Child Study Center Grand Rounds 10.13.2020

March 22, 2021

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The Wounded Healer Harnessing the Power of the Performing Arts and Storytelling to Challenge Mental Health Related Stigma

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00:02Weeks grand rounds.
00:03Before I introduce today's speaker who I'm
00:06absolutely delighted to be welcoming today,
00:09let me say a word about next week's
00:11grand rounds when Christina Cipriano,
00:14from the ruler program and from the
00:16Yale Center for Emotional Intelligence
00:18will be here to talk to us about the
00:22hundreds of millions of thousands
00:24of teachers of their training and
00:27how they're going global and all
00:29sorts of exciting things happening.
00:32Across the street.
00:33But today we are also very global and
00:36I am absolutely delighted that we have
00:39a dear friend close collaborator,
00:42someone who I admire deeply.
00:45Coming today to share in grand rounds.
00:49Um Achmed Hank.
00:50Here you will learn a lot about
00:52who he is from his talk.
00:54But what I can tell you is that I
00:57met Achmed because of our shared
00:59interest in mental health stigma,
01:01an area that he knows and has
01:04published widely about.
01:06And we learn about each other's work.
01:09We made one of these zoom calls
01:12that usually lead to nothing.
01:14Ann Boy has had led to a lot.
01:18We found that were really kindred
01:20spirits in many ways and we have
01:23brought a very exciting group of
01:25collaborators with Ashley Clayton
01:27and Julie Chilton in Amanda Calhoun
01:29and others who are here today.
01:33As you will learn, Achmed is a psychiatrist.
01:36He is almost perfect,
01:37but not quite because he's not
01:39a child psychiatrist.
01:41Although at the rate I'm going,
01:43hopefully I'll change his mind.
01:45But he's a psychiatrist working at Kings,
01:48Kings College, London,
01:50where he is a very busy clinician.
01:54And here's an extraordinarily gifted teacher.
01:56Among other things,
01:57he has been awarded the UK's
02:00highest awards in teaching,
02:01and I'm not talking about Southwestern
02:04Central Northeastern quarter of England.
02:06I'm talking about the whole thing.
02:09Uh,
02:09and he'll tell us about it and I'm going
02:12to be quiet now and let me take it away.
02:15By the way,
02:16I had emailed you all letting you
02:17know that today we were starting
02:19the CME credit business,
02:21but we're going to do that next week.
02:23So today we're in business as
02:25usual and stay tuned and thank
02:26you Ro for organizing that.
02:28It will be very easy for those
02:30of you who can and want to claim.
02:33CME credits to do that starting next week,
02:37but today we go International
02:39an I give you from Beirut,
02:42Lebanon to London, UK.
02:45My dear friend.
02:47Achmed here take it away buddy.
02:51Thank
02:51you, thank you so much, Andreas.
02:54Happy be an Arabic we say
02:58difficult to translate that word.
03:01It's a huge pleasure and
03:04privilege to deliver this ground
03:07round from Merry Old England.
03:18So here goes.
03:21Here goes some of you may be disengaged.
03:30And. If you were thinking this.
03:34You better think again.
03:40The path of the righteous man is beset
03:43on all sides by the inequities of the
03:46selfish and the tyranny of evil men.
03:49Now blessed is he who in the name of
03:52charity and Goodwill Shepherds the weak
03:54through the Valley of the darkness,
03:57for he is truly his brother's keeper
04:00and the Finder of lost children.
04:02And I was struck down upon thee with
04:05great vengeance and furious anger,
04:08poison and destroy my brother.
04:10But you will know. Try on the low.
04:13When they made Dungeon Suppon V.
04:16I've got one thing to say.
04:21King Kong ain't got **** on me.
04:25Are you still disengaged?
04:27I like to think there's
04:30some method in my madness.
04:35Greetings, it's evening here in in London,
04:39so. Good evening, if you're in the UK and
04:45good afternoon if you are across the pond.
04:49So the aims of this presentation I
04:53want to demonstrate the colossal
04:55power of the performing arts and
04:59storytelling in healthcare and education.
05:02I want to highlight the epidemic
05:05of psychological problems in health
05:07care professionals and students.
05:09Discuss and describe the role that experts,
05:12by personal and professional experience,
05:15play in reducing mental health
05:17related stigma.
05:18And I'll provide you with some
05:21information about what I mean by EP.
05:24P is a gnomonic that we coined.
05:29And I'm going to present some data from
05:32pilot studies on increasing interest in
05:35psychiatry as a career and challenging
05:38stigma in healthcare providers and students.
05:41Now there is a disclaimer alert.
05:46In this presentation performance
05:47I will be identifying them,
05:49edits of auto, biographical,
05:50narrative and so by definition I
05:52will be making reference to myself in
05:54my own autobiographical narrative.
05:56I hope you don't mind.
05:58I'm very proud of the goals that
06:00I've achieved in my life.
06:02I want to thank you all for
06:04providing me with this platform.
06:07To share my experiences with you.
06:09Now I will state no claim in being master
06:12of the phenomenon that has afflicted me.
06:14If, in the event you experience psychological
06:17distress in any of its many forms,
06:19the best recourse is to
06:21see your family Doctor Ann,
06:22Sir William Osler said that the physician who
06:25doctors himself has a fool for the patient,
06:27not the best person to assess
06:29your own mental health.
06:31So I really want to emphasize that point.
06:33Please do see your family doctor.
06:36In the first instance,
06:37now my talk will be making reference
06:39to intense experiences in my life,
06:42which may or may not evoke
06:44uncomfortable feelings and emotions,
06:45and that's not necessarily a bad thing,
06:48Carlyon said.
06:48Everything that I'm going to say
06:50about other people can lead us to a
06:53better understanding of ourselves.
06:54Just in case you find my performance irksome.
06:58And Lastly,
06:59on apologetically,
07:00it's going to be dramatic,
07:02which is so much fun for me and
07:05I really hope you enjoy it too.
07:12So it is our contention that we can harness
07:15the colossal power of the performing
07:18arts and storytelling to entertain
07:21and engage people and once engaged,
07:23inspire them to deconstruct and
07:26reformulate perceptions of mental illness
07:28and psychiatry not based on myth,
07:30not based on sensationalism,
07:32but based on the facts and on evidence
07:36the rifle man, pedicle research and
07:38the argument we make is how can you.
07:42Educate an audience.
07:43If you can't engage them.
07:45So what is mental health? Simply pots,
07:49there is no health without mental health.
07:52Mental health influences how we feel,
07:55think, talk and behave.
07:56It influences our mood,
07:58our memory, our motivation.
08:00Our modus operandi.
