Episode Transcript
Speaker 1 00:00:02 Welcome to Conversations with All of Us, the show that explores the evolving world of health research and the role we can have in creating a healthier future for generations to come. I'm your host, Cheryl McLeod, community engagement and communications manager for all of us New England at Boston Medical Center. Today we're talking about mental health, the barriers to accessing mental health care and the future of mental health research. Joining me are Dr. Jordan Smaller and Dr. Jessica Isam. Welcome.
Speaker 1 00:00:41 Over the past few years, there's been an increasing acknowledgement of the important role and effect that mental health has in our lives and on our general health and wellbeing. According to Mental health America, approximately one in five adults in the US experiences mental illness in a given year. And mental health does not discriminate. It affects people of all ages, genders, socioeconomic status, and ethnicities. However, when it comes to treatment and understanding the causes of a mental illness, some communities may face more barriers than others. Here to talk about mental health, the barriers to accessing mental health care and the future of mental health research are Dr. Jordan Smaller and Dr. Jessica Isam. Dr. Jordan Smaller is a psychiatrist, epidemiologist, and geneticist. He's a professor of psychiatry at Harvard Medical School and professor in the Department of Epidemiology at the Harvard School of Public Health in Boston.
Speaker 1 00:01:36 He played a leading role in national and international efforts to advance precision medicine, including serving as principal investigator of all of us New England. Dr. Jessica Isim is a board certified community psychiatrist, public speaker, medical educator, and consultant for diversity, equity, inclusion and anti-racism projects. She's also co investigative for all of us New England. Dr. Isim draws on her psychiatric training and humble background to connect across differences in power, education and perspective to foster a collaborative approach to achieving racial justice and equity in medicine and beyond. So let's dive in. Thank you doctors for joining us. How are you today?
Speaker 2 00:02:19 Very good. It's great to be here. Thank you, Cheryl.
Speaker 3 00:02:22 Yeah, doing well. Thank you. Also glad to be here.
Speaker 1 00:02:24 Let's start talking about the state of mental health in the US and how has it changed if it's changed in the last 10 years? Dr. Ison, why don't we start with you?
Speaker 3 00:02:35 I'll say a lot of the focus on mental health and more recent conversations have been grounded in what we've experienced with the Covid 19 pandemic. However, I would say taking a larger perspective over the past decade, one thing that stands out to me is that there seems to be reduced stigma and relatedly reduced hesitation around talking about mental health at all. And I see that as partially rooted in and pri maybe primarily rooted in a generational difference and how younger generations are talking about their mental health challenges. So I've appreciated that throughout my own experiences, uh, working with patients because it helps us to have more conversations and to be more of used not only for those that we're seeing, but also maybe for the the family. And then more broadly for the communities that they're connected to.
Speaker 1 00:03:19 Dr. Swallow, would you like to add to that and maybe talk about something a little bit about what you experienced?
Speaker 2 00:03:24 Sure, and I agree with Dr. Isim about that. The positive trend towards a little bit of reduction in stigma, uh, a greater awareness of, of the importance of mental health and that mental health is sort of essential to overall health. You know, even before the pandemic, mental health conditions and, and mental health problems were really a significant problem. And we know, for example, that most people, greater than 50% of people are expected to meet criteria for a psychiatric disorder at some point in their lives. We know that these are very common kinds of conditions, and we had already been seeing a rise in some of the conditions that people are probably familiar with, like anxiety and depression, a D H D and so on. But then, as Dr. Isam was saying, things really went to another level in many cases during the pandemic. And if you think about it, it was a little bit of a perfect storm of, of things that could contribute to problems with mental health, especially early in the pandemic when people were more isolated. There was a lot of uncertainty that some people were losing friends and family to covid itself. There were difficulties or interruptions and access to care, and that probably had a big impact in what we saw, which was a rise in anxiety symptoms, depressive symptoms, and particularly in many cases among young people.
