Dr. Miguel’s approach to mental health care is simple – let me learn what works for you, your culture and your community and use that power to find a better way to be. Hear from him about the issues facing our ethnic communities and how we can make our approach to mental health care more inclusive.
Kate Gosney Hof...: Hello and welcome to the Hope Happens Here podcast. This is Kate Gosney Hoffman. I'm so glad you're here. Today we are joined by Dr. Miguel Gallardo. He is a professor at Pepperdine University of psychology and he's also the director of research at MECCA, which stands for the Multi-Ethnic Collaborative of Community Agencies, which is a nonprofit in Orange County doing such amazing work for mental health and destigmatizing mental health.
So we talked to Dr. Miguel about so much under the umbrella of mental health and the stigma that lies within different ethnic communities and how to reach them most effectively. He brought up a lot of good points. One of the things that really sticks out for me is the impact of language, how language really mental health gets lost in the shuffle of language and words can mean something to me very differently than it can mean in another language. So, that's something to really think about in how we can be more sensitive to that. He also mentioned that the struggles that we see in Orange County really are not that unique compared to the struggles we see throughout the country, and it was interesting to talk about that and kind of what we need to do as a society because of how much our societal influences affect the mental health states of people with different diverse backgrounds and having a sensitivity to that as well.
Dr. Miguel is very much a glass half full, has a glass half full approach and he even mentioned that. His real work in the community comes from a mindset of let me learn from you. Let me learn what works for you and your culture, and your community, and let's build on that and empower your voice, and empower your self to really know what is working instead of coming from an approach of I'm the expert, something is wrong with you, the onus is on you. Let's work together and collaborate, and connect to find a better way to be.
I really, really appreciated talking with Miguel. I was a meaningful conversation, and I just loved that he's working so hard and has such a dedication to changing the narrative around mental health from what's broken, what's wrong with you, to what's working for you and what can we build on that to find a solution. So let's talk with Dr. Miguel.
Thank you so much for being here with us today.
Dr. Miguel Gall...: Sure. Yeah. Thanks for the invitation. I appreciate it.
Kate Gosney Hof...: Absolutely. Gosh, there is such a wealth of work that you do. I would feel a lot more comfortable if you shared with us what it is that you ... what you're focused on, focuses are on, what you do, what organizations you represent. Just tell us a little bit about yourself.
Dr. Miguel Gall...: Sure. Yeah, yeah. I mean, I think my primary, my home base is as a professor at Pepperdine University.
Kate Gosney Hof...: Okay.
Dr. Miguel Gall...: Every time I say Pepperdine University people think I drive to this beautiful campus on the beach and I've got a view of the ocean outside my window. We actually have an Irvine Graduate Campus, and so I'm at the Irvine Graduate Campus, and I teach graduate school in psychology. I actually run a graduate master's level training program that's specifically to train students to work with Latinx communities. So we have that at the Irvine Graduate Campus. So that's my home base and Pepperdine is a great space because it allows me to do a lot of work in the community. So I mean, my doctorate degree is in clinical psychology, but I consider my work to be really around community multicultural psychology. So I consider myself to be a community multicultural psychologist really, and so all the work I do and have been doing for the past 20 years is really around trying to meet the needs of underserved communities, unserved communities in whatever way I can.
I also was one of the original founders of MECCA, the Multi-Ethnic Collaborative of Community Agencies many, many years ago at this point. That's really a passion for me because it allows me to really support communities in ways that I think are much needed. We decided over a decade ago that coming together and supporting each other was going to be lot more successful in trying to reduce barriers, increase access to services, particularly for monolingual, linguistically isolated communities, Korean, Vietnamese, Spanish, whatever may be. So, that's where most of my time is spent professionally. I say that professionally, I have that disclaimer because my most important role is as a father.
Kate Gosney Hof...: Absolutely. I hear you.
Dr. Miguel Gall...: So I think that Mark Twain said, "The two most important days of your life are the day you're born and the day you find out why." So the day I became a dad was sort of a really significant moment. So, since I've had my daughters I've sort of balanced between how do I make these two worlds come together. So there's a rhythm in there, there's a rhythm in there. Yeah.
Kate Gosney Hof...: I know we talked a little bit before we started about you have a three and a six year old, right?
Dr. Miguel Gall...: That's right, that's right.
Kate Gosney Hof...: So you're in it, right? You are in it right now.
Dr. Miguel Gall...: That's right.
Kate Gosney Hof...: I'm sure that it's all very connected for you.
Dr. Miguel Gall...: Right.
Kate Gosney Hof...: The work that you're doing and the legacy you're leaving for your children too.
Dr. Miguel Gall...: That's right, that's right. Yeah, I mean, in fact, I was talking to this organization nationally last month or so, and someone asked, "How do you sort of move through everything that's happening right now in the world?" And I said, "You know, I think about my girls, and my kids, and how can I teach them to really honor and appreciate who they are as Mexican American little girls, and not teach them to hate others simply because they are Mexican American." I think it was a conversation around just race relations, cross-cultural relations and trauma around that. I say one of the greatest challenges is how do I teach my kids to love and honor themselves and understand that there are challenges in the world, but to not teach them to hate, and to dislike, and to have assumptions, and biases, and all kinds of things about others simply because of the color of their skin, or what their name might be, or where they come from, and that's the challenge in some ways. I think it's much easier to say all X are this way and all Y are that way, and I think we're perpetuating more of the same when we do that.