08:01We are utterly beholden to the
08:04power and mercy of our minds.
08:07Now people who experience.
08:09Mental health difficulties often
08:11suffer and struggle terribly.
08:13So much so that our suffering and
08:17struggling can drive us to ending that
08:21which is most precious human life itself.
08:25We know that every 40 seconds,
08:27someone somewhere out there,
08:29dies by suicide and suicide is the biggest
08:33killer of people under 35 in the UK.
08:37To emphasize,
08:38mental illness is a factor that
08:41contributes to suicidal behaviors.
08:43Yet many mental illnesses are preventable.
08:46People are dying.
08:48And this simply can't continue.
08:50That's why I'm outraged.
08:51That's why I'm indignant that's
08:52why there's a fire burning in my
08:54belly and Thunder in my heart.
08:56Now was at the time to be quiet.
08:59Granted, my approach is not conventional,
09:02but I make no apologies for not
09:06conforming with the status quo.
09:08We must disrupt rock the boat,
09:11be audacious, be tenacious,
09:13be an agent of social change.
09:15We invite you to join our Cultural
09:18revolution to erase the stigma
09:20attached to mental health problems,
09:23a cultural revolution that is
09:26gaining global momentum and traction.
09:29Now this is my tribute.
09:31Tonight's move,
09:32thinking the gauntlet has been thrown.
09:35Try and trace the threat in my
09:39train of thought it be well ours
09:42is a world of metaphor, intrigue.
09:45Fantasy and deceit.
09:47What is next move thinking?
09:50What does Knights making it
09:52will come back to that.
09:53Now my presentation isn't going
09:55to delve into the neurobiology
09:58and neuroscience of profound.
10:00Oscillations and mood because
10:02to be honest with you,
10:04I think that's really boring and I
10:06don't want you all to be snoring.
10:09What I want to do is demonstrate
10:11what night smooth thinking is in the
10:14context of an artistic temperament
10:16that is a seductive notion.
10:18Controversial and contentious,
10:19though it may be that there is an
10:22Association between craziness and creativity.
10:24I also want to provide you with an
10:27insight into what I call drama therapy.
10:30The performing arts.
10:31Who needs psychotropic medication
10:32when I can deliver this performance
10:35every now and then?
10:39Tonight's new thinking You're playing
10:41chess and your adversary claims
10:43your Queen with his or her night.
10:45You're thinking ***?
10:46I never saw that movement coming.
10:48My thinking in psychiatry is a thought
10:50disorder characterized by discourse,
10:52consisting of a sequence of
10:54unrelated or remotely related ideas.
10:57Nancy andreasen argues that,
10:59in the context of creativity,
11:02likely thinking is not a
11:04hallmark of mental illness,
11:06but rather can be used synonymously
11:08with lateral thinking.
11:09And it reminded me of this quote by Dryden.
11:13He said that great widths are
11:15shorter madness near allied and thin
11:18partition to their bones divide.
11:20There's a very fancy way of saying there
11:23is a fine line between what is same.
11:27When was insane,
11:29when is someone creative?
11:31When as someone crazy when is someone
11:35determined and when is someone obsessed?
11:39Moreover, who has the authority to draw that?
11:44SoC. Politicians.
11:46Potos, Boris Johnson or Bojo
11:50as we called him these days.
11:54If you're in Damascus, you don't have to.
11:58Satisfy the criteria outlined by ICD or DSM.
12:02If you oppose the regime.
12:05They will detain your ***.
12:06That's something just for you to reflect on.
12:10So I'm going to out stretch my hand
12:12and I dare you want to reach out and
12:14grasp it if you so will allow me to
12:17transport you to a different time and place.
12:20Of course there is a caveat before we embark
12:23on this Odyssey to Oblivion and beyond.
12:25You might want to fasten your
12:27seatbelts ladies and gents,
12:29because night new thinking is a bumpy ride.
12:32Its 7th century AD and we're in the
12:34Bazaar in the Arabian Peninsula.
12:36Merchants have traveled from
12:37far and wide to barter,
12:39frankincense and felt the
12:41marketplace is heaving with people.
12:42But wait just one moment there's
12:45some commotion in the corner the
12:47public had taken to the pulpit.
12:49But I had and what are the powers happened.
12:52Hawkins house where verse
12:54and prose are likely put,
12:55the slaughter and the bread
12:57are swear over there.
12:58It's in the water, open his face,
13:00open his face to lovers of poetry.
13:03Andreas Martin Willing and
13:07rich patron of the arts.
13:11When Andreas Martin invite
13:12the power tender Doors,
13:13catalog is kinda where wines and cakes
13:15around the skills approach upon or represent.
13:17Those songs begin whenever they're
13:19smart and invites the poet in.
13:22True that. Man, free thinker.
13:27Do you imagine you alone think in this world
13:31where life is blazing forth and all things?
13:35You are free to avail yourself
13:36of the forces you command,
13:37but the universe has gone
13:39missing from your prescriptions.
13:40Once Upon a midnight dreary,
13:42while I pondered weak and
13:43really over many acquaint,
13:45incurious volume of forgotten lore.
13:46While I'm not going up,
13:48and suddenly there came a
13:50tapping on my chamber door.
13:52Only there's nothing more, oh.
13:55So you think the darkness is your ally?
13:59You merely adopted the dark.
14:00I was born in it,
14:01molded by it.
14:02I didn't see the light until I
14:03was already a man, but then it was
14:05nothing but lying to me who started
14:07betray you because they belong to me.
14:12Let me tell you something Merriam.
14:15About a man's home.
14:19There is a ratchet. Ratcheting it
14:20doesn't like your mother's womb.
14:22It won't bleed and not
14:23stretched to make room for you.
14:25Remember that medium? I have seen
14:29things you people wouldn't believe.
14:32Attack ships on fire.
14:34Off the shoulder of Orion I was feeding
14:36glitter in the dark near the Tannhauser gate.
14:39All those moments will disappear like these.
14:42Tears. In the rain.
14:47Time to die.
14:49Nice move thinking ladies and
14:50gents in the context of an artistic
14:53temperament and an insight into
14:54what I call drama therapy and
14:56I'm hoping now you understand why
14:59there is no need for psychotropic
15:00medication because that is so
15:02deeply empowering therapeutic.
15:03Anything cathartic.
15:04Moving swiftly on.
15:08As many of us know, it ain't easy being.
15:13A medical student, so a systematic
15:16review and meta analysis on the
15:19mental health of medical students.
15:22Published in JAMA 2016 revealed
15:24that 27% of the 150,000 respondents
15:27reported depressive symptoms and 11%
15:30experienced suicidal ideations It's true.
15:35Doctors are human too.
