Your world with Dr. Beatrice Hyppolite
Hello,
I am Dr. Marie Beatrice Hyppolite. I hold a doctorate in Health Science with emphasis on Global Health and master’s degree in social work. I have over 14 years of experience in the field of health and human services.
This podcast is primarily focused on mental health and the quality-of-life elements that affect it such as divorce, death, domestic violence, trauma, toxic relationships, and single parenthood to name a few. It is no secret that mental health challenges continue to profoundly impact modern society although not enough discussion is given due to stigma. Research has shown an increase of 25 % in mental health crises after COVID-19. It is important to have honest, uncomfortable conversations about mental health while being supportive. Although we are interdependent, change begins with the individual, hence “your world.”
I welcome you to join me on my journey and look forward to your responses.
Your world with Dr. Beatrice Hyppolite
Co-occurring Disorder
This episode is about Co-occurring Disorder/With Mr. Marc Bonhomme.
Resources:
1. SAMHSA's Co-Occurring Disorders webpage
2. National Institute of Mental Health (NIMH) Co-Occurring Disorders webpage
3. Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Locator
4. Psychology Today's Co-Occurring Disorders webpage
Hello everyone, I am Dr Beatrice Ippolit and this is your World. Today, we have the pleasure to have as our guest speaker Mr Mark Bonhomme. Mr Mark Bonhomme, mr Mark Bonhomme is a friend, is a colleague, is a mentor, is a. Help me out, mr B.
Speaker 2:I have an extensive background in case management. I've worked with underserved populations in both capacity of teacher as well as case management. As I mentioned and you know, I'm just here and just honored to be your guest doctor- Today.
Speaker 1:I'm glad to have you and welcome to the show.
Speaker 2:Thank you, thank you, and today we're going to discuss co-occurring disorders, and Dr Hippolyt, who has more experience than me, has had background working with mental health, people with mental health diagnoses and oftentimes in the past this was referred to as mica or chem mentally ill, chemical abuser which is no longer the term now. Now the preferred term is co-occurring disorders. So we're here to discuss that and, uh, how this impacts the community and ways that we can deal with some of these issues.
Speaker 1:We do, you know. So it's like but one thing we're not going to focus on. We're going to address it, but not to really consider the clinical aspect of it.
Speaker 2:Yes, in other words, we're going to keep it in layman language, okay, so that the average person can understand.
Speaker 2:We don't want to get too clinical, we just want to make it relatable and just something to share with the community so we can all discuss and, you know, get something out of it, hopefully okay, let's get going what you have for us okay, well, just to share with you, this is a subject that I am passionate about, since, unfortunately, I have a family background of it, with both mental health issues as well as chemical addiction, and so this is something that I've been passionate about, and so I have a background working with individuals in the community. I've done case management for individuals living in supportive housing and other settings, and it's been very challenging in some ways. I've had some individuals that have some very, very profound issues. Some of the outcomes have not been the best, and so this is something, a subject, that I remain passionate about and hope that I can be of service to you and you know, with some of what I have to say on this program.
Speaker 1:Okay, so what do you know about co-occurring disorder?
Speaker 2:Well, from what I understand, oftentimes depression and substance use often co-occur, with like 30% of individuals with depression also experiencing some substance use disorder. Quite often anxiety disorders depression typically a mental health issue often frequently co-occur, with approximately 60% of individuals with depression also experiencing anxiety disorder. There's also trauma, like if you have a family history of trauma, you know depression often occurs with trauma-related disorders, such as post-traumatic stress disorder. Approximately 50% of individuals with PTSD also experience depression and really I think what it comes down to is getting to the root of the issue, which is often a mental health diagnosis, and how that can be addressed to better, more effectively deal with the chemical dependency piece.
Speaker 2:Also increased risk of co-occurring disorders, increased risk of worsening symptoms, treatment resistance, relapse, and quite often with some of the individuals that I've worked with, they have chronic relapse cycles. Sometimes they seem like they're doing very well and then suddenly out of nowhere you'll see them relapsing. And unfortunately there are situations where you have individuals that even come down with suicidal thoughts, suicidal ideation, and we want to curb that as much as possible, and we want to curb that as much as possible. One thing that we want to do is adopt a holistic approach and look at individuals as being components of various parts, various elements, and so this is why integrated care is something that's really important. Treating co-occurring disorders depression together is basically crucial and effective management and helps improve outcomes Okay.