So, when I think about my work from a multicultural foundation, how do I teach my kids and then just people in general? My work revolves around how to do conversations better, and that's important, so.
Kate Gosney Hof...: Absolutely.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: And such important conversations need to be had.
Dr. Miguel Gall...: Yeah, for sure.
Kate Gosney Hof...: And for you to marry the world of psychology and the world of cultural sensitivity.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: I mean, bringing those two things together, that niche that you have, is something that is greatly needed, in my humble opinion.
Dr. Miguel Gall...: Yeah, yeah.
Kate Gosney Hof...: As a therapist myself, I am very, very aware of the privilege that I've had in the mental health community. Then as a Caucasian American I'm aware of the privilege I have even just finding the resources that are available to me that I don't even think twice about, right?
Dr. Miguel Gall...: Right, right. Yeah.
Kate Gosney Hof...: So, I'm very interested in the work that you do and very grateful for the work that you do.
Dr. Miguel Gall...: Yeah, thank you. Yeah, thank you.
Kate Gosney Hof...: Because it's layered. You're working in the community and you're also teaching future mental health professionals.
Dr. Miguel Gall...: That's right.
Kate Gosney Hof...: And you're teaching your children, and so it's very embedded in ...
Dr. Miguel Gall...: Yeah. Yeah, absolutely. We have to do it differently. I mean, if you look at where we are now, I think it would be disrespectful to those who came before us to say that nothing's changed.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: But a lot hasn't.
Kate Gosney Hof...: True.
Dr. Miguel Gall...: So a lot has, and there's so much more that we need to do differently. So we just need to do this process a little bit differently going forward, otherwise we're going to find ourselves in the same place, 10, 20, 30 years from now, and I worry about that.
Kate Gosney Hof...: Sure.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: I know this is a very big topic and there are so many things we could talk about under this umbrella, but maybe let's just start with what are the themes that you see, maybe let's just start in Orange County in terms of what are the changes that you think need to happen first in terms of mental health.
Dr. Miguel Gall...: Right, right. Well, I mean, I think, I don't know that Orange County is unique. I mean, it is unique in many ways, but I think in terms of when I think about mental health, mental health systems, I think many of the challenges we face here are fairly consistent and across other places here in Southern California and whatnot. I think we just need to do a better job of destigmatizing mental illness, mental health just in general. I think that's a national problem we have. I think the more we continue to I think perpetuate misconceptions, misinformation about those who might be dealing with some kind of mental health condition, I think the harder it gets to try to break that vicious cycle, if you will. Because what happens is that when we have a narrative or there's a thing about stigma, there's the social stigma, the public stigma that comes with mental illness and mental health conditions that people may have, and that really creates in some ways self-stigma, internal stigma, and then that impacts do I go get help, do I not get help? Do I tell someone I have something going on? Do I not tell someone I have something going?
So it's all very connected to each other in many ways, and I think we struggle around talking about it in a way that destigmatizes these issues. The reality is, is that if you really think about it, I mean, sometimes I'll tell people like, "Have you ever felt sad? Have you ever felt anxious? Have you ever felt uncomfortable, uneasy about, and maybe more than one time?" Et cetera. I mean, those are all emotional ups and downs that people have, and I think we have to kind of really talk about it in a way that these are issues that people deal with on a daily basis, some deal with it much more consistently than others, but even if we contextualize it within the context of what's happening now.
There's a lot of research that's already come out that has said that if someone was dealing with some sort of mental health condition prior to COVID and this pandemic, it is even more intense to a certain degree for them at this point. But then the research also says even if you weren't dealing with something before, you're probably feeling it now.
Kate Gosney Hof...: Mm-hmm (affirmative), mm-hmm (affirmative).
Dr. Miguel Gall...: So I think the one thing, my glass is always half full, it's never half empty. So when I think about what's happening now with this pandemic, I think we're here for a reason. We're being poked and prodded as communities and people to try to sort of think about what we need to do differently. So I think that one of the outcomes that I think has been maybe we could argue more positive is that I think the conversations around the mental health and the focus on getting people to attend to it and see it as important and valuable I think has changed over these last eight, nine months in ways that I don't know that they would've happened quite so expeditiously if we weren't in the middle of a pandemic in some ways.
So I think I've loved that there's been much more of a discussion around thinking about how to take care of oneself and almost like normalizing that people are experiencing a range of emotions and circumstances based on what's happening right now, and I think this has been helpful in that way.
Kate Gosney Hof...: Yeah. Boy, I agree. One of those positive things to come out of a crisis where people are pushed to their limits.
Dr. Miguel Gall...: That's right.
Kate Gosney Hof...: And they're forced to look at themselves. It does seem like there is more of a conversation happening about people's mental health because we have to.
Dr. Miguel Gall...: We don't have a choice.
Kate Gosney Hof...: I mean, you can't live under a rock. People are all struggling in their own ways because this is such an unprecedented time, with so many challenges that people just never saw coming.
