Mental health calls to VA 'increased dramatically' since pandemic

So far this year, mental health consults are almost equal to the number for the entire year of 2020 and it could double by the end of the year.

Video Transcript

MAYRA MORENO: Welcome to our latest ABC 13 town hall, talking about a very, very important subject here that I think a lot of people may be dealing with but just too afraid to talk. So I want to start off by saying this.

So at the start of the pandemic, it was the beginning of what would be possibly one of the most challenging for many people. Some have lost loved ones, jobs, and even hope. Mental health can range anywhere from struggling with any day-to-day activities or even extreme situations, people struggling to do what they can to help their loved ones. Some may even have suicidal thoughts or even harming others.

According to the National Institute of Mental Health, mental illnesses are common in the US. Nearly one in five adults live with a mental illness. In fact, in 2019, about 51.5 million people were dealing with some form of illness. And according to the National Alliance of Mental Health, one in 20 experienced some form of serious mental health. And 17% of our youth, ages six to 17 years old, they experience a mental health disorder.

It's time to start talking about this topic and realize that it is OK not to feel OK. So with that said, tonight, I want to introduce my panel tonight.

Dr. Asim Shah with Baylor College of Medicine, executive vice chair; Dr. Maria Rivera with Harris County Public Health; Dr. Neal Sarahan with NAMI, Greater Houston executive director; Erik Verduzco with Pour Into Houston, executive director; Renee Tomczak, Mental Health America of Greater Houston president and CEO; and we also have Assistant Chief Wendy Baimbridge with the Houston Police Department's mental health division. And also, we have Vannessa Vasquez, an actress and also a Houstonian who has been a mental health advocate.

So with that said, I want to talk about the latest development. If you have not heard, there was a shooting in Bryan, Texas, and about six people were injured, to my knowledge. One person died. It was a workplace shooting, and officials there just said that they believe this may be related to some sort of mental health issue. So that is why this is so important, really, to talk about. We're seeing cases like this happening too often.

And with that said, I do want to start our panel. Once again, introduce yourself. Tell us a little bit about what you have seen when it comes to your job, mental illness, and the entire pandemic. I know you guys have probably seen some differences within the last year.

So I'm gonna start-- by the way, I see you guys here on my screen. So Wendy Baimbridge with HPD, if you want introduce yourself, tell me about what you do and what you have seen this last year with the pandemic and mental illness.

WENDY BAIMBRIDGE: So thank you very much for having me. Wendy Baimbridge, assistant chief, I have patrol region 3, which is five patrol divisions, but also the mental health division. And what we have seen from our perspective and our interactions with our public has been public frustration. And it's manifesting itself in certain types of behavior and crimes.

People are just angry. People are-- road rage is just an example of that. When somebody purposely or inadvertently cuts someone off, they'll react in a very angry way. And so what we've done is we're trying to educate our public on have something in your mind. If someone provokes you, have something-- a plan in your mind because it just isn't worth it. When you escalate that level of violence, you never know what people are carrying around and what they're dealing with.

We're seeing domestic violence go up, aggravated assaults going up. People are at home. Kids are at home. People are not working. People are stressed. Some people have lost their jobs, or many people have lost their jobs. And that just-- it's just exasperated the problem.

We're seeing also an increase in our mental health-related calls for service-- suicides, for example. We are seeing a increase in emergency detention orders. And that is the danger threat level-- that's a mental health crisis per state law. And so our officers handled over 12,000 of them last year.

And it's just been very, very difficult. But now that we're opening up, we are seeing some hope in those types of crimes and calls and that it's flattening. For instance, our family violence-- we had a 28% increase from 2019 to 2020, but now there's just a 7% increase in 2021. So we're hoping and praying that as the economy starts opening up, people go back to work and school, that we do bring down those types of incidents.

MAYRA MORENO: Thank you so much, Wendy. Dr. Shah, Baylor College of Medicine?

ASIM SHAH: Yeah, Wendy covered a lot of good points. So since the start, what we have seen is, of course, initially we saw a lot of panic, a lot of anxiety, then depression, then PTSD. We have seen easily 30% to 40% increase in the rates of depression, anxiety, PTSD.

Wendy also mentioned emergency detention orders-- absolutely. I work in the ER and I see that 2020, we have seen easily 30% to 40% more mental health patients in the ER. The number of medical patients decreased. Why? Because people initially were very fearful of going to the ER, going to the hospital. The fear was that they're going to catch COVID.

That fear is, of course, diminished now-- not as much as before. But mental health patients did not slow down. Actually, it did increase-- 40% increase. It was very difficult to even sustain because the volume was so high.

As she mentioned, suicidality-- we've seen not only suicidal ideation but completed suicide. And one thing which I would have to mention-- kids' or teenagers' suicide has become significantly increased, and that is a very, very big concern because the warning signs and symptoms in kids are completely different than adults, and sometimes people ignore it. And we are seeing a higher number of teenagers' suicide, which is very, very concerning.

We have seen a higher number of substance use. People who are at home, we've seen higher number of substance use. She mentioned domestic abuse. While we have seen a 30% increase in domestic abuse last year-- less, of course, this year-- but the number of reported cases were less.

Abuse was more, but CPS reports or [INAUDIBLE] reports were less. Why? Because the aggressor was at home. Usually, these reports are made through schools, but schools were, for a larger part, closed last year. And that was another challenge.

So we have seen a wide array of thing, from depression, anxiety, PTSD, and suicidality, suicidal ideation, social isolation. And I've said it in every single town hall or a place I am that we should have never used the word "social distancing." We should have always used the word "physical distancing" because the social distancing is definitely-- and Neal is shaking his head, you know.