15:39So Kate Center felt and colleagues
15:42published a paper in The Lancet
15:44in 2016 documenting that position,
15:47burnout, and emotional exhaustion have
15:49reached epidemic levels and globally.
15:52The pooled prevalence of depressive
15:54symptoms in positions is 29%,
15:56which is greater than the general population.
16:02Now, this systematic review
16:04revealed that the physician suicide
16:06rate is 28 to 40 per 100,000,
16:09which is more than double that
16:11in the general population,
16:13and we know that 400 positions
16:16die by suicide in the US. Along.
16:19This is a crisis situation.
16:22And this was even before COVID-19.
16:26This is my colleague, Doctor Davey,
16:29and she's the lead for Workforce well
16:31being at the College of Psychiatrists.
16:34She said not only are medical
16:37professionals at higher risk of
16:39suicide than the general population,
16:41but they are disproportionately suffering
16:43from the stigma of seeking help.
16:48Now a survey. Of over 2100 female positions
16:51who met the diagnostic criteria for mental
16:55disorder revealed that 50% was reluctant
16:58to seek professional help because of
17:01fear of exposure to stigmatization.
17:04I have to repeat that to emphasize.
17:0850% of female positions who met the
17:11diagnostic criteria for mental disorder
17:13were reluctant to seek professional help
17:17because of fear of stigmatization Zacks
17:20is an abomination in my experience,
17:22in my opinion, in my humble opinion.
17:25Now we have 3.
17:27Broad approaches to mental health.
17:30We have what you call a proactive approach.
17:33Prevention is better than intervention
17:34and developing mental health,
17:36resilience help healthy mind, for example.
17:38So that's a proactive approach.
17:40A reactive approach is once you've
17:42developed psychological problems,
17:43then you seek support from a counselor.
17:46For example,
17:47if your medical student on campus so that
17:50so reactive approach the third approach.
17:53Is instigating systemic change challenging
17:56that culture of shame and the stigma
18:01that permeates the medical profession?
18:04Now, stigma has been defined by Goffman
18:07as a deeply discrediting attribute that
18:09reduces their better from a Holden usual
18:13person to attainted and discounted one,
18:16the individualist bus disqualified
18:17from full social acceptance,
18:19so it is a deeply discrediting attribute.
18:22What is that attribute?
18:24Well, there's a phenom.
18:25There's a phenomenon known
18:27as intersectionality,
18:28and you have multiple deeply
18:30discrediting actually.
18:31But it's like layer upon layer upon layer.
18:35Of disadvantage,
18:35for example,
18:36you could be from an ethnic minority
18:39backgrounds and we use the acronym in the UK,
18:42BAME, Black,
18:42Asian and minority ethnic background.
18:44So that's the deeply discrediting
18:46attribute you could be a Muslim,
18:48and we know that Islamophobia is a
18:51growing problem in all of this kind of
18:53toxic rhetoric that's being espoused
18:55by populists and isolationists.
18:57And you could have mental owners.
18:59So if you're a Muslim man from a
19:02minority background with mental illness,
19:04you experience the triple stigma.
19:06The triple whammy and outcomes are,
19:09unsurprisingly, poor in backroom.
19:13Now, historically,
19:13a stigma was a scar from a burn or cut
19:17to the skin of Greek criminals or traitors.
19:20The mutilation was a sign of disgrace,
19:23indicating that these people
19:25should be avoided and shunned.
19:27Stigma still persist today in
19:29the attitudes towards those who
19:30have mental health difficulties.
19:32We see a fundamental divide between
19:35the manic mine and the automatic,
19:37long as if those who experience mental
19:40health problems do so out of there.
19:43Own making and as such the doctors
19:45are of the same kind of empathy we
19:47would ordinarily show to someone
19:48with a chronic condition like cancer,
19:51for example, this is. Trisha Goddard.
19:53She is the equivalent of Jerry
19:55Springer in the US and she was
19:58diagnosed with both breasts.
20:00Cancer and depression.
20:01She described both experiences as horrible,
20:04but with breast cancer.
20:06People run towards her with open
20:08arms and hugged her with depression.
20:11People run away.
20:12The moment she was diagnosed
20:15with breast cancer,
20:17she was inundated with get well soon cards.
20:21But when news leaked out that
20:24she was admitted into
20:26a psychiatric hospital following
20:28a nervous breakdown, not a peep,
20:32and certainly no cards. Stigma.
20:38Stigma. And a culture of same
20:40are formidable barriers to mental
20:41health services and consequently
20:43many people with mental health
20:45difficulties continue to suffer in
20:47silence despite the availability
20:49of effective treatments by repeat.
20:52Stigma and a culture of shame or
20:54formidable barriers to mental health
20:56services and consequently many people
20:57with mental health difficulties
20:59continue to suffer in silence despite
21:01the availability protective treatment.
21:03That's what keeps me up at night.
21:05That is outrageous.
21:06If that was physical health,
21:08then there would be a fury.
21:10That's the disparity of a theme
21:13that we have to address.
21:15This is Doctor Myles Christiane.
21:16He was terrified that he would lose
21:19his job if he talked openly and
21:21honestly about his mental health
21:23and he tragically died by suicide.
21:25This happened in October 2019.
21:27This isn't like a thing of the past.
21:30And his brother said there is a stigma
21:33surrounding doctors and mental health.
21:34And that's why I speak with urgency.
21:36That's why I speak with indignation.
21:37That is why I'm outraged.
21:40This is Doctor Doctor Hanson.
21:42C was a brilliant psychiatrist with
21:44bipolar affective disorder in London.
21:47ANSI tragically killed herself and
21:49her three month old baby daughter,
21:51Freya,
21:52during a psychotic episode she
21:55doused with kerosene and settler.
21:57An independent inquiry into her
21:59death concluded that she was the
22:01victim of stigma in the National
22:03Health Service Mental Health related
22:04stigma is rampant in the ender chest,
22:07but there's one take home message.
22:09Let it be this one.
22:11That stigma is killing people.
22:14Stigma is killing people.
22:20Sources of stigma.
22:21The 2008 Mile Survey of 4000 people
22:23using mental health service and tears
22:25revealed that health care professionals
22:27with a common source of stigma reported
22:30by people with mental illness and
22:32which medical specialty was one of
22:34the most stigmatising psychiatry.
22:38Sucking a physician bias has
22:40been reported in the literature
22:41whereby healthcare professionals,
22:43especially psychiatrists,
22:44tend to have more negative views about
22:46the recovery of people with mental
22:48illness compared to the general population.
22:51This is something known as the position bias.
22:55And I argue that mental health stigma
22:57is like mental illness in the sense that
22:59those who suffer from it or in denial.
