Letter from Emily

Dear friend,

 

Want to talk about mental health and social medicine? I’m your girl.

There are not enough of us who are talking candidly about mental health and social medicine. But I am going to take a risk here and say I’m one of them.

 

May 2018 I will graduate with my MPH from Penn. Right now, I work in behavioral health research. I spend my days designing surveys that examine the state of mental healthcare, exploring integrative behavioral health models, and studying alcohol use disorder and trauma. And I love my job -- not because every day is full of whimsy and excitement, but because each day I walk into work knowing that we are making serious groundbreaking steps to address the crisis of behavioral health in America. 

I was drawn to this work because of personal ties I have developed over the years to the mental health field. Throughout the years, my interactions with people have motivated my engagement with this field – and if you are one of those people who know me personally and are reading this, be reassured that I am not referring to your specific story. The fact of the matter is that in aggregate, stories of mental health trauma and experiences have been a constant theme growing in prevalence around me. In fact, it has become so prevalent in my life that those inside my immediate network have become desensitized to what we are experiencing. I’m talking about mental health trauma that causes depression, anxiety, and even suicide. 

I think these experiences, however tragic, have changed me for the better. Mental health does not scare me anymore. Suicide is the biggest public health concerns for our generation, so we have to accept that mental health is a topic to be discussed, researched, and understood. The problem is staring us in the face and robbing our friends of their futures.  I want to tell you a fictional story that I have aggregated from stories of many people I have met over the years. It’s of Ava. Ava is a junior in college from a small Midwestern state. She is a daughter of immigrants away at college on a generous scholarship, which she needs to work hard in order to maintain. Ava’s differences make her stronger, but it also makes her… well, different. To fit in, Ava starts going to college parties with her friends, her grades start to suffer and when the next semester starts she is ineligible for her scholarship. Her new friends don’t understand the pressures she is under and cannot empathize well with her situation and how she’s dealing with it. Feeling hopeless, Ava doubles down on parties and begins to isolate herself further. The story does not improve and eventually Ava commits suicide. She is the second person that year on her campus to commit suicide. 

You see, there were many public health on ramps that could have intervened in Ava’s story. The college could have noticed her poor academic performance and recommended a tutor, stipulating that she had another semester to meet the criteria for the scholarship. Her friends could have been given mental health bystander training to recognize the signs of healthy stress and unhealthy stress – and may have been able to offer Ava the help she needed or recommend her a place to go. The fact that the campus already had a suicide that year also seems to indicate a paucity of mental health resources. 

Addressing mental health in a robust and sustainable way is an uphill battle, but every day we are making progress. I have never been more excited to be a part of anything in my whole life because I know the benefits that can be had. We are quite literally working to save the lives of people like you and me. Our generation of researchers and advocates is the one that will make progress in the mental health space. We will change our social environments, and find a way through a lot of hard work to improve mental health outcomes. We are starting to see that mental health is just as important as physical health. Your high blood pressure and depression have equal significance on your wellbeing. 

There is something that is uniquely different about behavioral health. All of us experience a broken arm in the same way, however each of us experience emotional harm in different ways. My experiences have taught me that perception is reality. Period. How you perceive your experiences and your world is your reality. And I may not understand it and I may not be able to change it, but it’s important to step out of your own reality enough to recognize that. It’s going to be a huge fight, and I promise you I will do everything in my power to be a part of it.

 

My excitement for this imminent breakthrough in the near future has even prompted me to do something I never expected from myself, to write. Despite my current academic dreams, job, and personal experiences I have never written or spoken about any of this. For some reason I have silently read. The truth is it’s hard to be completely honest on paper. We all have a terrible habit of just making things sound better than they actually are. Depression is the leading cause of disability in the U.S.  Suicide is the 2nd leading cause of death in the 18-34 age group. There is no way even the most talented writer can make that sound good. Writing is brutally honest, and I believe that honesty is where we can start to affect change.

The pain that people are experiencing every day is real, but so is our progress. Just like a lot of our peers, I have been scared to publicly share and write about my academic aspirations in fear of not sounding “realistic” or “perfect.”

 

But really, I’m beyond okay with not being perfect. It’s never been about saying the perfect thing; it’s about moving the conversation forward.

 

So let’s keep moving,

 

 Emily