Kansas City Public Health Doesn't Understand Mental Health
Disclosure: I used to consult with Kansas City Public Health for a $225/month stipend since the inception of their community wellness ambassadors program. I also have a clinical diagnosis of C-PTSD, Autism, Treatment Resistant Depression, Multiple anxiety disorders, chronic insomnia, and numerous GI disorders, and I meet the criteria for a Borderline Personality Disorder diagnosis. I am not a doctor and this blog should not be taken as medical advice. Discuss with your medical provider what may be most suited for your personal medical care.
This blog is an analysis of Kansas City Public Health's "Coping Card" that they think will help resolve the mental health crisis in the Kansas City Metro area. Spoiler alert: It won't.
Before we get to the analysis, I will tell you that even though they advertise that a digital copy of the coping card can be found on their website - it can't. They have the URL wrong.
The URL they have on the site is:
https://letswinkc.com/request-cards/wp-content/uploads/2022/12/Coping-tips-card-page-150.pdf
Which pulls up a 404 Error Page.
The actual link is:
Now, let's begin:
The card states how the tips were developed - but going through the website I am unable to find any research papers or any actual methodology on how the coping card was crafted - no actual supporting data for the "tips" that the PUBLIC Health Department is pushing out to the PUBLIC.
I know government agencies are told to push the 988 line - but that line is not trusted by those dealing with mental illness. There are no actual guidelines on when a police officer can or cannot be sent, so those struggling with mental health who do not want to call 911 out of fear of death by cop won't call the 988 line for the same reason.
988 Has a Transparency Problem - VICE July 25, 2022
What mental health activists are saying about the 988 suicide hotline - USA Today August 4, 2022
Social media posts warn people not to call 988. Here's what you need to know - NPR August 11, 2022
Mindfulness is an easy suggestion for KCPH because it's free and places responsibility on the individual. In reality, mindfulness often doesn't work for many forms of deep trauma and many neurodivergent people. This is the government shirking responsibility rather than ignoring the core systemic roots of most of society's anxiety. In reality, mindfulness can actually be a trigger for trauma survivors.
When Mindfulness Doesn't Calm Anxiety - Healthy Place April 30, 2014
Is Mindfulness Safe for Trauma Survivors? - The Science of PsychoTherapy January 29, 2018
does the mindfulness fad in therapy bother anyone else? - Reddit Thread June 27, 2021
Mindfulness Works, But Not for Everyone - verywell mind September 15, 2022
Does anyone else hate mindfulness/mindful exercises? - Reddit Thread October 17, 2022
Further, many people who suffer from anxiety aren't in a mental place to ask for help, which leads to a self-imploding cycle. Help needs to be more readily available and normalized - and most importantly - be available both anonymously and online. This "tip" again places the responsibility on the individual when the problem is greatly systemic. Help not being readily available is perhaps the most significant barrier to mental health wellbeing, as mental health specialists are becoming harder to find and harder to pay for - as many have stopped taking private insurance.
We have to do better with cross-state telehealth now that many of the pandemic exceptions have expired or are set to expire. I think this will be easier than convincing Missouri's GOP stronghold to actually invest real money into mental well-being, at least for the time being.
Are You Afraid to Ask for Mental Health Help? - HealthyPlace May 24, 2014
Why Is It So Hard to Ask for Help? - GoodTherapy June 16, 2016
For Therapists: The Pros and Cons of Accepting Insurance - Good Therapy August 9, 2020
How to Ask for Help if You’re Struggling with Anxiety - Grotto April 16, 2020
Many States Face Shortage of Mental Health Providers - U.S. News June 10, 2021
Why It’s So Hard to Find a Therapist Who Takes Insurance - The Wall Street Journal October 5, 2021
What to Say (and Not to Say) to Someone with Anxiety - Right as Rain by UW Medicine October 18, 2021
What happens to telemedicine after COVID-19? - AAMC October 21, 2022
Therapists Who Don't Accept Insurance - Psychology.org August 18, 2022
I’m a Therapist. Here’s Why I Don’t Take Insurance. - SLATE September 16, 2022
Medicaid, Telehealth Future: Covid Emergency End Explained (1) - Bloomberg Law October 12, 2022
Breathing exercises have mixed results. Breathing exercises can prove ineffective for as many as 9 out of 10 patients being seen for anger. Breathing exercises require training, and simply breathing in and out for four seconds isn't going to do much for someone with anger issues.
