Mental Health

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The following program includes content of a sensitive nature centered around a mental health and wellness that may be unsettling for some listeners. If you need someone to talk to, you can contact Lifeline on 13, 11, 14 or online at Lifeline dot org didyou. A suicide call back service is one 300 six five nine four six seven or online. Add suicide call back service dot org dot AEW or beyondblue 1300 two, four six, three six and online and beyond blue dot org today. These websites and phone numbers will be repeated several times during the next program. We hope you benefit from this episode of Nothing's Off Limits. Nothing's off limits. It's off limits. Bringing together experts and people with lived experience to discuss the topics we love to avoid but absolutely need to talk about made with the support of Vision Australia and the NDIS information linkages and capacity building grants, including grants.

01:02

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Hello and welcome to the show where nothing's off limits. My name is Tess with my co-host Polly. We're delving

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into some subjects, which we might usually consider

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off limits, discussing them openly and honestly and through the specific lens of blindness and low vision dating and relationships, appearance and body image, mental health, physical well-being and much more. Each episode of Nothing's Off Limits is available to download from the Vision Australia website. Just go to Vision Australia dot org. That's Vision Australia dot org type. Nothing's off limits into the search engine, and you will be directed to a web page where you can view this and other episodes and do make sure you subscribe to make sure you don't miss any or else. If you prefer, you can tune in via Vision Australia radio.

01:48

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In this episode, we're talking about mental health. What are the common symptoms of mental distress? How are vision loss and mental health connected? And what's the importance of seeking support to improve our mental health? And we often tend to think about mental health in terms of mental illness. But the World Health Organisation has defined mental health as a state of well-being, which enables a person to cope with the stresses of day to day life, to be productive and fruitful and contribute to their community. Research suggests that high levels of mental health are linked to increased learning and creativity positive relationships with the people around you. Good physical health and an increased life expectancy test. Does that surprise you?

02:30

S5

Oh, you!

02:31

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It doesn't surprise me, I guess, because I've had a lived experience with mental health, mental illness. I should say I know how debilitating it can be, and I also know how much effort impact good mental health can play in. In just even just your ability to enjoy your day to day life, you know, illnesses or conditions such as anxiety and depression can make it really difficult to do, do really small things. And if you can come through those conditions, I have noticed how differently we can perceive the world, how much more productive we can be. So it's definitely not a surprise to me. You know,

03:10

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it's really interesting that, you know, if we have a a bumper bruise on our body, we don't think twice about seeking medical help. You know, emotional and mental mental health bumps and bruises are really no different, so it's really important to prioritize our mental health and seek support if we're experiencing mental distress. We asked you how you look after your mental health and got some really interesting answers.

03:32

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Nothing's off limits with Tess and Polly Polly. Do you find it challenging to discuss mental health?

03:43

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No, I think this is one of the most underestimated and talked about topics in the community today. No, not at all. I think it's a conversation we need to have more of and people need to recognise it as part of life in today's busy schedule that we've all got a title.

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I feel comfortable discussing mental health. I think it's a very important topic and we should absolutely discuss it more.

04:09

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I find it a little bit confronting to discuss mental health, but I think it's an important conversation and one that I learn from, not at all being

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a psychologist as my background. That's my bread and butter, really?

04:24

S6

No, I think it's very important.

04:26

S1

Do you think the blind community in general is better at discussing mental health and the wider community?

04:31

S6

There's no difference. I think there's some people who are comfortable doing it and other people really struggle. I spoke to quite a few people during the pandemic who were really struggling and awful and really suffered. If you listen to Studio one Vision Australia Radio, you'll know I talk about mental health a lot. I've had my own struggles. I think it's important to talk about them and be open about them, certainly being British. It's one of the things we try and push under the carpet a little bit. But as I've grown older, I've learnt that talking about mental health issues can help other people be less daunted, open up and down to the friends, family, support workers or indeed medical professionals.

05:14

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The answer is no, because I've done a fair bit of study. I am doing a counselling diploma at the moment, and I also have done a lot of the vision in Australia, things around mental health and in my role, I need to discuss this with clients a bit.

05:33

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You're listening to nothing's off limits. We're tense and poorly produced by Vision Australia.