Dr. Miguel Gall...: Right, right.
Kate Gosney Hof...: So, through your work with MECCA and then obviously all the work you're doing in the community through teaching as well, do you have a practice right now as well?
Dr. Miguel Gall...: I do. I have a small practice.
Kate Gosney Hof...: You have a practice?
Dr. Miguel Gall...: I do, yeah. I do.
Kate Gosney Hof...: Okay, thought so.
Dr. Miguel Gall...: Mm-hmm (affirmative).
Kate Gosney Hof...: So right, so you're seeing it from all angles.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: The conversations that you're talking about, has it seemed to shift within the different, from a cultural perspective? Things that maybe have been harder to talk about, has it been ... Is there a reason to talk about it now, is there less of a resistance I guess?
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: I know you kind of just said that, but I'm just curious about the different cultures that we're looking at. Like you said, the monolinguistic cultures or just the barriers.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: Are they shifting? What does it look like to you?
Dr. Miguel Gall...: I mean, a little bit, a little bit. I think there's still a lot of stigma. I think there's still a lot of work to be done, particularly in some of our mono, sort of linguistically isolated communities.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: I think there's certainly still a lot of stigma attached to having a mental health condition, or dealing with some sort of emotional vulnerability in some way or another. I certainly think ... So, for my practice for example, I work a lot, I wouldn't say primarily or exclusively, but with a lot of Latinx community members, and many of them are Spanish speaking community members. So, I'm hearing them talk about experiences, and circumstances, and situations in ways that maybe they might not have done prior to COVID. So, I definitely think everyone's experiencing it in a different way and feeling it in a different way. Because of that, they're being forced to have a conversation or to do something about it.
Now, these are people that I think in some ways have access to me through the different channels in which I maybe provide services in different ways. There are so many though who services are still inaccessible to them. So, if they are dealing with a certain emotional vulnerability and dealing with some kind of struggle, I'm not so sure that we've done anything during this time that is increasing access to services to help some of those folks who are definitely feeling it in ways that they haven't before. So, I think I would say that I'm hearing some conversation shift a little bit because people are just quite frankly their backs are against the wall.
Human behavior is that, for the most of us anyway, we don't change until we have no choice but to change.
Kate Gosney Hof...: True.
Dr. Miguel Gall...: That's just sort of-
Kate Gosney Hof...: It's just true.
Dr. Miguel Gall...: ... our human nature, right?
Kate Gosney Hof...: Yeah, exactly.
Dr. Miguel Gall...: It's like it's just who we are. So, I think a lot of people are at that space.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: Because of that, I think they're realizing they need some support. My concern is that I don't know that our ... It's like the perfect storm, I think. This pandemic has heightened and made more salient the range in which one can experience emotions as a human being, but it hasn't, and simultaneously it's also I think been a barrier to receive services, because many have gone to telehealth, many have gone to remote services in many ways, and we know, just like in the school system, there are many community members primarily more on the lower socioeconomic end of the spectrum, lower resourced community members who are having trouble accessing services because of the way they're being delivered at this moment in time.
Kate Gosney Hof...: It's almost one more barrier.
Dr. Miguel Gall...: It's another barrier in many ways. I think a lot of people have said in many ways that telehealth was increased some access in some ways.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: But that's only for a select sort of portion of our communities in many ways.
Kate Gosney Hof...: Yes.
Dr. Miguel Gall...: There are so many who are struggling. I mean, if we think about schools. The kids who are struggling the most because of distanced learning and whatnot are the kids who are in the lower resourced communities whose access to resources are incredibly limited, and that's true for mental health as well. So I worry about them.
Kate Gosney Hof...: Yeah, me too.
Dr. Miguel Gall...: I worry about them, yeah.
Kate Gosney Hof...: Mm-hmm (affirmative), because that's a whole nother topic of the children.
Dr. Miguel Gall...: Right.
Kate Gosney Hof...: The mental health implications of this whole thing in general, and then add that onto it, that they can't even get access to what they need to do to stay connected, and the anxiety that that causes is a big deal.
Dr. Miguel Gall...: That's right. Yeah. Right, it is. It is, yeah.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: For sure.
Kate Gosney Hof...: I want to kind of go back a little bit to what you were talking about with stigma, because yes, that is the hugest barrier, right?
Dr. Miguel Gall...: Mm-hmm (affirmative).
Kate Gosney Hof...: Kind of everything kind of trickles down from that in a way. So much of what this podcast is even about is destigmatizing mental health.
Dr. Miguel Gall...: Sure, yeah.
Kate Gosney Hof...: We talk about it a lot, we say stigma, stigma, talking about different ethnic backgrounds, communities, and I'm just curious from your opinion, and I know this differs, but maybe just because the Latinx population that you work with a lot, what is, in your opinion, what is the stigma? What is it for that cultures?
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: What is it? What keeps them from-
Dr. Miguel Gall...: Yeah, from seeking services or talking about it.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: Yeah. I think this is true for not only Latinx communities but other I think historically oppressed communities in many ways.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: There's a lot of ... Well, first off, I think in some of our communities we don't always have words in our languages that are consistent with how we talk about things in English. So I think even the linguistic differences in terms of how we talk about things may differ in some ways or may not be consistent. In some ways I think there's a great book, it's called Crazy Like Us by Ethan Watters actually, and it talks about how we in the United States have sort of exported, if you will, a mental health language and a way of treating mental health disorders to other parts of the world where maybe it didn't exist before in some ways.