When “Take a Deep Breath” Can Be Bad Advice - Psychology Today November 22, 2021
Moving away from the source of anger can prevent you from doing something you may regret, but it isn't actually a treatment to resolve anger. Anger, like many mental conditions, requires deep cognitive work with a mental health professional and potentially medication. Further, talking and thinking to yourself while angry can actually initiate a negative feedback loop of negative self-talk which could exasperate the episode.
The Destructive Nature of Negative Self-Talk - Psychology Today February 4, 2020
The Toxic Effects of Negative Self-Talk - verywell mind May 24, 2022
Let's review this step by step:
"Know that everyone has struggles that can lead to depression, anxiety, & anger."
1 in 5 Americans suffers from mental illness.
1 in 5 Americans Suffers From Mental Illness - ABC News January 19, 2012
Mental Health Disorder Statistics - Hopkins Medicine July 17, 2019
And that was BEFORE the pandemic. The pandemic has given 90% of adults a mental health crisis - as well as nearly 1 in 4 minors.
Mental Illness - National Institue of Mental Health May 1, 2021
2. "Serve those who need a helping hand."
In reality, many of those who suffer from depression think that they're a burden to people and believe (wrongly) that they would only make other people's lives worse by trying to help them. If a depressed person wishes to volunteer, that's great and they should be supported in doing so. But placing the responsibility of volunteering on those who are depressed only gives them more reason to internalize the belief of not being good enough to help other people. Those suffering from severe depression are the ones that need a helping hand.
5 Things You Should Never Say to Someone with Depression - The Guest House November 20, 2018
When It Feels Like Your Mental Health Is a Burden to Others - WebMD July 19, 2019
WHY DO PEOPLE WITH DEPRESSION FEEL LIKE A BURDEN - Bell Foundation March 22, 2020
Feeling Like A Burden? What It Means And How To Overcome It - betterhelp August 9, 2020
What Not to Say to Someone Who Is Depressed - verywell mind September 6, 2022
3. "Improve your diet & drink plenty of water".
Depression strips away executive function and with that is dietary choices. Depression robs the will to cook for you. Depression can manifest physically and makes you literally unable to stomach a meal. Depression isn't as simple as changing your diet - your diet will improve once the depression is addressed.
Executive dysfunction in major depressive disorder - NIH PubMed January 5, 2005
Depression's Effect on Your Appetite - Everyday Health Setpember 10, 2012
Has Anxiety Killed Your Appetite? Here’s What to Do About It. - healthline August 5, 2018
How Executive Dysfunction And Depression Are Related - betterhelp September 22, 2020
Depression and Loss of Appetite: What if I’m too Depressed to Eat? - PRIORY March 12, 2021
Executive Dysfunction - Cleveland Clinic June 26, 2022
EXECUTIVE DYSFUNCTION TREATMENT FOR DEPRESSION - AMFM Treatment July 2, 2022
4. "Strive for 7-9hrs of daily sleep."
Depression and insomnia are closely related. If getting 7-9 hours of sleep was as simple as scheduling 7-9 hours of being in bed for restful sleep, America's mental illness rates would be considerably lower. No, depression keeps you awake. Depression makes you toss and turn for 7-9 hours. Depression makes your mind race wondering why your awake and creates a feedback loop of depression causing insomnia and insomnia exasperating depression.
Sleep disorders as core symptoms of depression - NIH PubMed Setpember 10, 2008
A Vicious Cycle: Insomnia, Anxiety, and Depression - Duke Health August 27, 2013
Depression and Sleep: Understanding the Connection - Johns Hopkins January 6, 2020
Can depression cause insomnia? Yes, the conditions are closely related - Insider April 29, 2020
Depression and Sleep - Sleep Foundation September 23, 2020
Mental Health Spotlight: Treating Insomnia and Depression - healthline October 29, 2021
Sleep and Depression - WebMD August 2, 2022
Can depression cause insomnia? - MedicalNewsToday November 6, 2022
5. Exercise. See #3.
6 Reasons Why It’s Hard for People With Depression to Exercise - talkspace January 4, 2018
I Have Depression and Anxiety. Please Stop Telling Me to ‘Go for a Run’ - SELF April 16, 2018
The Problem With Suggesting Exercise For Depression - Huffington Post October 7, 2019
6. "Play inspirational music."
Depression actually makes it difficult to listen to music. This is as effective as telling depressed people to exercise more or eat better. The realities of the condition don't line up with the advice given. Musical anhedonia (a neurological condition characterized by an inability to derive pleasure from music) can also be tied to depression.