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Radio would now like to welcome our first guest, Courtney McKee. Courtney is a trained psychologist with lived experience of blindness and low vision. Courtney has worked for Vision Australia for 13 years and has some really fascinating insights around the impact that blindness and low vision can have on our mental health. Courtney, thanks for being here.

06:02

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Thanks for inviting me along, guys.

06:04

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Thanks so much, Courtney. Courtney, why don't we start by kind of rolling right back to the basics? And maybe you can help us understand what are some of the common symptoms of mental distress?

06:14

S5

Yeah, I think a really good place to begin is in talking about what being psychologically well is actually. So it's it's natural for us to experience ups and downs, the full gamut of human emotions and sometimes quite intensely. There's really no such thing as a wrong emotion. And when we experience emotion, it can be something that we feel. It often leads to us thinking in particular ways. It leads us to behave in certain ways and there is an impact on our body. So we have physiological symptoms of the emotions that we experience. But wellness is really about us being able to manage the ebbs and flows of those emotions, being aware of them, being able to express them in healthy ways and do what we call self-regulate when we're experiencing mental health issues. It's where we're getting stuck in a distressing emotion and that distress or the dysfunction that follows it. So that behavioral part tends to be consistent over time. So, for example, we might feel low for a couple of weeks, and that might come together with a couple of other symptoms, like a loss of pleasure in the activities we usually enjoy. We might have sleep disturbance. We might experience negative thinking that leads to a sense of hopelessness and that might be moving into territory that we would call a mood disorder like depression or anxiety. And that's where we might need to think about handling things a little bit differently.

07:47

S4

What are the key components around vision loss that can impact your mental health? Is there anything specific there, I guess, to be aware of?

07:55

S5

Yeah. So I would think about grief here because grief is a natural response to doing without something precious. So when, for example, we lose a loved one or we experience the end of something like a job or a relationship, we recognize that we will grieve in those situations. And in this case, where grieving for the loss of a sense, our vision and vision loss often includes what we call compounded losses. So when you are unable to stay, you're often unable to drive. You can't communicate nonverbally, like through eye contact. You can't use other kinds of sighted strategies that everybody else around you is using. And the way that you're perceived by others is different from the way that they would perceive, say, the average person on the street. So we grieve for all of these things. That's a part of being vision impaired and

08:50

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recognizing and dealing with grief. It's really a central component of your work with people who are blind or low vision, I think. Can you tell us a bit more about that?

08:58

S5

Yeah. So recognizing that you're grieving is about being aware and then getting on good terms with grief so that you can actually move through it so that you're not getting stuck like we were discussing earlier. And it's also about learning how to cope practically so being open to what's possible and learning the new skills associated with the life that you'll need as somebody who has a vision impairment, but you're also placing yourself around that emotional component as well. So you're adapting both emotionally and practically, and you're rebuilding your self-esteem, which is your relationship with yourself, as well as your self-efficacy, which is your ability to do what you want to do in the world.

09:40

S4

There's possibly an assumption that people who have lost their vision feel more grief than people who were born without it. Is that something you've noticed during your work?

09:50

S5

Well, certainly a difference between how people experience grief. So if you're new to vision loss, you experience acute grief. So we have those intense feelings and you're right at the beginning of your practical learning process as well. It's very confusing and painful, and it's really hard for somebody who's new to vision loss to not express someone. It's important that they do, whereas somebody whose long term vision impaired might be more practiced in their coping strategies both emotionally and practically. So they make it look easy, but it doesn't necessarily mean that it is so they're still doing without. They're still dealing with the losses that we talked about before because the world still set out this. Added People and most strategies, work arounds, that social construct of disability still impacts our everyday activities and how you perceived by other people. For example, when you're going for a job or how you perceived as a potential employee, how you're perceived as a partner or a parent. So I guess people who are long term vision impaired have learnt to carry their grief gracefully.

10:57

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How do you know if you're feeling grief? How can you identify that? What are the sort of things that the kind of a maybe, I guess, red flags? And how can you seek support for that?