But the problem with social distancing is that we wanted people to socialize because if we don't socialize, it becomes another problem and it causes more depression. So we want people to safe socialize-- wear mask in the backyard and everybody knows the safety rules. But definitely keep a physical distance. So here has been very stressful.

And lastly, we talk about patients, we talk about others. But we should not mention talking about providers, about us, about frontline people, because there's a lot of burnout. There's a lot of stress, burnout, and people have worked umpteen hours, and still, nobody has done a whole lot about that. And that's another missing piece.

MAYRA MORENO: Yeah, definitely. You bring up a good point. I think when you talk about certain things like social distancing, it just-- it sounds harsher, right, when you hear that, especially if you deal with it for over a year. So now I have Renee Tomczak with the Mental Health of America of Greater Houston. If you can tell me what you have seen and any other thoughts you have.

RENEE TOMCZAK: Sure, thank you. So I'm gonna talk a little bit about the numbers rather than just say ditto because you're gonna hear the same story from everybody. So when we look at-- Mental Health of America has screening opportunities available, and I think it's really important that we promote that because if we want people to get help a great way to do that is through taking a mental health screening. It's a great way to-- it's a great first step, especially when you are unsure about how to open that conversation with your doctor or your friends.

So looking at the screening data that is available through our website, since the lockdown started, last March through February, we have seen nearly 20,000 screens completed for a variety of conditions, whether it's alcohol abuse or depression, anxiety, PTSD, bipolar, any number of those, it's the highest numbers that we have ever seen since these screenings began in 2014. And, you know, that number is just talking about the greater Houston area.

I think what is particularly difficult here in Houston-- and I'm a transplant from the Midwest, so some of these things have been new to me-- but when we think about what's happened in Houston in the last four years, the trauma that Houstonians have had to deal with resulting from, you know, the devastating hurricanes that have occurred, school shootings, of course, the pandemic, and as well as our recent winter storm. And again, that's just in the last four years.

And when you think about the youngest residents, right, our most important natural resource, our children, we've got five-year-olds who have experienced all that in their very young lives. So finding opportunities to increase resiliency and provide-- and thinking about prevention, which is a primary foundation of the work that we do at Mental Health of America, is vastly important as we look to move through the pandemic.

MAYRA MORENO: Thank you, Renee. And yeah, you bring up a good point. I never even thought about that. Houston in general, a five-year-old seeing this happening-- something every year, that can really do a lot for a young child.

So now I have Neal Sarahan with NAMI. If you can explain for us what NAMI is, what you do, and what you have seen.

NEAL SARAHAN: It's a really gentle word, NAMI. It stands for the National Alliance on Mental Illness, and we're the nation's largest grassroots organization of families and persons in recovery in the nation.

We have 800 affiliates. Houston is one of the largest affiliates in the nation. And we are-- when people talk about grassroots, actually, I wanted to start and say that, as everybody has said this, that we are living in an environment of imbalance-- that we're all thrown off balance.

There is an environment of uncertainty. There is an invisible virus which is out there. We have all been challenged to change, disrupt routines. And as Dr. Shah said, we've been told the thing to do is to socially isolate.

And what I've just mentioned are the four or five primary triggers for mental health escalation, right? I mean, you know, if you are living a schizophrenic existence, you probably are going to have an escalation of your symptoms relative toward this invisible virus. It's not a matter of being paranoid. It's being an environment of fear and an environment of want.

And so what we've experienced-- ours is a volunteer organization. I have 240 volunteers who offer classes and support groups throughout Houston, which means Fort Bend and Harris County and Montgomery County, right?

When we went totally virtual, we had no dropoff in classes. Everybody needed those services. In fact, we expanded services, which is kind of difficult to do in a virtual world. And I think every one of us has expanded our services, right? We have a warmline center that expanded from about 2,000 or 3,000 calls a month-- 2,000 or 3,000 calls a year, I'm sorry-- to more than 26,000 calls. And to do that, we received the support of some foundations that helped us hire people living in recovery to run our call center, people living with experience or know what it is to be off. I hope I'll be able to list that warmline center as a resource.

And then the largest-- a way that I knew what was going on was by the number of funerals I attended either on Zoom or in person. The number of funerals that I knew about that were-- and it got, in July and August and September, up to sometimes three a week.

MAYRA MORENO: Dr. Sarahan, I'm so sorry. I didn't want to, like, cut you off, but--

NEAL SARAHAN: No, you should. You should. You should. Go.

MAYRA MORENO: --can we get to everyone so we can--


MAYRA MORENO: There's so much to talk about, you guys, especially--


MAYRA MORENO: And also trying to keep track of time. And--

NEAL SARAHAN: That's your job. That's your job. Thank you.

MAYRA MORENO: Thank you, Dr. Sarahan. But yeah, you bring up a good point, and we do have those numbers. So as we go on with the town hall, we'll make sure to make that available to everyone. Next up, we have Erik Verduzco. So introduce yourself, the organization Pour Into Houston, and just quickly let us know what you've seen this past year.

ERIK VERDUZCO: Good evening. Thank you for having me. I'm honored to be with these panelists. But I am the executive director for Pour Into Houston, and we're a local nonprofit organization in the Houston area. And our mission is focusing on everything that everybody's already talked about-- all the focus areas for anxiety, depression, suicide awareness and prevention, PTSD for veterans and first responders, substance abuse and alcohol abuse, marital counseling, grievings counseling, all these items that are already been touched upon. And our mission with Pour Into Houston is to facilitate the mental health care services that Mental Health of America, NAMI, et cetera, organizations like that, provide to the members of our community.

