Mental Health

  • Is lasting, full healing possible for those facing even severe mental and emotional illness?
  • Is it possible that some of the common ways we try to support these individuals might make that kind of deeper, more sustainable healing less likely?
  • In particular, are dominant approaches that attempt to make distress go away inadvertently causing some problems to become worse over the long-term?
  • And in that case, might we be unaware of that because we have over-relied upon short-term definitions of “effective” or “successful” outcomes in both our research and professional interventions?
  • Are there other aspects of the current mental health conversation that are also limiting our vision of what is possible – for instance, ways we talk about the mentally ill brain as deficient in an enduring way, or allowing “treatment” to become synonymous with “recovery”?
  • Could broadening the terms of our current mental health conversation make a real-life, practical difference for those facing mental or emotional issues?

How would many people answer any of these questions? (if they even get asked at all)

Not really.  Nope.  This sounds a bit ridiculous….maybe even dangerous?   

But why?

Because a certain way of thinking about the brain, recovery, and treatment has become so dominant that other options have been “rendered largely unthinkable.”

In the early 2000’s, I was struck by the sharp contrast in conclusions being made about anti-depressants.  Some swore they had transformed their lives, while others wondered if they had factored into a surprising suicide.  Between 2003 and 2007, I conducted a research study interviewing individuals in Illinois and Utah about their in-depth experiences of depression and its treatment.  My analysis focused on both their experiences, and how they made sense of those experiences in strikingly different ways:

“Prozac Saved My Life” Vs. “Prozac Ruined My Life”: Investigating the Adoption, Constitution and Maintenance of Distinct Interpretations associated with Depression and its Medical Treatment

Talking about the Talking. Since then, I’ve published three shorter pieces highlighting some of the main conclusions:

My overarching concerns are represented in a more recent video that summarizes key ways the mental health conversation in American may be (inadvertently) making things worse (A Plea for a More Honest + Less Despairing American Mental Health Conversation).

In collaboration with a physician in Colorado and a professor at Florida State University, we recently published a more in-depth exploration of the U.S. mental health conversation, and how it might have subtle, but significant consequences for those facing mental health distress:

Hess, J.Z., Decker, A., Lacasse, J.R., & Foster, M. (2016). A Dialogue About the U.S. Dialogue on Mental Health: Exploring the Nature, Scope, and Implications of the Conversation. Ethical Human Psychology,  and Psychiatry, 18(3), 172-195.

I’ve also published several other peer-reviewed papers with a number of collaborators over the years:

In 2013, following the Sandy Hook shooting, I was also invited to be one of the facilitators for the national mental health dialogues launched by the White House online. With Joan Blades (Living Room Conversations) and Debilyn Molineaux (Bridge Alliance), we also conducted a workshop on ways to help expand this conversation as well:

Blades, J., Hess, J.Z., & Molineaux , D. (2004, October). Expanding the conversation on mental health – One living room at a time. National Coalition of Dialogue and Deliberation Conference, Washington, D.C. 2013  Invited moderator of online discussions for the National Dialogue on Mental Health sponsored by Health and Human Services. Creating Community Solutions

Mindweather 101: An Online Course Exploring Creative Ways to Work with Intense Thoughts & Emotions

As one way to help broaden the mental health conversation, I worked over several years with wonderful partners and supporters to create a free, mindfulness-oriented online class that individuals and families facing mental health distress could watch.  This class draws on interviews with over 30 mental health professionals, patients and mindfulness teachers. [To see the full class, go to Mindweather.org and you can check out the Introduction & Background of the class here). Or, you can click in and view individual segments of the class below]:

Part 1 Making Sense of the Problem

Lesson 1 The brain’s role in mental distress: One view

Lesson 2 What we believe about the brain matters: First installment

Lesson 3 The brain’s role in mental distress: Another view

Lesson 4 What we believe about the brain matters: Second installment (Part I, Part II)

Lesson 5 Just being there: Insights for family and friends (Part I, Part II)

Lesson 6 Different ways of thinking about recovery (Part I, Part II)

Part 2 Responding to the Problem

Lesson 7 One way of responding to mental distress (Part I, Part II)

Lesson 8 Can making it go away, make it worse? (Part I, Part II)

Lesson 9 Another way of responding to mental distress (Part I, Part II, Part III)

Lesson 10 Lesson 10 Surrounded with gentle acceptance: More for family and friends (Part I, Part II)

Lesson 11 Can a gentle approach make a difference for mental and emotional pain? (Part I, Part II)

Supplementary Intro on Mindfulness

 Part 3 Working with Difficult Thoughts

Lesson 12 One way of thinking about thinking (Part I, Part II)

Lesson 13 Re-thinking thinking (Part I) (Part II; Part III)

 Part 4 Broadening the Conversation

Lesson 14 Exploring the full range of contributors to mental/emotional distress (Part I, Part II)

Lesson 15 Considering the full range of options (Part I, Part II, Part III)

Several shorter videos were created to help spread the word about the class:

Avoidance, Aggression and the Alternatives. A central exploration in Mindweather 101 are ways to turn toward emotional distress in a gentle way that avoids unnecessary force. This is a topic I’ve addressed over years:

