Mental Health Revolution: Healing Together with Dr. Manasi Murthy Mittinty #25

Transcript

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 0:00

you don't see pains, pain is very subjective. You don't see mental health issues, very subjective. You have to trust your patients.

amit-gupta_1_04-18-2024_083542: 0:07

That's infusing

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 0:08

Yes.

amit-gupta_1_04-18-2024_083542: 0:12

me, how are the biggest challenges of both indigenous and immigrant communities?

rahul-mehra_1_04-18-2024_180544: 0:18

Hello and welcome to Indian Community Podcast. I'm your host Rahul Mehra along with my co host Amit Gupta. Today we are joined by Dr. Manasi Murthy a distinguished physician scientist who is at the forefront of mental health equity in Australia. Dr. Manasi has been recognized for her groundbreaking work in developing personalized patient care programs. Aimed at achieving mental health equity for all Australians, including vulnerable populations such as children with juvenile idiopathic arthritis and indigenous communities. Stay with us as we uncover the challenges, innovations and triumphs in our quest to ensure mental wellness for every individual. Welcome to the Indian Community Dr. Manasi.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 1:14

Thank you, Rahul. Thank you. That was a very heavy and very kind introduction. Very happy to join with you and Amit today and look forward to a chat.

rahul-mehra_1_04-18-2024_180544: 1:23

Yeah, definitely.

amit-gupta_1_04-18-2024_083542: 1:24

Okay. Thank you.

rahul-mehra_1_04-18-2024_180544: 1:24

Dr. Manasi, could you start with explaining what mental health equity actually means to you and why it's so important in today's healthcare landscape? In fact, you know, it would be great if you could, let our audience understand first, what is mental health? Equity.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 1:41

Sure. I think when we speak about health equity in general, the idea is that each one of us should have the availability and the opportunity to live well and to experience good health. So when we say mental health equity, we mean experience good mental health. essentially the focus should be that no one should be. alienated from accessing services or receiving the care purely based on their, say, race or ethnicity or cultural background. So that is where mental equity comes into play. And like you very rightfully said that it's a big topic at the moment because we have seen so much of migration in last So in the last two, three decades, that in lot of western countries, we see lot of ethnic background, communities rising. And so there is a need for representation. from these communities into the health care that's provided to them. So I think that's where mental health equity has become stronger and stronger, also because COVID hit and we saw that, of course, pandemic was challenging, but mental health challenges related to the pandemic were weighing heavy for all. you know, all countries, all healthcare systems. And that is the main focus. I think moving ahead that how do we build resilience in the communities, how we make them self sufficient in a way to manage their own health in that broader context that mental health comes in. But I do want to emphasize because my work in mental health is related to chronic pain, I do want to emphasize that. Nowhere, health should be categorized as physical health, mental health. It should be seen in a construct of biopsychosocial well being, where we see that not only their physical health, but their social health and their mental health is good. So I think that is really a key message from my perspective in this work is that, do not alienate others. Presentations look at the individual look at their life as a whole and not just how they present or the symptoms that they present.

rahul-mehra_1_04-18-2024_180544: 4:01

That is quite thoughtful. Quite thoughtful.

amit-gupta_1_04-18-2024_083542: 4:02

I came across today which is the biopsychosocial well being. Is that, did I phrase it right? Okay, that,

rahul-mehra_1_04-18-2024_180544: 4:11

Yeah.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 4:12

you did.

amit-gupta_1_04-18-2024_083542: 4:13

I

rahul-mehra_1_04-18-2024_180544: 4:13

Yeah. All

amit-gupta_1_04-18-2024_083542: 4:15

thought about this in this manner, right? So thank you so much for sharing that. Dr. Manasi, you've been instrumental in developing web based programs aimed at supporting children with chronic illnesses. And so how do these programs address mental health disparities? And what are the typical outcomes that you've observed when you've run these programs?