Lack of joy from music linked to brain disconnection - ScienceDaily January 4, 2017
Inside the Heads of People Who Don't Like Music - The Atlantic March 10, 2017
What it Feels Like to Get No Enjoyment From Music - VICE August 23, 2018
WHY CAN’T I ENJOY MUSIC WHEN I’M DEPRESSED? - MIC April 14, 2022
The Impact Of Musical Anhedonia - Bright Star Musical October 24, 2022
7. "Prayer and mindfulness meditation may help."
While this is listed as "8." on the document, it's actually the seventh one listed. I already addressed mindfulness, so I'll focus on the prayer aspect. Prayer/faith has been confirmed to act as nothing more than a placebo for mental health. Further, 3 in 10 U.S. adults are agnostic or atheist. And considering that the Constitution dictates a separation of church and state, a municipal PUBLIC HEALTH department should NOT be advising faith as a public health remedy.
The Number of Americans with No Religious Affiliation Is Rising - Scientific American April 1, 2018
The Science Behind Prayer And The Placebo Effect | Contributor - Forbes December 4, 2018
In U.S., Decline of Christianity Continues at Rapid Pace - Pew Research Center October 17, 2019
Why Is It Called the Placebo Effect? - Mental Floss October 29, 2021
More Americans are becoming secular, poll says - The Washington Post December 17, 2021
Missouri’s War on Public Health Shows Extent of National Rift - Kaiser Health News February 8, 2022
Suicidal ideation is NOT temporary for many who suffer from it. There is a difference between active and passive suicidal ideation. Passive suicidal ideation is thoughts about wanting to be dead and/or killing themselves without a direct plan. Active suicidal ideation is when those thoughts become a plan with the intent to take action. Anecdotal experience, but I have personally suffered from passive suicidal ideation since I was ~8 years old. I am currently 36 years old - 37 in July. I have carried this burden with me for nearly 30 years. That may be temporary in celestial time, but in human years that is virtually half of a lifetime.
During that time I had bouts with active suicidal ideation, and I admitted myself for emergency treatment in the summer of 2020. I am now under the care of a provider in which we have made an action plan for emergency treatment shall my passive ideation escalate into active, and I do suggest that anyone with these types of thoughts reach out to their medical provider to discuss a direct treatment plan if they have the access to such care. I am also in a treatment regimen with that provider (more details below), but from my life experience and from what the research indicates, medical assistance in dying options should be further researched for mental illness so that humane legislation can be drafted.
Should assisted dying for psychiatric disorders be legalized in Canada? - NIH PubMed October 4, 2016
‘What could help me to die?’ Doctors clash over euthanasia - STAT October 26, 2017
What Is Suicidal Ideation? - verywell mind March 21, 2019
Managing Suicidal Ideation - healthline May 29, 2016
What Do You Do When a Suicide Crisis Line Fails You? - healthline June 12, 2019
Should Mentally Ill Patients Have the Right to Euthanasia? - Psychology Today April 21, 2021
6 Differences Between Passive and Active Suicidal Ideation - Psych2Go June 23, 2021
6 Ways You Can Help a Loved One With Depression - Everyday Health July 7, 2021
What It's Like to Live With Suicidal Thoughts - Everyday Health September 23, 2021
Contemplating Years of Chronic Suicidality - Psychology Today July 18, 2022
Passive Suicidal Ideation: What It Is and What You Can Do - PSYCOM October 11, 2022
Canada Soon to Allow Euthanasia for the Mentally Ill - VOA News December 7, 2022
Editorial: Assisted dying in persons with mental illness - Frontiers December 14, 2022
Who can die? Canada wrestles with euthanasia for the mentally ill - BBC News January 14, 2023
Photo by Nastya Dulhiier on Unsplash
Issues with Antidepressants
We need to evaluate the tools we have. Traditional antidepressants have a high failure rate and an even higher tolerance build-up rate - leading to depression symptoms relapsing. They may be cheap, but as more research comes out, we're finding out that they're cheap because they're largely ineffective. If you are on antidepressants, be open with your provider about what you're experiencing. If they are working for you, that's great, but if they seem to be less effective compared to when you started, communicate with your provider. Your dosage may need to be adjusted or you may need to try a different class of antidepressant. Up to 70% of patients with Major Depressive Disorder (MDD) could actually have Treatment Resistant Depression (TRD).
