 Welcome back to Think Tech. I'm Jay Fidel. Here it is on a given Tuesday and we're examining the community. So this is Community Matters and today we want to talk with NAMI. That's the National Alliance on Mental Health. Let me ask for a definition from the executive here who runs the organization. That's Kumi McDonald. Hi Kumi, welcome to the show. Hi Jay, thank you for having me today. Okay, so it's NAMI. It's NAMI of Hawaii. It's part of a national organization. Tell me about it and extend the acronym so I know what it is. We are the National Alliance on Mental Illness, NAMI, and we are a part of the largest grassroots mental health organization in the nation. We have over 600 affiliates across the country and we have the state organization, which is in Hawaii. We serve as all of the islands, but we do have localized programs specifically for Oahu, Kauai, Maui, and the Big Island. And what we do is with our grassroots meaning that we started off with people wanting to help other people who are affected by mental illness. Well, let's define mental illness, you know, because as I tell you before the show, I believe that everybody has a touch. We're mammals and so we're biochemical, you know, animals and no two are the same and no two are exactly, you know, ideal. And everybody has their own eccentricities and sometimes that's diagnosable and sometimes not. And it's also a dynamic. It changes in your lifetime and get better and get worse. So when you say mental illness, what are you talking about? What's the spectrum there? Well, mental illness is an actual illness about behaviors, how the mind works. And it's often not visible. There's no blood test that you could specifically take. But we know that when your behaviors and your thinking affects the way you live your life, then it becomes as illness. But like we try to educate people is that all of us are affected by mental health. And it's a spectrum of one to four saying some of us have a little bit of a sleeping issue. We might have a little bit of stress. We might have a little bit of anxiety here and there that might be a stage one. And that's majority of us, we are all affected by that. But when it becomes a two or three or four, especially three or four, you'll notice it severely when people are, you know, having hallucinations or so depressed, they can't even leave their bedroom or they have other types of, you know, exaggerated moods. Then we know that becomes a serious mental illness. But what we're trying to do is we're trying to say, hey, everybody's affected. Let's all stay mentally healthy before it becomes a serious illness. Can you come back from a serious illness? I suppose there are drugs that will help you and all that. Go ahead. Absolutely. And what Nami is about is that there is absolute hope for recovery. Now, mental illnesses, we have to treat them like an illness. And that's the whole point of what we do is we're trying to tell people, educate people that it's not being weird. We don't call them crazy. We're saying they're just people just like you and me that might have been going through some kind of struggle. And it got a little bit bad. And we just needed a little bit more help and medication. There's therapies. There's cognitive behavioral therapy, art therapy, music therapy, journaling, support groups. There's so many different things that can help people in their recovery journey. Faith plays a role. Also staying connected to their communities. Also new research is showing that there is more nutrition based evidence that changing the way we eat can help with mental health issues. But we see it over and over. People even with serious, serious mental illnesses live productive lives. Once they get on medication or go through treatment, can go on to have relationships, have wonderful careers, be contributors to our society. In fact, many of our board members happen to be people living in recovery from mental illness, including myself. I live in recovery from depression and anxiety. And I'm not ashamed to say that, that there is hope for recovery. Have you seen that movie Joker? It came on recently on Netflix. It's a story of somebody who's really got serious mental illness problems. And in the end, he goes off the wall. But it strikes me and I want to oppose this to you. There are a lot of people in our community, in our world, in the country, in the world who are really off the wall. And they're not taking their medicine. They may have been prescribed medicine. That could help them, but they don't take the medicine. And it strikes me there's no specific structure or system to follow up with them, to make sure that they're in the middle of the channel, that they're taking the medicine and they're not acting out. Is not any concern with that? Yes, absolutely. So there has been a bill that was passed in 2019 to change the language for the assisted community treatment. And assisted community treatment or assisted outpatient treatment, they call in other parts of the country. But AOT or ACT, what we call it in Hawaii, will get, it's a program where we get the judicial system, we get families involved, we get their clinicians, doctors, therapists, all of them involved. It's a community treatment program. And it will be court ordered where somebody who is severely mentally ill, who haven't been taking their medication or been fighting treatment, will now have a community treatment that it's not just one person or one agency, but it's a partnership where we get everybody involved and get this person the help that they need. And this is something that is just starting to change in Hawaii. We were going to do a wonderful training workshop on this in March 30th, but