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 4:39

So I think one of the things is that I was involved in developing a way best program for upscaling professionals. So it wasn't directly related to patients, but that's where I think the biopsychosocial concept comes in. for the longest period of time, we have looked at presentations or symptoms and we have said, okay, if someone has a headache, you give them a neurofin, so on and so forth. So we have just looked at symptoms and trying to manage symptoms, What this particular model of care does is it looks at the whole human and how does that symptom present? Is he, for example, is he going through a rough patch at work or in personal front? Is that the reason why he is presenting with headaches every day? then we are trying to reach to the root cause and not just the symptoms, not just a band aid for the symptoms. And specially healthcare practice, what is a little bit limitations, which now the healthcare professionals are trying to build on is that we want to revise the curriculum such that we train the young generation of physicians at the person in front of them and not just look at their symptoms and just write the scripts and get it done. So I was invited to build this web based learning program, particularly for rheumatoid arthritis, which is a chronic painful condition. And the intention was to create these kind of training modules, which look at the entire picture, but also that they're interdisciplinary, which means that when we launch it, we're It won't just be for rheumatologist or it just won't be for physicians, it would be for physiotherapist. It could be a ed health practitioner, like a naturopath who wants to find out or learn more about it. So that platform was built with this intention that we are training and we are upscaling healthcare providers to provide a person centered care to look at the. the patient as a person, what their requirements are, and then make a management plan or a diagnostic plan for them. To give you a little bit of interesting fact about it is that, um, we have included a module on communication on that upscaling web, which will be launched in a few months. The reason is that there's a lot of literature which says that patients often feel not heard. When they visit a physician because they're time poor. There's a clock ticking. You have a 10 minute appointment. We want to get through everything. So oftentimes patients report feeling like I was not able to communicate. I didn't feel come out feeling fully hurt. So that's why we have introduced communication module just to, you know, just give them a sense of how to ask open ended questions. Do not ask questions. We just get you a yes or no. But go a little bit deeper. How to build a rapport with your patients, that sort of approach. So that's the work that I've done very recently. Yeah, no, yeah.

amit-gupta_1_04-18-2024_083542: 7:45

about this, I was also thinking about how, especially the root cause and the symptoms you know, conversation. Now there's a lot of about how AI has to be leveraged by healthcare professionals and AI is again going to probably treat those symptoms, right? Because AI is going to say, okay, there's a headache, take a neurofin, right? But, um, going down to that root cause is going to be a lot of human intervention is going to be required, right. So I think that's very

rahul-mehra_1_04-18-2024_180544: 8:17

right.

amit-gupta_1_04-18-2024_083542: 8:18

To see that there's there is investment of time and effort in, in training our healthcare providers to be able to take up such topics, but it's going to be a very tricky balance because at the end of the day, they also have time sensitivity in terms of how much they can invest on, on a patient. um, It's interesting to note that training, you're able to, you know, give them questions which will give them the right answers to get to that pause.

rahul-mehra_1_04-18-2024_180544: 8:47

So you make a healing touch. You are meaning, you know, healing touch. They should give patient, which is what is the gap.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 8:55

terminology which is called as patient provider relationship, which for many years just highlighted that it's the physician and it's the patient, their dynamics. And I did a very interesting study with UCLA London Pain Hospital, their pain clinic there. And we extend that construct to being patient provider and the team dynamics. the patients are extremely influenced right from the get go right from the moment they enter the reception to the nurses to everyone who interacts with them has a lost lasting impression. And so we extended that construct to incorporate the other team members as well. I have graduated from medical school not that long ago, 2008, we were never, there has been no education, formal education about how do you talk to your patients? How do you make that heart to heart connect? And in all honesty, medicine is a taxing career. You miss out on a lot of social engagements. You're never at your cousin's wedding or birthday parties. You're always in the college, always preparing. And so a lot of times we miss out on that training. Very essential part of becoming a full grown, you know, human being is that how do we connect? How do we interact? It's not that the intention's not there, but you somehow become more. Um, trained in looking at, is the patient at risk? What does they need from me now? They should not escape from the, you know, filing and they should be reported well and all of those really important things. But I think looking at where we stand as a community now, globally, I think there is a greater need for. attachment, you know, that kind of heart to heart that I hear you, I get you, especially in my world of research, which is chronic pain. You don't see pains, pain is very subjective. You don't see mental health issues, very subjective. You have to trust your patients. And so you need that very deep connection with them.

amit-gupta_1_04-18-2024_083542: 10:59

that's infusing

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 11:01

Yes.

amit-gupta_1_04-18-2024_083542: 11:05

me, how many marks did You

rahul-mehra_1_04-18-2024_180544: 11:07

You know, what actually happened is, you know,

amit-gupta_1_04-18-2024_083542: 11:09

doctor.