Speaker 1:Have you ever directly worked with people with co-occurring disorder or depression and alcohol or drug use or abuse?
Speaker 2:Yes, I have, and I'll be honest with you. In the beginning it was a bit frustrating Some of the individuals that I work with. I didn't even feel safe around because I felt like they were constantly scheming and looking for ways of getting over and really not even seeing me as a person as much as they would just see me as a vehicle to get whatever they wanted. So it always felt very awkward engaging them and I used to refer to their way of engagement as stinking thinking okay, when we like the individual's always looking for a way to kind of get over on someone. So I learned to look past that and I learned to understand that this is a clinical condition and you know, when you look at it from that, from that perspective, you depersonalize it and understand that this is someone who's dealing with you know these disorders and you just have to look at it that way and just just separate that from the person.
Speaker 1:Okay, so in a situation like that, since I understand it's not really your area of expertise, so what you normally do in terms of providing a more consistent assistance to those individuals, Well, one thing that I do is, when I engage the individuals, I always make sure that, when addressing the problem, that I don't make the problem and the individual synonymous.
Speaker 2:Okay, and that's very important, and it comes back to what I said earlier about depersonalizing. This is something that is separate from them, this is something that you know. Even though it's something that they're grappling with, you don't want to make it synonymous with the individual, okay but in that setting that you used to work.
Speaker 1:So is there any mental health providers or clinicians or or any professional in that area that you see?
Speaker 2:yes, actually, with those clients of course, actually, in my background, as far as case management goes, I've worked with various mental health providers. I've made referrals. One thing that I've done with my individuals is I've consistently stayed on top of them in terms of keeping their appointments and keeping their commitments. You know, for example, if someone says I'm going to do something, you want to hold them to that, hold them to their word, and so this is something that I've done with my individuals.
Speaker 1:And I think that when I approach them with that consistency, because a lot of them there is a 25% increase, you know, of mental health situation going on and it's throughout the world.
Speaker 2:Of course, and it doesn't surprise. I mean, if you have individuals that are holed up in an apartment all day and they can't go anywhere, especially if they're dealing with these issues, chances are it's going to worsen. Human beings, we are social animals. We crave being in contact with each other. It's so vital that we utilize opportunities to be together. When you have a situation where people can't socialize, where they can't leave their apartment, you're only going to have problems.
Speaker 1:So it doesn't surprise me that since the lockdown, and in situations like that, oftentimes people don't really know how to deal with it Absolutely. And so the best way you know to many to deal with is to kind of like crunch themselves into whatever substance that may be, either like you know weed cocaine crack or heavy alcohol.
Speaker 1:So it's like many people that I've worked with in the past, you know, claim that, oh, you know what. So when I drink, you know, despite knowing that I have a mental health problem going on, but when I drank, so that kind of helped me to forget about my situation, absolutely, absolutely. So what do you think about that? You think that's really helping somebody forget about their situation?
Speaker 2:when they drink? Well, of course not. Or do drugs? Of course not. It's basically just a temporary solution, if you want to call it that, but it's really just a temporary fix, but it doesn't address the underlying issue. One thing that I like to do with my individuals is get to the root, talk about what it is that they're dealing with and then say you know what? Let's not talk about the drugs or how you're coping, let's talk about dealing with that issue. What steps can we do to fix that problem? And I think that once that happens and you redirect their focus to addressing the issue, then you can have some progress.
Speaker 1:Yeah, because I've worked with people in the past. You know who claim that. Oh, missy Pollitt, you know that. Oh, missy Pollitt, you know, I know I've been dealing with depression or anxiety or any type of other mental problem but for whatever reason, I cannot stop doing drugs and so, and a patient like that, it's hard to really assist them, even when you refer them to the mental health department. That's right. So you know all you're going to be hearing. So it's like. So it's not really the problem, the mental problem, it's more like the drugs. You know, component of it. Exactly, it's a challenge.