Our mission also delivery purpose is to create awareness to the community with our community outreach programs and events that we have throughout our fellow partnerships. It's to let the community know that there are organizations out there that can provide this assistance, that they're not alone, that mental health is a big stigma.

That's our biggest challenge. It's such a big stigma that people don't want to talk about. It's so personal, and like we talked about it, even virtual. People have a problem talking about it face-to-face in person, much less over virtual. So those trust issues have risked that higher stigma for people to be less prone to talk about it.

So as an organization, our mission is to provide [INAUDIBLE] and help facilitate these individuals that can't provide-- they can't afford these mental health care services and prescriptions, you know. For everybody, the cost of mental health care overall is sky high, even with insurance, not to mention without it.

So what we do as an organization is we raise funds and we provide these scholarships [INAUDIBLE] and help these organizations to provide this mental health. So our delivery method's a little more indirect, but also the awareness that we provide to the community when we're out and we do speak in public.

MAYRA MORENO: Thank you, Erik. It's great to have businesses like yours-- or organizations, I should say-- that really continue that outreach to make it more available to people and people feel OK with talking about it because I think that's a big deal.

With that, Dr. Maria Rivera with Harris County Public Health, talk to us about quickly about what you've seen this past year. And yeah, I mean, just talking about mental health is not easy for anyone at all.

MARIA RIVERA: Yeah, and thank you for having us today. And this is such an amazing group of people, an amazing group of experts that can really talk about this subject. So I'm the medical director for our nutrition and chronic disease prevention division. And so I oversee our mental and behavioral health programs at the health department, and I just echo what everyone else has said in terms of the trends that we're seeing in the community.

Unfortunately, we've definitely seen increases in anxiety-based disorders and depression, in suicides, particularly alarming in youth, as some have mentioned. We've also seen an increase in substance use disorders and an increase in the number of overdoses in the community.

And even prior to the pandemic-- so last year in 2020, Harris County released a landmark study called Harris Cares where we looked at the entire population. And at that point, there was already almost 200,000 individuals in Harris County living with severe mental illness. And one thing that was even more staggering is that there's at least 20-- at least 20% of the population that has mental illness has no form of insurance or a form to access mental health services. And I wouldn't be surprised if those numbers have increased.

And so that's one of the other things that I want to highlight is that we're seeing the number of patients requiring mental health therapies increase and the needs for psychiatrists and psychologists increase. But we still have really limited resources to serve those people. And so that imbalance has also been really staggering.

And I think one way that we've seen some of the impact in the community at Harris County is we've actually been screening those individuals that we've been doing case investigations and contact tracing on for depression, referring them to resources. We've partnered with groups-- with other groups such as the Harris Center, et cetera, to also do surveys within our own organization.

And really want to highlight what Dr. Shah said as well about providers, public health professionals being really overwhelmed, overworked, burned out, and this is something that we're seeing time and time again. And so this is an extremely valuable conversation, and I'm very excited to be here with you all.

MAYRA MORENO: There you go. I lost my mouse. OK, so now I want to get to Vannessa Vasquez. So she's a Houstonian, now a Hollywood actress-- a good friend of mine. We went to school together.

So Vannessa, I started noticing how you started to post about, you know, your personal thoughts and the issues that you were going through. Is this something that you have been dealing with for a long time? What made you finally decide to come out and talk about it?

Because it's not easy for anyone, especially, you know, you. You know, you're a Hollywood actress. People see you as someone that's put together, you know. And then to hear this, it's tough to talk about. Just take us through that and why you decided to finally put it out there on social media.

VANNESSA VASQUEZ: For sure. Thank you, Mayra, for having me. It's truly an honor to be here with all of you. Yeah, and I think it's-- I did major in psychology in University of Houston. But it's a totally different thing to read about it and actually implement the practice of any type of healing, right?

And for me, it was just always something that was in the back of my mind, something that wasn't really talked about in my household-- in my culture, really-- growing up. So I started going to therapy about four years ago. And when the pandemic hit, a lot of actors, people in entertainment, lost their jobs, right?

Our identity was our job. The studios shut down. A lot of us lost our insurance because the unions made certain changes during the pandemic, which kind of just put us all out. So I immediately, like many people, I started feeling anxiety.

I started feeling like, what am I gonna do? How am I gonna survive, you know? And for me, my thing had always been work, work, work. That's how I always substituted or tried to avoid anxiety or just kind of distracted myself. And I noticed that I kept doing it. I kept trying to fill my life with something.

And then I had a family member that passed away from COVID, and it kind of hit me into depression and it hit me into anxiety. And I felt myself overworking. I felt myself overdoing stuff. I tried to do challenges to keep myself going, and it worked for a little bit. And I got back to working towards the end of the pandemic-- well, it's still going on-- but towards the end of the lockdown or last year.

And then, again, I had a grandmother pass away and another family member that passed away from COVID. And it just, like-- I collapsed. I shut down. I had a panic attack, and I went numb.

And I just-- and I remember that specific time I got a message from someone saying that they were big fans of me and, you know, they just really looked up to me how I was always so confident, so put together. And there was a part of me that was just shouting, saying, I'm not, I'm not. I don't have it all together. And I was just tired of, like, pretending to have it all together.

And I just, like, was kind of, like, scrolling. And when I began talking to people about it, mostly my family and some of my friends, and the moment I did that, I started to hear from all of my friends from their own anxiety that they've been dealing with for years and I didn't even know about.