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There are a number of different models of grief that you might think about, but a lot of them simply talk about experiencing intense emotions like anger, sometimes denial or a sense of numbness, low mood. And all of these things sort of oscillating with moments of acceptance. But I think if you are experiencing what we were talking about before with a period of low mood and stress or you have that as well as potentially some kinds of dysfunction in your practical coping, then that's a cue for you, maybe to reach out and get some support, potentially through your GP to have a conversation about your health, which includes your mental health and get a referral to a psychologist so that you can look at different strategies for managing that. But I'd also think about connecting with a rehab service. Maybe Vision and vision Australia is a good example of a holistic rehab service for people who are vision impaired, and then you can come on board with some practical skills. But there's also the opportunity to connect with other people are experiencing what you're going through, and that peer support is really important for things like normalizing your experience. So letting you know you're not on your own with that and validating what you're feeling if you're experiencing vision loss, often you're the only one among the people that you know who is. And so connecting with other people, even for a brief time. But get that in a way that you're the people around you may not is really important. But I can also show you different strategies that you can use, and that gives you more options which will help you adjust.

12:49

S4

How important, Courtney, would you say that acceptance is for people who are blind to have low vision?

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Let's say a human condition inevitably involves some discomfort and often where opting into that discomfort because we want to grow in some way so we might set a goal and then we'll work hard towards that. But even when we don't opt in, we can still grow. And the way that we do that is by choosing to stop resisting the discomfort and accept that it's part of life, and then we can commit to taking action to make meaning as well. So it's commitment therapy part of that. Can you tell us a little bit about that? Yeah. So acceptance and commitment therapy is about developing what we call psychological flexibility, and there's two parts to it. So it's the ability to be present psychologically, so open to the experience that you actually having. And second, it's your ability to control your behavior to act in accordance with your values. It works really well for people who are experiencing a loss like vision loss. But there are what we call psychological modalities that your psychologist might use with you, like mindfulness or problem-solving therapy, so you can really ask a psychologist to work with you in a way that fits your needs.

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S4

And Courtney, I mean, you mentioned earlier, a good place to start is going to your GP and they can refer you on to to what other health services are available and the best for you. But I just wondering, particularly if this isn't something you're comfortable talking about, it sounds like these feelings are incredibly common. What does that conversation go like? How do you start the conversation when you go to your GP and they usually start with, So how can I help you? What's your answer to that?

14:29

S5

Yeah, I think that's fine when you say, I just want to let you know a little bit about what's going on for me, and it can be things that are going on in your body. But it can also be things that are going on in your mind and your GP is very experienced at supporting their patients around those things. There's a particular pathway they can send you down. It's called a mental health treatment plan, and that's simply an acknowledgement of the fact that we all need some support from time to time, and it will enable the cost of the psychologist to be reduced or at no cost to you through bulk billing. And I also think it's good to have a backup in place. So even while you're waiting for your doctor, you should feel free to call services like Lifeline on 13 11 14 to get ad hoc counselling when you're feeling low. Because those connections that you make with somebody who's ready to be supportive to you can help move you through in a really constructive way.

15:26

S4

We've only skimmed the surface, but that's been really helpful hearing some of those, I guess how normal these things. And some of the things that we can do to to be proactive about them.

15:35

S5

Absolute pleasure.

15:36

S1

If this program has brought up any issues for you, please contact Lifeline on 13, 11, 14 or online at Lifeline dot org dot a--you. The suicide call back service is one 300 six five nine four six seven or online at Suicide Callback Service dot org. Today you there's beyondblue 1300 double two four six, three six and online and beyond blue dot org. Today, you know you're listening to Nothing's Off Limits with Tess and Polly. Did you know? Fish in Australia's peer to peer support program provides one on one support from a trained volunteer who is blind or has low vision and who can relate to your circumstances? If you'd like more information on this one, go to Vision Australia dot org or call 1800 eight four seven four double six. Visit Australia Blindness Low Vision Opportunity.

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Our next guest is Vickie Contreras. Vicki is one of Vision Australia's paediatric counsellors, and she works with young people and their families to overcome the challenges that blindness and low vision presents in their day to day lives. Vicki has been working with young people for 20 years, and she's a qualified family therapist and she has a voice you could listen to all day.

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Thanks, Wally.

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S3

You certainly do, Ricky. And how common are concerns about mental health?