Speaker 2:Yes, and unfortunately, oftentimes the way healthcare is structured. Usually you just have specialists working in those particular areas, but it's hard for them to actually work together Okay, where they're both on the same page. And that's why integrated health or holistic health is really a better way to go, because you're looking at the person and all their parts and you want to make sure everything is coming together.
Speaker 1:Looking at the person and all their parts and all the, and you want to make sure everything is coming together. But, mr Bonhomme, do you feel that you know, I know, like you know. So you love working with young black men. Yes, that's something that you that's my target population You're passionate about. So, before I even ask the question that I wanted to ask, let me inquire the reason why you are so passionate about working with young black men.
Speaker 2:Well, one reason is that I'm a black man myself and I come from, you know, an underserved community and I have seen, you know, a lot of things that I just felt found were very unsettling. I see a lot of young brothers unfortunately become statistics and I wanted to do something about that. I didn't just want to be idle and sit back and continue to watch that. One thing I've seen quite often is a serious mental health crisis happening with Black men particularly in the communities that underserved.
Speaker 2:I oftentimes will find myself riding public transportation or being in the community and I'll see a black man on the street having a psychotic episode and people are treating this like it's just background noise and I say, no, this is a real problem and we need to address it. You know, I mean, we look at crime stats and we look at what's going on with random violence and things like that. Let's deal with the fact that we have a very serious mental health crisis in our community, especially pertaining to Black men, and I think that more services and more attention needs to be put on it.
Speaker 1:I agree with you on that 100%, and so it's like working with those Black men or individuals who suffer with co-occurring disorder. So what would you consider the most challenging aspect while working with them?
Speaker 2:I like that question. One thing is that, unfortunately, there are a lot of, I would say, acquired habits and behaviors that are sometimes very hard to unlearn, especially if these are behaviors that have been passed hard to unlearn, you know, especially if these are behaviors that have been passed on from generation to generation. A lot of these, some of these behaviors can actually be traced back to even slavery, and so I think what it comes down to is really just focusing on unlearning those behaviors or replacing poor habits with good habits.
Speaker 1:So you mentioned that some of those behaviors can go back. Be traced back to slavery To slavery, in what way and why you think?
Speaker 2:Okay, like, for example, there's a lot of internalized self-hatred. You know, oftentimes, men of color, we tend to not feel that we're deserving or that we're adequate or we're not good enough, and so we internalize these beliefs and oftentimes this leads to self-destructive behaviors. Not only self-destructive behaviors, but oppressive behaviors, where we even keep one another down so you might see another black man who's doing his thing and you become envious. So you think, oh well, who's doing his thing and you become envious. So you think, oh well, who does he think he is? And you feel this need to put him in his place, because you internalize this idea that people that look like you aren't supposed to be successful.
Speaker 1:Because you were taught that way.
Speaker 2:Absolutely.
Speaker 1:So what I'm here to do is to say that it's time that we unlearn these habits and learn these behaviors so that we can become the best version of ourselves. But you know, it's so uh amazing that you mentioned that. One thing that I also notice, you know, like in uh, black people, or young black people, if I may say that way you know, often time you know it's like. You know it's like they tend to not only have the urge to seek help, but they tend to kind of like internalize everything, making believe that, oh, you know what. So I'm a man that's right you know.
Speaker 1:So it's like because I'm a man so I should not have feelings.
Speaker 2:Right, right, right. And I like that you touched on that, because quite often, when it comes to emotion, men are taught to suppress, even deny our emotions, which is not healthy. But I also don't believe that men should just allow their emotions to run amok. I think what it comes down to is having the ability to be in the moment, of course, being in the moment, feeling the emotion, acknowledging the emotion but at the same time, allowing the rational mind to have the final say, and not the emotion. The emotion should not overwhelm you. A master once said uh, emotions make great servants, but poor masters, okay. So it's really important that it's okay to acknowledge and feel the emotion. Okay, I'm feeling tense, I'm feeling angry, but the emotion will not have the final say, my rational mind will.