And I started communicating it with-- and I just posted one thing online. I posted one thing online, and it was just me not-- it was, like, a post picture, I think, of me coming out of EMDR therapy. And my face was swollen, and I was red, and I said, this is my post-therapy look-- you know, like, making a chic, like it's a cool thing.

And I had so many responses. I had a lot of people that just, like, came out and were sending me DMs and talking about how they felt so connected to what I was going through and things that I had been posting and they just felt like, thank you for speaking up. I feel seen. I feel like I'm not the only one.

And from then on, I just started realizing, like, how many of us are really going through stuff and not talking about it and the importance of advocating and just speaking up on it and just normalizing it, you know?

And I just hit a point. I got tired of it and I said, you know what? This is it. Like, I'm done pretending, and this thing needs to get normalized.

So I'm excited to be here with all of you guys. And anything I can else do to help continue the conversation and get more people to get assistance and know that there's resources out there, I'm here for it. Hello? Mayra, you're mute.

ASIM SHAH: She lost her mouse again.

MAYRA MORENO: Sorry. For some reason, the mouse just disappears and I can't figure out a way to bring it back. But yeah, Vannessa, you bring up a lot of great points, and I'm sure all of you guys can attest to that. We are so used to being busy. We have our jobs.

And I think a lot of people who have anxiety who are dealing with these things in a sense put it in the back of their mind, right? And they say, well, I don't have time to deal with my anxiety. I don't have time to deal with this because I got to take the kids to school. I got this workload. So I think when it all just came to a halt and we sort of just stopped, everything just came tumbling down, correct? I'm sure that's how Vannessa was describing it.

So here we have this yearlong pandemic that is still ongoing, and then we had Harvey before, we had all these other situations, then we had the winter storm. So you start to see all of these people that have been dealing with things like this really-- just nowhere to turn.

And so with that, I know we have a couple of statistics here that, hopefully, we can bring up. But it says that one in 20 US adults experience some serious mental illness. One in five adults experience mental illness. And then this one is just so alarming. 17% of our youth ages six to 17 are experiencing a mental disorder in their lifetime.

That's huge. We know that kids have a hard time talking about what's going on. So with that, I guess, Wendy, with HPD, you were just telling us these calls just started coming in. You guys are seeing, you know, high numbers of incidents, suicidal rates, all of that. Listening to Vannessa, I'm sure you were probably thinking about a lot of things that HPD has been dealing with.

WENDY BAIMBRIDGE: Right. We have a very healthy collaboration with our local mental health authority, the Harris Center for Mental Health and IDD. It's a wonderful organization. They change lives. And we have several collaborative programs with them to help respond to those incidents, and I'll just go over three very, very briefly.

We have our crisis intervention response team. And what that is is an HPD officer paired with a clinician from our mental health authority. We have 12 such teams, and they are in the call for service [? loop ?] and patrol. And they are responding directly to those mental health-related calls, as many as they can get to.

Then we also have our crisis call diversion program, where we put the crisis hotline counselors from the mental health authority on our dispatch [INAUDIBLE]. And they're diverting calls away from police and fire because they're not crime or medical-related and they're just mental health-related so they're getting the help instantly, because a lot of times, when somebody goes into crisis, all they know is 911.

And sometimes, when things are coming up, they don't know the hotline for the mental health authority-- which, by the way, is 713-970-7000. And they also have a COVID mental health support line for the state of Texas, and that's 1-833-986-1919.

And so we also have our chronic consumer stabilization initiative, which is a wonderful program. And what they do is it's [? six ?] mental health authority case managers. And they proactively engage those citizens that are using HPD or 911 services the most because of their mental health issues. And so as a result of that very case management intensive-program, there's a 50% to 80% reduction in HPD encounters because they're getting the help that they need. There's also a 50% to 80% reduction in the number of times they even go into crisis.

So it's a very great-- they're wonderful programs. We're very fortunate for our collaboration with our mental health authority. We feel they change lives.

MAYRA MORENO: OK. So I do want to start bringing up some numbers, and if you guys have other phone numbers or websites that you guys want to bring up.

With that, I want to go to Renee. I know you guys have hotlines as well and even a website that people can go to. You were talking about the assessment online where let's say there's somebody right now that says, you know what? I think I'm maybe dealing with something. I don't know who to turn to. I don't know where to go. Talk to us about where people can go to take this assessment and then figure out what the next step is.

RENEE TOMCZAK: So it's very easy. You go to, our website. You'll see on the big banner there as well as a button "Take a mental health screening." It's free. It takes minutes. It's anonymous.

These are screenings that are well known, developed by doctors, for any number of things-- the screening in-- I'm gonna make sure I get it right-- depression and anxiety, that's available in Spanish. And if you look-- oh, it's great to see it on the screen-- we've got that little-- something I recently learned, when you see that globe there, it's an opportunity to get the information in other languages. So very easy to do, and it really is helpful in starting that conversation because you don't know where to begin. You can take that information to your doctor and get a real diagnosis.

It's not a diagnosis. I want to be clear about that. But, you know, you're able to start that conversation and get the help that you need.

MAYRA MORENO: Let's talk about the warning signs and see if-- maybe we have this graphic as well. I'm gonna be reading off of it. I guess people, maybe they don't know that they're dealing with something, you know, and the last thing that people want to want to hear is like, oh, you're crazy. Like, that's just such a heavy word to say, right? We use it so much to, you know, call out people-- that person's crazy or whatever. But that can really do something to someone to hear that.

So here are some of the warning signs if you can see it there-- it says "feeling very sad," "trying to harm or end your life or someone else's," a feeling of just, like, panic, out of control; sudden, overwhelming fear for no reason; and I think Vannessa was mentioning that she just kind of felt like, oh, my God, what is going on? I'm just feeling so out of control right now.