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So mental health concerns are common, and just to get a sense of how common? In a report written by the Australian Institute of Health and Welfare and it was written in 2020, the statistics show that one in five Australians experience mental illness every year. Forty five per cent of Australian adults will be affected by mental illness at some time in their lives and for children. The statistics show that almost one in seven, which is approximately about 14 per cent of children and adolescents aged between 14 and 17 years, were assessed as experiencing mental health concerns. So that report was written in 2020 with COVID 19. I suspect the numbers are higher from your observations.

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What has been the impact of COVID 19 on the mental health of people who are blind or have low vision and their families from from your observations?

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So the pandemic itself has impacted people greatly, and I say this just from the children, young people and the families that I work with. For some people who are blind or have low vision, the experience of isolation and loneliness increased and therefore had a profound impact on their mental health. In fact, being isolated from one another is in contrast to our very human biology because we are profoundly social creatures. Research has repeatedly stressed that a sense of social connection is one of the fundamental human needs. On the other hand, though, surprisingly some children and young people found being homeschooled better than being at school for a number of reasons. One is because they got a break from being bullied at school, and another reason was their schoolwork was received online and it was inadvertently a lot more accessible and was completed without the added pressure that comes with having to complete set tasks in class within a certain time frame. So that's just a couple of examples. And unfortunately, I do believe the true impact may not be known for years to come because the impact does not only touch on mental health, but also a number of other interrelated domains.

19:03

S3

So do you have any strategies that you suggest to your clients who are dealing with those feelings of isolation that you mentioned before?

19:11

S5

Yeah. So it is beyond the scope to provide an extensive list of strategies. But first and foremost, I would like to read it, reiterate the importance of connection and talking things through with someone, whether it be a professional GP, psychologist or a counselor or a trusted friend or family member. And another strategy that has actually proven effective is mindfulness, particularly mindful breathing. And I must say I never knew the importance of breathing mindfully for mental health since I started doing it myself.

19:39

S3

Now, when it comes to blindness and low vision and the connection between that end and mental health in your experience, have you noticed a stigma around mental health in the blindness and low vision community?

19:54

S5

Yeah. So unfortunately, mental health itself is, I believe, still perceived to be a hot topic. So in other words, it's a topic that remains on discussable. And given that stigma is a social phenomenon that is greatly influenced by historical and cultural forces, people who are blind and have low vision continue to feel the stigma around mental health. Because we live in a society that heavily relies on traditional methods of communication, such as eye contact. And there seems to be a perception that our physical health needs are somehow disconnected from our mental health needs. I do believe, though, that we are improving at DESTEK. Rising mental health for all people and one way changing the language we use, and if I could, I'd like to read a recent quote from our royal commission into Victoria's mental health system. And this really resonated with me. And it says good mental health is about more than just the absence of mental illness. Mental wellbeing is a dynamic state of complete physical, mental, social and spiritual well-being in which a person can develop to their potential, cope with the stresses of life, work productively and creatively, build strong and positive relationships with others, and contribute to the community that they can.

21:06

S4

I you've said to me in the past, is that really important distinction between mental health or mental ill health and also mental illness and what the differences between those two things? And when you were mentioning about mindfulness as being something, you practice yourself, whether there's something proactive you can do to kind of boost your mental wellbeing.

21:25

S5

Yeah. So there is a difference between the terminology. So mental illness, it includes a range of conditions for which there are standard criteria used to diagnose them. So an example of that is depression, anxiety and substance use disorders. And they usually you have to go to a GP to get diagnosed and then to a psychologist or even a psychiatrist in some cases. So mental illness, it significantly affects how a person feels things behaves and interacts with other people. Whereas mental health is, is a state of well-being and is more about wellness rather than illness.

21:59

S3

So how important for mental health is it for people who are blind or have low vision to have support around them and not just the support of professionals is important as that is, but also the support of friends and family. What impact does that have on their mental health?