rahul-mehra_1_04-18-2024_180544: 11:09

myself being a

amit-gupta_1_04-18-2024_083542: 11:11

many marks

rahul-mehra_1_04-18-2024_180544: 11:11

pain patient, rather, if I would say that I have had it for a very long years. Dr. Manasi knows about that. And you know, what happens is whenever you go and see a new doctor, You know, they would not know what is your level of pain and what you're going through. So they have a protocol to follow. They'll follow the same approach, you know, but with your exact doctor, perhaps, you know, who has worked with you for the last 20 years or whatever, you know, they would know that they still understand. And that is how this you know, I don't know whether the doctors have applied to this patient doctor relationship with me, but that relationship automatically forms over a long period of time. But yes, if that is the case, sometimes when you have to, you know, mandatorily change the doctor for some reason, you're moving out. I've seen those times when it is very difficult to explain. For example, I have ankylosing spondylitis and doctors telling me, you know, you have cervical and I tell them that it is not cervical. You understand how it goes. And they are referring me to a physiotherapist at the time when I have a few spine. So, you know, these are the things which I understand. And sometimes what happens in case of pain, your family also gets carried away. They say no, Doctor jo keh rha hai it's fine. Doctor thik keh rha hai doctor ki suno You know, that's how, especially in India, we treat doctors that way that, you know, doctors are God and, you know, listen to them properly. So, yes, I understand. This is very important. What you're doing in great. Mere gharwale to ye puch

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 12:36

lete hai tumhare science

rahul-mehra_1_04-18-2024_180544: 12:37

me marks kitne aaye the Tum doctor ko challenge mat kro tum ye btaao tumhe science me marks kitne aaye the

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 12:45

No, it is a very interesting thing. A one part of my research, when I look at mental health, I've started pushing for this agenda that why don't we ask about family functioning? a clinical parameter, because do invite families into the consult. So we have someone sitting right there. so how about making that as an important parameter, not necessarily giving us, you know, insight into private life, but essentially it very acceptable that your family functioning is key to your recovery. think when you share this knowledge, in my experience, I've seen that whenever you give this information in a very simplified way to families and carers and support people in someone who's struggling with mental health or chronic pain, it just improves their you know, way they cope with the issues. Multiple times, because then it becomes like a collective thing. have someone to remind them of that. And you also give some power back to the person who's suffering and say, look, the way you respond to your loved one has a long lasting impact on not only your well being, but their well being as well. So more power towards a share of that. And I have seen very outcomes with that. And it's going to be a lot of, you know, fancy term here. There's some work that I'm doing on it. Very fancy term, but it's simply that when you are in a very close family relationship, whether it's your partner, your spouse, or a carer, Um, um, or dad, happens is when you have a chronic conditions, you not only are coping with it as an individual, but aap saath me mil k you're trying to navigate that challenge. So you're coming together as a team and you're trying to approach it. And so as much as they can support the patient, the patients, we, they respond also influences their mental health. So it's a give and take. And I think that information when you put out or when you share it in a patient forum, that has a very strong impact. I have seen, so much of, um, growth from those kind of sharing of knowledge and giving back the power that, okay, you can self manage this. is the way you need to look at it. So it's a very interesting that, you know, you get to hear this kind of stories, which align with what work you do. So thank you for sharing that.

rahul-mehra_1_04-18-2024_180544: 15:20

So, Dr. Moorthy you spoke about communities, right? How do you ensure that treatment plans are culturally sensitive and you know, supportive of the backgrounds of your patients?

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 15:32

No, I think it's a very brilliant question and something that I will be very honest that I'm still trying to navigate. I think one of the key facts that whenever I get an opportunity to speak anywhere, me, it's really important that. People do realize that representation really matters and most of the times the conversation is based on how do we bring a community on board who is underrepresented often it's looked from a deficit perspective that there's a gap. How do we fill it? But honestly, if you bring, um, ethnically diverse community on board, you are going to get more perspectives on board and also learn from their traditional knowledge. You know, their way of coping, how they were doing it when you were not part of that storyline. And so there's a lot of sharing going but Oftentimes from a you know, Caucasian perspective, it's looked at as a deficit. think that needs to change. Always have a representative from the community that you want a representation on board right from the get go. So when you conceptualize your, say, a pre treatment plan treatment service. Have the representatives from that community on board from the inception. So they become a part of the co design it with them. Do not create a product and then try and fit it on the community. It should be the other way around. Consult with them. this meet your needs? Does this meet your demands? Is this sufficient? How can we tailor it? And that's how you progress. on a practical level, um, clinical management or a practice guideline. I think that is very key. And I have seen that we are, I'm working with a pain unit here in South Australia, where they have a lot of Nepalese community seeking pain care. And so they approached me and we are developing this practice where the community will be involved to understand what their specific needs are. Where are the gaps in the system? How can we make it seamless, that they take it home and make it their own. There is no point in having something which just sits on, you know, great publications or, you know, just on a computer. It needs to go and gel well with families and for that you need that family when you design it. That's the only way forward.