23:02So I will share an anecdote with you.
23:04I delivered the Woon,
23:05did healer as a grand rounds in an
23:08Ivy League University and after my
23:10performance it was being recorded.
23:11The cameraman's assistant.
23:12No background in mental health, no training.
23:14He ran towards me and he embraced
23:17me and he said thank you brother.
23:19Then I met the head of the Department
23:22of Psychiatry.
23:23When I entered his office and
23:25opened my mouth,
23:26his face contorted as if I was about to
23:29contaminate him with some costly disease.
23:32He was disgusted by me.
23:34And if I'm in a mental health crisis,
23:36am I going to go to the self
23:38proclaimed expert in mental health
23:40who likes to isolate himself and
23:41lock the confines of ivory tower?
23:43What am I going to go to?
23:44the Commons assistant?
23:46Because that time with Amanda's
23:48assistant made me feel dignified.
23:49He didn't make me feel judged and just
23:51because I have lived experience living
23:53experience of mental health difficulties.
23:55It doesn't mean that I'm not a potential
23:57source of mental health related stigma.
24:00We have to be brutally honest with ourselves,
24:02engage in introspection and
24:04remove any stigma that might be.
24:06Uh,
24:06lingering inside you.
24:11Now, stigma is an umbrella term that can
24:14be deconstructed into three components.
24:17Now this is important when you
24:19want to operationalize stigma and
24:21evaluate anti stigma campaigns,
24:23so problems of knowledge, ignorance,
24:25problems of attitude, packages and
24:27problems of behavior discrimination,
24:28and there are validated psychometric stigma
24:32scales in all three of those domains.
24:35How do we challenge stigma?
24:37There are three broad approaches protest.
24:41Education.
24:43And come in contact social contact.
24:47Now Patrick Corrigan.
24:48I mean the the Titans in mental health,
24:51stigma and research on mental health,
24:53Sigma Patrick Gordon,
24:54Chicago professor, claimed.
24:55Phonographs at the Institute of Psychiatry,
24:57Psychology and Neuroscience
24:58and at Kings College, London.
25:00Now, Patrick Corrigan conducted
25:01a systematic review and meta
25:03analysis on challenging the public
25:05stigma of mental illness,
25:06and he concluded the most effective
25:08way of reducing mental health related
25:10stigma is when you make contact
25:12with someone who has recovered
25:14from mental health difficulties.
25:16Why?
25:16Because?
25:16We have these preconceptions of people
25:18have mental health difficulties,
25:20but when we meet them,
25:22we discover that these people
25:24have hopes and fears and dreams
25:26and vulnerabilities like everyone
25:28else that we are human beings.
25:31And supported Carbon argues that experts
25:34by experience must operate at the
25:37Vanguard of any anti stigma campaign.
25:40The evidence is clear.
25:42How do we react? The public stigma.
25:45We internalize it with.
25:46We develop diminished self
25:48esteem and self efficacy.
25:50Some of us we don't care.
25:53You know we are non shalant
25:55Stillwater and there's a third group.
25:57I don't think it's any surprise
25:59which group I belong to.
26:01You develop what you call a alright.
26:03She was indignation you will energize
26:05you want to be the agent of social
26:09change you want to contribute
26:10to that cultural revolution.
26:13So many people with mental illness
26:15often have to choose between
26:16concealment and disclosure and
26:18will come back to the terms.
26:20'cause I'm just quoting the
26:21author of this article verbatim,
26:23but that term I have qualms with
26:26and I'll elaborate as to why I do.
26:29Now coming out proud,
26:30it used to be called cop.
26:33Now was called hop the honest Open
26:35Empowered Program offers support
26:36with making this difficult decision.
26:39Now a an RCT on COP,
26:41published in BJ's site the position
26:43of Psychiatry revealed that it had
26:45immediate positive effects on disclosure.
26:47Again,
26:48a term that we load and Sigma
26:51stress related variables.
26:53So this is a manual.
26:55That was Co produced by Patrick
26:57Corrigan in Chicago and my friend
26:59at University College London.
27:00Katrina Ski or and it's a self help
27:02guide for mental health professionals.
27:04OK,
27:05so I have decided to embrace my
27:07vulnerability and to be honest and
27:08open about my living experiences
27:10of mental health difficulties.
27:12But far be it from me to impose
27:14my approach in anyone.
27:15It is a personal choice and so
27:18let's say you do want to share and
27:20this is the term that we prefer.
27:22Both mean Andreas prefer this time
27:24because why because disclosure?
27:26It has kind of criminal connotations.
27:27You disclose a forensic history,
27:29but there's nothing criminal
27:30about having mental owns,
27:31so you might decide to share.
27:33And if you do this, this is a very
27:35helpful manual because it gives you
27:37guidance on how much you share and what
27:39do you share and who do you share too.
27:42So there was that that line
27:43from the poem by Dylan Thomas.
27:45Do not go gentle into that good night,
27:47but rage Rage Against the dying of
27:49the light and it's the digital age,
27:51so I've kind of tweaked the words.
27:53Do not go gentle into that good night.
27:56But tweet,
27:56tweet against the dying of the light.
27:58So I I I do a lot of setting on Twitter
28:01and I'm very fortunate I have a.
28:03I have many connections and there's an
28:05online community that I feel are very
28:07supportive towards me and so sharing on
28:09that forum has for me been beneficial.
28:11But obviously we're not oblivious to the
28:13fact that there are plenty of trolls,
28:14so you have to kind of way
28:16up the pros and cons.
28:18And that's the great thing about this manual.
28:22There is Harry going around,
28:24breaking young girls hearts.
28:25Prince Harry I think is in California
28:28right and he was honest and open about
28:30his psychological problems precipitated by
28:32the death of his brother Princess Diana.
28:37And Prince Harry is an expert
28:39by living experiences.
28:40The quote Prince Harry himself.
28:42He said that with regards to his mental
28:44health to requires constant management.
28:47He takes mental health one day at
28:49a time and hence he's an expert by
28:52living experience as opposed to lived
28:54experience because lived with this kind
28:57of there's a sense of finality with lived,
29:00whereas living it's kind
29:02of ongoing right and.
29:04Mental health charities in the UK report
29:06that following the Royals or Revelation,
29:08there was a surge in the number of
29:10people who contacted their helpline.
29:12One of the biggest rental properties
29:14in UK is mind and they said there
29:17was a 38% increase.
29:18So by being honest and open
29:21we can reduce public stigma.
29:23Here we have. Sean Sir John Curvin,
29:27accidentally known as JK,
29:29and he was a winger for the All Blacks.
29:33The national rugby team in New Zealand.
29:36This small nations like 5,000,000 but
29:39they have dominated rugby for decades.
