Michele Hart is a licensed clinical social worker and the co-author of Mental Health Emergencies. More people are suffering from mental health illnesses than ever before and with so much stigmatization surrounding mental health – many of us find it difficult to speak out. Today we talk about how to help the people that you love and that you work when they’re facing mental health emergencies like depression, anxiety, substance abuse, eating disorders and suicide. We discuss the importance of self-care, listening and how to be an acute listener for those in need.
Charlie Hoehn: How did you get started?
Michele Hart: My journey started about 25 years ago. I’ve always worked with youth, and my sister in law had a traumatic experience happen in her life at the time. She was kidnapped, and we went through FBI and many agencies. This was a year-long process.
As I was moving through the process, I realized that the only person really that helped was a social worker.
That’s when I made the determination that I wanted to be a social worker. I wanted to be that person that could break through all of the red tape. Break down all of the barriers and give people access, get information, while helping them and supporting them emotionally.
She did that for me and my family, and it turned out okay and everything worked out. But the only thing that stuck with me was the social worker that helped me through this. From that point on, I started college and a bachelor’s degree and couldn’t get enough of social work. That led me to my career for the last 25 years.
Charlie: What is your specialization?
Michele: I’m a licensed clinical social worker and I have been an LCSW for the past 18 years. I am employed as a middle school social worker doing therapy in groups in the school. We’ve expanded this mental health framework into the schools have decided this is needed within their own buildings. I have the opportunity and the privilege to be that person.
Writing Mental Health Emergencies
Charlie Hoehn: How did you come up with the book’s idea?
Michele Hart: The beginning of the Mental Health Emergencies is an amazing story that brought Nick to the place where he felt this book was needed. Nick is not a clinician by trade. He was a QMHA and working as a business director at the agency I worked at.
QMHA is a qualified mental health associate, which is somebody who is not really licensed to do therapy. However, he found himself time and time again being in the first responder position because clinicians are busy in a small world community.
That’s where I met Nick, and through his experience (which is the opening story in the book), he decided that this is something everybody needs to know. When he approached me about the book, I agreed wholeheartedly. This is the question that’s always brought to me and I find myself answering it over and over again, so why not put this in written form and let people have it.
The idea was Nick’s, and I jumped right on board and offered the clinical perspective. I helped with firming up from a clinician’s point of view, how can we help people.
How to Help People through Mental Illness
Charlie Hoehn: How can we really help people?
Michele Hart: It would be to understand yourself. To help others, you have to help yourself first.
Always maintaining a healthy physical self is key. When people around us are crumbling, we tend to crumble with them. We need to understand that as a support person or a person in our life or ourselves suffering with mental health illness, we need to take care of ourselves.
“To help others, you have to help yourself first.”
Primarily and most importantly is self-care.
Secondarily is listening skills and being aware of body positioning. Being just self-aware is the best thing anybody can do for themselves. Especially when needing to handle a mental health emergency, whether it be themselves or others.
Charlie Hoehn: How can listening be so important?
Michele Hart: Being an active listener is made in steps. Being present in the moment, we tend to listen.
“People think we listen with our ears, and we actually listen with our mind and our bodies.”
Being an active listener, being an attentive listener, is somebody who is tuned in to what you’re saying. Who is nodding and not just thinking about the next thing they want to say.
They are in the moment, they are hearing, they’re giving micro expressions. They’re leaning in, reassuring and re-clarifying things that they may or may not hear and avoiding at all cost assumptions.
Many people hear something and then they assume. And when you’re dealing with mental health, assumptions are probably one of the most dangerous things you can do. It really ties into how can you be a good listener—how can you be a good person in a mental health crisis?
Listening to Ourselves
Charlie Hoehn: How do we listen with our bodies?
Michele Hart: We’re listening with the way we position our bodies, our body posture. We are listening with our mind, we’re thinking about what’s being said without being judgmental. Clearing our mind of all of the things that happen in our daily life.
And we’re really tuning in to an individual to hear what they’re trying to say. Clarifying with them, so that they themselves could make and come up with answers rather than us answering the questions for them.
When handling a mental health crisis/mental health emergency, you’re dealing with a very vulnerable population/yourself being vulnerable. At that point in time, people want to jump in to the fix it mode. They want to give suggestions and want to give answers. They want to problem solve.
“Being a good listener isn’t problem-solving time.”
You’re just taking in information that that person wants to impart in that moment. It may or may not have anything to do with the final solution of the problem. But this is the immediate need of the individual.
Being an acute, astute listener is something that will help get you through that first emergent need in a mental health emergency. Taking care of yourself will allow you the stamina needed. You need to be rested, you need to be in physical shape, otherwise, you find yourself falling into your own crisis.
There are days we’re better at that than others, and same with listening skills. We’re not perfect. I’ve done this for 25 years, and I wish I could say that I still had all these skills down. I don’t. Every situation brings a new problem that might arise or a new situation that you have to really think over. But if you’re remaining mindful and you’re genuine with that person, it will all come together.