So Dr. Shah with Baylor College of Medicine, how can someone try to help their loved one? Is there signs that people can notice from a loved one or even-- we're talking about the youth as well. They don't talk about it. Are there specific signs that maybe parents or anybody else can look out for?

ASIM SHAH: Yeah, there are definitely specific signs. Renee mentioned the website where they mentioned the screening tools. They are absolutely important. And not only do we want to screen people, but we want to also provide access to care-- and not only access to care, early access to care. You don't want a depressed person to see a physician two months later. That's too late, right?

So what would be the warning signs. The warning signs are, if you think about it, if you're specifically talking about depression, feeling sad, down, depressed, isolated, withdrawn, staying in your room, not coming out. Another thing which is very, very important, which we need to remember, is losing interest in things you used to enjoy.

So if you are a child, you used to play games, you're not doing that. Even if it's video games, you're not doing that anymore. So that's a change in your behavior, losing interest in things you used to do-- very, very important. Sleep and appetite are important, but not as important. But anhedonia, or lack of interest, is really the most important thing.

Then the other thing is we miss these warning signs-- especially kids, because I like to focus a lot on kids because we have seen a huge increase there-- that kids would mention a lot of these things on social media-- Instagram, Twitter, and Snapchat. They use so many social media that I don't even know all of them.

But truly, they will post it, and they will mention something. So really and truly, their friends, whoever is with them on their social media, if they see any of those warning signs-- I would rather end my life, life is not worth living, or I will take an overdose, or somebody is bullying them-- bullying can cause a lot of severe reactions. We need to seriously, seriously pay attention to that.

And sometimes we take it kind of easy that, oh, it's just a child. They're just saying it. They should be OK. No, it should not be taken lightly. We need to get them help. And help means take them to a provider.

We are blessed to have, as Wendy mentioned, MHMRA or Harris Center, Harris Health, other places. We need to take them to get help. They have crisis hotline. They have 1-800-273-TALK, which is the suicide hotline. So there are lot of things which are available. Even if you don't have insurance, there are a lot of things available.

And two more things I would like to mention is that mental health is something which has stigma in its name. The word "mental" has stigma in it. So that's one.

And second, we talk about it, unfortunately, during times of stress. We talk about it when there is a shooting. We talk about it there's a terroristic threat. We talk about it during COVID time, stress. COVID is a ongoing phenomena. It's over a year now. The effects of COVID may last over a decade-- because if the effect of Katrina can last four years or 9/11 can last four to five years, which was a one-day disaster, this is a ongoing pandemic, a vaster trauma. The mental health effects can last over a decade. We don't need to stop this discussion today or tomorrow, or next month. This needs to continue.

And lastly, Vannessa mentioned earlier that she's delighted to be here and anything she can do-- you know, you've already done a lot by being a celebrity and coming out and talking about it, because people relate to celebrities, to sports people, more than they relate to us, which is perfectly fine. But if a celebrity, if a person who is famous or a sports person comes out and say, hey, I have depression, I have anxiety, I have eating disorder, somebody else who has that problem will say, oh, it's normal. I can go and seek help, too, and I can be successful because look at Vannessa, how successful she is.

So all those things are extremely important. And I wish more and more people like that will come out. There's nothing wrong about that. All these things are same as high blood pressure, asthma, diabetes, anything like that.

So yes, it's absolutely important. So kudos to you, Vannessa. Thank you, actually.

MAYRA MORENO: Yeah, you're right, and we're human. We're human.

ASIM SHAH: Absolutely.

MAYRA MORENO: We're not machines. We're not machines. And--


MAYRA MORENO: --talking about mental health and saying, hey, I'm not OK, should be--


ASIM SHAH: It's OK to say. It's OK to say.

NEAL SARAHAN: Can I get a moment here and that's-- when we say how do we generate those discussions, we have to make it OK to ask a question which is not, are you OK? A better question is how are you dealing? How are you dealing with the imbalance? We are all imbalanced. How are you dealing with that? How are you feeling about this wild environment that we're on?

And in response to that "how" question, people will give you more honest answers. You know, that's-- I think that's really important to watch our language, that if we shut down-- I have suicidal ideation. I do. Neal does. I bet a lot of us have thoughts, right? Thoughts are not actions. Thoughts are not actions, but they are an expression of feelings.

And so we need to build our toolkit for what we're gonna do when those things come. We can't chase them away. We can't deny them away. We have to say that oh, man-- like Dr. Shah was just saying-- don't talk about this in just the crisis time. Just prepare your children for the times that-- say we are all going to be depressed sometime in the next period of time. Let's talk about how we're gonna deal with that. And it's OK. It's OK.

MAYRA MORENO: Dr. Sarahan, with that said, I'm sure it's a conversation that parents would want to have with their kids. What can they say, or what should they say if they want to start that conversation with their five-year-old, with their 15-year-old just to sort of analyze how they're dealing and coping with this past year?

NEAL SARAHAN: Yeah, for five-year-olds, it's a really-- this is a really great time to pull out a series of books about emotions. It's a wonderful time to have them not catastrophize about happy, sad, mad. There are wonderful books out there that are children's books. We've got a great movie about where the emotions were actually the characters.

And I think that parents and caretakers and teachers need to invest in emotional expansion so that kids know that they don't-- when they say, well, I feel like killing myself, then they only associate that with an action. And so you try to substitute the feeling-- the name that the kids have-- and say, oh, if you're feeling that, that must mean that you're feeling depressed. Now, it's gonna be a whole lot better if you tell me you're depressed than it is if you're having thoughts of harming yourself.

