"PPPPre-Existing Conditions" (Four P's #165)
Mental Health, Tokens, Beating Burnout, Vaccines for Kids, & Ted Lasso
"I wish I would’ve told him."
And with that line in the most recent episode of "Ted Lasso," the funniest show on television took another step to becoming the most meaningful show in years. It's kind of amazing that I haven't written about it yet, and I'm not likely to add anything new to the accolades for the most recent winner of the Emmy Award for Outstanding Comedy Series last week. Yet there is so much to unpack from these first two seasons and I definitely regret not talking about it more.
Season 1 of "Ted Lasso" was a joy. The one-liners, pop culture references, mediocre soccer, and feel-good storylines about humanity and hope were all the rage. We fell in love with the amazing AC Richmond team, its staff, and supporters. Not all of it made sense, but it all felt great.
The second season has been less about humor, good cheer, and positivity, though still replete with 80’s film/music references that 40 year-old Americans will appreciate. It hits much harder than viewers were expecting, like a well-struck direct kick finding the back of the net. We experience a diverse range of emotions and learn much more about the back stories of it two lead characters (Jason Sudeikis and Hannah Waddingham).
Which brings us back to Coach Lasso’s quote from this week, which was delivered at the end of the deeply painful scene in which he finally shared the story of his father’s death with therapist Dr. Sharon Fieldstone (played by Sarah Niles). From "Frazier" to the "Sopranos,” this is hardly the first show to address therapy in a focused way, but “Ted Lasso’s” mainstream appeal, coming now, when mental health awareness is gaining traction, makes it potentially more impactful.
After Ted's father's suicide, he promised never going to let anybody in his life get by him without understanding that they might be hurting inside. We all have our back stories, our personal trauma, and baggage. They are at the very core of our mental health and our identity. Sure, life would be a lot easier if we were goldfish, with a 10-second memory… but it's also okay if you’re NOT the happiest animal on earth.
Something Personal: Mental Health Awareness
Next Sunday, October 10, is World Mental Health Day. The objective of World Mental Health Day is to raise awareness of mental health issues around the world and to mobilize efforts in support of mental health. While awareness and advocacy for mental health has improved over the past decade, we still have a long way to go in destigmatizing the complex issues and challenges that impact so many of us. Happiness is not synonymous with mental health, but they do have a mutually symbiotic relationship. Which is why I’m combining something that makes ME happy with doing good and supporting this important day.
As someone who has gotten more interested in, and involved with, the NFT space over the past year, I believe in the power of these innovative creative platforms to deliver and spread important messages. The unique nature of blockchain-based assets is that they can be acquired, collected and traded in ways that generate progressive value. So not only can they inform and inspire, but can be sources of ongoing revenue generation. Or fundraising.
In advance of this year's World Mental Health Day, I partnered with a great, up-and-coming artist to develop 50 unique (1-of-1) Neon Flamingo Therapy (NFT) mental health “tokens.” Each has a unique, inspiring message of hope, tolerance, acceptance, and support. It is our goal to see these visual messages spread across the blockchain, and note that ALL profits spent on these (basically everything not including the gas fees spent on both ends of the transaction), will go directly to mental health organizations and charities. Please spread the word, donate, make an investment. But no matter what, please know that you are valued, cherished, and important. #MentalHealthMatters
Of note, we're seeing so many new and different use cases with NFTs popping up every day. Yes, this is still very much an emerging niche that people don't understand. We're seeing art, music, and sports culture drive so much of this progress, but for the NFT transformation to see mainstream adoption on a pervasive scale, the missing agent of change is brands. Marketers. You. Me, Us.
There are communities of "fans" for certain brand sand products, and there are (albeit secondarily) roles for brands to play in fan communities. With money to spend at every step of the process - from sponsoring creators, to amplifying reach, to engaging and expanding communities - relevant brands can and will accelerate awareness and ease apprehension, thus driving NFT-commerce en masse. Now we just need the tech infrastructure to facilitate adoption and lower the barriers to entry. And I know for a fact that it's coming...
Something Professional: Beating the Burnout
As we all know, the nature of work has changed considerably over the past year, (not to mention the past few decades). The term I've heard most frequently over that span to describe and encompass a range of issues is “burnout.” It's an epidemic. We often work long hours, bust our butts to get ahead, deal with new expectations around working remotely, while often losing the narrative. What if, and hear me out here, we stop trying to live up to some external standard of success and instead discover what makes work meaningful for each of us, individually?
One of the things we see and hear most often celebrated is "hustle culture. That that hard work is the secret to success. But a lack of balance can be exhausting. (Ironically, I'm literally writing this very post on my phone, in bed, at midnight, waiting to fall asleep.) Yet working harder, or even working smarter, isn’t enough to stave off the feeling of burnout. We're not all equally equipped to deal with pressures, stresses and strains. “Grit” is great, but it isn't enough to survive and thrive in today's modern workplace. In 2019, the World Health Organization officially classified burnout as a major global health challenge. Workplace stress has created unsustainable cycles of employee turnover and absenteeism, and it’s a contributing factor in hundreds of thousands of deaths every year in the United States, alone.
Knowing this, understanding it, and learning to identify are the first steps that employees can leverage to prevent burnout. Setting realistic goals, being aware of negative thinking, connecting with others, and resting must be part of our plan:
Goal-setting: Goals are meant to be bigger than what we have already achieved or accomplished. They should be uncertain and uncomfortable. Too big, you’ll get discouraged. Avoiding burnout starts with setting stretch goals, and enjoying the journey towards achieving them.
Being Mindful: With stress, our brains work harder, and often become filled with negative thoughts. These thoughts cause us to lose focus and enjoyment in our work. Even worse, they cloud our realities and ability to make good decisions. So the next time a worrying thought pops up, try becoming curious about it instead of instantly concerned. Be compassionate toward yourself and learn how to respond to the stress.