Kate Gosney Hof...: Interesting.
Dr. Miguel Gall...: So I think there's certainly I think some worldview differences in terms of how we talk about and think about what we're experiencing, and I think because we have in some ways this idea of stigma, it comes from the Greek mark of disgrace, if you will.
Kate Gosney Hof...: That's true.
Dr. Miguel Gall...: So, if you think about that it's like nobody is going to want to be seen in that kind of a way, and so there's a lot of shame-
Kate Gosney Hof...: Yes.
Dr. Miguel Gall...: ... around talking about once maybe what one might be experiencing from a mental health perspective. So I know in a lot of Latinx communities, I mean, it still happens today where people are like if there's a family member who might be on the spectrum, might be autistic, or someone who might be on the maybe schizophrenic or dealing with some sort of severe mental illness, there's almost like a hiding of that individual and those symptoms from even within the family sometimes because there's so much I think shame around that and what does that mean for us as a family. What does that say about us?
Kate Gosney Hof...: How does that reflect on us?
Dr. Miguel Gall...: How does that reflect on us and whatnot? Yet I think one of our greatest strengths as Latinx community members, as communities, is that we're family oriented in many ways. We're certainly not the only ones that are family oriented, I think.
Kate Gosney Hof...: No, but it ...
Dr. Miguel Gall...: Family is important to many communities, but I think for us-
Kate Gosney Hof...: Intergenerationally.
Dr. Miguel Gall...: Intergenerationally, it has certainly played an important role. Speaking of schizophrenia, there have been I think quite a few studies over the years that have said that when families who have, particularly Latinx families, when they have an individual who's been diagnosed with schizophrenia, if they receive that individual with warmth, and acceptance, and kindness, and sort of understanding, if you will, it may sound very simple, the likelihood of the individual in some ways reexperiencing those symptoms, or being rehospitalized, or being retriggered decrease significantly actually than if within the family there's that family stigma. If there's that family stigma in there, that individual is going to have ... they're going to have a difficult time, in many ways.
So, I think a lot of it's shame. I think a lot of it is sometimes linguistically we don't talk about things in the same ways. I also think institutionally we think about institutional stigma around policies, and laws, and whatnot that I think we have not done a very good job of creating systems in which it is okay to experience anything that might be out of our cultural or social norm.
Kate Gosney Hof...: Outside the bell curve.
Dr. Miguel Gall...: Outside the ... Yeah, and I find that really interesting because if you think about it, like someone who might be experiencing an intellectual disability. So, we're going to diagnose that individual. That's a diagnosable situation and circumstance.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: Someone who's an intellectual genius, have you ever been around someone who's off the charts like-
Kate Gosney Hof...: Savant kind of, right? Yes.
Dr. Miguel Gall...: It's like there are some-
Kate Gosney Hof...: Something's off there.
Dr. Miguel Gall...: There's maybe some away from the norm types of ...
Kate Gosney Hof...: Yes.
Dr. Miguel Gall...: But we're not trying to pathologize and diagnose that individual.
Kate Gosney Hof...: That's true.
Dr. Miguel Gall...: Major depression or depressive disorder is like we want to pathologize it, we want to sort of stigmatize that. Unconditional optimism on the other end of that spectrum, like there's also I think some ... There are some things there too.
Kate Gosney Hof...: Uh-huh (affirmative), denial.
Dr. Miguel Gall...: Yeah, right. Right, yeah, exactly. Do you see what I'm saying?
Kate Gosney Hof...: Yeah, I do.
Dr. Miguel Gall...: So it's like I think we have this like-
Kate Gosney Hof...: Why do you think that is?
Dr. Miguel Gall...: Well, I think in some ways that it's like who's invested in how we talk about thing? Who benefits?
Kate Gosney Hof...: Yes.
Dr. Miguel Gall...: What systems are benefiting? What entities are benefiting? What people are benefiting from how we talk about things, how we end up categorizing, and labeling and diagnosing, and whatnot? Who's benefiting from those types of conversations, from that discussion, from talking about and really classifying things in certain ways? I think sometimes people have reactions when I say this, but I think some of these are very politicized processes.
Kate Gosney Hof...: Yes.
Dr. Miguel Gall...: I'll tell you. I talk about this when I talk about sort of cultural issues and whatnot, I tell people look, Aristotle said that we are political animals as human beings. I'm not talking about who's Democrat, who's Republican, who's conservative, liberal, whatever it is. It's more like we cannot remove ourselves from the context in which we find ourselves, and therefore we are political. So we are being impacted and influenced by the very environments, and context, the circumstances we find ourselves, which has a lot to do with how we understand things, how we make sense of things, how we see things, how we understand ourselves within the context or others, and I think all that matters when we talk about how we make sense of why depression is problematic, but unconditional optimism somehow there's no issue with it.
Kate Gosney Hof...: It's okay, right.