So this is an opportunity for people to realize that all the people around them are resilient. They have resilient possibilities, and we all should be building our toolkit. I'll just say that again. I don't have a great, you know, perfect answer. But investing in those conversations with your children, with your teenagers, is the open door-- asking them are they OK--

MAYRA MORENO: Yeah, great. Just a conversation starter, right?

NEAL SARAHAN: I got nothing. Yeah, Renee, Renee, you had--

MAYRA MORENO: You want to say something?

RENEE TOMCZAK: Yes. Thank you for that. I know we have to get to everybody, but I really want to point out a resource through-- it's called ReadyRosie. And our organization has worked with ReadyRosie to create videos that parents can listen to and help have those conversations to the youngest. And I am not sure. I think it goes to maybe the mid-adolescent. There are videos how to start those conversations.

And I do want to say, you know, I am in my mid-50s. I find it harder for people my age to talk about it. What I think, you know, to find something that's, you know, a silver lining or hopeful, what I have seen from kids is they are more than willing to talk about it. So for a parent, just be there for them. Listen to them. Give them the time to let them talk about that.

But I think it's called Healthy Home or something, but if you get that far, you'll know where to find those videos that are available. Child Mind Institute also has videos that can help parents do that.

ASIM SHAH: And mid-50s is very young, Renee.

MAYRA MORENO: OK, and Vannessa mentioned it, too. She said at home, especially with the Hispanic families, we don't talk about our feelings. And I mean, I can attest to that. We never talk about our feelings. We don't talk about what's going on. We just work, work, and that's it.

VANNESSA VASQUEZ: Or it gets dismissed. It's like, oh, you're fine, come on, you know, look what I went through.

MAYRA MORENO: Exactly, Vanessa.


MAYRA MORENO: Yeah. It's that stigma still related to that. It's-- you know, it's like you're gonna be OK, you're gonna get over it. But, you know, you do need to talk about it. You do need help.

ASIM SHAH: But have you ever thought that why people don't talk about it. So if you're saying that you don't talk about it-- Hispanics-- the reason people don't talk about it is-- you have the answer-- stigma. We need to stop calling it a disease. It's the same disease as any other disease, whether it is high blood pleasure, asthma, diabetes, or anything else.

Maybe we need to call it, rather than mental health, brain health, so that the stigma is gone. And that way, at least, hopefully, people will talk about it because people talk about their headache, which is a neurological disease or brain disease. Maybe that way they can talk about depression if you call it brain health.

VANNESSA VASQUEZ: That could really work out, right? Because people do so much physical work out, going to the gym, detoxing their physical body, but nobody's detoxing their mental or emotional state.


MAYRA MORENO: Exactly, good point.

VANNESSA VASQUEZ: I also wanted to add to Dr. Neal. When he said having your toolkit or, you know, what are you gonna do, right, when this happened. I remember when I had my panic attack, I also didn't know where to call. My first thought was, like, should I call 911? I can't breathe. I don't know what's happening to me.

And it was something that I knew I had experienced, like, 15 years ago. And so I knew there was something wrong with my body. I also, you know, have read about it. But experiencing this again, I had to go online. I had to call my nurse friends and say, who do I call? I need to do something. Should I take myself to the hospital? Like, what's going on right now?

And I eventually did some grounding techniques to kind of help calm myself and other different things. I ended up not going to the hospital. But yes, our first thing is, like, how do we prepare ourselves with these tools of what do we do when we feel triggered or we feel like we're losing that sense of control?

And having-- I think, furthermore, not just, like, our parents teaching us about it, but having a conversation with the school system, right, and the school board. How do we start normalizing? We used to have programs for DARE and talking about the war on drugs. What about the war on mental health?

Right now, I mean, should the school system start implementing some sort of after-school programs? Or something in which they can do is to start getting the nation to talk about it and normalizing in the school system in case their parents don't have access to it or the parents, like Renee said, still aren't comfortable talking about this.

So I did want to add to that because I think these are great points that everyone is bringing that I've also--

NEAL SARAHAN: There's a fabulous Facebook video out right now about a six-year-old calming down his three-year-old brother in tantrum by talking him through breathing.


NEAL SARAHAN: By talking him through breathing. And boy, I want that person on my volunteer staff. But he knew how to do that, right? He was prepared.

And you have the expectation set. I don't know, just-- if you get a chance, look at that one. That is phenomenal-- something we all can do.

MAYRA MORENO: Renee, I know you wanted to say something. I also wanted to get to Erik and Maria soon.

RENEE TOMCZAK: I'll be really quick. I want to say that we are working with 25 school districts, over 100 schools, in the greater Houston area, through our Center for School Behavioral Health, where we have-- are providing trainings in how to create a trauma-informed classroom, also how to talk about mental health throughout the year.

We've got a curriculum we call Emotional Backpack. It provides toolkits, all kinds of resources, more than I have time to mention because I know you have to move on. But I think it's important to know that schools in the greater Houston area are working with us and, I'm sure, other organizations to help our students excel because it is going to impact-- it definitely impacts learning to the future.

MAYRA MORENO: Thank you so much. Yeah, I'm trying to keep track of time here. I know we have a limited amount of time, but yes, we can see there's just so much to talk about, right, with mental health. And there's just so many aspects to this.

So with that, I know we haven't heard much from Erik and Maria. So if you guys want to chime in, anything you have in top of mind right now-- and Erik, I know as well, you're very well informed when it comes to PTSD. And I think people in general feel that PTSD is connected to our veterans, but not so much.