22:18

S5

So, so, so important. A main research shows that there are proven links between social connections and good mental health, and these proven links include lower rates of anxiety, depression, higher self-esteem, greater empathy and more trusting and cooperative relationships across the lifespan. And research also shows that having supportive people around you, that you have developed a strong and healthy relationship with can also help to strengthen your immune system, help you recover from disease, and may even lengthen your life. So having supportive networks and people around you, whether they're inclusive of friends, family, your community and like you said, Tess, even those professional supports around you are extremely important and you also

23:02

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work with families. And sometimes parents may not have expected their children to be blind or have location. So how important is it that parents of children who are blind or have vision, practice, self-care and what might

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that look like? Self-care, in my opinion, has become a word that's been used, reused and probably even overused that I get a sense it might have lost its meaning. So given we're doing I'm Nothing Off Limits podcast, I would like to propose a different way of thinking about self-care if that's OK. Fantastic. So firstly, what I'd like to do is reframe self-care as health care, because essentially self-care is health care. And secondly, I would like to propose a collective and systemic approach to self-care by expanding the meaning to incorporate the idea that wellbeing is a shared responsibility of a group rather than the lone task of an individual. Fast we act in a collective health care approach rather than us doing it individually.

24:04

S3

OK. So for parents with children who are blind or have low vision, what might that self-care or health care involve? What might they be able to do to also look out for them and to help, as well as the mental health of their children if if they're struggling?

24:18

S5

So for those who do want a more tangible self-care approach, I do have a YouTube on Vision Australia's YouTube channel, which is it's about developing a self-care plan before the family. So it's not just yourself, it's inclusive of family members as well. So take a look at that, but I actually would love if I can if we are to keep in mind the proposition that I've just said, and it's a collective health care approach to self-care. What do you guys think that would look like?

24:51

S4

Oh, I like that. As tables have been turned on us, I like that usually. I think for me, there'd be a communication component to it. I guess the thing about mental wellbeing or whatever kind of terminology you want to use is one of the challenges is the isolation and how you have that conversation and also how you alert to how someone else is feeling. So kind of making the conversation, I'd like the conversation to be more every day. So not kind of a how are you feeling to result in questions around my legs better? Thanks. You know, my my headaches gone. She should be more about kind of where are you on an emotional level? Where are you kind of feeling, as we'd say, back home in yourself, but that to be an everyday? Information for people to be able to check in and express when they're not feeling great.

25:34

S5

How about you, Tess?

25:35

S3

I agree. I think communication is so important. I also think having access to information and not just information that you can Google, but professional health care information about where you can go, who you can talk to, because you know, it particularly may be for people who might be a bit isolated, particularly in COVID 19. It can be. It can be difficult that in the past where they may have had had lots of time to to spend time with people who may have been there before or to join support groups. I mean, they can still do that online. But having the right information is so important, I think. And Vicki, it's just been such a such a joy for us to chat to you about. This is so informative at just such a wealth of knowledge. Thank you for being here.

26:20

S5

Thank you so much, Tess, and thank you to you, Polly, too.

26:23

S4

Thanks so much, Vicki. Make sure to put a link to that YouTube video. I've watched it myself, and it's absolutely wonderful, so that will be an amazing resource.

26:30

S5

Thank you. Thank you.

26:32

S1

If this program has brought up any issues for you, please contact Lifeline on 13, 11, 14 or online at Lifeline dot org dot AEW. The suicide call back service is one 300 six five nine four six seven or online at Suicide Call Back Service dot org. Today you there's beyondblue 1300 double two four six three six and online and beyond blue dot org. Today you.

27:01

S5

We've only just started the conversation about mental health. Please don't let it be the end of the conversation. There's a lot of useful resources and information you can find on the Vision Australia website. Just go to Vision Australia dot org. That's Vision Australia dot org. One of the resources that you can

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find is a really useful webinar, a check in and

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chat webinar featuring one of Vision Australia's psychologists

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talking about managing anxiety in times of uncertainty.

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Next time, we'll be talking about personal care and chatting with some great guests about everything from menstruation to using public toilets. So thank you again to our guests, and thank you for joining us for the show where nothing's off limits.

27:48

S1

That was nothing's off limits. Made with the support of Vision Australia and the NDIS information linkages and capacity building grant. Learn more about our radio and podcast offerings by visiting VOA Radio, dot org and access all there is to know about our range of client services via our website. Vision Australia dot org. We thank everyone who participated in this episode, but especially you for listening today. We rely on your support, so please share this podcast with just one person today and brighten our day or rate us on your preferred podcast platform. Bye for now.