Dr. Miguel Gall...: Or someone having an intellectual learning difference is problematic, but someone who's an intellectual genius and on the other end of the spectrum is sort of more socially acceptable to a certain degree.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: So I think those processes, when I think about mental health issues, mental illnesses, mental health disorders, I think about social construction and the context, the way in which we talk about things. Even when I was talking about schizophrenia earlier, even schizophrenia, I think it was Bleuler who initially kind of coined the term schizophrenic and schizophrenia, and when he described it he was describing that individual as having some unusual behaviors, unusual behaviors. European and American sort of ideologies and interpretations it went from unusual to bizarre. Big difference.
Kate Gosney Hof...: Big difference, yeah.
Dr. Miguel Gall...: Big difference.
Kate Gosney Hof...: Yeah, it's a jump.
Dr. Miguel Gall...: Yeah. So I think that's problematic when we talk about stigma and how we ... Languaging is critical, how we talk about it, how we understand it. I think there's so much misinformation, misconceptions, lack of awareness in our communities here in Orange County.
Kate Gosney Hof...: Yes, yeah.
Dr. Miguel Gall...: I think that has a big role in some of the challenges.
Kate Gosney Hof...: Boy, that's something that ... Boy, you just don't even really think about, the language part of mental health and how what words are used to describe certain experiences and how that could be very confusing cross-culturally.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: Also, you think about the evolution of language and mental health.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: Diagnoses especially.
Dr. Miguel Gall...: Right.
Kate Gosney Hof...: Right, imbecilic behavior used to be in the DSM.
Dr. Miguel Gall...: Right, right.
Kate Gosney Hof...: Or tons of other things that now would be not okay to say.
Dr. Miguel Gall...: Right, absolutely.
Kate Gosney Hof...: It is fascinating. It's something that I really appreciate that point, to realize that this might not cross over. This might not be to you what it is to me.
Dr. Miguel Gall...: Yeah, that's right. Yeah. There's this process called ... There's an anthropologist who sort of developed this how we understand issues from different cultural communities, it varies, it differs. So how we make sense of it, how we understand it, how we define it, and that what we believe are the means to restoring health and wellness is going to differ. So I think a lot of times we end up comparing apples to orange. So it's like if I'm comparing myself to something else that is contextually and congruently and culturally inconsistent with me, I'm going to look off.
Kate Gosney Hof...: Totally.
Dr. Miguel Gall...: There's always going to be a problem with me.
Kate Gosney Hof...: Yes, and therefore the shame happens.
Dr. Miguel Gall...: That's right, but if I'm looking at okay, what's the gauge, what's the comparison group that I'm looking to understand what this individual's behavior is and what makes sense, what doesn't, we're going to be a lot more I think respectful and mindful about how we understand people's behaviors. Anything out of context is going to always look bizarre.
Kate Gosney Hof...: It's true.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: Absolutely. I think the last episode we recorded was with Iliana Soto Welty.
Dr. Miguel Gall...: Yeah, yeah, yeah.
Kate Gosney Hof...: From MECCA.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: And boy, she was so lovely to talk to. We were talking about almost this exact same thing, and she was talking about the ways in which she reaches people that may not otherwise be, or that MECCA reaches, be open to having these conversations.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: She shared with us in depth about this writing project that she's headed up. Giving people the opportunity to share what it is for them, the experiences that they're having in their own words.
Dr. Miguel Gall...: Right, that's right.
Kate Gosney Hof...: And what it is for them, and what it is within their context, and how they would describe it versus kind of more of a top-down approach of this is it, you fit in this category, don't you, or what not.
Dr. Miguel Gall...: That's right, yeah.
Kate Gosney Hof...: And it's so powerful when you sort of reverse that approach.
Dr. Miguel Gall...: Yeah, yeah.
Kate Gosney Hof...: One size does not fit all. One word does not fit all.
Dr. Miguel Gall...: No. No, it's powerful. Those programs that she's referring to, we're also using community members to help us destigmatize and break down some barriers and increase access.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: So, that matters too. I think when you pull folks from the communities that you're trying to reach, that matters. That matters a lot because if I walk into certain communities, look, I don't need to be there. I can be there for a nanosecond and people are like, "He's not from here." Right? It's like so people are going to know. So, that may not ultimately be a make or break, but I think it's something we have to be mindful of, that we need to help I think in some ways educate, and train, and work with people from the communities who we're trying to reach, and do that more and more I think, and I think that's going to help us a lot.
Kate Gosney Hof...: Yeah, having that.
Dr. Miguel Gall...: Mm-hmm (affirmative).
Kate Gosney Hof...: Would you say that there's a certain level of protection that they have over their community and when they have somebody from outside, especially from the world of mental health, psychology and whatnot coming, does it feel there's an extra layer of resistance there?
Dr. Miguel Gall...: Yeah, I certainly think there's a mistrust, because when you're talking about even if you look at Latinx communities, we are experiencing mental health concerns just like everyone else is, but our rates of actually going to talking about it with a primary care physician, or going to a mental health professional, just with each one it just decreases how much we're actually doing that and how much we're going to services. The percentage is incredibly small compared to the number of folks who might be experiencing it in many ways. So, the access to services.