amit-gupta_1_04-18-2024_083542: 18:01

You take it home and make it your own.

rahul-mehra_1_04-18-2024_180544: 18:03

Excellent.

amit-gupta_1_04-18-2024_083542: 18:04

I like the slogan there. Dr. Manasi, in, in your line of work, and especially when you're dealing with mental health and trying to build equity around that, are the biggest challenges of both indigenous and immigrant communities? I think they they may have slightly different challenges that you observed. What would be the differences and how are you, um, addressing those?

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 18:34

No, that is very important question, especially from an Australian landscape. I think one of the major challenges for the Indigenous Australian group or the First Nations people is that there is a history of colonization. There is a sense of intergenerational trauma. So it is, comes with that narrative. And also they have a deeper connection to the land, to the country. So when we look at chronic pain, you cannot just look at it from a very biomedical perspective. to give you an example, the research that I have done, some of the interesting facts that have come out, uh, say for example, you have a young adult. Australian male who got injured in an accident, comes to an ER and is getting treated for an acute, say, arm injury. So you look at the arm, it needs bandaging, it needs plaster, you do that. But if it's a First Nations community member, really need to go deeper in the history because that might not be their primary injury. It might be that they have had similar injuries in the past because of the high rate of you know, violence in the community, but also look at where their emotional level is, where, you know, what sort of, um, history their families have had. That is really key because If you treat their arm just as an acute presentation, but it's actually not. It's a chronic presentation. are just not matching up the care that is needed. So I think in that sense, there is a a contrast difference between communities and the care that they require. And that is what I'm trying to push forward a little bit that, you know, when you see someone who is, um, ethnically different, take a different lens when you look at that patient that you can have a, you know, good management plan for them.

amit-gupta_1_04-18-2024_083542: 20:29

And how do you avoid bias

rahul-mehra_1_04-18-2024_180544: 20:31

True. All right. All right.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 20:34

Very difficult, I think. I think For me personally, because I'm born in India, coming from a low caste background myself, I have been very close with discrimination. It's almost been a part of my growing up. So for me it was never a thought whether I want to work for underrepresented community. It was just something that I absolutely knew I was going to put my hand in. But I think when you think of challenges such as You got to accommodate for certain community. I think that's where the bias is creeping. Whereas what I try to promote is that we are going to gain a lot more if we include those communities because there is some knowledge base. There is in those communities, which we have not tapped into. So our lives would be much richer as a fabric. I often try and explain it as a puzzle that you If you want to tackle an issue, you got to put all the cards on the table, align them, look at the whole picture, and only then you can set something which is really sharp and really you know, perfect on management plan. But if you just look at half the picture, half a treatment, And try to, you know, maximize it to a hundred percent. That's never going to happen because you are missing a part of that very important story. I think that's where I think bias can be minimized. If you just understand that it's not really, um, changing your ways, but just accommodating different needs and, you know, different communities, and that would make. Our management far richer, far better with the knowledge that we gain. So it's not really, um, any adjustment in my eyes at least.

amit-gupta_1_04-18-2024_083542: 22:26

Thank you. Dr. Manasi? Dr. Manasi,

rahul-mehra_1_04-18-2024_180544: 22:30

Dr. Murthy mental health care often requires, you know, some sort of collaboration across various disciplines. Um, can you discuss any interdisciplinary partnerships that have been vital to your projects? Dr.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 22:47