Speaker 1 00:04:51 Could either of you just talk a little bit about, number one, the kinds of things that are considered mental health issues and two, Dr. Isam, you mentioned the younger people are getting over some of the cultural barriers and things like that. Why do you both think that changed? Because, you know, we in many communities we're talk not to talk outside of our family about mental health and sometimes not even inside our family about mental health problems.
Speaker 2 00:05:18 Well, I think the, the issue of, uh, I think you're asking about what, what shifted in people's minds about recognizing mental health and being willing to talk about it. And I think it was probably a mixture of things. Some of it was simply the growing recognition that, you know, as we often say in our department here, no family goes untouched. People, uh, see these difficulties that people are struggling with, and it becomes, you know, much more evident I think as time goes on. But also, I think it is true that there were a number of other forces that, uh, raised the profile of some of these conditions in ways that people perhaps were a little bit more, bit more willing to talk about them. Some of it had to do with, you know, even things like, uh, well-known people coming out and acknowledging that they have struggled themselves.
Speaker 2 00:06:06 People have been more willing to talk about that in the media, which, you know, does have an effect. We've seen policies change and, uh, economics change where mental health conditions, although this hasn't been fully fulfilled, but there's supposed to be parody in, and what what that means is that insurance and, and coverage of care is not supposed to be any more different between mental and physical health. So there's been an effort to really try to improve people's coverage of mental health conditions when they need help and access to care. And I think that may have had something to do with it as well. Yeah,
Speaker 3 00:06:45 I'll say two things. You know, I had a patient yesterday who was in their late thirties, and they described an increase in anxiety that for them became so much that they could no longer function normally, and it represented for them the first time that they presented to mental health treatment, specifically with a psychiatrist, a person who would offer them medications as a part of their treatment plan. They talked about the pandemic, specifically about this increased anxiety around getting c ovid 19, how they noticed themselves getting tested like multiple times per week, and their world just became very small. They were fearful of going outside, fearful of going to work, and it spiraled into what for them became an actual diagnosis. One, a panic disorder where they were having and are having panic attacks every single day, multiple times per day in a very unpredictable way.
Speaker 3 00:07:38 And then two, they also are having more generalized anxiety where they are just worrying multiple hours of the day, very difficult for them to relax, they're having trouble sleeping, et cetera. So basically for them, anxiety had overtaken their life in a very distinct way, connected to their experiences during the pandemic. So I've seen patients like that present, uh, in the clinic, and they're new patients even. And they're not always young. They oftentimes are, uh, middle aged or even older, and they're newly presenting connected to some of the stress, some anxiety symptoms, depressive symptoms, or even substance use related to the pandemic. To your second point though, I think a part of what has changed is that we are talking to more people than we've ever talked to before and exposed to more perspectives than we've ever been exposed to before. So even as in my family and maybe even my own friend network, we're not having conversations about mental health challenges. I could go on social media or I could find an article, you know, if I have access to technology and the web that will help me understand more of what's happening to myself or maybe what's happening more to others around me. And I think that has facilitated more awareness of what is mental health, what counts, what doesn't, and then hopefully has translated to reduced hesitance around engaging with traditional mental health supports, which I think is a good thing as long as we're prepared to meet them when they do come to us.
Speaker 2 00:08:56 That's such a good point that, you know, the, the greater in some ways, connectedness, uh, that everybody has or access to different perspectives has really, I think also raised the profile. There's also a kind of a flip side to that though that I've seen, which is that sometimes there's misinformation and people unfortunately are, have ideas about mental health conditions or how to address them that are not always informed. And so I think people do need to take, as all of us, I think are exposed to social media and other online information, maintain that understanding that we have to be, you know, thoughtful about how we interpret some of those things. And there are lots of resources to get good quality information, some of which are on the web, but others as well.
Speaker 1 00:09:43 Do you think we're at a better place than we were 10 years ago, worse, or did Covid sort of stall everything? Dr. Isam, why don't you start?