Speaker 1:I agree with that. But you know, so it's like, but it's like as many too often. So we hold on on that mentality, or you, you know. So you get in situation where you know society said oh, men don't cry, men don't complain, men, don't you know, come on. So, at the end of the day, besides being a man, you know you are a human being, you know, with feelings, emotions and everything. You know with feelings, emotions and everything. So it's like, you know. So if, uh, if you feel that you have a need to cry, cry and I will agree with you when you said you know not to, and you know like to focus more on the crying don't waste your entire day or week or month or life crying.
Speaker 1:So it's like you feel like crying for that moment, cry but at the end of the day, what you're going to be doing. You know about the situation.
Speaker 2:That make you feel that way Exactly, and so one thing that I like to do is, in terms of dealing with you know difficulty and dealing with difficult feelings, finding outlets, finding things that you like to do that are constructive. I mean, even if it's going to a gym and punching a bag or working out all these things are great ways of relieving stress and great ways of managing your emotions, because, instead of doing something destructive, you're finding something constructive to do. Working out, for example, is very good for your body. It increases your circulation and so many benefits.
Speaker 1:It's clear off your mind too.
Speaker 2:Absolutely, and it's a huge de-stressor. So you know, when I deal with my individuals, I always encourage them to work out, to take walks, do things that involve physical activity and do things they enjoy. That includes hobbies, for example. If you like to paint, or if you like to draw, or if you even like to listen to music, that can be a great outlet for you.
Speaker 1:Yeah, in terms of managing emotions difficult emotions. Very important. Yes, but you know, so I know that you know you like to focus on young black men. So what about like young black women or women in general? So I understand working with black men of course, your preference of course but what about if you get in a situation where you encounter, you know, some black women who dealing with the same issue and need assistance? So what would be your move in that situation?
Speaker 2:well, of course, in that situation, while I would do my best to address whatever their concerns or issues are, I would then, of course, refer those individuals to maybe a female care provider or someone who is more competent in that area.
Speaker 1:Okay, okay okay, so it's like but you one thing that you're gonna make sure that you do is to be of assistance.
Speaker 2:Of course you know at that moment, absolutely At that moment, Very important. Yes.
Speaker 1:Because sometimes you know you have a lot of people you know out there. So who have you know situations that need, that require you know direct assistance.
Speaker 2:But oftentimes they don't know.
Speaker 1:That's right, you know not only the assistance may not be there, but even when the assistance is there, many people tend not to know where to go.
Speaker 2:That's right. And also we have to address that there's often a stigma associated with seeking help, especially with mental health, particularly in communities of color. There's this idea that, oh, if you know, if you go to a psychiatrist or you see a mental health provider, that you're crazy. You know, no, you're not crazy, you're just someone who needs help, that's all. And we have to understand it from that perspective, because we have to remove this, this negative stigma that somehow seeking help from mental health professional is bad. You know, you know. We have to get over that.
Speaker 1:Yeah, and especially in the Caribbean community we see that a lot, my community, you know, including.
Speaker 1:So it's like Asian people, you know they don't get out, no, so it's like it always has to do something that has to do with bad spirit or voodoo. You know you've done something to somebody you know and eventually that person put a curse on you. So it's like, and, and many, many oftentimes you know I may say so you see, that the person you know has a need for urgent help. But because you know it's like sometimes it's hard to kind of walk toward that belief and to really help them switch and get the help that they need. Right, right, so it's a serious challenge.
Speaker 2:Yes. So it kind of goes back to what I was saying before about unlearning ways, unlearning bad habits and replacing them with better ones.
Speaker 1:Okay, being more rational and looking at these issues from a more, uh, rational point of view okay, all right, so um, let's see um, now, you know it's like you know, I understand you know, so we're not being clinical about this, so so, but in terms of treatments, there are many, many, many, many, many types of treatments, you know, available around there, but therapy so considered to be one of them, yes, well, I highly recommend therapy and I have benefited personally from therapy.