Then when I think, when we go to receive services, and this is beyond just even Latinx communities but many others as well, we're maybe being responded to in ways that are making us feel I think more shame.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: More sort of pathologized, more away from the norm, more abnormal. I think that also creates a barrier around I don't want to go to a system that's going to not understand who I am. So when you have someone coming in from outside the community, there's already a level of hyperawareness and hypersensitivity around okay, what does this person want? Quite frankly, we know from history that outsiders have come into communities and exploited those communities to their benefit.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: Right? And that's still happening in many ways. So, there's definitely I think a layer of protection and mistrust that I think is very healthy for our communities to have actually. So, we should question, we should understand what people's intentions are. We should understand what they're trying to accomplish. We need to understand how it's going to benefit our communities at the end of the day, and not just the person coming in from the outside and getting what they needed and leaving in many ways.
So I think when we use folks from the community, there's a level of investment there that I think is very powerful, and I think it also breaks down some of the mistrust and some of those other barriers as well. Yeah.
Kate Gosney Hof...: I really like that point. Correct me if I'm wrong or I'm misstepping in a way, but I feel like what you just described about that mistrust that should be there, they have a right to that.
Dr. Miguel Gall...: That's right.
Kate Gosney Hof...: I agree. It's a fragile thing, right? Because you want to make sure that they have the resources, and yet you're not disrespecting the culture and disrespecting the doubts that they might have. So using the community members right is really, really important.
Dr. Miguel Gall...: Right.
Kate Gosney Hof...: This is an opportunity to actually empower them in their mental health, and asking questions maybe out of what begins as cynicism, but maybe turns into empowerment and actually getting more educated in a way that feels closer to home, more aligned with who they are, or what they believe, or their family believes, or the culture they come from, and it's an opportunity to empower, because having people operate in kind of a silo effect, where we're all kind of not connected isn't quite the answer either.
Dr. Miguel Gall...: No.
Kate Gosney Hof...: Right? How do we reconcile that? We want to empower people in their own metal health by providing resources and not take away their right to question, and we want to empower them.
Dr. Miguel Gall...: That's right, that's right.
Kate Gosney Hof...: And yet not continue to isolate. So it's a little bit of a conundrum.
Dr. Miguel Gall...: Yeah, yeah. Well, in some ways I think we have to let people know that we need to walk into communities I think as an observer, and a listener, and a learner in many ways.
Kate Gosney Hof...: Beautiful point, right.
Dr. Miguel Gall...: Because I think a lot of times when we walk into communities, and I don't want to generalize this too much, but this certainly happens and I think it continues to happen, where it's like I walk in thinking I know what the solutions are to people's problems. I think there's an assumption there that we don't know what our own solutions are to our own problems. I think that's a problem, so I think we have to go with assuming that communities have resources, internal, cultural, whatever they may be that are going to probably be very advantageous for us to sort of understand, to learn to incorporate, and to work together and have some synergy there, because if I say, "Look, I'm going to give you money to go and work with the Latinx communities, but here's how you got to do it, and these are the stipulations, and these are the guidelines." I'm concerned about to what degree and what impact that's going to have positively in that way.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: So I think there has to be some flexibility around how we walk in, and I think it's understanding that we don't have all the answers.
Kate Gosney Hof...: Yes.
Dr. Miguel Gall...: Even if I think about just contextualizing this, our sort of traditional mental health systems in some ways, the onus is put entirely on the individual. So the problem lies solely within the individual in many ways. Again, some people may argue with me on that, and that's fine, but in general there's this thing like look, you were the sole bearer of responsibility for sort of what you're experiencing, and that fails to take into account how everything that someone brings into a clinical and counter-therapeutic, kind of whatever we want to call it, is socially produced.
Kate Gosney Hof...: Right. Not to mention generationally.
Dr. Miguel Gall...: Generationally.
Kate Gosney Hof...: Generational trauma.
Dr. Miguel Gall...: Exactly.
Kate Gosney Hof...: Which also is socially produced.
Dr. Miguel Gall...: Absolutely.
Kate Gosney Hof...: Yeah, yeah.
Dr. Miguel Gall...: So I think we have to even understand that that's like ...
Kate Gosney Hof...: Right, right.
Dr. Miguel Gall...: When we reinforce that idea, whether it's conscious or unconscious, we're also minimizing, and I think failing to recognize the strengths and resources within people and communities in many ways.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: So I think we have to ... I always tell my students, I said, "I don't care where the person comes from, if they're living on a box in the street, are the CEO of a Fortune 500 company or whatever, somewhere in between there, find out what's right with the person before you try to figure out what's wrong with them."
Kate Gosney Hof...: Love that.
Dr. Miguel Gall...: What's right with them? Everybody, there's something we can find good and right with people, and I think that's the place we have to start. So when you go into a community, find out what's good about the community. What resources, what do they have already that we may not know of that may be a source of support, and resilience, and thriving for them in many ways that we just may not be taking into consideration or maybe even understand from our perspectives? Then I think at that point organically, inherently, you're going to find out some of the challenges. Let's find out what's right with people and communities first.
Kate Gosney Hof...: And what is working for you.
Dr. Miguel Gall...: And what's working.