Antidepressants: Can they stop working? - Mayo Clinic January 7, 2014
Treatment-resistant depression - Mayo Clinic January 7, 2014
Yep, It's Possible to Build Up a Tolerance to an Antidepressant - SELF April 11, 2018
My Antidepressant Isn’t Working Anymore—Now What? - Well+ Good July 18, 2018
Debunking the Two Chemical Imbalance Myths, Again - Psychiatric Times August 1, 2019
Definition of Treatment-Resistant Depression in the Medicare Population - CMS.gov November 24, 2021
How Much Do Antidepressants Help, Really? - The New York Times April 21, 2022
Hospitals Fear Abortion Bans Will Worsen Staff Shortages (1) - Bloomberg Law August 9, 2022
Can I Develop A Tolerance To My Antidepressants? - AddictionResource.net September 2, 2022
"Chemical structure of psilocybin" by Cburnett under CC BY-SA 3.0
Psychedelics for Mental Health
The research is increasingly pointing to psychedelics being the answer for those suffering from mental illness. Legaling THC has proven that illegal drugs can actually be a net benefit to society. Legalizing psychedelics - starting with MDMA and psilocybin - is the natural next step toward real mental health breakthroughs.
How LSD and shrooms could help treat anxiety, addiction and depression - Vox July 25, 2016
MDMA Could Help Cure PTSD - VICE News December 19, 2019
How MDMA is treating PTSD in war veterans - CBS News May 1, 2021
Psychedelic spurs growth of neural connections lost in depression - YaleNews July 5, 2021
Can magic mushrooms be used to treat racial trauma? - The Guardian March 28, 2022
Colorado becomes second state with legalized ‘medicinal psychedelics’ - STAT November 10, 2022
Legal Use of Hallucinogenic Mushrooms Begins in Oregon - The New York Times January 3, 2023
Adults Can Now Use Magic Mushrooms With Supervision in Oregon - Smithsonian Magazone January 4, 2023
Psychedelic churches in US pushing boundaries of religion -AP News February 2, 2023
"Chemical structure of esketamine" under public domain by Edgar181.
As for the time being, Spravato (eskatamine) is showing promising results for people with treatment-resistant depression. I have personally been using this treatment regimen since the summer of 2022. A potential solution that I would propose would be for Kansas City Public Health and other government health departments across the State to administer Spravato directly. Kansas City could revie partnering with local providers to get candidates onboarded (assessment, diagnosis, prescribed treatment plan) and then the patients could go into Kansas City Public Health for their treatment once-twice a week. This could be the quickest and most efficient way to treat mental illness for the low-income and the non or under-insured.
FDA approves Spravato nasal spray to help with depression - ABC 7 Chicago March 7, 2019
Spravato side effects: What you should know - Medical News Today March 21, 2022
All About Spravato’s Dosage - healthline March 28, 2022
Side Effects of Spravato: What You Need to Know - healthline April 26, 2022
Community health center in Denver using esketamine to treat depression - NBC 9 News May 30, 2022
Spravato (Esketamine) - Nasal - verywell health October 4, 2022
Nasal spray could help prevent depression relapse - European Pharmaceutical Review November 28, 2022
Ketamine linked to rapid improvement in depression among a third of patients - UPI December 29, 2022
Photo by Vonecia Carswell on Unsplash
People need people.
Public Health organizations need to realize that truth - they can organize community-building events that have no religious connections and are focused on uniting the community's people. Another solution that I would propose would be free dinners, lunches, etc. Simple meet and greets with no schedule or targeted intentions.
Public Health could also look into taking over support groups. AA/NA, etc have too many issues - especially their religious elements. Public Health could fill this niche by offering various support groups for substance abuse and trauma that are tailored by psychological research rather than religious belief.
Critic Faults Alcoholics Anonymous For Lack Of Evidence - NPR March 26, 2015
THE IRRATIONALITY OF ALCOHOLICS ANONYMOUS - The Atlantic April 2015
Support groups: Make connections, get help - Mayo Clinic April 4, 2015
Key Ingredients for Successful Trauma-Informed Care Implementation - SAMHSA.GOV April 2016
How Alcoholics Anonymous lied to the American people - New York Post April 13, 2019
AA and NA Are Popular, but Are They Actually Effective? - healthline February 25, 2021
Can Group Therapy Help Heal Trauma? - PsychCentral July 14, 2022
Are PTSD Support Groups Effective? - betterhelp January 15, 2023
Written on March 1, 2023