  • October 2010: “I’m really, really trying to make those feelings go away.” Can working harder to ‘fix’ depression make it worse? Depression Recovery Conference, Salt Lake City, UT.
  • October 2013 (with Vicki Overfelt):  Why Trying to Make Distress Go Away Can Make It Worse…and What to Do Instead: A Discussion on Mindfulness in the Law.  Lawyers Helping Lawyers sponsored CLE event. Utah State Bar, Salt Lake City, UT.
  • March 2014: Turning Toward What Hurts, MindfullyMormon.org blog
  • April 2016: In Praise of a Non-Aggressive, Creative Way of Working with Unusual Mental States Foundation for Excellence in Mental Health Care blog

Learned hopelessness.  One of the major findings of my interviewing research was that on top of the despair of something like depression or anxiety, individuals sometimes carry a Story about Depression/Anxiety that appears to compound the suffering. This is one of the overarching themes of my dissertation study, as well as several peer-reviewed articles that came out of it (here and here and here). At our educational non-profit, All of Life, we’ve experimented with other ways to convey this message, including social media posts like this one and the video that follows it:

Getting at the Roots.  A central focus of Mindweather 101 is helping draw more attention to the many root contributors to mental and emotional challenges, a topic I often speak about [e.g., this workshop in 2009, Evidence for a depressogenic society?  Cultural patterns as incubators of severe emotional problems.  Moving from Depression to Emotional Wellness Conference.  Innovations in Education:  Salt Lake City, UT].

At the end of Mindweather 101, we make the following tools available:

We’ve also begun to experiment how this approach would apply to other challenges more associated with physical health difficulties, including:

Suggested Pivots in the Mental Health Conversation. Earlier this year, we kicked off an online campaign to raise awareness of some simple pivots that may make a difference to decrease the despair and hopelessness of those facing these problems.  Here are some of the messages:

In what follows, I summarize the other themes of my mental health educational and research work:

Narrating the Brain. Presentations and papers exploring the question, “What role does the brain and body play in mental/emotional problems?”

  • November 2006 (with Becky Levin): Narrating the brain:  Investigating competing portrayals of the embodiment of depression.  Clinical-Community Psychology Division Brown Bag. University of Illinois.
  • June 2010 (with Nikki Preece): Neuroplasticity, mindfulness, and the restoration of hope. Family Workshop at Alpine Academy Parent Conference, Erda, UT.
  • October 2010: Neural-plasticity, nature and nurture.  “This is your brain on society.”  Depression Recovery Conference, Salt Lake City, UT.
  • October 2010: Change your brain, Change your depression?  “Neural-plasticity,” mindfulness & other good news about chronic unhappiness. “Healthy Living” Presentations. What a Woman Wants Show, Salt Lake City, UT.
  • January 2015 (with Ed Gantt & Jeff Lacasse): Narrating the Brain: Investigating Contrasting Portrayals of the Embodiment of Mental Disorder

Narrating “Recovery.”  In collaboration with colleagues who disagreed about what “recovery” meant, we published a paper exploring: “What does it mean to ‘recover’ from serious mental/emotional problems?”

“Is There a Getting Better From This, or Not?” Examining the Meaning and Possibility of Recovery from Mental Disorder? (Hess, Lacasse, Harmon, Williams and Vierling-Claassen, 2014)

Narrating “Successful” or “Effective” Treatment.  Since my dissertation, I’ve written several times about this question: What does it mean for a treatment to be “effective” or “successful”?

Long-term vs. Short-term Outcomes.  In particular, I am interested in the comparison of short-term “success” and more lasting, sustainable healing – trying to understand what differentiates the two.  I have explored this in both residential treatment and medical interventions over the years:

In home support. I’ve always been fascinated by the possibility of more robust in-person support as a way to support families in crisis:

High-quality mental health education. From the research I’ve done, I’ve long believed that a key in improving mental health outcomes is expanding the nature of our education:

October 2011:  ‘If McDonalds is the only place in town ….then we all eat hamburgers’: The case for diversifying community mental health education in the U.S.  Annual Meeting of the International Society for Ethical Psychology & Psychiatry (ISEPP), Los Angeles, CA.

Soon after graduating with my PhD., I experimented by starting to teach a mental health class in my basement based on the latest research. It was so impactful, that I eventually moved to community centers and other organizations:

  • (June-August, 2008). “What else can we do?”:  Nine critical issues in understanding and addressing severe emotional problems. Community Class, Community Dialogue Institute, Farmington, UT. [8 weeks, 13 participants].
  • With David Larsen & Ed Fila (January-March, 2009).  Restoring emotional wellness:  A course in overcoming depression and anxiety.  Davis School District Community Education Series, Bountiful High School, Bountiful, UT. [8 weeks, 35 participants].
  • (October-December, 2010). Moving toward freedom from chronic unhappiness and fear: A course on mindfulness & lifestyle interventions for depression/anxiety. Utah Youth Village parenting class, Salt Lake City, UT [8 weeks, 25 participants].
  • (January-March, 2010). Society’s role in depression, anxiety and attention problems: Research and interventions into cultural risk factors. Osher Life-Long Learning. Commander’s House, Fort Douglas, Salt Lake City, UT [6 weeks, 30 participants]

Eventually, my father said, “you need to just put this online! That’s how Mindweather was born.

Mental health in my faith community. I’ve also written a few pieces about mental health questions within a religious context:

The Crucial Conversation about Suicide. With suicide rates increasing sharply (in virtually all age groups), I’ve also been focusing a lot of my attention on understanding why and considering ways to move in a better direction.

The other struggles of our kids. And like many Americans, I have been thinking (and sometimes writing) about what more we can do for children facing, what appears to be, increasing mental distress: