Melinda Briana Epler: Hi, everyone. We are going to get started in a few minutes. We are just having some technical issues on our end, so please, introduce yourself in the chat and let us know where you are from and why mental health is important to you. We will see

you in a minute.

>> Melinda Briana Epler: We will get started in just a minute. Please introduce yourself in the chat window, say where you are from and what mental health means to you or why it is important for you. We will get started in just a minute. July

>> Melinda Briana Epler: OK. Let’s get started. All right. Well, hello, everyone. Welcome. Forgive us if we have a few audio glitches right at the beginning. We had some technical issues in the background here so we will get started and we may troubleshoot. This is the work we are in right now. Please feel free to chat and have conversations in the chat as we go. I know several of you are practitioners and doing great work yourselves. Last time we had some great links shared in the chat and resources shared in the chat too so, all right. Welcome to Leading with Empathy & Allyship. This is episode two. I am your host Melinda Briana Epler. The founder of Change Catalyst. This series goes deep and gets real. We are focused on building empathy for underrepresented and historically marginalized populations and providing tangible, actionable steps we can all take to be better allies and advocates for each other.

Just a few logistics before getting started. We are extremely lucky to have Jewel, an ASL interpreter and that is sponsored by Interpreter-Now. This is also being live captioned by Maggie at White Coat Captioning. If you want to turn on captioning, go down to the bottom of your window under “closed captions”. Check that option. If you are on a computer and you want to adjust the size or anything, go up to roar Zoom preferences and — your — and you go go to preferences and accessibility and you can change the size there.

I want to thank our team at Change Catalyst who will be monitoring the chat and the Q&A. Please be kind and inclusive in your comments and chat and in the Q&A. We do have a code of conduct and we will be adhering to that. Use the chat for chat and the Q&A specifically for questions you would like us to answer. We’ll have a good amount of time at the end to answer those questions. Put in those questions throughout our conversation and we will get to them towards the end, some of them towards the end.

All right. Today we are discussing mental health during COVID-19. Please welcome Jessi Gold, assistant professor at Washington university and Dr. Ayana Jordan, assistant professor at Yale university school of medicine. Thank you for joining us.

Dr. Ayana Jordan: Thanks for having us. Very happy to be here.

>> Melinda Briana Epler: Awesome and both your audio sounds great. There is your audio test. As we shelter in place and work from home during a pandemic, many of us are experiencing anxiety, depression and generally a rough time, you know, I go in and out and I am sure many people do and some people are having a more rough time than others. We have seen huge spikes in crisis hotlines and articles are showing frontline workers in particular healthcare workers are experiencing anxiety. I will say my own personal anxiety has been much more severe and working through that with meditation and yoga and just allowing myself to heal and giving myself that time and space is a combination of COVID-19 and the resulting economic crisis, furloughs or fear of furloughs, unemployment, loss of business, isolation, and uncertainty.

Today we will look at the solutions at hand and then we will talk about solutions because it is important to focus on solutions and find ways to create positive change. That’s what this is all about.

So Jessi and Ayana, if you could please just tell us a little about you and your work and what you are doing now to get started.

Dr. Ayana Jordan: I will go ahead and get started. I am an assistant professor at Yale. My Speciality is in addiction psychiatry. I see all types of people who have many different types of addiction but really right now the focus is on substance abuse disorder. I work predominantly with black and Indigenous people of color and Latinx communities. I work in a community mental health center where a lot of my folks do not have access to health insurance. One of the reasons why they come and see me is because they are indeed uninsured and I am continuing to see patients at CMHC. For most of our patients, we have transitioned to TeleMed caveat meaning we do the best we can because a lot of our people don’t even have access to any technology so in thinking about equitable services during the time of COVID-19 and actually pre-COVID I love to introduce the concepts of health inequity and how we are interfacing and providing care for many black and Indigenous people of color and Latinx people during this time. Thank you for having me.

>> Dr. Jessi Gold: I will go. I always like following Ayana because she is cooler than me. I am Jessi Gold. I am an Assistant Professor of Psychiatry at Washington University. I mostly see college and graduate students at the student health center. The other part of my practice is outpatient psychiatry and I tend to see faculty, staff, health professionals. That part has sort of expanded more recently because of need. So usually that’s less of my time and now it has been more of my time. I have been involved in the hospital response to helping the frontline workers for coping with COVID-19 and trying to figuring out how as a system we can be better prepared to help with the mental health of frontline workers and also management and staff and everybody who is affected by what is going to be a big effect on the system. I have transitioned to primarily phone and telehealth. I am currently without internet so I am experiencing on my own what does it look like to not have internet in practice. I do think we need to be really mindful of what this looks like in an inequitable situation because I am really struggling to even find how to contact my patients so it is really complex with everybody in different places and a really significant reliance on something that is very variable and expensive and unpredictable. So I am glad that we are having this conversation.

>> Melinda Briana Epler: Thank you and thank you both for doing the important work that you are doing.

So let’s talk more specifically. What are some of the specific things you are seeing and how are you addressing those inequities? And later we can get to how we can all address them. We will start there.

Dr. Ayana Jordan: If I may just start off by kind of refocusing the discussion because I hear people talk about pre-COVID-19 and getting back to normal and I just want to put a plug in and say for many folks who look like me and for many folks that I take care of pre-COVID was terrible. The reality is that there is no desire whatsoever to go back to normal nor do I think that we should continue that into our general discussion about when are we going to go back to normal realizing that minimizes the existence of millions of people actually who normal was quite terrible. And then thinking about how can we use this opportunity to really think about a better future and a better normal.

So in terms of what is actually happening, so, you know, many of the folks that I take care of are experiencing homelessness on top of their mental health disorder and substance abuse disorder. They are not able to engage with a lot of the services that are being afforded to people now because of COVID.

Let me be particular. If we think about telemedicine. One thing you need in order to access telemedicine is internet service. It is one thing if you just have a disruption of your internet services which is really inconvenient but if you don’t have internet at all, how can you think about even interfacing with your doctor when all of the mental health and addiction services have been transitioned to telemedicine squill and also if you have never had access to the internet how are you accessing the information? So much about accessing resources, the CARES Act and the stimulus check are all being circulated through the internet and many of my folks don’t have it. We have to think about taking care of the mental health needs whether that is an exacerbation or the triggers that might stimulate substance because we have had to deal with the social disruption of life. We have had to have a whole committee directly related to social vulnerabilities because we have had to figure out how to get internet to our folks. How do we get telephones to our folks? How do we even make sure people who are experiencing homelessness, how do we get them access to housing so they can indeed be physically distant? And I will stop talking because there is so much to say here but one of the things I like to say that’s physical distancing as opposed to social distancing because I think now more than ever especially for these communities of color, it is important for everybody to stay socially connected while we are physically distancing and social distancing can be a misnomer especially for people who think social distancing just means not hanging out with people you don’t know. It is really about physical distancing and keeping yourself safe while staying socially connected.

So the take home is on top of the medical illnesses, we have to deal with the social structures and policies so that people can take care of themselves both physically and mentally.

>> Dr. Jessi Gold: Yeah, I think a lot of the stuff she is saying is actually maybe surprisingly applicable to the people that I see. I think people take for granted just because people are in college or just because people are in health professions that they don’t meet a lot of those criteria but they actually do. A lot of people that are in college are first generation in college and they’re going home to places or don’t have the money to being going home to those places and don’t actually have access to food or it isn’t actually a safe place to go home to. When we made the decision to let people go home across the country, you saw people get up in arms about that pretty quickly because some of the colleges may those decisions really quickly and without much forth thought into that which is like home is not the safest place for everyone and some people might, you know, be a member of the LGBTQ community and their family might disagree with them and home is not a place that they feel welcome. I have a lot of patients where that quick decision making was quite hard for them. A lot of schools have done a good job opening up places where they can stay but I think it is important to point out just because someone is in college doesn’t mean these things don’t apply to them. We also have a really big international system and the group of students that were international were not able to go home because we put travel restrictions in place before we told them they could go home plus they are unable to actually communicate or talk to or even know what’s going on in their home countries and that’s really complicated plus there is an additional racist that we saw at the beginning and have continued over time and that has been compounding for the people that I see at the college campuses. I think those things have been continuing over time and are important to consider. I don’t think people necessarily think about that when they think about big groups I see and people are like oh, they are in college. You see a privileged group and I think there is a privilege to getting to get an education like that but often college has been expanded, who gets to go and who is qualified and how aid has been given and that’s great, but with that has come a lot of struggles with what kind of groups are put together and what kind of supports are not really in place to help those people feel really connected and supported to the community. We don’t do a very good job of that to begin with and I agree with Ayana that there are so many things we didn’t do great and going back to whatever we had before wouldn’t have been great to most mental health professionals in many different ways. Mental health has needed a dramatic shakeup for a very long time. If a pandemic has to be the reason that we have one, I don’t think any of us would have really wanted this to be the reason, but if it gets us money, resources and eyes it has always been — depression has been the number one cause of global disability forever but why is everyone now saying did you know that people are depressed? I mean, come on!

Of course I knew. It has always been a bottom line issue for companies but all of a sudden people are thinking about it because it affects management and it is tangibly affecting people at home. It has always been in front of our minds and always had problems, so I agree, there is no let’s go back to pre-COVID-19. It is like let’s shake up the system and make it better.

>> Melinda Briana Epler: Ayana, were you going to say something?

>>

Dr. Ayana Jordan: I was but I will defer. I just want to say amen. I grew up in a black church and when you agree you say amen. I am interested in hearing what people have to say for sure.

>> Melinda Briana Epler: Well, your amens are welcome. [Laughter]

Thank you. That was, I think, a really good context for all of this. There are some real historic, systemic current inequities that need to be addressed and this is exacerbating — it is exacerbating. Let’s take a step back and talk about mental health. What is mental health? What does it mean for different communities? I think it is different for different people. When we say mental health for some that means one thing and for other that means something very different. Let’s talk about that a little bit. What is mental health? What does that mean?

>>

Dr. Ayana Jordan: I think your framing is a very good one. Realizing there is no one definition of mental health. It really depends on, not only what kind of race you identify with, or have been assigned to, but just thinking about cultural belief/cultural norms and how you were socialized. You can be, you know, native Indigenous person and grow up in Minnesota and not have any cultural identity with native population. I think it has a lot to do with how we are socialized.

Thinking about my own definition and how I talk about with patients is taking care of your mind, body and soul so that you can function. That is a way that people are able to really understand and it makes it really sticky and salient to them. We are not talking about a disorder per se. We are not talking about an ailment but what do you need to do for yourself in order to take care of your mind, body and soul and thinking about how those are really important parts to come up with a whole to be able to function. If any one of those is off balanced, sometimes that can lead to an inability to be yourself, and really thinking about how we can incorporate spirituality. I am a community engaged researcher and I work with black and Latinx and substance disorders and one main thing is how can we incorporate spirituality because a lot of times in the way in which psychiatrists are taught spiritual self is divorced from the brain or the mind. We are seeing in order for certain communities, and especially for minoritized communities in this country that have had to endure so many different forms of oppression whether it is interpersonal or structural it is important to access that resilience. I think it is mirroring all these things so people can be able to function and really trying to dismiss a euro centric Freudian view of what mental health is.

>>

>> Dr. Jessi Gold: I think it is important that the mind and the body are not disconnected. I think we do a really bad job of saying this is focusing on the physical symptoms of something and this is focusing on mental health and by doing that we have done a really big disservice to everything that we do in our jobs and people think our job is last-resort or really bad or super stigmatized and really don’t notice when physical symptoms are actually physical symptoms of depression or anxiety and it is really hard when they are told they are because then they think there is something actually wrong with them that’s mental and psychological and now I am crazy and that’s not good for us and really hard for us. I think it is really important that the mind and body part stay connected. Functioning is like at the core of the definition too because really the point of what we do is to make it so that you can function, right? You are coming to us because some part of your life is not going the way that you want it to like your relationships, your work, your day to day. You are not getting out of bed. Something we can work on. That’s what we can do. Maybe you don’t define it with a disorder. Maybe you can’t. Maybe your family can’t. Maybe you don’t want to take pills even though we are people who prescribe them. Maybe we can’t get there yet but the conversation around how do we get you to something that is a goal that we can talk about and maybe eventually get there together in a way that we can mutually agree on the ways to do that is part of what we do.

I think I will point out as a white psychiatrist I have been mindful that there are a lot more of me and a lot less of people that look like Ayana and a lot more people that don’t look like me who would like to see people that look like Ayana and there are not the availability of seeing people that look like them is hard in access. Plain and simple. There are not enough of them. We do not have enough therapists and psychiatrists of color to fill the need. I would love more but we don’t and because of that I have to be aware of the issues in population and be as open as I can be to understanding and listening and learning from and to, like, you know, from people like Ayana, from my patients and also open to say like, I know what my weaknesses are and I know that like, if you had a choice maybe you would chose not to see someone who looks like me and I understand why those reasons are but I hope that given the options, I am doing the best I can and that we can be an OK pair where you can still come to a place where you can trust me and know that I am doing the best I can to understand where you are coming from despite not having experienced the same things that you have and never really going to experience the same things that you have.

>> Dr. Ayana Jordan: I think that’s an important point, Dr. Gold, what you are talking about is a true definition of being an ally and allyship. I think in your social media that you have been an Ally to many oppressed identities whether that be women, whether that be people who have been involved in sexual harassment, sexual violence, and definitely for black and Indigenous people of color and Latinx folks. I think that’s really important because the reality is for black psychiatrists they only make up 2%. If you are really thinking about how to take care of minority populations, the reality is most people are going to have to see white physicians. That’s the setup in this country. Really being curious and coming to the therapeutic sessions or the alliance with I don’t know everything and I am willing to learn and this is what I do know and am I on target or not and then really consulting with friends and professionals from those communities to say what can I do and what can I learn is super important as opposed to not doing anything at all. I think that’s what extremely frustrating just being a black woman who happens to be a physician during this time. I have spent so many days crying at the disproportionate number of folks that look like me in the hospital. It is such an emotional thing because I didn’t even realize. These are not my family members. They are not necessarily people I know but just knowing the difficulties that come with surviving in this country on top of the oppression that happens caused just a sense of mourning. One of the things that I have had to learn is just to allow myself to feel all the feelings. If that means I am going to cry in between patients that’s what I am going to do. Or if I am talking to one of my Chinese folks who I take care of and they say Dr. Jordan, I cannot go outside because I am afraid for my life because 45 is calling it the Chinese virus that’s real. And just mourning the bigotry that’s in our society can also acerbate dealing with this pandemic in and of itself.

One of the things I really appreciate is for allies to check in and say Ayana, how are you doing, and I don’t have to initiate that. Just in terms of tangible things is just checking in on people maybe because they just identify with a group who is not doing well. You know, 14 out of our 15 people in our ICU are black. That’s terrible. That can really hit deep, you know? Or turning on to the news and you see all these experts but none of the experts look like you. Dr. Phil. Dr. Oz. It is like we are out there. Why aren’t you asking? All of this is very painful and I think having the space to mourn that but also having allies like Dr. Gold to say hey, what’s up? Are you OK? How can I elevate your voice is equally important and thinking about how can you be an Ally for somebody in your life that is marginalized and being an upstander to support them. Super important during these times. MRJ

>> Melinda Briana Epler: Agreed 100%. Thank you. If we could talk more about allyship now I think that would be good. Allies for each other, allies for practitioners with each other, and also allies for colleagues where we don’t know what they are going through in terms of mental health and wellbeing. How would you recommend to somebody who is listening in that they check in? What can you do as an Ally? What’s the best way to step up as an ally?

Dr. Ayana Jordan: I have a few things to say but I want to introduce this little one. Her name is one gari and she just came two me two weeks ago. She is my Rona puppy and helped me cope through this. In terms of allyship one of the things I love is thinking about how to access resilience and one of the ways in which people can really be a wonderful Ally is thinking about how they can increase their own resilience and what I mean by that is just the fact that resilience doesn’t cost anything and it is accessible to everybody no matter where you come from, or what group you identify with, and so we all can, like, practice resilience and really exercise it and build it up in order to really bring about better connections with folks.

Four things I think in terms of being able to increase resilience that can lead quite nicely into Allyship is building connections and thinking about how do I prioritize or join a group that might meet my health? Could it be volunteering for a woman’s shelter? Taking calls? I know for physicians there is a physician hotline for people who are not doing so well with the pandemic. So many colleagues volunteering to be on the hotline to help with physician needs. Really thinking in terms of allyship, how can you build connections with groups that you may not necessarily be familiar with but you want to support them? Can that be, you know, volunteering for a rape hotline or thinking about how you might make maps for a particular group that don’t have access to that. Those are ways to be tangible in doing that. One of the things you said, Melinda, when we first started was practicing yoga and thinking about how can you as an ally you can promote wellness whether that be physical, mental, emotional or spiritual wellness. One of the amazing things for the black women I take care of is one of the allies started a free yoga program. So for people who might not know they have access to exercise, or moving, or couldn’t afford gyms, now they have an opportunity to follow along through yoga, so I thought that was really, really nice.

And so it doesn’t necessarily mean that you have to have an in with that particular community but thinking creatively about how can you warn those connections in order to really benefit folks and that really creates a sense of hope that can allow people to kind of deal with the realities of a pandemic because if you are focusing your efforts on your yoga class, you don’t have the space to think about, you know, the reality or whatever is going on. Just really thinking about healthier coping mechanisms. So those are just some thoughts.

>> Melinda Briana Epler: To add to that, yoga and meditation both is breaking the cycle of that fear/response/anxious anxiety response and physically too I think it is really important to get your blood pumping to your brain and to your heart and really staying healthy right now is super important as well. I think for me having those moments of getting away whether that’s meditation or prayer or yoga or whatever that is for you I think is really important to break that cycle. Get out of the news and stress cyclical and just come back to your own being.

>> Dr. Jessi Gold: Yeah, I think for me, I grew up in a community that looked a lot like me and I have learned a lot over time from people that don’t look like me how to be a better friend and an ally honestly by listening. I think that’s really important. I think I had to learn a lot about the balance between listening and asking them to educate me too much. I think they play the role of educator a lot and it gets exhausting and I think we take that for granted in our patients and in our friends. I think I still make those mistakes sometimes. It is not always known I am doing it and sometimes people will say this isn’t a good time for me to answer that question. I will answer that question because I know you are asking from a good place but I just can’t right now but keep in mind there is a balance between like how much they have to constantly explain how to be a good support and ally and taking on that role often and being the mentor to all people in all communities and that’s a really hard role to play and it is a lot of responsibility. I think that’s just like something to keep in mind. I think it is really important to check in on people that might be extra struggling right now so there are groups that are additionally affected right now that you can tell are additionally affected. If you have friends or members of that group, also including healthcare professionals, reaching out with just a text of I am thinking of you and not asking who they’re because that requires an emotional commitment to answer that question. It does not require emotional commitment to look and see someone cared about you. Sending a meme or quote or something just to — it is always nice to know someone was thinking about you and I have always felt when I am not in a good head space looking down and remembering which friends remembered is nice to look back on. That’s an easy way to bridge communication gaps and show people you are thinking of them even if you don’t have a lot of emotional capacity to give but you do want to give a little bit because I do think we don’t have that much to give right now either. I do think that it is important that you realize that. There is a degree of benefit that we do get from being altruistic. It is a defense mechanism for a reason. It does give you some sort of control over uncertainty. It does give you some kind of control and you do feel like you are helping and it is true. As a person who is not a front-line health care worker I have done a lot to feel like I am grabbing control which for me is writing and talking to people on social media and amplifying others on social media that have voices that should be heard. And I think that can feel good but you do need to realize that you also have emotions and needs and you need to check in with that too. As much as you do want to give, there is a point at which you need to stop giving and check in with yourself and say, oh, why am I still giving and giving? Do I have more to give? And where is my tank right now? Do I need to do some stuff to make sure I am there enough to be giving? We are often covering our own feelings by giving and it is a good way of doing it. There are worse ways to do it but you do need to check-in with yourself especially if you feel non-stop doing that. I do that often so it is coming from experience that I am saying that.

Dr. Ayana Jordan: Dr. Gold, I think that’s such a good point and makes me reflect on one of the participants who was extremely vulnerable and then talked about being viewed as a strong person and how it took so long for her to even admit to herself that she had mental health issues and I think in terms of having that balance because strong people can do so much, keep going, and use it as a way to ignore their own inner experiences or what’s going on and it can be very painful to have to admit I am not OK, so really slowing it down to check in and say where is my tank right now and is it just a matter of self-care? Or is it a matter of, you know, getting professional help in order to really be whole back to Melinda’s point of mental health. Sometimes strong people especially have to be vulnerable to say we need help and that is OK. I think it can be harder depending on what communities you come from. Definitely, definitely in so many black and Latinx communities it is like for them to see somebody like me is just not a thing. When they first come through the door I am like I am so glad you are here. Let’s celebrate that. I really appreciate, Melinda, this platform and how we can elevate and talk openly about getting help whatever that means to you. It is OK no matter where you look like or where you come from because we all have to get help at some point and the degree of what it is and what it looks like may be different but it is OK. Anyway, thanks, Dr. Gold, I appreciate that balance in doing and practicing altruism and recognizing that might be masking a larger issue.

>> Melinda Briana Epler: That brings up a point for me and just that people with power and privilege have an opportunity to acknowledge that in ourselves and also model that acknowledgment in ourselves and let people know that it is OK and that it is important to work on it and also, you know, a lot of the people that listen to this are leaders in their companies and have an opportunity to create a safe space, to create a supportive place/workplace and where sheltering in place still has ways to create that space for courage and vulnerability and working on ourselves and being allies for each other. Could both of you talk about the ways people within companies, people who are managing teams, might address mental health right now? And I know Jessi you have been working on that in your work. It would be good to know both things you can do to support and also things you can do to just bring joy and, you know, positive things into people’s lives right now.

>> Dr. Jessi Gold: I can take it first. First I want to point out Dr. Jordan calls me Dr. Gold and I call her Ayana and I am really aware of that and I want to point out I am aware of that. I am not meaning to disrespect her by calling her Ayana and I want everybody to know I am aware she is doing that. She has also known she is called Jessi. She keeps doing it anyway. I want to point out that I am aware. Anyways things you can do as a leader, one, admit you are aware of these things. Two, I think when you are in — hospital leadership. If you are thinking about hospitals they are a very big company and the bottom line of hospitals is, unfortunately, the same as most businesses. Make money, make employees happy, have them come back, keep retention. Same kind of thing even though you would like it to be health outcomes. It’s not. When we think about how we have been trying to incorporate mental health into the program I would say most hospitals are starting from scratch. They should be starting from higher than scratch because it has been in the conversation for a very long time and we, as health care professionals, have had high rates of depression, suicide and substance abuse and it has been documented and researched for years and they know and our licensing boards have known but yet they haven’t changed anything. They are still starting from scratch in some places. Some places not starting from scratch are doing better at being quicker. Most of the changes have been things like trying to open appointments. There are flashing lights in my neighbor’s house FYI. The question here is if you open up appointments are people more likely to go and see people in the place that they work or would they feel more comfortable going outside a place they work? I think that’s a question companies have dealt with because a lot of companies bring in a therapist or psychiatrist and have them work in the company. Amazon and Google and big companies do this. But I think people sometimes feel scared to go to HR or the person who works for the company for the reason it will brand them oh gore on their record. We don’t have a ton of choice and we have available so we are doing it internally and opening up appointments for therapy, and opening up appointments for meds as much as we can. We are also doing groups. Skills groups. Mindfulness which is centering and similar in process to meditation. Some other skills like deep breathing and other things you can do quickly. Some just venting sessions frankly where people can top in over Zoom and do that. They don’t have to sign up. They can just show up. Those are led by a psychologist or other volunteers in the departments. We have a crisis hotline we have expanded. I think most programs are doing this as a place to call and go for support. I will say that a lot of our stuff is underutilized right now. We think it is a cultural thing and it needs to catch on and feel branded and safe in some way and it has never felt safe. Mental health has never felt safe in our culture. I just filled out a licensing application and they just asked if I have ever had a mental health problem and I don’t know how I could feel safe with going to see anyone for stress if that counts. What counts? It is very hard so I think people really worry about things like that and don’t get help when they need it. Don’t recognize they need it. Our very adrenaline focused right now and don’t recognize that they need it. Those are main things and then there is this whole gratitude angle which is some of thought Melinda is taking about which is because it is a little slower on the uptick of the core mental health things right now we have been aware that people are just feeling underrecognized. I think without seeing people in person you don’t feel as good. You just don’t. Nobody says thank you and nobody says hello. It just feels a little bit more lonely. I think we have been doing things like there are ways to shout-out and you can fill out gratitude things and people get them in their inboxes or the people in the hotels that are frontline workers that are exposed get welcome bags when they come in that are like if you stayed in the hotel for a wedding and you get randal things for staying in the hotel for a wedding but at least it shows that the school thought about it and cared.

You know, little things like that. The chancellor is doing Zoom bombs in team meetings which I think is funny but it shows — you know, he shows up and just says hi, just thinking of you because there are all these team meetings over Zoom and nobody has probably met the chancellor so it is kind of nice and kind of funny. There is a lot of stress right now and a lot of pay cuts and furloughs and all of that going on at the hospital levels and most hospitals across the country so I think it adds a little bit of something extra. Those are the things that have been going on in the medical sphere and I think a lot of them are applicable across the country. I think that the whole thought process is quite important in everything.

Dr. Ayana Jordan: Yeah, I know we are running short on time so the only thing I will add is one, thanks, Dr. Gold for recognizing it but it wasn’t about you, really. It is about me because a lot of times when I am engaging with medical colleagues I automatically call a doctor and by women I call their first name so I am trying to get into that practice. No matter in terms of whatever leadership position you are in, if you are able to provide a space where people can vent, and allow them to have some really tangible takeaways and say what does that mean? It doesn’t necessarily always have to be monetarily, although that’s important, like for instance I was able to send an email and said no matter what part of the institution you are working in, you will be paid until the end of May. That’s huge. Just in terms of knowing you will have that financial security. Now, I don’t know if every system can do that but if you are able to at least assure some level of your job will be here, your parking is free, childcare will continue on. Those are like tangible benefits that need to be communicated in this unprecedented time.

The other thing that I think is super powerful in terms of one of the things I lead here is the stress and resilience group. To Dr. Gold’s point about expressing gratitude, one of the things we do as soon as we start with this group and hold it for 45-50 minutes is thank you so much for showing up, thank you for being here, and thank you for being a part of the community because we go through our days physically distancing and sometimes you never even get acknowledgment that you are here, that you showed up for something. That can just be a really nice way of honoring the person and their identity and their humanity. What we practically give is deep breathing. That’s something I have questioned for many years and allows me to calm my thoughts and mind to be at a place of peace in the middle of the storm and so many people that participate in these groups say to Dr. Jordan and Dr. Tate thank you for allowing me 10 minutes of peace. That is tangible and free and it can be practiced. In terms of being leaders, and I think women do this amazingly well, is just creating a space to acknowledge the humanity in all of us but also to provide some reassurance in terms of basic needs if you are able, and finally give something. Give something tangible. It doesn’t have to be financial. It can just be a skill.

