“I Believe The Misunderstanding Of Mental Health Stems From Our History — Confusion About Mental Health Truly Being Part Of Health.” With Bianca L. Rodriguez And Christine Moutier, M.D.

As a part of my series about “Mental Health Champions” helping to normalize the focus on mental wellness, I had the pleasure to interview Christine Moutier, M.D. Chief Medical Officer, American Foundation for Suicide Prevention. As a leader in the field of suicide prevention, Dr. Christine Moutier joined the American Foundation for Suicide Prevention in 2013, […]

As a part of my series about “Mental Health Champions” helping to normalize the focus on mental wellness, I had the pleasure to interview Christine Moutier, M.D. Chief Medical Officer, American Foundation for Suicide Prevention.

As a leader in the field of suicide prevention, Dr. Christine Moutier joined the American Foundation for Suicide Prevention in 2013, and it’s through her passion and commitment to the work that we see a lasting impact via research, education and support to communities across the U.S.

She has testified before the U.S. Congress and provided multiple Congressional briefings on suicide prevention, presented to the White House, spoken at the National Academy of Sciences, she co-anchored CNN’s Finding Hopesuicide prevention town hall, and has appeared as an expert in The New York TimesThe Washington PostTimemagazine, The EconomistThe AtlanticAnderson Cooper 360, the BBCCNNNBCand other print and television outlets.

Throughout her career she has focused on training healthcare leaders, physicians, and patient groups in order to change the healthcare system’s approach to mental health, fighting stigma and optimizing care for those suffering from mental health conditions. In addition to co-founding AFSP’s San Diego Chapter, Moutier co-led a successful suicide prevention and depression awareness program for health science faculty, residents, and students, which featured AFSP’s groundbreaking Interactive Screening Program.

Since earning her medical degree and training in psychiatry at the University of California, San Diego, Moutier has been a practicing psychiatrist, professor and dean in the UCSD School of Medicine, medical director of the Inpatient Psychiatric Unit at the VA Medical Center in La Jolla, and has been clinically active with diverse patient populations, such as veterans, Asian refugee populations, as well as physicians and leaders with mental health conditions. She also served as co-investigator for the Sequenced Treatment Alternatives to Relieve Depression study (STAR*D), a large National Institute of Mental Health trial on the treatment of refractory depression.

Moutier has authored articles and book chapters for publications such as the Journal of the American Medical AssociationAcademic Medicine, the American Journal of Psychiatry, the Journal of Clinical PsychiatryPsychiatric Times,Depression and Anxiety, and Academic Psychiatry.

Thank you so much for joining us! Can you tell us the “backstory” about what brought you to this specific career path?

Even as a kid, I gravitated toward authenticity, which meant the reality that all people suffer. Somehow, I knew it was ubiquitous and I wanted to make a difference. Later during medical school, I experienced my first mental health struggles that made me more attuned to the disconnect between certain aspects of our culture and the needs of real people who experience mental health problems. And then during my residency training and early faculty years, my medical institution experienced the loss of more than a dozen physicians to suicide.

I became a dean for students and medical education and was charged with figuring out a path to preventing these tragic losses from continuing. I found myself grappling with how to translate scientific studies into actionable change that would amount to saving lives. Today, that program at the University of California, San Diego School of Medicine, called HEAR “Healer Education, Assessment and Referral” is still going strong saving physician and nurse lives.

According to Mental Health America’s report,over 44 million Americans have a mental health condition. Yet there’s still a stigma about mental illness. Can you share a few reasons you think this is so?

I believe the misunderstanding of mental health stems from our history — confusion about mental health truly being part of health. Our society has long believed that human behavior is a matter of will, choice, spiritual or moral deficits and strengths, and a bit of personality or temperament traits. But human behavior is influenced by the brain, by mental health, which we all have just as we have physical health. And the brain is a tangible, very real physical organ in the body, just like the heart and other vital organs.

Before advances in neuroscience and other fields, we had a very primitive way of understanding human behavior and mental health. People generally understand that physical health outcomes result from the interaction between genes and environment, for example a person with a family history of heart disease can potentially change their cardiovascular health through changes in diet, smoking, exercise and stress management. The same is true for our mental health. We are still laying the foundation with building blocks based in science for every day people to understand the parallels between the mental and physical health.

Can you tell our readers about how you are helping to de-stigmatize the focus on mental wellness?