29:42And there is this.
29:43There is this bravado.
29:44Isn't there like a man should
29:47not express his emotions?
29:48And is there any wonder that the male to
29:51female suicide ratio was three to one?
29:54If this kind of this kind of masculinity
29:57is kind of flourishing in our world,
30:00so.
30:00Men are not able to express their
30:02emotions and a man should certainly not cry.
30:05But is that true?
30:07So he might not be a member of
30:09the Royal family,
30:11but the Kiwis revered him as such
30:13and he collaborated with the
30:15governmental campaign in New Zealand
30:17like minds like mine using it.
30:19All world leaders at reducing
30:21mental health related stigma.
30:23And in this autobiographical narrative,
30:24he talks about his living experience
30:27with major depressive disorder,
30:28and this campaign was associated
30:30with reductions in public stigma.
30:32The point I'm emphasizing is that by
30:34being honest and open, we can reduce.
30:37A mental health related stigma,
30:40public and and self stigma as well.
30:43OK moving.
30:45So the health humanities has been
30:49described as the application of
30:52art and literature to medicine.
30:55This is one of my favorite
30:57books ever by oral ***.
30:58And he emphatically exclaimed in his
31:00previous that in order to restore
31:02the human subject at the center,
31:04the suffering afflicted fighting human
31:05subject, we have to deepen a case
31:08history into a narrative or tail.
31:10What is the suffering behind this symptom?
31:12What is your story?
31:13What is your tale of woe?
31:15Tammy, what does your tale of happiness?
31:17What is your recovery journey?
31:19We need to share our stories.
31:22Yes, Carla. So, Carl young.
31:27He used the archetypal dynamic.
31:28The Woon did,
31:29healer to describe a phenomenon that
31:31may take place in the relationship
31:33between analysts under the Sun and
31:35Young discovered the Woon did healer,
31:37archetype, relation to himself.
31:39He he was able to identify
31:41with that kind of archetype.
31:43The Woon did, he said.
31:46In essence,
31:46he said,
31:47the deeper your wounds the better a woon.
31:49Did healer you are,
31:50but the better the healer you are.
31:52But I really want to emphasize
31:53you don't have to have lived the
31:55living experience of psychological
31:56problems to be empathetic.
31:57Of course not.
31:58I'm just saying that having lived in
32:00living experiences of mental health
32:02difficulties is not entirely disadvantageous.
32:05I would argue,
32:06On the contrary,
32:07that is actually advantageous,
32:08and I'll explain later on.
32:10So this is an award winning essay
32:12from Doctor Clare Polkinghorne
32:13entitled Doctors Gone Mad Too.
32:15And I'm going to read it out to you verbatim.
32:19As a psychiatrist.
32:20I had hoped that I was pretty good
32:23at empathizing with my patience.
32:25However,
32:25the last nine months of my life had
32:28taught me more about mental illness.
32:30Then years of clinics,
32:32Ward rounds, home visits,
32:33or reading the psychiatric literature.
32:35So Doctor Polkinghorn was diagnosed
32:37with major depressive disorder and she
32:40was detained under the Mental Health
32:42Act and spent several months on a
32:44psychiatric Ward in an NHS hospital.
32:46Now if you read.
32:49The auto biographical narratives of
32:51doctors who have living experience
32:53of mental health difficulties a
32:55motive or a recurrent theme is that
32:58we have become more insightful that
33:00we have become more driven and that
33:03we have become more empathetic
33:05and without a doubt without a
33:07doubt my living experiences of
33:09mental health difficulties have
33:11not only made me a better doctor.
33:13They have made me a better human being.
33:20So this is the moment
33:22you've all been waiting for.
33:24Biographical narrative.
33:24I would say that because I have kind of
33:27self aggrandizing kind of tendencies,
33:29it's work in progress.
33:30I have a twin brother where
33:31monozygotic Twins number here.
33:33He looks like he dresses like me.
33:35Might be the next best thing,
33:37but it's not quite not quite me.
33:39Something happened in utero himself
33:41facing I'm self aggrandizing but
33:43it's work in progress so this is me.
33:4517 years old in Beirut International
33:47Airport and I have to say goodbye to my
33:49family because the situation in Lebanon.
33:51But then the situation level now even.
33:54It wasn't great.
33:55I mean in Lebanon, for example,
33:5870% of the population are
34:00experiencing poverty.
34:01So.
34:04Can it make sense?
34:06Just go to the UK?
34:07There will be more opportunities.
34:10I'm over there for you.
34:12It's not easy. It's not easy.
34:14Saying goodbye to your to your family.
34:16It's extremely difficult,
34:17but I didn't really have a choice.
34:19And actually, I stumbled upon this picture
34:21recently and I think it might betray.
34:24Maybe how innocence naive I was, but I
34:26think also maybe how pure I was as well.
34:30Back then, when I had a blank soul
34:32and I won't go into that, but.
34:34We arrived in England with high
34:37hopes of a better future and I
34:40thought that the academic community
34:42would embrace me that I would
34:45just walk into medical school.
34:47The reality was different.
34:49I was a janitor.
34:51Cleaning floors in the morning and
34:53a stock advisor stacking shelves
34:55during the day and I was working
34:57sixty 7080 hours per week on
34:59minimum wage just to put a roof over
35:02my head and food in my stomach.
35:04I was 17 years old.
35:06My mind was still maturing.
35:08My brain was still developing.
35:09My heart was still expanding.
35:12And I thought, lonely,
35:14I felt afraid, I thought isolated,
35:17however.
35:17I was aware that I was given this
35:20decent shot at life because in the
35:22UK education is the birthright and
35:24I would be ****** if I squandered
35:26that Golden shot at life.
35:28I just had to stay focused and work
35:30hard so the following year I enrolled
35:32into a sixth form college and I
35:34continue to work full time hours
35:35to sustain myself to stay alive.
35:37And I spoke to the head of the Sixth Form,
35:40which is kind of like a premed
35:42equivalent to the US and she asked
35:44me what do you want to study at
35:46University I said I want to study medicine.
35:48She laughed at my face.
35:50And we didn't have to say it
35:52in so many words,
35:53but she made me feel I was this dirty
35:55little immigrant with delusions of grandeur.
35:58Your name is Ahmad that
35:59is your station in SoC.
36:00You will never get into medical school.
36:02Choose something else is too
36:04competitive and I you know you
36:06know Lebanese people right?
36:07And you can see we're quite kind
36:09of confident with quite gregarius
36:10and outgoing and extrovert but
36:11whenever he was walking opposite
36:13directions in the corridor,
36:14her pride was so palpable that my
36:17gaze would be fixed on the floor.