>> Dr. Jessi Gold: I would add, I do think you are right. We don’t often see leaders express vulnerability and most leaders that are vulnerable are the best leaders I have met. As someone who is a mental health professional I am biased but any time I have seen a leader even in confidence express that it was really hard for me too or medical school was not fun, you are right, it’s horrible. Nothing is good about medical school because there is this whole facade that it is perfect and you feel like you are the only person who is struggling. When somebody who looks like they have it all together tells you they didn’t for a long time or still don’t it means a lot. It doesn’t mean they’re going to go tell every person you ever met you told them the one vulnerable thing but it means a lot to that one person that I told them that. I felt really supported by people who have done that to me or confided with me about something that maybe they haven’t told every mente but told me in times I needed it and it made a big difference on the help that I have sought their help I have taken or the mental health resources that I have looked for and the ways that I approach the things that I have said yes to or the things that I have said no to and the things that I value.

>> Melinda Briana Epler: Yeah. Great. We are just about out of time. I wanted to just quickly ask you both if someone is needing help, where is the best way — where can they go?

Dr. Ayana Jordan: There are so many different ways. I think it depends on what type of help you need. One of the things that I will do while Dr. Gold is talking is I will put the suicide hotline in the chat for everyone to see because even if you are not suicidal and I have done a walk-through so I have called the line people can be extremely supported and just plug you into wherever you need help.

I am not exactly sure where people are right now, so that is definitely an option. Another thing that I will say is just think about no matter where you are calling your equivalent of 211 or information to say where can I get access to mental health services. That has been a wonderful resource in terms of just figuring out where to go. But because we don’t have a universal health care system it is hard to have one way to access health. I would start with the hotline or the equivalent of a 211 in our area. Let me get to why Dr. Gold is speaking.

>> Dr. Jessi Gold: I think the crisis hotline is 741741. Ayana can check me on that. I think that’s what the crisis text line is. People use that for stress relief and anxiety and there are people that text you back. While you are home it is quite nice. I am pretty sure it is 741741. There is a lot of different apps and things that are quite good that you can turn to from home like for mindfulness and for just kind of, you know, journaling and things like that. There is a gratitude journal app and headspace and calm where you can use the free versions of them. You can do some mindfulness. You can do bedtime stories which sound silly but they are actually quite helpful. Those kinds of things are grateful for health. If you are looking for therapy we often direct people to the psychology today website because it is like a Facebook of therapists. You can search for your insurance and you can see what little blurbs people put up. It is not complete in any means and there are lots of gaps but it is better than your insurance’s website.

>> Melinda Briana Epler: Awesome.

>> Dr. Jessi Gold: Sometimes the people are no longer taking people on insurance sites and sometimes the number goes to McDonald’s so you are better going there and seeing them there. Ayana put up one of the physician support lines. There is a thing called project parachute which is pro bono therapy for physicians. People are doing really cool stuff for frontline workers if you are interested in being a person that supports that or amplifies that.

>> Melinda Briana Epler: I will put additional links in all of our different social media and YouTube channel. I know Ayana and Dr. Jordan you have to go. Thank you, Jessi and Ayana. Dr. Gold and Dr. Jordan, for your time. Appreciate all you do. Thank you, everyone for joining us today. Join us each week for Leading with Empathy & Allyship. Sign up to attend live with audience Q&A or check the podcast. The YouTube video. You can stay in the loop by going changecatalyst.co and signing up for the newsletter. Be brave and courageous and take action. Don’t forget to subscribe to our podcast on our YouTube channel and see you next time. Thank