Kate Gosney Hof...: Yeah, absolutely.
Dr. Miguel Gall...: What's working, yeah.
Kate Gosney Hof...: We have a lot to learn too. Just because we're experts in the field or whatnot does not mean-
Dr. Miguel Gall...: No.
Kate Gosney Hof...: ... that we have all the answers.
Dr. Miguel Gall...: No.
Kate Gosney Hof...: If we ever feel that we do, then that's a problem.
Dr. Miguel Gall...: It's a problem, it's a problem. It's a problem.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: So, I love that, that we can learn from each other. What strikes me when you say find out what's right with them before you find out what's wrong is actually how that is a whole paradigm shift from-
Dr. Miguel Gall...: For sure.
Kate Gosney Hof...: ... the way the world of mental health works.
Dr. Miguel Gall...: And how we train people.
Kate Gosney Hof...: And how we train people, exactly.
Dr. Miguel Gall...: And how we talk about it, absolutely.
Kate Gosney Hof...: Yeah, and going back to what you're saying, kind of who pays for things. I mean, that's a whole rabbit hole, but-
Dr. Miguel Gall...: And what's reinforced, yeah.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: So, I guess I would just say too that this idea of we have to ... You asked a question earlier, and I want us to get back to it briefly, but we have to work together.
Kate Gosney Hof...: Yes. Yeah.
Dr. Miguel Gall...: If you look at our histories, any time we've done that we've always been much more successful. We are in one of the most divisive and divided times that some people are saying since the Civil War.
Kate Gosney Hof...: Yes.
Dr. Miguel Gall...: So, we need to work together. So we need, we have to. We have to, there's no other alternative. So, how we do that and what that looks like I think has to be co-created, not just one-dimensional and one-sided, but we need to. So I want people to want to support my communities, but I don't want people to think that my communities don't know how to help themselves and we don't know how to sort of take care of ourselves.
Kate Gosney Hof...: Victims, right.
Dr. Miguel Gall...: Yeah, we are some of the most resilient people I know.
Kate Gosney Hof...: Absolutely.
Dr. Miguel Gall...: So, I think even just I think that is imperative when we think about sort of what it means to work together.
Kate Gosney Hof...: Yeah, I couldn't agree more. To your point, this time is sort of it's a pressure cooker.
Dr. Miguel Gall...: Definitely. Yeah.
Kate Gosney Hof...: It's kind of do or die when it comes to we need to get all on the boat together and start kind of stretching and coming outside of our comfort zones and respecting one another, and connection. I mean, it's connection is everything.
Dr. Miguel Gall...: It's important.
Kate Gosney Hof...: This is a especially hard time for that too, you know?
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: The connection piece of things.
Dr. Miguel Gall...: Right.
Kate Gosney Hof...: So yeah, collaboration and yeah, beautifully said. Thank you.
Dr. Miguel Gall...: Yeah, sure. Sure.
Kate Gosney Hof...: Thank you. So, for you, the work that you do. I believe that I can sense from you that your passion about fighting the stigma of mental health and making sure that that narrative changes and that you're part of that. I think when you were talking about the schizophrenic diagnosis and the families. If they were received in a different way, the outcome would be very different.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: When we're talking about young people in these specific kinds of communities, what would help, you think if ... What kinds of things would be helpful if they were implemented earlier on? What kinds of shifts would be helpful to help with starting earlier so we have that more kind of embedded in the family instead of later on? I mean, what's your opinion about that?
Dr. Miguel Gall...: Well, I mean, I think this is probably nothing that other people haven't already said, but I think it's around how we can start earlier in our education system, in our educational processes, integrating these conversations. When I went through my formal education, there was no psychology courses in high school, or middle school, or wherever, and now I think they have some in some places, and I think that's important. But I think it's around really giving voice to the obvious and being transparent about that. I think we have to talk about it. It's like we were talking about, cultural issues and simultaneously with us talking about stigma, and it's like we need to talk about cultural, cross-cultural relationships earlier also.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: It's like we don't talk about those with kids, and yet they know very early on that there are sort of skin color differences and that those things mean something, and so we have to prepare our children and the next generation and give them the language to be able to do it. I would say that the younger generation I think in many ways is developing and fighting and pushing against some of that, which I think is good, but I think systemically and institutionally we have to do a better job of embedding, and integrating, and normalizing the experiences that people are having on a daily basis.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: I mean, everybody at some point in time were experiencing some emotional variability in how we're feeling, and how we're responding to life, and what happens to us, and what happens to the ones we love. So I think that's really important. I think we need to do that, and I think we also need to sort of develop ways to create more educational outreach and programs in communities where there's sometimes misinformation quite frankly.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: I think the misinformation can also generate, I think can further increase the stigma, and the shame, and the reluctance to see. I mean, stigma can lead to someone dying.
Kate Gosney Hof...: True. Yes, it can.
Dr. Miguel Gall...: For not wanting to talk about, not wanting to seek help, not wanting to take medication, not wanting to ... Whatever it may be. So, I just think we have to really hold that thought simultaneously while we're talking about everything else. It's like the stigma can cause people lives, people their lives in many ways, and we see that happening all the time.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: You look at that and I bet, well, we don't know what happened, it's unexplainable.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: But the reality is there was so much shame because of this stigma that it just led to sort of a dark place. I think that's a very good reminder to be sensitive of that, it's more than just being kind of socially compliant. It's actually realizing that that is a mental health concern in itself.