36:19But something astonishing happened on
36:21the day that the results were announced.
36:23There was a role reversal,
36:25and her gaze was fixed in the floor
36:27and despite being in full time
36:29employment to keep a roof over my
36:32head and food in my stomach and to survive,
36:34I received straight A grades.
36:36And so I was.
36:37I know there's a quote vision without the
36:39ability to execute is merely a hallucination,
36:42but I had that ability to execute.
36:44I was determined and I matriculate
36:46into Manchester Medical School,
36:48and life was like a song.
36:50Open till.
36:531006
36:54A warning to discover that my hometown
36:57in Lebanon was bombed and that hundreds
36:59of people were killed overnight.
37:01My nightmare turned into a reality.
37:04My world turned upside down.
37:05I saw harrowing and horrific images of
37:08dead bodies tune on the streets of Lebanon,
37:11and I feared that my family
37:13were among the dead.
37:15I couldn't through to them.
37:17Unbeknown to me, they were activated
37:19by the British Government,
37:21but I thought I thought they
37:23were killed and so I reacted.
37:25I developed a severe episode
37:26of psychological distress,
37:27however debilitating, or the symptoms were.
37:29The stigma was far worse,
37:31I was ostracized,
37:32I was marginalized and I was
37:35dehumanized by little bit of my
37:37closest companions at the time.
37:39And in extremist I contemplated
37:40I contemplated suicide,
37:41but I resisted the impulse to act upon
37:44those sorts because I'm a practicing Muslim.
37:47And Islam is,
37:48and suicide is forbidden in Islam.
37:50So it was a protective factor for me.
37:53I gradually recovered.
37:54I got back on track.
37:57I resumed medical school with renewed
38:01resilience and determination are qualified.
38:04I qualified.
38:06And I wanted to quote I wanted
38:08to share a quote with you that
38:10insanity is much like gravity.
38:12All it takes is a little.
38:15Gosh, how about a full blown war?
38:18But as I said,
38:19I gradually got back on track and
38:22I qualified against all the others.
38:24So what are the names of the
38:26wound dealers to debunk myths?
38:27And is this a factor is a myth
38:29that people with mental health
38:30problems will never succeed
38:31under doomed underachievement?
38:32I have always been made to feel that I
38:34will never amount to anything in mind.
38:36But as Andreas kindly said,
38:38in 2013 I received the Royal College
38:40of Psychiatrists Foundation Doctor
38:42of the Year Award and the RC Psych
38:44Awards marked the highest level of
38:45achievement in psychiatry in the UK.
38:47But there are still people
38:49who didn't believe me.
38:50They still stigmatized me.
38:51They just said he was lucky.
38:53So I went and did it again.
38:56That's unprecedented,
38:57this never happened before.
38:59By the grace of God.
39:01I got the Royal College of Psychiatrists
39:03Award for Doctor of the Year and
39:05sometimes I say that's not bad for a man,
39:07right?
39:09Pioneering innovative approaches.
39:10So OK, we have a story right,
39:12but what do we do with the story?
39:14Any anti stigma intervention has
39:15to be data driven an evidencebased.
39:17What do you do?
39:20And we know,
39:21according to the Canadian
39:23Psychiatric Association,
39:24that conventional education and
39:25mental illness alone does not
39:27reduce stigmatising attitudes and
39:28behaviors in medical students.
39:30We need to pioneer innovative
39:32Anti Sigma programs and I spoke
39:34with the World Authority professor
39:36Graham Thornicroft and he brought
39:38this paper to my attention.
39:40Key ingredients of anti stigma
39:42programs for healthcare providers.
39:44There are six key ingredients.
39:46One of them is a personal testimony
39:48from train speaker who has.
39:50Left living experience of mental illness.
39:56So we pioneered the WOON,
39:57did healer which has been
39:59described as an innovative.
40:00Teaching the blender power at the
40:03performing arts and storytelling
40:04with psychiatry aims are to
40:05entertain and engage and to educate,
40:07to debunk the many myths about mental
40:11health difficulties that are banned.
40:13And encourage care seeking.
40:14It is expert by personal and professional
40:17experience lead and this is something
40:19that upsets me because the space has
40:22largely remained unoccupied by a
40:24psychiatrist with living experience
40:26in mental health difficulties.
40:27Experts by experience who will need to
40:30empower who will need to dignify and
40:32we must amplify the voices of experts
40:34by experience but experts by personal
40:37and professional experience are also
40:39by definition experts by experience.
40:41So I that's why I for me
40:44it's divine intervention.
40:45That my path crossed with Professor
40:47Martins Path because I think
40:50that we as experts by personal
40:53protective screens should be showing
40:55leadership in that in that space.
40:57And the great thing about
40:59collaborating with each medical
41:00school in the UK has a psychiatrist.
41:02Exciting.
41:02So when you work with the students
41:04they designed this really catchy,
41:06aesthetically pleasing promotional material.
41:07So I mean,
41:08I was a man on a mission I took
41:11three years out of my training.
41:13And I delivered the wound healer to
41:1675,000 people in 19 countries on five
41:18continents worldwide all over the world.
41:21And these are some of the kind of Flyers
41:23that medical students designed in the UK.
41:30That the global footprint.
41:31Of the wounded healer.
41:35This is the feedback I continue
41:38to encounter resistance.
41:39I mean only recently a senior psychiatrist.
41:43Who claims to be active against mental
41:46health related stigma stigmatized?
41:48He blocked me and I have not had I mean.
41:52Well, it was sounding.
41:54Reputation precedes him.
41:55He claims to be a passionate
41:57mental health advocate,
41:58a champion, and yet he stigmatized.
42:00I know where I'm going tonight.
42:02It hurts, it hurts,
42:03it keeps you up at night but we get
42:05feedback like this from the students.
42:07It inspires you to continue
42:08with your campaign.
42:11So this is a COVID-19 world we're living in,
42:15and this is actually it's
42:17happening now, right?
42:18You don't have face to face contact with me.
42:21You have virtual contact with me
42:23and the evidence actually suggests
42:25that virtual contact is not as
42:28effective as face to face contact,
42:30but nonetheless it remains.
42:33An effective. And so the authors
42:35of this paper concluded that short,
42:37effective video interventions are
42:39relatively cheap, conveniently accessible,
42:40and easy to disseminate globally.
42:42We can scale them up because I get these.
42:46Invitations are pouring in, and there's
42:48only so many talks that I can give.
42:51But when we created the weed
42:54killer film and we digitized it.
42:56We can scale it up and actually there's
42:59a project that I'm collaborating with.
43:02The Professor Martin,
43:04an kind of more will be revealed
43:06about that project,
43:08so please do watch that space.
