Psychiatry
Care
UH Manoa
May is Mental Health Awareness Month, a time dedicated to raising awareness about the importance of mental well-being. Post-pandemic, the need to highlight mental health is greater than ever.
The John A. Burns School of Medicine is committed to offering stellar resources for its students, staff, and faculty while extending its reach into the community through partnerships with many healthcare systems in the state.
According to the Centers for Disease Control and Prevention, 1 in 5 adults in the U.S. lives with a mental health condition, underscoring the urgent need to prioritize mental well-being.
Normalize Talking About Mental Health
Our psychiatric conditions affect parts of us that make us uniquely human. Dr. Anthony Guerrero, Psychiatry chair at the John A. Burns School of Medicine, understands that because the most sensitive parts of us are affected by these illnesses, a stigma can sometimes be attached to discussing these highly private thoughts and emotions. “I think it’s very challenging to admit that these very important things about us can be affected somehow by an illness,” he said. “It makes people feel like they’re different or sometimes not even human, and because of this misunderstanding, I think people may not want to talk about it or try to ignore it.”
Since mental health issues may not present themselves as apparently as a patient with a broken arm, many may avoid seeking treatment. Still, Dr. Guerrero strongly suggests people take the step to care for their mental well-being just as frequently and commonly as they would any other health issue.
“If we have a heart or stomach issue, we seek help. These are things we can see and are tangible, so we’re more likely to think that it can be fixed by something,” Guerrero said. “Also, stomachs and hearts don’t make us uniquely human beings. In comparison, psychiatric illnesses are things we often associate with being a person, having it as our character or temperament. People may have an extra layer of sensitivity talking about these topics.”
Over the years, Dr. Guerrero has seen incremental progress in people opening up and seeking help.
“I think there is much more openness to routine screening, but we have to look at the other headwinds we’re facing in this specialty,” Dr. Guerrero said. “There’s much more stress, especially coming out of the pandemic.”
Accessing Care
While depression and anxiety may be the most common mental health issues psychiatrists encounter, they routinely work with patients struggling with autism spectrum disorder, learning disorders, attention deficit hyperactivity, obsessive-compulsive disorders, and substance use disorders.
As mental health treatment becomes more normalized, Dr. Guerrero said access to resources could become strained, at least in the short-term, before the benefits of prevention and early intervention become fully realized.
“Even though there’s probably more understanding, more acceptance, and more enlightenment around these conditions, there are further problems with access and availability of resources,”
he said.
While telehealth therapy is becoming a standard outlet, and while larger healthcare systems are offering primary care and mental health integration programs, many Federally Qualified Health Centers (FQHC) offer mental health options.
“More community health centers are including behavioral health programs,” Dr. Guerrero noted. “That can include a psychiatrist who is a physician who can provide medical treatments, including, but not limited to, medications.”
Kalihi Palama Health Center, Kōkua Kalihi Valley, Waimānalo Health Center, and Waiʻanae Coast Comprehensive Health Center are just some of the options for mental health treatment on Oʻahu.
“As the need grows, one of the ways to hardwire the access is to make mental healthcare as routine as accessing primary healthcare,” Guerrero suggests. “We don’t think twice about going to the optometrist or dentist, so I don’t see any reason why we can’t start identifying a mental health provider or at least a mental health resource for people at some early point in their lives. Other states like Vermont, through the Vermont Family Based Approach, have implemented a model like this, and it seems to be successful.”
JABSOM Resources
While the medical community stresses the importance of mental health to the general public, it’s essential that the healers, too, are mindful of their well-being. That’s where Haylin Dennison, JABSOM’s licensed clinical therapist and confidential counselor, comes in.
“Physician burnout is a huge concern in the healthcare system right now, and it’s absolutely real,” Dennison said. “I think a lot of people don’t want to look at it because there’s a lot of stigma attached to it. A lot of times, the identity of being a physician doesn’t allow you to admit that you might need help as well because you are the person that makes people feel better.”
Dennison aims to shed the stigma for JABSOM students, faculty, and staff.
“We all have to be mindful about our mental health,” Dennison said. “I think we have to understand that our brain is an organ like every other organ. It can malfunction. We do have to take care of it.”
Dennison and a team of four other counselors offer JABSOM students, faculty, and staff opportunities for one-on-one sessions.
“I am an advocate for people staying in medicine. I want to help physicians, doctors, and residents to find their true selves so that they can navigate this system that is so difficult,” she said. “Therapy works. Coaching works. It’s really the person in front of me and whether or not they’re willing to do the work it takes because it’s not easy.”
In addition to counseling sessions, Dennison offers luxury wellness retreats for physicians, residents, and medical students and coaching programs for physicians.
Dennison believes one of the most powerful ways to break the stigma around mental health care for the medical community is to have experienced physicians, attendings, and program directors share their experiences with their mental health.
“That’s going to be huge,” she said. “Right now, I think that many students feel like they’re the only ones.”
What the Experts Do
Dr. Guerrero practices what he preaches and shares what he does to care for his health. He exercises regularly and finds things to celebrate outside of birthdays, anniversaries, or other important dates.
“Find things that you can look forward to throughout a week,” he said. “Also, making sure you maintain your hobbies is important.”
Dr. Guerrero finds that solace in music.
“One of the things I happen to do every week is music. I’m a church musician. I think that forces me to maintain another skill and do something that puts my focus on something else other than the things that are likely to cause worry.”
In addition to his hobbies, Dr. Guerrero connects with friends and family and actively tries to drop his devices so he can be fully present with them.
JABSOM in the Community
JABSOM aims to bring mental health to the forefront of the community and engages the public each year via the annual Hawaiʻi Addictions Conference. It highlights issues of disparity and allows the JABSOM community to reach out to the underserved and vulnerable.
“They delved into a lot of timely topics in the field. They looked at what it’s like from a personal struggle standpoint,” Guerrero said. “I think looking at the cultural aspects of care is really important.
Dr. Guerrero says the annual Hawaiʻi Addictions Conference is one of the great services that JABSOM provides to the community.
“Our mission is, ‘Attaining Lasting Optimal Health for All,’ and I think what we uniquely provide is the orientation towards educating our current trainees and educating the entire community so that we really have a workforce that can best achieve this goal. The education piece is such an important part of translating all of the science that we know into doing something meaningful and getting people to do things that will actually make a change. We can have all the knowledge we want, but unless we can educate our patients, the community, and frontline providers about what to do next, all of it exists in a vacuum as if it never really happened.”
If you or someone you know is struggling with mental health, please visit:
https://mentalhealthhawaii.org/
https://namihawaii.org/