Speaker 3 00:09:53 Well, I'll say, you know, one of the other things that's shifted dramatically in the past few years is the demand for services. And that's connected to increased demand on people and, you know, families and communities, and also some of the other things that we've been talking about. And I'll say for me, it's nice to be able to serve and to serve folks who are wanting to engage in services and improve their mental health. But I felt an increasing sense of demoralization because there's not enough of us to serve. And that's become more and more salient as more and more people have been, uh, interested in, in making use of services. So while there's always been things such as a workforce shortage, things such as resource shortages, things such as, you know, lacking proper reimbursement for offering services, to Dr. Fuller's point earlier about parity, it's becoming more and more clear across the board for both those offering services and those desiring them or receiving them that we don't have enough to go around. And I think that's one of the more pressing issues that's just grown over time and parallel with some of the more positive aspects of this that we've talked about. And I think what that demands of us is more creative solutions to meet people where they are and be as responsive as we need to be.
Speaker 2 00:11:03 Yeah, I agree. And I think that, you know, there's been two shifts in some ways in the access story, at least in my experience. One is right when the pandemic hit, for example, our department of psychiatry, about 5% of visits were telehealth visits, and within about two weeks it was 95%. And that's obviously continued not to that extent, but this whole new era of being able to connect with people in ways that are sometimes more convenient to them or more comfortable to them, sometimes more accessible, just the, you know, the hassle of sometimes getting into see somebody that's in some ways been a positive because there has been some increase in access in that sense. At the same time, there's been a, a, I think, a really dramatic shortfall, as Dr. Eisel was saying, you know, access to care in certain settings is definitely more difficult now than it was. Part of that is the, the workforce shortage. W we see this in in emergency departments, people come in for emergency care, and it is, you know, that has really spiked in the, in the context of the, of, you know, the shortage of workforce, the increase in people's difficulties struggling with mental health symptoms, but also with social determinants of health. And being able to provide care quickly, get people connected to the care they need, has actually become more difficult.
Speaker 1 00:12:32 Dr. Ison, could you speak to some of the inequities and disparities in mental health and in mental health care?
Speaker 3 00:12:38 Yeah, I can, and I think I'll separate this into a few different buckets. So, um, one bucket would be access to services and I would say services across the board, services that are preventive, which means that they can, you know, reduce the likelihood that you might experience a, a mental health diagnosis or reduce the severity of it. And then there are services that you actually access and initiate. And where you get those services can be different as far as disparities, how long it takes you to get into those services can be different as far as disparities. And then sometimes the options that you have available to you are different as well, based on the type of insurance you have or whether you have insurance at all. A lot of what we don't talk about though, is what happens for people who do have access. So what are experiences like when everyone, for example, has an insurance card maybe from the same insurance company and they're all accessing this particular, you know, center, um, receiving therapy or maybe working with a psychiatrist?
Speaker 3 00:13:37 What, what happens there? And what we do find is that there are differences in those experiences, and it it's related to the relationship that folks have with those providing care, the quality of that alliance can be different. We call that the therapeutic alliance. And then the types of services that are offered can be either not useful for your presenting concern or might be of poor quality. And what that means is that you're seeking help with an anxiety disorder. Uh, and what you're being offered is a type of treatment that we might say is the treatment that everyone should get if they have anxiety, and that if you receive these eight sessions at the end of these eight sessions, you should have an improvement in your symptoms. That's what it should look like. But there are lots of pitfalls that can happen across those eight sessions, maybe in the middle of a session.
Speaker 3 00:14:25 Number four, there is a microaggression that you experience with your counselor. The counselor's unable to prepare that and you prematurely terminate the, the therapy relationship, or you just can't get, you know, as much out of the experience with that counselor because something about your connection has been affected or maybe what's being offered, for example, C B T, it's just not what you need. Uh, and you need a variation of an intervention that's more responsive to, to your needs at that time. Those kinds of pitfalls and barriers are more commonly experienced by folks who are racially and ethically minoritized often because the services weren't constructed with us in mind. I know there's one statistic from CMSA that I believe is from like 2018. 2019 talks about the rates of followups after the, the first visit to a mental health professional for BiPAP individuals. And it was 50% of folks don't return after that first visit.
