.org: Why is it important that we continue to raise awareness around behavioral health issues?
Kristine Kwok: One of the few good things I have discovered about the COVID-19 pandemic is that it has destigmatized asking for behavioral health support. All of us have experienced increased stress, depressed mood, grief/loss, and worried thoughts during this pandemic. That’s raised awareness about the importance of our emotional and physical health. While we don’t have control over how the pandemic has affected our economic situations or personal relationships and losses, we do have the ability to learn new skills to accept and address our emotions.
Kristine Kwok, LCSW, shares her culture to help patients recover
I lead a weekly depression and anxiety virtual support group called Con Calma on Tuesdays at 4:30pm (which is open to all Spanish-speaking adult patients) and I am so impressed on how quickly the patients who attend group learn the new skills of meditation, EFT tapping, and qigong to create calm in their lives.
Dr. Horevitz: Historically, as a society, we don’t talk about depression, anxiety or other common behavioral health conditions because of fear of judgment. This is problematic because depression is one of the leading causes of disability world-wide and is a main contributor to the overall global burden of disease. Moreover, suicide is one of the top 10 leading causes of preventable deaths world wide. From that perspective, staying silent about our struggles is not only painful on an individual level, but dangerous on a global level.
I’m pleased to say that this has been changing, as more and more people –including celebrities– acknowledge that they have or are struggling with mental health and addiction issues. The more we talk about it and normalize that we all struggle, and that recovery is possible, the better off we will all be.
marinclinic.org: What does treatment look like and what are some of the resources currently available through Marin Community Clinics around mental health?
Dr. Horevitz: The good news is that there are lots of wonderful and effective treatments for mental health and behavioral health concerns. For some people, reaching out and connecting to supportive/caring others is enough to help them move through a stressful time. For others, therapy (working with a trained psychotherapist) can help them identify unhelpful patterns/behaviors and learn new coping skills. For others, medication is a helpful intervention to address some of the chemical changes in the brain that happen as a result of prolonged distress. For many, a combination is key!
At MCC, we offer individual and group psychotherapy, psychiatry services, and substance abuse counseling. We also offer resource referral and case management to help address the stressful life circumstances that so often undergird mental health problems. Our services are available via telehealth (phone/video visit), and starting in June, we will be seeing patients back in-person in-clinic, if they so-desire.
Like other federally qualified health centers, we serve individuals with “mild to moderate” behavioral health concerns. For individuals needing more intensive services, we can help refer you to the appropriate resource.
marinclinic.org: What would be the first step if someone in our local community wanted to seek out care for themselves (or perhaps someone close to them) but didn’t know where to start?
Dr. Horevitz: Patients of MCC can call the main number to request a behavioral health appointment for psychotherapy, group classes, or substance use counseling. We can help assess what your goals are and help identify a plan of action. For individuals interested in psychiatric services (medication), call to make an appointment with your primary care provider, who can help identify medication or refer you to psychiatry, if indicated.
If you are not sure whether MCC’s “mild to moderate” services are right for you, we encourage you to call the County ACCESS line (available 24/7) for assessment and referral: 1-888-818-1115.
marinclinic.org: Kristine, how do you describe your role at MCC? What are some of the things you enjoy most about this line of work?
Kristine Kwok: I am a Spanish-speaking Chinese American Behavioral Health Provider trained in trauma-focused therapy, and consider myself a guide to my patients on their journeys to heal after trauma.
Our brains and bodies are designed to heal and restore balance, and what I enjoy most is the incredible experience of seeing my patients’ capacity to recover and move forward with their lives. I also enjoy how the Con Calma virtual support group gives me the opportunity to share my Chinese culture with qigong and EFT tapping (which is based on tapping on acupressure points) in the Spanish language, since I never had the chance to learn the Chinese language.
marinclinic.org: Lastly, what are some of the warning signs and symptoms of mental health conditions? When is it time to seek out help?
Dr. Horevitz: We all experience stress, mood changes, and “bad days”, when we just don’t feel like ourselves. However, signs that you may be experiencing something more serious include feeling emotional distress for 2 or more weeks, noticeable changes in appetite, activity levels, and changes in sleep patterns (like insomnia). Certainly, thoughts that you’d be better off dead or hurting yourself or someone else in some way, feeling out of touch with reality, feeling out of control are also a sign it is time to seek out help right away.
It is so important for all of us to remember that we are not alone, and that help is available and recovery is possible! Here are some other helpful numbers to keep on hand for yourself or a loved one:
- Marin’s Crisis Stabilization Unit (CSU), available 24 hours a day, 7 days a week, and can be reached at 415-473-6666.
- County of Marin’s Mobile Crisis Response Team at 415-473-6392. This is not a replacement for calling 911.
- Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to be connected to a trained counselor.
Find more information about MCC’s integrated behavioral health services on our website: marinclinic.org/services/behavioral-health.
Learn more about mental health in general at NAMIMarin.org.
Marin Community Clinics’ Mission: To promote health and wellness through excellent, compassionate care for all.
Touching lives through health: Our work is made possible by generous gifts from community members like you. When giving to Marin Community Clinics, you’re improving the health of our patients and our community. Make a lasting impact and give today!
Feature photo by Nik Shuliahin / Unsplash