Speaker 2:Fortunately, I had a clinician years ago who I had a clinician years ago who I had a very good relationship with, and I encourage everyone to do it. At least everyone, I think, should have therapy at least at some point in their lives. I think that there are benefits to it. One thing that's great about therapy is that it really helps you get to know yourself.
Speaker 1:You know what some of your real issues are and the thing and the work that you really need to do and to change your Situation not only to really know yourself but it's also help you to gain and sign the actual problem that you are dealing with because you know the way. Too often I've seen people dealing with serious situation but don't even know that the problem is serious. But if you get to make it to therapy and sit with that professional, that will kind of break down things into pieces and let you understand, you know, like the way that you're supposed to. So that treatment that you've been resisting for so long, now you will be much easier to embrace it because you understand exactly what you are dealing with. But when you, we don't have no knowledge, no insight about what's really going on, so it's that treatment it's it will be hard for you to embrace that's right.
Speaker 2:And then you're going through life not even knowing you have a problem.
Speaker 1:Yeah, exactly, and family and social support.
Speaker 2:Yeah, I can't stress that enough. It's very important. I put a very high premium on that. That's something that's invaluable. It's so important that you have someone in your corner, even if it's just one person, and I have a saying about friends it's not really about quantity, but all about quality. I'd much rather have two quarters than 50 pennies, and so when you have people in your corner, people that support you, it can really go a long way, because if you feel like you're having a rough day, or if they even notice something is off about you, you have someone there to support you, and that really means a lot it's like you know.
Speaker 1:If I know that, oh okay, I've known mr bonhomme for a while now and I know he's not a type who normally go to bed at six or seven, and it's been like three, four days.
Speaker 1:I've been calling and he's always in bed at six or seven. Something is not right, you know. So I have to check that out, and you know, so, even go to a, mr b, so that's not you. What's going on, let's talk about it. So, or do you want to talk about it? Because as much as I want to help, but one thing that is very vital you have to respect privacy, of course.
Speaker 2:You know, Of course.
Speaker 1:So it's like you know you want to be of assistance, but make sure the person wants to talk about the situation. That's right, because I can be there to help you. I can be there for you to lean your head on my shoulder, but I have to give you space.
Speaker 2:Right, and that's something that's very delicate. That's something very delicate because you want to offer help but at the same time, you don't want to browbeat, you don't want to come off as imposing, because that's just gonna scare people.
Speaker 1:Yeah, because, exactly, you don't want that, because while you're trying to to help and the person is drifting away from you. So so, not only, not only you may you may lose a friendship over you being too, uh, imposing or bossy, or you may end up person may end up losing himself or herself because you didn't know how to address or approach the person appropriately. Very important, you know. So you want to be of assistance to your friends and family member, but also understand that, hey, it's, they have a private life and it's important, it's vital to show respect to anybody that you want to assist, in other words boundaries.
Speaker 2:You have to respect those boundaries.
Speaker 1:Yeah, exactly, yes, exactly, of course. So it's like you know, if I don't open the door for you, you know, so you cannot decide to step foot in. So, oh, you know, uninvited.
Speaker 1:Yes, so you wanna assist, but hey, so I can have limitation to what degree that I need your assistance so and so, and it's no point for you to get upset and think that, oh, I don't consider you as a friend or I'm pushing you away. So, because it's like we all are different, you know, some people may have the need and be willing and open, you know, to embrace the help that you may bring on the table. Some people will make decide on how to get the help that you may bring on the table. Some people will make decide on how to get the assistance you want to offer. So, and one thing that you mentioned earlier. So it's like, uh, uh, you know, get socially more involved. You know, take some time for yourself. Take me day, you know, or me time, like people normally say yes, you know so and uh, I've, you know.
Speaker 1:So it's like and I admire that from you from time to time. So you say you know what I need a mental day. You know from, you know, a mental health day from work. So not because you don't like to work or you're lazy or what have you. You have those vacation days, so use them. So it's like you have personal time, use them. So it's like some people may be working and they tend to be overwhelmed, so while they could have used one or two days of, you know, relaxation, so it's like, take times off from work. Take, you know. So it's like, for those who can go, you know, to a spa, to just to go to the park and enjoy some ice cream from the ice cream shop, that's right, you know. So take time to go and have a nice hair cut or a nice hairdo, so take times you know to.