ERIK VERDUZCO: Yes, Mayra, that's a good segue into just kind of wrap up what everybody's been talking about-- stigmas. So I was a veteran myself. I served seven years in the Army and I did a tour in Iraq. Kind of like Vannessa and Dr. Neal opened up about, I myself battled PTSD, you know, having anger, remorse after everything that goes on in the military.

And like you said, PTSD is related directly. You automatically think military, war, veterans, et cetera, but it's more than that. You know, it's in the term itself, post-traumatic stress disorder-- not specifically just war, it happens to everybody.

And Renee mentioned early on in the town hall where she discussed what's been going on the last four years in our local community, events such as our recent freeze, Harvey, events that cause traumatic situations to each individual. And everybody deals with these, and they have triggers that come with them.

So we have to just kind of not normalize it, but just let everybody know that there is help out there for you and that you're not alone and that PTSD is common. It's not just specifically because you're in Iraq or Afghanistan or in a war combat situation-- or first responders have dealt with that in the last year with COVID, the traumatic situations that they've dealt with in hospitals and leading the forefront. I mean, firefighters deal with that every single day when they're trying to fight fires, like the one that happened yesterday in [INAUDIBLE]. You know, those situations happen to everyday individuals, and it's OK. It's OK to accept that.

Like you said, we are all human, and these feelings are normal, but that there is help out there for you. You're not alone, and there is help no matter what type of situation you're in. Like Vannessa said as well, just reach out. And I think it falls upon us-- you know, the leaders of the community, the leaders of organizations like the ones that we lead and represent-- to provide the awareness out there. That's the biggest deal.

You know, Dr. Shah mentioned the stigma, and there is no way to change that because these things have been predefined before us, but as how we change to approach it and inform our public about it. And I think that, you know, getting rid of the stigma and raising awareness, starting with us individuals and when people see people like Vannessa, celebrities that are open to talk about it, you're doing a great thing, Vannessa, because you have so many more followers.

So I think that's the way that we can attack this and let everybody know that situations like PTSD are normal. You know, everybody-- we're all human. We all feel. So thank you.

MAYRA MORENO: Maria, do you want to add something, specifically, to what everybody has said so far?

VANNESSA VASQUEZ: Yeah, I mean, I think I completely agree with what everyone has said. I think that stigma is a huge issue. It's definitely a huge issue in the Latino community and Hispanic community. We at Harris County Public health have a couple of clinics and primarily Latino patients and have just launched mental health services and still see that, that even though we have now launched free mental health services for anyone who's uninsured in the community and we know that there's high rates of mental illness or even just high rates of anxiety and stress, the uptake from that community's-- particularly the Latino community-- has still been slow.

And I think it's because of this stigma, because people aren't used to talking about it because they've been told that they have to deal with it on their own because you have to suck it up and just do it and keep putting one foot in front of the other and all those comments that I think are really damaging.

And I think the only other thing that I want to add that-- just to not be repetitive, that I think is really important, is just to keep in mind and keep changing the language around mental illness and how we talk about people-- like, someone is not bipolar, they are living with bipolar-- and just some of those subtle things and not using-- not telling people, you're crazy, just in passing language, and making sure that the way that we use our language is really deliberate, and that will also help change the conversation, I think.

MAYRA MORENO: And I think it begins with us talking about it now, figuring out ways to change the conversation, to open up the conversation. I know we have about five minutes left. So I do want to get to, hopefully, at least one question here.

And, you know, other town halls, we've had so many people flood our survey and to say, hey, I have this question. I have that question. But I had a feeling this would happen with mental illness. People don't want to talk about it. People don't want to put their name out there. They don't they don't want to say, hey, I have a question, because they don't want people to know, I'm going to counseling. They don't want people to know that they're dealing with something like this for fear of what society and their peers are going to say, right?

But I did get this question from someone on Instagram, and I thought it would be interesting. I believe this might be a question for Dr. Shah. She says-- so I'm assuming she has been on antidepressant-- I can't even say it for a while-- she calls it her "pair-a-sut-teen"? I'm probably--

ASIM SHAH: Paroxetine.


ASIM SHAH: Paroxetine.

MAYRA MORENO: So I guess she was taking it and now she stopped is what I assume. So she wants to know how long does the withdrawal from that last? How can she cope? And obviously, she's recovering from anxiety. Any advice you can give her?

ASIM SHAH: Yeah, this is a very good question. The problem with antidepressants or medications for anxiety and depression is-- and I'll try to be quick-- is that people start, people get better, people stop. They don't go to the doctor. They don't ask the doctor. They feel, I'm better, I can stop it. They keep forgetting the fact that they're better because of the medicine. So that's one thing.

And second thing is paroxetine or antidepressants do have withdrawal symptoms, out of which paroxetine or Paxil is one of the most significant or serious for withdrawals. And the withdrawal depends on the number of time, meaning however many years you've taken the medicine. So if you've taken the medicine for five years, you may have more withdrawals. If you've taken the medicine for five weeks, you will have less withdrawals.

So rule of thumb is if you're taking paroxetine for five years, hypothetically, you need to take five months to taper and stop it. If it's one year, you may need to take one month to taper and stop it, and then just like that. Please see your doctor, taper it slowly, and stop. If you don't do that, you're gonna have withdrawal symptoms, which are-- I'll mention very briefly-- which are lightheadedness, dizziness, flu-like symptoms, kind of shaky, wobbly, and sometimes people take it as my depression is coming back. You've stopped the medicine for two days and you have these symptoms and you feel your depression is coming back, depression does not come back in two days. That may take six months, but withdrawals come back immediately.