Speaker 3 00:15:17 And it just brings to mind all of the wonderful opportunities that we have had in the past few years connected to the pandemic to connect to folks who may not otherwise have come, and then how important those initial points of contact are. And just making sure folks know that when they, they meet us, that they are gonna have an experience that will be responsive to their needs. And that speaks to some policy things that have to pick up around equity, but also some workforce development emphasis as well, making sure that we're primed to meet these people when they come in. So there's a lot of work that we have to do around tailoring those services differently along with other aspects of this too, to kind of change those, those numbers, those disparities and statistics. Dr. Smoley, you're nodding your head. Would you like to jump in here?
Speaker 2 00:16:00 Yeah, no, I agree with that. Uh, that's a beautifully described picture of, of, you know, really what's happening for people in real life that makes it difficult and makes some people the burden of some of these mental health conditions or symptoms. Things like anxiety or depression weigh even more strongly or heavily. There's also, you know, the things, uh, in advance of even coming to treatment that start to create disparities in terms of, you know, the stress and social determinants of health, which means things like the environment that you're exposed to, the socioeconomic resources that are available to you, insurance parody itself, you know, whether you have the coverage to get care talked about discrimination, which is something that, you know, I think is increasingly recognized as itself a, a driver of mental health difficulties for people. We see this some greater discussion recently about, you know, L G B T Q communities and, um, individuals who feel stigmatized and we know, uh, I mean, it's sort of self-evident that that would have a negative impact on people's mental health, create a sense of shame, maybe make it harder for them to access care.
Speaker 2 00:17:16 And again, finding care that is culturally sensitive and attuned to these, some of these particular issues can be difficult for people. And then, you know, just some of the added burden and stress that people feel when resources are not as available, even when, even in the context of, you know, treatment. I mean, I, I see this in my practice frequently as well, where people, they're experiencing the same kinds of conditions, they're just as committed to, to getting help, but life makes it difficult. It's difficult to, you know, maybe have the resources to have somebody watch your kids so you can go in and come to the visit or get to the pharmacy to pick up your medicine. Those kinds of little things add up. And we know that stress takes a toll, even a physical toll, not not only on our emotional health, but on our physical health, on our cardiovascular health, on the aging of our bodies. And we need to find better ways to, you know, alleviate that stress, to prevent that kind of toxic, uh, impact of some of these social determinants and some of the barriers that people are experiencing in accessing care and making use of care.
Speaker 1 00:18:28 The All of Us research program recently released new surveys for participants to take on mental health and wellbeing. Dr. Small, you played a big role in making this happen. I would love it if you could tell us about the surveys and how you think the data collecting will be useful.
Speaker 2 00:18:43 Yeah, I'm very excited about this because as, as you know, uh, the all of us research program is, you know, one of the largest ever studies of health and certainly one of the most diverse and really committed to the diversity of representation of people as we make these advances in health. And so, for a long time, as a part of this program, I've been very passionate about making sure that mental health is well covered and that communities and individuals and families who have faced some of these issues are also represented both as participants and stakeholders and partners, but also that, that the questions that we want answered, and there are many about mental health do get addressed. And so over a period of, you know, a couple years or more, we've put together surveys that really address some of the most pressing issues in mental health.
Speaker 2 00:19:39 And our hope is that by creating this kind of research resource, that we will be able to address questions that we just haven't been able to in the past, at least on this scale. And very importantly that we do it in an equitable way and recognizing the diversity of the country, frankly, because many of the studies, as Dr. Ison was alluding to many of the studies that have been done in the past, certainly most of the studies that have been done in the past have not been very diverse. We don't know, uh, in some cases what is the role of things like certain social determinants of health, or what is the magnitude of certain health disparities, because we just haven't had the information. So I really think that these surveys, which ask people about things like their level of anxiety, their depression, what kinds of difficult or adverse experiences they may have had that may have contributed to mental health difficulties, what is their sense of wellbeing, you know, what are some of the other, uh, experiences that people have in terms of their own mental health and wellbeing or treatment for mental health and wellbeing.