Dr. Miguel Gall...: Yeah. I think, again, just normalizing that.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: Look, every human being is moving through different emotions at different times for different reasons.
Kate Gosney Hof...: Having a human experience, right.
Dr. Miguel Gall...: Having a human experience, and that's really what we're talking about here. Some of those human experiences are going to be a little bit more intense than others, or maybe require a little bit more support than others, but nonetheless they're part of the continuum of the human experience that I think every single one of us is susceptible and vulnerable to experiencing at any given moment in time under the right circumstances, in the right context, depending on what's going on. I always tell people whenever I see things happening, and I always tell people I don't know how I would respond if I were in that ... I'd like to think I could tell you how I'm going to respond, but if something's happening to a family member or something, or there's a major, I don't know how I'm going to respond. I can't tell you that because ... So I think we also have to be less judgemental around looking at other people's experiences, because it's too easy for us to see ourselves outside of that.
Kate Gosney Hof...: Yes.
Dr. Miguel Gall...: Quite frankly, what happens to you, okay, is also I think part of my human experience. It should be.
Kate Gosney Hof...: Yeah.
Dr. Miguel Gall...: If I love and respect you, then I love and respect myself.
Kate Gosney Hof...: Right.
Dr. Miguel Gall...: If I do harm to you, I'm doing harm to myself in many ways.
Kate Gosney Hof...: We're reflections of each other.
Dr. Miguel Gall...: We are reflections of each other, and I think that's part of the human experience. Now, all our human experiences are not the same.
Kate Gosney Hof...: No.
Dr. Miguel Gall...: So I don't want to say that we're all humans and we're all the same, because our lives don't unfold that way, but there is something that transcends the human experience that I think we have to really appreciate and understand that when something happens to you, in many ways I really believe that something's happening to me.
Kate Gosney Hof...: Mm-hmm (affirmative).
Dr. Miguel Gall...: I think that's partly what keeps at least me grounded and sort of situated in trying to remain, as much as I can, respectful, mindful, kind of try to walk with humility and try to respond to people with love and kindness.
Kate Gosney Hof...: Absolutely.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: It's a good humbling reminder that we are all connected.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: And from a mental health standpoint it is a beautiful reminder that you matter just as much as I matter, and my human experience matters just as much as your human experience does.
Dr. Miguel Gall...: Yeah.
Kate Gosney Hof...: To not judge one another, and to just focus on that connection and try to rise together.
Dr. Miguel Gall...: Yeah, yeah. That's right.
Kate Gosney Hof...: So, we are just about out of time.
Dr. Miguel Gall...: Yeah, okay.
Kate Gosney Hof...: And I'm sad because I have a lot more things I wanted to ask you.
Dr. Miguel Gall...: Time flies when you're having fun.
Kate Gosney Hof...: It sure does. But I wanted to just ask, give you the opportunity, talking about resources, if there's anything that you feel that our listeners, if there's any resources you want to just sort of let them know about if you're struggling, maybe a family member's struggling or they're struggling during this time, and anything you would just like them to know.
Dr. Miguel Gall...: Yeah. I think, well, you talked about MECCA. I think MECCA is a great resource for communities.
Kate Gosney Hof...: Definitely.
Dr. Miguel Gall...: And not just even just some of the specific communities that we're serving, but we are a good resource for anybody who might need some resources and who are looking for maybe low-cost or pro bono resources. The county has a lot of I think resources that are accessible, at least information wise and how accessible they are may depend and vary on the sets of circumstances and situation, but there are a lot of resources that I think folks can pull from to at least get some information. I think MECCA is a great place to start.
Kate Gosney Hof...: Okay.
Dr. Miguel Gall...: Because we have a lot of ... I think we've over the last decade or so we've really generated a lot of connections between all our agencies there. We are covered county wide and have ... If we don't do it, we know someone who does-
Kate Gosney Hof...: That's awesome.
Dr. Miguel Gall...: ... in many ways. So, I think MECCA is a great resource for people to seek out information and whatnot. So yeah, and I think I would just say be kind to yourselves. Be kind to yourselves and I think that's important. We just need to have more self-compassion for ourselves and with each other, and I think that's important. If we're going to try to make this process better, make our conversations better, make our relationships better, we just need to be a little bit more compassionate with ourselves, with others, and try to be more respectful to each other.
Kate Gosney Hof...: I couldn't agree more.
Dr. Miguel Gall...: Yeah, yeah.
Kate Gosney Hof...: Thank you so much for being here, Dr. Miguel.
Dr. Miguel Gall...: Thank you, yeah.
Kate Gosney Hof...: We really appreciate it.
Dr. Miguel Gall...: Sure. Thanks for the invitation.
Kate Gosney Hof...: So nice talking to you.
Dr. Miguel Gall...: You too, you too. Appreciate it. Yeah.
Kate Gosney Hof...: Take care.
Dr. Miguel Gall...: Okay.