At the American Foundation for Suicide Prevention, we use the most current, cutting edge scientific discoveries, and blend them with the stories of people from all walks of life — our amazing chapter volunteers in all 50 states all touched personally by suicide — to educate the public about mental health and suicide prevention. Nothing like science and real people’s narratives to create a culture and a movement that’s smarter about mental health! This is how we create change and help others better understand mental wellness and that suicide is a health outcome.

One example of how we shape new narratives in our culture of mental health and wellness is a new public service campaign for teens and young adults called Seize The Awkwardthat helps peers who are concerned about a friend to have deeper caring conversations. By experiencing the support of a peer and their actively engaged listening skills, most will actually open up (and feel relieved to share their struggles with a caring friend) and are more likely to seek professional help as well.

Was there a story behind why you decided to launch this initiative?

We saw the trends in culture and social media and the negative effects on mental health and interpersonal connectedness, one of the protective factors reducing suicide risk. We wanted to do something more targeted to young people given the rising rates of suicide in teens and young adults in the U.S. over recent years. With nearly 1 in 5 young people having serious thoughts of suicide each year, only half of them tell anyone about these thoughts. Of those who do disclose, 2/3 only tell a peer. Young people truly want to help their friends, but we heard from them that they didn’t feel they had the language or skills to break the ice and take things deeper. This led the American Foundation for Suicide Prevention to the development of Seize The Awkward along with our partners, the JED Foundation and the Ad Council.

In your experience, what should a) individuals b) society, and c) the government do to better support people suffering from mental illness?

Everyone can start by getting educated about mental health and suicide prevention. Anyone can learn some of the basics that will help them follow this rule of thumb: anytime you’re wondering how to approach a situation that involves someone’s mental health, ask yourself, how would I approach it if it were hypertension or diabetes? That really helps keep your frame and approach clear.

As a society, attitudes have already shifted in a positive way →90% of Americans believe mental health is as important as physical health and that suicide is a health outcome that can be prevented, according to a recent Harris Poll that the American Foundation for Suicide Prevention participated in this past fall. Now it’s time for people to stand up and demand that mental health is afforded the same support, policies, investment in research and treatments that have reduced mortality from other leading causes of death.

Our government leaders need to listen to their constituents. The majority of people in every community across the U.S. has been personally affected by suicide, either through loss or personal struggles. Our federal government invested over $1B toward a solution for the zika virus before a single American had died, and we need our policy makers to feel the same sense of urgency for suicide, which takes 129 American lives every day. We may not have had evidence-based ways to prevent suicide in the past, but we do now.

What are your 6 strategies you use to promote your own wellbeing and mental wellness? Can you please give a story or example for each?

I use my calendar to gauge the upcoming weeks’ events and amount of stress/work/prep associated with each work/personal event. For a while, my husband and I even used a hokey point system, assigning a “numerical stress load quantifier” for each event and summing them up for each several week period! This only lasted a few months, but it got me in the habit of protecting my “resilience reservoir” as a resource to others and myself. I’ve now been in the habit of trying my utmost to prevent personal emotional spirals for over 20 years. It’s not a perfect science, but it has made a huge difference.

All the time, but especially during periods when my stress load is higher:

— I schedule exercise. A good 60-minute spin class is great, but I’ll take a 12-minute yoga session in my hotel room.

— I protect my sleep including charging our family’s cell phones in the kitchen each night.

— I talk with my partner about stuff going on with a focus on how we can support each other. Processing the gritty realities and hardships of life is key for all of us! We just simply weren’t taught that it’s critical, let alone how to do it.

— I mental-set and pray for extra doses of flexibility and compassion for others and myself.

— I remind myself that I’ve been given a gift of opportunity to make a difference- how lucky I am to live this authentic life with the mission focused on suicide prevention, and as a responsibility which I take very seriously.

— Make sure I’m spending time with the people in my life who make me laugh and who “get me.”

— I watch the amount of alcohol I consume, so rather than using it to de-stress, I make sure there are other strategies I’m leaning on.

What are your favorite books, podcasts, or resources that inspire you to be a mental health champion?

Reading the real stories of people who have struggled and made it through their struggles always inspires me. One place I find these is on our AFSP Blogseries. Also, I like podcasts like the Mental Podcast, RadioLab, Death Sex & Money, The Mental Illness Happy Hour, one amazing one on veterinarians’ suicide risk.

I also anchor my ongoing learning by keeping up with the latest in science, reading JAMA, National Academies of Science posts, etc.

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