Speaker 2 00:20:48 These are big unanswered questions that we may be able to address through this kind of research.
Speaker 1 00:20:54 You are asking people to share information that may be extremely personal and actually painful for them to share. Why do researchers, not just all of us, but researchers in mental health, need this information?
Speaker 2 00:21:06 Well, I think the big thing is that it, it will allow us to improve the state of our care for and, uh, understanding of mental health conditions for, for all of us in the future. And the fact is that you're right, that, you know, some of these questions address sensitive issues, including things like thoughts of self-harm or, uh, that people may have had or, again, difficult or even traumatic experiences. And one of the things that I can tell you as a researcher is sometimes these questions don't get asked because people are concerned that it, it just may be too difficult to ask them. And as a result, we don't know enough about, for example, the problem of suicide, which is a, a, an area that I'm particularly concerned about, which is a, you know, a problem that of course is one of the most devastating outcomes that we have in the mental health field.
Speaker 2 00:21:58 And rates of suicide have been rising, uh, uh, over the last two decades, 35% increase. We don't really have a good way of understanding who's really at risk, who needs help, how can we prevent it? And if we don't ask or gather the information, we won't be able to make those kinds of advances. And so it is a, it is a generous thing that people are doing in participating in research, but I, I truly believe that research is hope, that that's the way we make things better for the future. And I think we have a, in some ways, a once in a generation opportunity to, to gather the information in partnership with our, you know, participants to kind of change the game and make sure that we're addressing the questions that people really care about.
Speaker 1 00:22:47 Dr I assume, how do you envision the future of mental healthcare changing if we have a truly diverse population stepping up and sharing this, this personal possibly painful mental health information?
Speaker 3 00:23:01 Yeah, I think it's, um, it's interesting because we're asking people to go through a process that's invasive and anytime something's invasive, you wanna know what's the return on this investment gonna be, you know, if I'm revealing these things. And I think one way that I think about this is when people are asking me questions, when they're curious, there's a lot of potential that that could translate to myself having better experiences, but also for those who come after me, um, who might benefit from the insights that I've offered. Um, so for example, it could be me, I have a, a daughter, um, so if she's seeking therapy or working with another mental health professional, like a psychiatrist down the line, what I offer in this, this survey or this assessment or these conversations might help shape the ways that she's engaged with when she accesses services down the line.
Speaker 3 00:23:50 And I frame it that way because most of us, if not all of us, are very altruistic. We do wanna offer things beyond ourselves, contribute in ways that go beyond ourselves. And I think keeping that in mind might help folks who are filling out the survey to keep their perspective that I'm doing this for a purpose, it's connected to something bigger than me, and it could result in maybe even changes in the numbers that we've talked about in the conversation that we've had today. I think a lot about workforce development. If I learn these things, how might I, as a person who's involved in workforce development help develop the workforce in a way that's more responsive? Or how might we, in future iterations of the ways that we create services, make use of technology in ways that help us to be more responsive? It's kind of like teaching us how to do better. <laugh> is how I view it, view it in that way that they're, they're offering something that's insightful, that's educational. Again, it might help with some of the anxiety, the angst, the worries that comes along with being vulnerable in service of that goal.
Speaker 2 00:24:48 Just to, to also connect back to what you were saying about the impact on covid, and we were talking about social determinants and so on. I can tell you a couple of examples of insights we've gotten because of the All of Us research program about mental health during the pandemic period. So for example, there was a survey that part of the All of Us program, we called the COPE survey, which people filled out during the early part of the pandemic. And it asked questions about how they were, what was their experience, how were they feeling, what was their sense of wellbeing, social isolation, other things. And one of the things that we were interested in, because we were seeing a rise in things like anxiety and depression, is what are the factors that are driving that? And we were particularly interested in whether discrimination, which we were also seeing on the rise in many cases during that period, was contributing in some way.