So please don't stop the medicine cold turkey. Seek advice from your provider or doctor. And if you have to stop it, do it under their guidance and taper it.

MAYRA MORENO: Thank you. And we only have a couple of minutes. I feel like there's still so much that we need to get to, right? So we have a suicidal hotline here for you. If you guys are thinking about anything that you feel is not normal or harming yourself or somebody else, there's a hotline there. Please take advantage of that.

There's also the COVID-19 mental hotline. And we have more here for you-- the Trans Lifeline, the Trevor Project LGBTQ hotline. We know that a lot of people are dealing with bullying and stuff like that. So as we close here, I just want to say thank you once again to everyone.

I do want to go around the room one more time to close it off and-- just maybe quickly a line you want to say, maybe something you didn't get to put out there. If you want to put your hotline number out there again, go ahead and do so. So I'm gonna start once again the way I did when I saw you guys here on my screen, so with Wendy Bainbridge with HPD.

WENDY BAIMBRIDGE: Thank you so much for having me. And I just want to say all our programs, what we have learned is treatment works. Counseling works. So please take advantage of all of these opportunities, and I want to thank everyone on the panel for what you do for a living and for working with our citizens. Vannessa, you're very brave, so thank you very much for speaking out, and thank you for having me, Mayra.

MAYRA MORENO: Thank you, Wendy. Dr. Shah?

ASIM SHAH: All I want to say is that these diseases get better. Mental illnesses get better. If you get treatment, if you get medications, if you seek a doctor and follow therapy or whatever the advice is, things get better. And truly, the only thing each and everyone can do is that if you see somebody near you-- your brother, siblings, friends, neighbors-- suffering, get them help. It's our responsibility to get them help and provide them whatever we can.


RENEE TOMCZAK: I just want to remind everybody that self-care is not selfish. You need to take care of yourself. And there are so many ways to do that, and they sound very cliche, right? Take a walk or call a friend. They really do help you, and it's really important that we do as others have said about normalizing the conversation.

It's generally eight to 10 years before somebody will get help. That doesn't happen with cancer or heart disease. We need to remember and think about before stage 4, right? We don't wait that long when we think about cancer or heart disease. We don't wait till stage 4. When symptoms appear, reach out, get help. Our website, again, is

Thank you for doing this, showing all those numbers. We all have access to technology. There is no reason that you can't find help if you're looking for it. And we're here for you.

MAYRA MORENO: Thank You. Dr. Sarahan?

NEAL SARAHAN: I wanted to do a bit of a brag. For this entire year, Tuesday talks has been on the NAMI Facebook.Houston-- NAMI Facebook Houston-- we've had Tuesday talks funded by the Be Good Foundation and Start Small for accessing communities of color. And we call it our diaspora project on mental health equity. And we think it's so important that there is a whole series-- now a yearlong series-- of people of color speaking to the issue of mental health and wellness. It's a library. Go to it. Find it. Be inspired by it. And we're proud of it. Thank you.

MAYRA MORENO: Love it. Thank you so much. Erik?

ERIK VERDUZCO: Yes, ma'am. I wanted to say that if you visit our website, which is, you'll see that our tagline is "what's your story?" And again, this goes back to just opening the dialogue, the importance of opening the dialogue, open communication about the awareness of mental health, and try to normalize it and make people feel that it is a normal situation and to seek help.

And there's organizations like ours that provide assistance to organizations like Renee's and Dr. Sharon's where people can seek the help that they need, get better, and helping the community become better and bettering ourselves by helping others.

So again, thank you guys for having us. It was an honor to serve with you and the rest of the panelists. Thank you very much.

MAYRA MORENO: Thank you so much. Maria?

MARIA RIVERA: Yeah, I think the last thing that I want to say-- and just kind of continuing to echo what everyone what everyone has said-- is that this time is not normal. This pandemic is not normal. Being socially isolated as humans is not normal. And everyone is struggling in some way or another. Every single person is struggling. And it's completely OK to ask for help. Please do.

As all the people on this panel have mentioned, there are resources out there. Even if you feel like you've never been depressed before, you've never been anxious before, this is not a normal time. Lots of people are experiencing these symptoms for the first time. And you can get help. You can feel better.

MAYRA MORENO: Thank you, Maria. Vannessa, final thoughts?

VANNESSA VASQUEZ: Yeah, I just wanted to say thank you, Mayra, for having me here. And everyone here that's on the panel, it's honor here to serve with you, the community, and share everything that we're doing and what we're continuing to do.

And so I want to give my Instagram because on my Instagram, my email's on there, so feel free to reach out to me. It's @vannessitav. And I think, Mayra, I think you reposted to me or something. But if anybody wants to work or wants to have me come on, I'm more than willing to, willing to do something with your nonprofit organizations, or I also have gone to a lot of schools to do some speeches as well.

So count on me to be there for you guys, and let's continue this. Let's normalize mental health.

MAYRA MORENO: Thank you. Well, it sounds like a possible Tuesday talk with Dr. Sarahan and Vannessa Vasquez in the future. Thank you once again to everyone, everyone on the panel tonight. You know, I wish we could talk about this on and on and on, because there's still so much that I feel I didn't get a chance to go through. But it was a great start.

And thank you to everyone that joined us, whether they saw us on Facebook, on our website, or saw us on Apple TV, Roku, all of that good stuff. This is going to live on on for folks to go back and to reference to it, maybe reach out to some of the organizations, some of the folks here on the panel tonight. And again, Vannessa, you always can find her on her Instagram. I have it on my work Instagram as well. You guys can look for her there.

Thank you again for this amazing talk, COVID-19 and our mental health, hopefully one of many talks to come.