You don’t have to be perfect, you don’t have to be a trained clinician. You just have to be someone who really cares, and listening is a very caring thing for people to do.
Michele Hart’s Self-Care
Charlie Hoehn: What’s your routine in taking care of yourself?
Michele Hart: I use mindfulness. I’m a very mindful person, and my basic mindfulness is breathing, I make sure that I’m in a stressful moment, I’m taking time to take a deep breath and clear my mind. I make sure I get sleep and eat balanced foods. I would love to say I’m perfect at that part of it, but I’m not. I’m human.
For the most part, I try to remain balanced. I sleep a little and I play a lot. Make sure that, for equal parts of the stress I feel, I have an outlet that allows me to go out and have some fun and play and hike and swim.
“Play is a very important part of being mindful.”
You have to be able to get out there and let your cares go free, not worry about what other people are thinking, and just have fun.
One of the biggest balances for me is to just go out. I go to places and I laugh and I talk and I make sure I’m with friends and with people who care about me. I’m around people that I care about. I try to just keep my life balanced with work and play.
Removing the Stigma
Charlie Hoehn: Why do you think de-stigmatizing mental illness and mental health emergencies is so important in our world?
Michele Hart: We’re seeing that mental illness isn’t some separate category. It’s the whole person. It’s ourselves, it’s our spouse. It’s not a category of people that we used to set aside. Historically, it’s been us and them.
Now it’s become everybody, and we have to recognize that. Throughout your life, not everybody’s going to suffer with a mental health emergency, but at any given point, in anybody’s life, you’re going to have some mental health concerns.
Through de-stigmatization, we are learning that we can say, “You know what? I did have some postpartum depression.” “I did have some anxiety,” and recognize it for what it is rather than “You’re weak or you’re lazy.”
We put so many labels on it that we have to de-stigmatize and say, “This is just a whole-body response to an event. What can we do with it?”
Watch for Warning Signs
Charlie Hoehn: What are your recommendations in the book Mental Health Emergencies for someone who is suicidal that other people may not be recognizing?
Michele Hart: We’re starting to put parameters on suicide. The leading cause of death is suicide now. You know, we blamed heart and cancer, and now we’re starting to see that it is the number one, especially now that it’s gone down to 15 to 34 year olds. A lot of people thought, “Oh they’re just people are trying to get attention.”
It’s not something that we’ve decided we’re going to take lightly any longer as a society. Embedded in every culture, every community, every school, any kind of bureaucracy we have, everybody is trained in suicide awareness now.
It’s necessary because we don’t want something that can be prevented to be the number one killer of our people. We just need to stop that trend. This is not something you want to deal with alone. This is something that takes immediate mental health care. Don’t try to hold it, don’t try to keep it a secret.
“We’ve found that secrets do kill people, and we don’t want that to be the secret you keep.”
Bringing it out into the open and not having the shame surrounding it. It’s something that happens when people start feeling major depression or overwhelmed, and we want people to know that there is immediate help in any emergency room, in any 911, in any situation that you might need anybody.
Whether it’s a coworker or a stranger in the street. Take it seriously and get them the help they need right away.
Charlie Hoehn: How do you recognize when someone is at that point, what kind of cues are you looking out for?
Michele Hart: The most obvious would be them saying, “I don’t want to be here anymore. I don’t want to live any longer. I can’t take this life.” It’s the wording, the finality of the statements that they might make.
Or if you see somebody that has been very depressed and then all of a sudden they wake up and they’re very happy.
“They’ve come to terms that they can be happy now because they have a plan.”
It’s that instant relief. People that have a really big shift within a 24-hour period of emotional depression into elation or even into peace and happiness, it’s a risk factor.
Giving away belongings, isolating themselves…anybody that has access to weapons would really need to be watched.
You want to make sure you are watching for anything that is lethal, and we want to make sure that we are protecting people at that point in time, because depression is something that overpowers and overshadows the logical mind.
Living with Depression
Charlie Hoehn: What do you tell a person like me who struggles with hiding our depression?
Michele Hart: We put a lot of pressure on ourselves to be something. When we say to reach out and help, that’s easier said than done.
“Understand that what you go through is very real and very much what most people do.”
As a person with your background—you use play as a big thing and put out there that these are the things that keep you balanced—you want to hide because we fear the repercussions if someone sees us as weak.
Understand that that’s the stigma. Reducing the stigma is understanding that it’s not a sign of weakness, it’s just a sign of where we are. It’s usually a time in our lives where we have stacked up things. It’s rarely just one instance—it’s a layering effect.
There’s the top 100 things in life that can cause the biggest mental health catastrophes, if you will. Divorce, death, birth, marriage, moving. It sounds like you had probably the top three of the top five happen in a two month period, and at some point, we do retreat within ourselves. But having that person that you talk to is what you need. It isn’t always going to be the perfect situation where you retreat, but have that person.