because of COVID-19, we had to postpone it, but we will hold this event where mainland trainers are going to be coming in to train our judges, our mental health courts, lawyers, public defenders, advocates, clinicians, hospitals, family members, people who care anything about this situation, how this program can take effect in the state of Hawaii and how we can implement it. And it's a one year program. It's not just one day training, but the training will happen. And then they're going to follow up with several other meetings to make sure that we have certain things set in place. And so we will have that sometime later this year. And again, this will be a partnership with NAMI, with Mental Health America, and we have some great sponsors who are sponsoring us for that. Why do we care, Kumi? Why do we care? I mean, we don't put that much effort into helping people with dermatological problems. Why do we care about people with mental illness problems? Why is it a community concern? It's a community concern because it affects one in five people. And that means it affects your family member or a loved one or your neighbor, a coworker. And also, 46% of all human beings have been affected by mental health condition, at least once in their life. That's about half of us. So let's say even if you have never experienced the mental health condition, I'm sure one of your family members has. I can say I have, and at least half of my family members have. So it does affect us. And then if you say, well, none of my family or anyone I know has been affected, well, what about the person that you work with? What if that person didn't show up for work because they're depressed or they have anxiety and that workload gets put onto you or your company business is not functioning as well because somebody with mental health issues didn't do their work and trickle effects. So it does affect our economy. What about people on the streets, people who are homeless, people who are on addicted to substance use? These people are also affected by mental illnesses. And they could be trespassing or they could be doing things on your property that you're not happy with. And so it does affect us as a nation. It does affect us as a community. Let's move to coronavirus because coronavirus exacerbates it. I mean, we talked before, I mean, if I threw you in Lubionka prison for a few months in Arthur Kessler's book, Darkness at Noon, you would lose your rationality pretty quickly. You lose your identity, you become unproductive and worse. And so if I give you a hard time, if I give you a lot of stress, if I give you a lot of unknowns and risks and threats, what have you, you know, you're at risk for an exacerbation of whatever might avail you or things that haven't availed you before, but now you're into another world of mental health. So here we are, coronavirus. People worried. They're worried sick about getting it. Worry sick, do you like that? They're worried sick about getting it. They're stressed. They're stressed for themselves, their families, for their business. I mean, everything. And they don't know. They're fear of the unknown. This is a very stressful time, not only here in the mainland, certainly, in a hot spot like New York. Oh my goodness. And in various places in the world. So to me, this is an exacerbation increase in mental illness that is predictable. It's understandable. It's part of the human condition. What can NAMI do about that? What is NAMI doing about that? So mental health, we're not probably not as healthy as we'd like to be with coronavirus. We're not getting the sunlight we need. We're not getting all the exercise we need. We're not getting the physical contact that we need to stay mentally healthy. Routine is not there. So there's a lot of people under a lot of duress, lots of stress, a lot of fear. And so what we've noticed is we have had a lot of people concerned calling us and saying, how do I get help? What do I do? And so NAMI has been really at the forefront. We're so, I'm so proud of NAMI as a nation and even in our tiny little state of Hawaii. So we are online. We're providing online support group. We're providing online workshops on how to deal with this stress. So maybe it's not going to be a mental illness, but you're under a little bit of stress like we all are. And so what we want to do is we want to teach you skills to stay mentally and emotionally healthy. And so our first workshop that we had last week was on coping skills with COVID-19. How do we stay stress-free? How do we stay mentally healthy? And that one, a really great turnout. And then the next one we're going to offer on the 24th will be art and music therapy. How to use creativity to cope with our stresses. And that's going to be a great workshop as well. And then again, we have support groups that meet Wednesday at noon. You can find all that on our website, NAMI, Hawaii. This is all online, right? This is all by remote, right? Absolutely. And then we also provide phone support. If you want to call us or email us, we're available too. That's good. Is that 24 by 7? No, I wish, but our helpline on the national level, I believe, has a little bit of a longer hour. Locally, we answer phones 9 a.m. to 1 p.m. Monday through Friday. You know, the thing about being in isolation is, I mean, it's a deprivation of our normal life routine, expectancy for, you know, engagement with the community and with other people and so forth. And I'm sure that it works on everybody to be isolated. Probably works more on people who are alone, you know. It's interesting. My own experience, I'm not unhappy doing this because I can talk to you and others. I can engage and I can learn. This is a