Slowing Down: Making time for silence, sanctuary, and solitude is a great goal. Our productivity decreases with longer work hours, as studies have shown. Working harder and longer doesn’t automatically equal better quality work. While we can’t all escape to a lavish garden or beachside retreat, we can build moments of calm into our daily lives.
Making Connections: Just as being alone with your thoughts can be good, successful people also seek out support and relationships. Whether it's with peers or leaders, people need people. It also takes courage to ask for help. One of the best ways is to cultivate compassion for your colleagues, and practice being there for them. Check in with coworkers who seem to be having a bad day, and offer them support. They'll then do the same for you.
So what brings meaning to your life? What are your core values? What are your unique skills? How do your friends or colleagues describe what you’re good at. One of the tasks I've recently taken on is identifying a meaningful pursuit. This is the impact that you make – or wish to make – in your life. If you want to avoid burnout, understand why you chose your job, and why your work matters. If your job exhausts you, it may also be your activities and not the purpose. It’s also essential to tune into your emotions as you go through your day. Emotions represent the subconscious as much as the consciousness.
Developing your energy and emotional awareness is not going to come easy, making space for vulnerability, tuning into your thoughts and emotions, learning to ask for help and building positive relationships is going to make burnout far less likely.
Something Political: The Politics of Mental Health
There are many reasons why a standardized, nationalized approach to health care in the United States would be beneficial. Today's politics is not exactly great for our mental health, and there have been too many challenges to recent legislative efforts aimed at improving treatment.
The Mental Health Parity and Addiction Equity Act (passed in 2008), the Affordable Care Act (ObamaCare), and state mental health parity laws require certain health care plans to provide mental and physical health benefits to individuals. However most insurers still do not cover mental health care in a sufficiently adequate way.
First and foremost, most healthcare networks fail to get enough "in-network" providers in geographical areas. This forces insured plan members to wait longer periods than necessary to get treatment, travel longer distances to see an in-network provider, or go outside of the network at a high out-of-pocket cost.
A 2019 report found that a behavioral health office visit is over 5x more likely to be out-of-network than a primary care appointment. Health insurance companies also use restrictive standards to limit coverage for mental health care.
Fortunately, the Affordable Care Act is still law, and health plans have to meet network adequacy standards and “maintain a provider network that is sufficient in numbers and types of mental health providers. The law also requires small-group and individual health plans sold on the insurance marketplaces to cover mental health services, and do so at levels comparable with medical services.
Private insurance companies still interpret mental health claims more stringently than those for physical illness.
In 2019, a Congressional Budget Office study reported that private insurance companies are paying 13% to 14% less for mental health care than Medicare does.
Some other stats: only half of the nearly 8 million children who have been diagnosed with depression, anxiety or attention deficit hyperactivity disorder receive treatment, according to a February 2019 research letter in the medical journal JAMA Pediatrics. Fewer than 1 in 5 people with substance use disorder are treated, a national survey suggests, and, overall, nearly 6 in 10 people with mental illness get no treatment or medication, according to the National Institute Of Mental Health.
Suicide is the second-leading cause of death in people ages 10 to 34 according to the National Alliance of Mental Illness (NAMI). Mental illness has skyrocketed since the pandemic, and it has disproportionately affected younger Americans, and specifically racial and ethnic minorities.
To tackle stigma and shame, these communities have to come together to learn about mental illness, while addressing some unique challenges faced as minority and immigrant communities. The good news is that more non-profits, advocacy groups and health organizations are banding together. But there is definitely more work to be done.
Something Practical: 1-877-VAX-4-KIDS
We are just a few short, and long, weeks away from the expansion of COVID vaccine eligibility to include children ages 5-11. And while we all thought the first introduction of a vaccine at the beginning of the year would change everything, this next phase of availability gets us a big step closer to that "normal" we've all been craving.
While the most common criticism of the COVID vaccine is the speed with which is was approved, the actual science and research behind its development goes back many years. Tens of millions of adults have gotten it already, and it's been proven beyond effective AND safe. The testing required for children has been more about getting the dosing correct, not efficacy or safety. But now we're close. Really close. And I have no intention of waiting to get my own kids vaccinated the very first chance we get. Deployment will be challenging as many pediatrician offices won't be able to supply it. Larger practices, hospital networks and pharmacies will do the initial heavy lifting, just as they are doing now.
Pfizer is going to be first to roll out under the Emergency Use Authorization (EUA) amendment for 5-11 year-olds. Delta and pandemic resurgence led the FDA to be more aggressive in its approval. As far as I can tell, we're still awaiting approval from VRBPAC, an external scientific committee that reviews data and provides feedback, but this step was skipped for the 12-18 age demo earlier this year, so it's possible we skip this step.
The CDC also has a role here, along with ACIP (an external scientific committee for the CDC). ACIP was in the news last week for its recommendations about the booster for adults, and the overruling by the CDC that recommends a third shot for more people. Assuming that the FDA and CDC agree, we could see vaccines for 5-11 year old by the end of October. Surveys say that 1-in-4 parents will sign up right away, with 2-in-4 taking a wait-and-see approach. The reasons NOT to rush out to get the vaccine are also worth considering and discussing. Myocarditis was NOT seen in any of the pediatric studies, and fertility is a major concern for parents and the COVID19 vaccine. Antivaxxers are driving much of the anxiety, so relying on the medical science is crucial.
The question now is going to be adoption. Ultimately, if/when enough kids and adults get the vaccine, only then can we truly stop the spread of this virus. It’ll help with hospitalization rates, transmission, and even adult mortality. Personally, I can’t wait.