Speaker 2 00:25:45 And so because the survey asked questions about their experience of discrimination, everyday discrimination, and also their levels of depressive symptoms or anxiety, we could actually test that question. And what we found was really pretty striking. So people who said that they were experiencing discrimination, at least, you know, more than once a week, had a 17 and a half fold increased odds of developing moderate to severe depressive symptoms during that period early in the, in the pandemic, and more than a tenfold increase in experiencing suicidal thoughts. And this was particularly true when the reasons that they felt they were experiencing this discrimination was based on race or nationality or ancestry. That to me is a pretty dramatic, uh, message. In fact, the effect of everyday discrimination on, uh, leading to depressive symptoms was as strong as if you had a prior history of depression and had had a mood disorder in the past.
Speaker 2 00:26:55 We also have been very interested in things that, again, are actionable, things that we might be able to modify to make things better. And another example of that was a study that again used the COPE survey data that we recently published, which showed that, again, during this early pandemic period, social support was a powerful protective factor. And in fact, for people who experienced high levels of social support, that reduced their risk of developing moderate to severe depressive symptoms by 55%. And that's a finding that really fits with a lot of what we've seen in some other contexts, where two things in particular, actually, social support and physical activity, which don't require medications or, uh, or formal treatment, seem to have this consistent protective effect on depression, on developing depression. So those kinds of insights you could imagine have actionable information for us in helping to give people some, uh, guidance about protecting their mental health.
Speaker 1 00:28:00 How will advances in precision medicine research change mental health? If you could look into a crystal ball or, or, or speculate, what would you think?
Speaker 2 00:28:08 Well, one thing I would say is that the All of Us research program is focused on this framework of precision medicine, precision health. And that's not a framework that we have previously had the opportunity to, to apply in mental health care. Uh, most of what we know, for example, about the treatment of mental health conditions is based on what works for the average person. And this is a different way of approaching how we might diagnose and prevent and treat disease generally, and has a lot of potential impact for mental health. So for example, many of the treatments, like medication treatments that we have for things like depression or as you mentioned, schizophrenia or bipolar disorder, some of them are very helpful and sometimes lifesaving, but for many people, they are not helpful enough or they cause side effects. On average, they do better than not.
Speaker 2 00:29:07 But just like we've seen now in other areas of medicine like cancer and heart disease and other areas where using this kind of information data, things about our lifestyles, our genetics, our environment, we may be able to tailor things in a way that's much more precise and perhaps, uh, individualized to what the needs of an individual person are. That would be a big hope. And I think we could maybe do much better in what we can offer people. At the same time, on a larger scale, learning what are the social drivers, the environmental drivers that really have a big impact? I mentioned social connection and there are ways to enhance that. Those kinds of things can also be, you know, learned from this in ways that, that change how we approach mental health care in the future.
Speaker 1 00:29:58 Dr. Ama, I'd like to start with you this time. What advice or resources do you have for people struggling with a mental health condition?
Speaker 3 00:30:05 Yeah, I think, I'll say two things. One, it's important when struggling to seek out really good information. To Dr. So's point earlier, there's lots of inaccurate information out there and misinformation. So going to really trusted sources can be really helpful. I'll say a few of those would be nami n aami.org. Another would be the two APAs, the American Psychiatric Association and the American Psychological Association. Those are some launching points. And then from there, it could be searching for really culturally informed resources, which some exist on those websites, but others exist that come from community-based organizations, which can be useful as well. And then I would say too, it's really important to have an honest, uh, self-assessment of what supports are needed. And for a lot of people, that big step is figuring out, do I have enough coping here? Do I have enough support here to do this on my own, or do I need more support from, for example, traditional mental health services? And I think finding resources that help you to answer that particular question is important because that can help you get help before things get so severe that you end up in a position that that could have been avoided by just getting more support in a, in a timely manner. Those would be my suggestions. Rep
Speaker 1 00:31:16 Small.