benefit for me and it keeps me real. But there are a lot of people that don't have that opportunity. And we talk about phone calls. You know, sometimes at night, when I'm, you know, when I'm not working on think tech, I will, pardon me if you do a little therapy on me right now, I will make a call to a friend of mine or he will call me or she. And I will spend an inordinately long period of time on the phone. I mean, I haven't talked to people for such lengthy calls since I was a teenager. Usually my telephone calls are very quick, you know, just the facts. But in this case, I feel like I need to do that. I need to have this social experience there. And I also need, I also think that if I didn't have this, I would be missing something. And I also think that if somebody else was isolated and didn't have anybody to call, that would be corrosive experience and not healthy. What do you think about all of that? Absolutely. Part of mental health is being connected to our community. Science shows over and over that even people with depression, which is the, you know, one of the biggest mental health issues in the nation is that just being with other people is so important. And so through this coronavirus and the shutdown, being available to, there's so many platforms. You can do Zoom. There's free versions. There is Facebook. There's Google Meet. There's so many different ways to connect visually, right? Facetime, Skype. And so when you were able to see people's faces, you really do feel that sense of connection. And it's hard because your routine is, you know, shifted. But you have to fight hard to try to get some of that back. And so even for me personally, I mean, there were times it was very stressful. There were times when I was very lonely, but I'm back on doing Zoom meetings with board members. We're doing Zoom for our support group. We have the workshop that's coming up. I also do it for my Sunday school class. I do it for my Sunday church service. I'm online. So there's so many ways for me to connect now that I'm a little exhausted with meeting people so much on Zoom because now I feel like, wow, I am interacting with people even more now, I feel, because everybody's available now. They're at home and they have more flexible schedules. So, you know, it is a good way to connect. I'm not saying it's perfect. We still need physical touch and hugging each other, the oloha spirit, but this is a great way to stay connected. And we're trying to give everyone that opportunity to try it out. And so please join us. You know, in the past, in the past, you wanted to have a meeting with somebody or just meet person, a person, the meeting would start with a handshake or a touch. And when the meeting was over, it would end with a handshake or a touch. Well, somewhere in there a few weeks ago, you know, it says before you went isolated, we stopped touching. We stopped handshaking. That was, you know, oh, bad idea. You know, I can catch something. Okay. And my worry about this is that going forward, when we come out the other side, when we resolve the problem from a medical point of view, people are still going to be slightly paranoid about touching. They won't want to do a handshake. They're going to be slightly paranoid about surfaces and washing their hands and all those things and looking directly into somebody close, you know, within six feet and having a conversation with somebody where the micro droplets can get into your respiratory. They're going to be paranoid about that. I mean, for a long time, maybe for a whole generation. I know I'm going to be thinking those thoughts because I'm never sure. Now, when is an absolutely effective vaccine? Maybe you could convince me. But for a long time, these lessons of social isolation are going, and this is going to change our lives, isn't it? This is going to affect our ability to retain our mental health? Well, I think humans are amazing. We are going to find ways to get around it. We're going to find ways to cope and communicate with each other, show our love and support and connection in other ways. The mind is a very powerful thing. If you can connect via Zoom or Skype or FaceTime and see someone's face and say, oh, that's the person that I care about, and then give yourself a hug while you think about them, you're going to still release some of those endorphins. You're going to still release some of those happy chemicals. I think we can get around it. It's not a perfect world, but I think we're the human condition. We're strong, and I think we're going to survive. I believe that. Okay, but some of us are going to have a problem, and I'm sure you hear about those problems. People living alone, people are isolated. They don't have that kind of stimulus. They don't have the interaction, and they probably begin to decline emotionally. What happens to them? What's the classical story? You must have some of these on the phone. What's the classical story where they're alone and they begin to decline, decompensate, what have you, and even get depressed, and even think suicidal thoughts, possibly even do suicide? How does that track work? Well, you know, just because someone is alone, just because someone is isolated doesn't necessarily mean that they will have depression or anxiety or any other mental health issues per se, because some people just are born genetically very strong. You know, just like some people are predisposition for heart disease, you could be an Olympic athlete and still come down with cancer or a heart attack. So it's just sometimes that's just the cards you're dealt with. So you know, not saying that everyone who's isolated will have mental health issues, but I would say that if people start to go downwards, the first ones that people will notice is your family members or your close friends, because the person with a mental health issue very rarely will say, something's wrong with me. It's very rare for people to be able to catch themselves once they get to a certain level. And so it's usually the family members who will call us and say, my family member is depressed. My family member has psychosis or my family member is having delusions. What do I do? And then that's when we step in. And what we provide is an eight week education class for these loved ones. We teach these loved ones how to communicate with your loved one with a mental illness. How do you do this remotely now? Is this something you can do remote? We're not quite there yet. We just had our class start in January and we were not able to finish, but we are going to try to continue on and we just started our online support groups last week. So give us a little bit of time and we will go online. I would predict that this is one of those things that comes out the other side of the pipe. I would predict just as doctors are going to be more amenable to diagnosing patients about things they can see and maybe have the patient test himself or herself. The same thing, there'll be psychiatrists and psychologists and mental health workers, if you will, who will give treatment and solace on the internet in a conversation just like this. In fact, I feel better just talking with you, Kumi. But let me ask you one last question. We have a few minutes left and I want to get into this. It was predictable that if you coop up a bunch of family members or people who are living together called partners, what have you, that there would be arguments and there would be disagreements and there would be tension and there would be violence, domestic violence. There's been plenty of talk about increases in domestic violence because people are cooped up and they can't fashion a relationship that can coexist in a cooped up space. What about that? Have you heard of that? Can you speak to that? What is the process and what is the solution? Well, I don't have a really detailed answer because, again, I'm not a specialist in that. But the one thing that I can say is if we can take away some of those stressors, if we can work on coping skills, like if I'm irritated, what can I do about it before I hit somebody or yell? What can I do about it? Those are the things that we're trying to educate our community. Before I hit someone, maybe I can journal about it. Maybe I can go and do some music therapy. Maybe I can do some art. Maybe I can listen to music, whatever works for me. We try to get people to create their own little toolkit and put in it what works for you. For me, it's I have essential oils. I have a little chocolate bar. I have supplements. If I get really stressed, sometimes I want to take some herbal supplements or sometimes I just want a hot cup of tea, take a shower, go for a walk. Meditation apps. I have all these meditation apps that I go to every day. I do my prayer and do my Bible reading. All of these things that help me deal with my stressors so that I don't take it out on somebody else. And then if we could take care of our stressors, if we can figure out good coping skills, we won't run to drugs. We won't run to alcohol. We won't run to other people or bad behaviors. And that's what our goal is. You know, one of the things that's been on the tube you can hardly escape it is the tragedy of losing a family member to the coronavirus in a hospital setting where you cannot participate. You can't say farewell. I mean, they use iPads once in a while. And often the doctor has been in a number of articles about it. The doctor steps in and he acts as a proxy for the family. And he hears the last comments of somebody on a ventilator who is not making it. But I think the most frustrating thing of all, of course, is the family member who is close with the patient but who cannot share anything with the patient really for the last week or maybe more or two weeks of the patient's life. Now, that's real stress. That is breaking all the social rules for that person. And I can imagine him or her getting really upset about it. What about them? What can we do? What can they do so as not to carry around a scar forever by virtue of this separation and death phenomenon? That is what Nami's about. We're about community and about giving people hope. Whether you're the person with the mental health issue or whether you're the family member or you're the loved one that supports that person. And what we do is we provide support and we build communities. And so we have these community support groups for family members. We have support groups for people living in recovery from mental health issues. So whatever side of the coin you're on, we have a support group for you. There's also grieving support groups. We don't provide them specifically but they're available and you can find those on the web, on the internet somewhere. But there are places where you can connect and more than ever we need to support one another and say, hey, we're here for you. And we're about sharing stories about the lived experience. And when you hear the story of somebody else and it gives you a little bit of hope, it gives you a little comfort knowing you're not in this all by yourself. Okay. That's uplifting. What is your website, Kumi? NamiHawaii.org. Even if you Google us and just put in mental illness Hawaii or Nami, Hawaii, it will pop up. Thank you. Kumi McDonald, the executive director of Nami, Hawaii. Thank you so much for coming down and joining us. I hope to talk to you again. Stay safe. Thank you, Jay. Thank you.