43:10But the plan is to leverage the
43:13power of digital technology virtual
43:15contact to reduce mental health.
43:17Related statement OK.
43:20Real quick a survey on the general
43:22public revealed that 60% believe that
43:25psychiatrists know what you were thinking.
43:27So we're talking about the stigma
43:29attached to being a psychiatrist.
43:3250% did not release that psychiatrist
43:34have a medical degree and this I
43:37thought was really interesting.
43:3950% would feel uncomfortable sitting
43:41next to a psychiatrist in a party.
43:43What we like the life and soul of parties.
43:47What's happening here?
43:49So this is a paper published in the
43:52British entitled Boxed Badmouthing
43:53Attitudes and Stigmatization in Healthcare
43:55as experienced by medical students.
43:58So you know,
43:59this banter is not so friendly.
44:01Is it because our profession is being bashed?
44:05Other specialist surgeons positions.
44:07I'm sure you've heard of it before.
44:10Psychiatrists are not real doctors.
44:12And these disparaging remarks that
44:14denigrate the psychiatric profession
44:16are deterring medical students from
44:18choosing psychiatry as as a future career.
44:20Actually a third of medical
44:22students may be put up psychiatry
44:24as a career choice because of the
44:28stigmatization of the profession.
44:30So this is the Royal College of
44:32Psychiatrists Recruitment campaign.
44:33It's a huge success.
44:34I was fortunate to contribute
44:36to this campaign.
44:37This is a paradigm shift in UK psychiatry.
44:40We are reaching out to medical
44:42students have living experience
44:44of mental health difficulties.
44:45And we're saying that we need you
44:47that your living experience is an
44:49asset that our profession embraces.
44:51That's a paradigm shift in
44:54psychiatry in the UK.
44:56So this is the impact of
44:58the true security campaign,
45:00so these are the occupancy
45:02rates in psychiatry.
45:03As you can see,
45:05less than 70% in 2017,
45:07up to almost 80% in 2000 and 1893%
45:10except 2019 and almost 100% in
45:122020 are highly effective campaign.
45:14And this is a study a single on
45:17peoples competitors comparison
45:18study on experts by personal,
45:20personal,
45:21professional experience and using EPS
45:23to increase interest in security risk
45:26period and look at these P values.
45:29People are saying that they will
45:31talk positively about psychiatry
45:32after attending a talk by an EPPE.
45:34And if you look at the C3 construct three,
45:37I would consider choosing psychiatrically.
45:39There was a statistically significant
45:41increase, so this was an unintended positive
45:43consequences of the dealer that we would
45:45reduce mental health related stigma and
45:47with increased interest in psychiatry,
45:49security and and this is the kind
45:51of the freeze onset protecting from
45:53students very, very encouraging.
45:56And I'll just kind of blast
45:58through this real quick.
45:59We had also a talk delivered by an expert
46:01by personal professional experience and
46:03there were statistically significant
46:04reductions in mental health related stigma.
46:06After attending a talk delivered by an expert
46:09by personal and professional experience.
46:11So that this study that we conducted was
46:14pilot study and it was the first study
46:17of its kind comprised of an expert by
46:20personal and professional experience,
46:22and it was associated with statistically
46:24significant reductions in mental
46:26health related stigma.
46:27However, it was fraught with limitations.
46:29There was no control group.
46:31It wasn't randomized.
46:33So we thought you know,
46:35this urgently needs to be done and
46:38there he is. Professor Martin himself.
46:42A godsend. No exaggeration here it is.
46:46This is his randomized study.
46:48It was an intervention comprised of two
46:51experts by personal professional experience.
46:53They administered validated instruments.
46:55The attitudes towards psychiatry and
46:58attitudes towards mental illness.
47:00And the participants in the active
47:02group had more favorable attitudes
47:04towards the country and towards mental
47:06illness compared to the control group.
47:08And 91% of respondents endorsed
47:10that knowing positions further along
47:12in their careers.
47:13Who struggled with mental health issues,
47:14got treatment,
47:15and who are now doing well would make them
47:18more likely to access care if they needed it.
47:21That's that's astonishing.
47:22That's groundbreaking.
47:23And guess what?
47:24Patrick Corrigan didn't do.
47:25The study.
47:26Professor Green Phonograph
47:27didn't do this study.
47:28It was your very own professor
47:30Andreas Martin.
47:30I think this is a game changer.
47:33We have evidence to prove now that aips
47:35have the power to reduce mental health
47:37related stigma in the medical profession,
47:40and I can't emphasize how
47:41important this study is.
47:42In my humble opinion.
47:46Kind of a concluding remark by Andreas
47:50and his team. We're almost done,
47:52so counting stigma starts off with
47:54the individual by challenging our
47:56own prejudices and preconceptions.
47:57Now those of you experiencing psychological
47:59distress in any of its many forms,
48:01I know, believe me,
48:02I know that the world can be
48:05a dark and lonely place,
48:06but please don't give up hope.
48:08Please don't give up.
48:09That's what we must do as mental health care
48:12professionals instill hope in our patients.
48:14And then it's also instill hope.
48:17Come in our colleagues
48:18because we are human too.
48:20It is OK not to be OK and having
48:22mental health difficulties is
48:23nothing to be ashamed about.
48:25And effective treatment is available
48:27and recovery is a reality for the many,
48:29not for the few.
48:32So this is my palm and I delivered this
48:34in Lisbon in Portugal as the largest
48:37medical student conference in Europe 1000.
48:40Uh, students and this brings
48:41back some very fun memories with
48:43regard to comment back to be done.
48:45No, no,
48:45we're not done.
48:46Could
48:47you stop screen sharing so that we
48:48just have it? Is it just me? Can
48:51you just see me now or is it
48:53no no stop screen sharing
48:54so I'm not very tech savvy,
48:56but I think I can do this.
48:58We can do this with your look with
49:00your brains for your lock sampling.
49:02How do I do this?
49:03Don't worry, just leave it.
49:06There's a, there's a tab there you go.
49:10Yep, there you Alleluia?
49:11Oh, this is actually got better 'cause
49:13I can see the audience over Professor
49:16asked if Hello Professor asked.
49:18OK, so regards the conflagration in my wake.
49:22On Inoxidable Inferno Burning
49:26Bridge after bridge emancipate
49:29me from the struggles of my mind.
49:34Release me, I beseech thee,
49:36from the indignations of my past.
49:39Take up the quill.
49:41I will, and relate my tale of woe.
49:44I shall.
49:46But wait, an incandescent silver lining.
49:49Was it not the Mr.