Also, set up a care plan, if you will. So the care plan looks similar to these are the things that happen when I start not feeling well and letting people around you that love you and you trust know what this checklist is so they can be watching. When it’s you, it’s hard to recognize.
“It’s like your brain and body are out of step with each other.”
Care plans are becoming an essential part of agencies. If you’ve ever had a hard time, they ask about your health. “Do you have diabetes, or what do you look like when you have a diabetic episode?”
We need to move that into the mental health arena. “Do you have depression? Well when you start feeling depressed, what does that look like for you?”
Let your friends and your co-workers help you through that, because at that point in time, you’re not recognizing it yourself.
That’s what I would recommend. Make a checklist and give it to your loved ones. Give it to more than one person, and let them help you through that when you get there.
What’s at Stake?
Charlie Hoehn: Why don’t we listen?
Michele Hart: We’re problem solvers. We have to multi-task, and we’ve trained our society that if you are only doing one thing at a time, it’s not enough. You are not productive enough, you’re not this enough or that enough.
“In being mindful, we learned that we have actually done an injustice by teaching multitasking.”
You can’t do anything good if you are doing more than that at the time. So be mindful in the moment and do one thing at a time. Our youth think they are super humans now because they can do five things at once, but what they are forgetting is by doing those five things, you are not accomplishing the one thing you really want to set out to do.
And that drives the problem solving. We’ve got to put this in a box and put a lid on it and move on, and life isn’t like that anymore. We need to take time and stop and slow down and be mindful.
Charlie Hoehn: What systems do you think schools need to encourage children to grow up to be good listeners to themselves and to others?
Michele Hart: I think listening is the key. Understanding your emotional reactions, being able to understand what triggers you, to really get to know yourself. And then how you communicate to others and how the people around you communicate.
So it is getting to know yourself, but then taking a step outside yourself and saying, “Well this is what triggers me; however, this is what I see triggers my family.”
And sometimes you will see them inherit that or do that because that’s what they’ve been taught. In schools, they are teaching a lot of character education, for a lack of a better word, to get specific on programs. They are being mindful and they are taking time out and they are teaching kids to step back and do something right rather than do something quickly. Quality rather than quantity.
I’ve seen great leaps and bounds in the 15, 25 years I’ve been with the schools.
Response to Mental Health Emergencies
Charlie Hoehn: Can you talk about some of your biggest success stories?
Michele Hart: I’ve had several stories that have made me prop up a little bit and feel proud. One was a person who really had severe enough anxiety that they literary couldn’t drive a car anymore. In the area I live, it’s very urban, lots of traffic, high speeds. All roads are 50 and above. So, you don’t go anywhere with a slow pace. Anybody with the slightest bit of anxiety can be triggered by all of that.
They were able to read through the book (Mental Health Emergencies) and understand how to slow themselves down. How to take care of themselves. After a few months, they reported to me that they’re driving. Not long distances, not on the freeway, but they are on the road.
Another individual actually did get on the freeway and is able to drive his family around and is able to now not jump and beep and become rage-full behind the wheel. It really has helped with a lot of the road rage, and driving seems to be the trigger where I am at this moment.
“Another individual, when I had a book signing, waited in line for hours because he felt he needed this book.”
He had read excerpts and felt he needed this book. Well he is a vet and contacted me after he read it. He was just so thankful. Sometimes just knowing you are not alone and this is real is enough for people.
I think that is one of my proudest times. When somebody reads this and says, “This is real.” This is everyday language, it’s not a textbook. It’s not trying to make me become something I am not. It’s just telling me that what I am experiencing is real and valid.
Charlie Hoehn: What can you tell our listeners to do this week from Mental Health Emergencies that will make a positive impact on their life?
Michele Hart: I would like them to identify any barriers they themselves have with mental illness. To really sit down and take a look at themselves and say, “What was integrated in my life with mental illness and what are my views of it?”
Try to expand that a little bit of a non-judgmental perspective, if you have a judgmental perspective. Some people have very negative interactions with people with mental illness, but that is the exception not the rule. To step back and say it’s every day, it’s in our lives.
“I would like people to step back and evaluate how they feel.”
Are they taking enough care of themselves? What can I do to be better to myself and understanding fears?
You don’t have to be a warrior or champion or a hero when you’re doing this. It’s okay to have fear, okay to go into it and say, “This scares me.” It is okay to be afraid and to face your fears and understand that we do have fears and it’s okay.
Not that you fear the person, but you fear, “Am I going to do the right thing?” You being there is the right thing. Understanding them as a person is what somebody needs, not expertise at the moment.
Connect with Michele Hart and Nick Benas
Charlie Hoehn: How can our listeners connect with you and maybe follow your journey? What’s the best way for people to stay connected with Michele Hart?
Currently, I am open to speaking engagements. I do work full-time, but I love this topic and I would love to be able to educate people. I do book signings and I put them on Amazon on my author’s page: Michele Hart. When I have a signing, I post it in advance.
So, anybody is welcome to show up whether you buy a book or not. I’ve had people show up and just want to talk, and I am happy to have conversations.