Speaker 1:Or sit on the beach you know sit on the beach or, if you have kids, just go take a long walk in the park. You know, do whatever. Because you know everybody's financial situation is different. That's right, you know. So. It's like you know, some people may be able to go and enjoy a Broadway show. Some only can go to, you know, enjoy a Broadway show. Some only can go out for a movie. Some can go to a nice fancy restaurant. Some can only go to McDonald's or BBQ.
Speaker 1:Whatever that you are capable of doing or you can afford of doing, but doing, but the most important thing, you have to take care of yourself. It's a must. You have to take care of yourself because the body, so it's like it's a hole, you know. So the same way, you know you, you know you diabetes, you have high blood pressure or you may have any other health condition going on, and you're going to make sure that you go to the doctor and taking care of that Mental. You know your mentor is important, absolutely, because what they always say is about the head. That's right, you know. There is a slogan about the head, you know so. The body cannot function or sustain without the head. That's right. So if it is true, then let's go out there and take care of our head. Amen to that.
Speaker 2:Amen to that.
Speaker 1:Relapse, you know. So prevention, so you want to tap on that.
Speaker 2:Yes, you know I've dealt with individuals that, unfortunately, have had chronic histories of relapsing and one thing you have to do as a provider is not take it personally. You know, sometimes what happens is you know you have so much hope and faith that this individual is going to get well and going to get better, and then they relapse and they keep disappointing you. And then what happens is you find yourself sometimes interjecting your own personal feelings into that. You don't want that to happen. You just say, ok, this is just another stumbling block, all right, and I'm just going to continue to work with this individual. That's how you have to look at it. Disconnect your feelings from it. Don't make it personal. I mean, like I said, you might have had high hopes for that person, but don't look at it as a disappointment and don't project that onto the care that you're providing for the person.
Speaker 1:You know what, you just nailed it right. You know on the head. We have to be patient, we have to understand where the patient you know is coming from, like in social work. They have that, you know that powerful statement you meet the client where he or she's at.
Speaker 2:Meet them where they are, that's right, and one thing that's very powerful and this is very significant is you celebrate and applaud even small victories or small steps. Small steps, Okay, that goes a long way. Yeah, because it varies.
Speaker 1:You know every individual is different. You know, while you've been working with this client or that client, it may take that client six months to achieve the treatment plan or the treatment goals, but some clients it may take them six months or six years or even more. So it's like and you know, I agree to what you just said be patient, don't take it personal, because at the end of the day, so you know, some people you know can be quick, some people you know they're like oh, you know what, I've tried, but something happened.
Speaker 1:We deal with pressure differently that's right and, as a provider, as a care provider, it's not your role to put a time limit on treatment definitely, because at the as a provider or therapist or whatever your title may be, you know so, a mentor, a coach, always remember the treatment is your client treatment. It's not your treatment, that's right, you know it's not your treatment. Sometimes you may have somebody come and walk while you're walking with that person. So don't make believe that, oh, I have this plan, you know, lay out for that person. As a matter of fact, you should not be making a plan for the client, so we are making the plan together. Let the client be the master of his or her life right.
Speaker 2:In other words, you're assigning them agency, because that's ultimately what we want to do. We want to give them control, because oftentimes there's this feeling of not having control or lack of control, and this is thus the problem.
Speaker 1:So we want to give them agency, empower them so that they can believe that they can do something about their condition, exactly, exactly, because you know it's like, while you may force some changes in that person's life, if the person is not ready, you know it's not going to happen. The person has to be ready to embrace and accept changes because it's with him, absolutely, Absolutely. Mr B, that was a great moment. That was a great show. I enjoyed it and I'm assuming that everybody who's listening or watching now is going to enjoy it as well. So thank you so much for your time.
Speaker 2:It was a pleasure having you. Yes, it was an honor being your guest. Thank you, doctor.
Speaker 1:Thank you so much. I'll see you next time, Take care people. See you another time.