49:50Khalil Gibran who proclaimed the
49:52more melancholy carved into your
49:54being the more jubilation it can contain,
49:55and even the beauty of birth,
49:57even the beauty of birth,
49:59will leave its own scars.
50:01So adorn my face then not with
50:03the masquerade but with a smile
50:05that never fades and patient.
50:06No more particular now I am and often
50:08to the Kingdom of the sickle cell,
50:11for a with lineament and manner born out
50:13of experience as my instruments of healing.
50:15And as I behold my neighbors gaze,
50:17she whispers on to me.
50:19You're a good doctor, doctor Hunter.
50:22Unbridled joy just gushes
50:23forth from my heart.
50:25It's not me who heals you my dear?
50:30But it's you closely.
50:33Thank you.
50:36Oh yeah, wonderful audience.
50:39I've met we could. This
50:42is so amazing and I just
50:44want to say one thing.
50:45Thank you for your kind words,
50:47but Julie Chilton, who is here is,
50:49is really my partner in crime in developing
50:52that study that we did in Tel Aviv.
50:54So Julia here and maybe we
50:56can hear I saw where is he?
50:58Doctor Kyle Pruett has
51:00been preparing a response.
51:01Kyle go for it.
51:02We have very little time but go for it.
51:07I Amanda. I know
51:10you're mute, hear me. No, not you Kyle.
51:16Kyle unmute yourself, unmuted
51:19there we are. Doctor Ankier,
51:23I'm feeling liberated.
51:25By the passion that you bring to
51:27this topic because it is something
51:30that sits under the table whenever
51:32we meet with patients with
51:34our colleagues with are the people
51:37who agree with us and the people
51:40that we don't. And the power of
51:42the storytelling narrative that you
51:44talk about, I think elevates this
51:47discussion to beyond intellectualization.
51:48And as this is something that we have to
51:52experience emotionally and affectively, or
51:54it's not going to work.
51:56Medical students have held our
51:58feet to the fire about this
52:00for decades, and I think you
52:02are helping us come clean that
52:04it is not something that can
52:06be done to a medical student.
52:08It is something that must be done
52:10with a medical student an enriched
52:12by the story in the narrative era of
52:14your own life and distress. I feel
52:16really liberated. You've given me a gift.
52:19I wish I'd known you 30 years ago.
52:21I might have taken a
52:23different path.
52:24Wow, you know I'm blown away, Kyle.
52:27If I can just speak my mind
52:29with you in Lebanon would say
52:31what comes from the lips,
52:33which is the ears comes from the heart,
52:36which is the heart and your
52:38words are heartfelt and I really
52:40hope that we can stay in touch.
52:43Maybe, hopefully
52:44you will and you know there's a number
52:47of comments, but another of the great
52:49serendipities of life is that Achmed
52:51bribe you to another great man.
52:53He of the purple background.
52:55Professor Asif Ahmed,
52:56who if you don't know what
52:58his background is about in SF,
53:01maybe you can start unmuting yourself now.
53:03But it says one test 1 pill serves 2
53:06lives outside who is not a physician.
53:09He's a PhD, something very dramatic and
53:11he developed this treatment for eclampsia
53:13and that's the idea between merzon,
53:15but we're not here to talk about
53:18that were here because he has
53:20connected us and I give you a sev
53:23who happened to be the first.
53:26Non white I think Dean of
53:28a medical school in the UK,
53:30something that we're tremendously proud
53:31of and he is just like the best so us.
53:34If anything
53:35you want to say thank you.
53:37I just wanted to comment on.
53:39Well, first of all,
53:40I'm not the first non white Dean.
53:43I created a medical school from scratch
53:45as the first non person and let's
53:47not talk about non white or white.
53:50It makes no difference but it's
53:52about social inclusivity and that's
53:53what I wanted to talk about that.
53:56As someone who's not have
53:58a mental health issue,
54:00who's not a physician and who's not
54:02a doc and is not except for the
54:06fact that my wife is a psychiatrist.
54:09Apart from that,
54:10I think what you guys are doing.
54:13Is not just relevant for medical students,
54:17but for students per say and SoC per say.
54:24And that's what I that's why
54:26we've tried to get this program.
54:29What you're talking about?
54:31Annam's life, you know it was very emotive,
54:34listening to the struggle he went
54:37through and I just put that to myself or
54:41to my kids didn't have to experience that.
54:45So that story that journey is something.
54:49Every student,
54:50specially those who come from
54:52hard to reach background.
54:55Need to hear and see so it's by example.
54:58That's what I was trying to get out
55:00that it's not just about mental health.
55:02This is bigger than that.
55:04A mental health is should be seen as an ink.
55:08Part of society's inclusivity program.
55:12Thank you so much and thank you for
55:15correcting me as you should have.
55:17I guess at the last word I
55:18want to give to Julie Chilton,
55:20who has who's not only on our
55:22faculty now. And yes, can
55:24we ask roll to take a
55:26screenshot if that's alright
55:27with you, I'll take a screenshot.
55:29Don't worry about it.
55:30I'll take a screenshot now,
55:31as Julie Chilton has the
55:33last word because Julie,
55:34who will have something wonderful to say,
55:36is who pulled me and us into this space.
55:39So Julie smile 1st and then
55:40say something wonderful.
55:41Look at the camera everyone.
55:44I have to say is that I'm just so grateful
55:47to Andres for taking leadership in this
55:51role because it was 2001 when I first
55:54was open about my living experience
55:56at UCSF Medical School in order to
55:59normalize mental health struggles and
56:01doctors and medical students, and.
56:04Through UCSF through pen and even
56:06through my fellowship at at Yale,
56:09I didn't have a single higher up come to me.
56:12After one of my talks and say,
56:15hey me too, you know don't feel bad.
56:18Come to me if you ever need you
56:21know some support 'cause there I
56:23think it was just too much stigma
56:26for from were successful in senior
56:28positions and having Doctor Martin
56:30this giant and child psychiatry and
56:32wonderful human being be so.
56:34Open I think has really changed
56:37everything for a lot of people.
56:40Thank
56:41you, you're very sweet,
56:42so let's close Yaffa Ahmed.
56:44It's been a real joy to have.
56:46You were so honored to have
56:48you don't lose your computer.
56:49Thank you so much and just a
56:52correction that next week.
56:53Next week at this time we're going to be
56:56meeting to talk about the holiday party,
56:58but you have given us a
57:00holiday prize document.
57:01It's where we're really blessed to have you.
57:04So how baby thank you so much.
57:06Send us with some wonderful
57:08words in the original but.
57:09I'll get round in Arabic and you know,
57:13come on
57:14some some beautiful words.
57:16Hi baby, an Betacam and will be so
57:20karangelen shukran shukran.
57:23OK, thank you everyone.