Speaker 2 00:31:17 Yeah, I think those are great suggestions. I, I really agree. There are other organizations that, uh, that also come to mind for me. The National Institute of Mental Health, if you search there, they would be a trusted source. They have information, also the Anxiety and Depression Association of America adaa.org. It's also important for people to know that if things are really at a crisis level and they need, they need to talk to somebody right away. There are some resources that are now available to everybody for crisis services or support. And it's, it's important to know things like the 9 8 8 number. This is a national number, which twenty four seven you can call to reach somebody to talk with you, particularly if you're in the midst of a crisis or there's a concern about self-harm or that kind of thing. And also the crisis text line you wanted to text. You can text hello to 7 4 1 7 4 1. So those are both free, available 24 hours a day, seven days a week. And I do encourage people to explore some of these resources that we've mentioned.
Speaker 1 00:32:25 Dr. Isam, any final thought you'd like to share?
Speaker 3 00:32:29 Yeah, I think just a thought that came to mind as Dr. Schooler was talking about precision medicine connected to what I hear from patients often, you know, is I don't wanna be a Guinea pig. And I think a part of what I, I see as the potential from this is that you can have an experience where you're more known connected to precision medicine where we do things more quickly, get to the point of being able to be useful to you more efficiently. So for folks who are really wanting to have healthcare experiences and mental health care experiences specifically, where we get to that point of having a more tailored approach to your care, your engagement with these kinds of efforts will help support that developing more quickly. So thank you for the opportunity to speak on behalf of the project.
Speaker 1 00:33:10 Thank you. And Dr. Sm final thought from you.
Speaker 2 00:33:13 Oh, I just wanna add my thanks as well. And I, again, I'm really excited about the opportunity that we have here, both in terms of gathering what we need to, to do better, advancing what we know because there are so many unmet needs that we need to address. And, you know, in terms of the All of Us program itself, I think having a, a program where the values are about partnership with our participants, about, uh, addressing the questions that people care about and doing it in a equitable and inclusive way as just a unique opportunity. And so I'm very excited that mental health has now taken, uh, an important role in the kinds of information that's gonna be covered. I look forward to lots of discoveries in the future that I hope will make things a lot better.
Speaker 1 00:33:59 Well, I wanna thank our guest today, Dr. Jordan Smaller and Dr. Jessica Isim. The resources that we mentioned today will be on the podcast episode description. I also, all of us New England has developed a mental health resources guide for BiPAP communities. It's available for free in English and Spanish on our website, mgb dot join all of us.org and the link will also be available in the episode description.
Speaker 1 00:34:26 Conversations with all of us is brought to you by the All of Us Research Program in New England. All of us is an initiative from the National Institutes of Health and Mass General Brigham, a leading integrated healthcare system in New England and Boston Medical Center and Academic Medical Center, with a deep commitment to clinical excellence and health equity are working together with the All of Us Research Program to help researchers understand more about why people get sick or stay healthy. Medical research hasn't always included everyone. This is why medical research has gender, racial, and age gaps. The all of Us Research program is working with Mass General Brigham and Boston Medical Center to change this. And you can help us close these gaps and receive $25 when you complete the steps to enroll. So join all of us today to learn more. Call 6 1 7 7 6 8 8300 or visit join all of us.org/podcast and e are you a participant in the All of Us Research program? By completing your surveys and other new activities, you may be contributing to advancing medical research that works for all of us. So stay connected. Log into your portal today by visiting, join all of us.org or use the All of US app to complete new surveys for help. Call 6 1 7 7 6 8 8300. That's 6 1 7 7 6 8 8300. And thank you for being part of the All of Us Research Program.