my whole career has been such an interesting journey, primarily because I've worked with really different groups because chronic pain and mental health are such presentations that they. merge well with different, you know, illnesses and different conditions. One of my mentor, Professor Lisa Jamieson, who is from University of Adelaide. met when I was doing PhD and we just started discussing what my PhD was and I mentioned chronic pain and she said, okay, I said, I'm interested in First Nations people understanding their chronic pain. She said, why don't you come along and see what we can do in our research project? And so we tried to look at the data and we started asking the study participants just to get a sense whether this is necessary or not, do you have pain? And we had almost 90 percent people say yes. because they were from an oral health background, they had never asked that question. And so when 90 percent of them said, yes, I have pain and chronic pain, which is like pain more than three months. And I've been dealing with mental health issues related to it. I lack confidence. I'm struggling to speak up. I'm embarrassed. Sometimes it brings stigma to my life. Like really. issues, but because it was something study did not necessarily need it. It wasn't asked. But when we did ask, we had like this Pandora's box open up and we have been asked. Touch wood. So lucky that we had very successful collaborations. We ended up doing the first study in chronic pain, understanding First Nations people's perspective of what they thought about chronic pain, how they coped with it, and which ended up, um, developing a pain scale, which is co designed with the community. So quite a long standing and very interesting collaboration. That comes to mind, but also other bits like with rheumatologist on chronic pain. We have a very MRFF grant, which will now connect to understanding chronic pain and mental health burden in children and adolescent population and will connect it to biobank. So we'll have samples from all sort of fluids, blood samples, saliva, and it will be an ongoing longitudinal study. So we'll have a record first time in Australia. So very fruitful collaborations have come around with this area of research. Dr.

rahul-mehra_1_04-18-2024_180544: 25:13

Manasi we have a lot of audience, which is in India also, right? So in the US and I understand that whenever there is chronic pain, there are, you know, mental issues also.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 25:23

yes,

rahul-mehra_1_04-18-2024_180544: 25:24

Because they're struggling with it. Right. So is there something back home for Indians that, you know, where they can go and address it? Because it looks like, you know, whenever you go to a rheumatologist or a, you know, pain doctor or orthopedics people also you hear people go to, you know, they will only treat your pain, right? So, is it okay for a person who is experiencing pain to go to a mental a neurologist or a psychiatrist as well? How does that work?

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 25:56

sure. I'm not very experienced, I must say, with the Indian way of management at the moment, but I would strongly suggest that It is definitely a good idea to be mindful about mental health challenges when it comes to chronic pain, because what we see from research and clinical practice is that the presentations are very similar. So when you have chronic pain, you're usually in high distress, function, you struggle to function well, your mood is not very good, your sleep patterns are all over the place. very close presentations when it's a mental health issue. So what literature shows us is that oftentimes when you see a physician, one of the things will get treated, focused on, the other will get kind of backsided. So it is really important that patients or people who experience chronic pain are mindful of it. So some things that I think have really helped in my world, what I see has helped my patients is Just the knowledge that keep this in mind that you need to take care of your mental health. And by that, I mean, slow down a bit inbuilt strategies such as mindfulness, even if it's just between different tasks, just taking a moment, taking slow breaths, grounding yourself wherever you are, whether you are standing, you're sitting, doesn't matter. But just take a second to just yourself, bring yourself into the present moment, then move on to the next task. If it's a really heavy day, you're busy plan, plan it out in such a way that you pace it. So you do not do too much in the morning or too much in the afternoon or evening, but you pace it out across the day that really helps keep your nutrition well in, in sense that. do not indulge in, you know, junk food, try and keep as much clean eating habits. Exercise is always great. But when we say exercise, people often think that we are asking them somehow to increase their, um, you know, energy expenditure by doing cardiovascular or such exercises. What literature shows is even taking like Even taking like a 10 minute walk in nature can have impact on your mental health and chronic pain because nature does has the ability to kind of calm down the nervous system, make you feel like this is going to be okay. And that's the whole thing that once you recognize that I can ride this out, can overcome this. That's what helps you manage your mental health or chronic pain situation really well. So there are simple things, but you said, it would. It would not be a harmful thing to have a session with the counseling, um, not psychiatrists, but psychologists have a chat or even your loved ones or family or someone think is comfortable, you know, confiding in, have a little bit of a conversation. I think that would always be very helpful.

rahul-mehra_1_04-18-2024_180544: 29:04

Thank you, Dr. Manchia. It was very insightful. I understand.

amit-gupta_1_04-18-2024_083542: 29:07

the previous question, you mentioned about the grants and how they helped you with ensuring that you're able to, um, your initiatives forward. So what is the typical, how would you rate the importance of the awards and the grants especially in the mental health equity subject, right? So how is that helping you propel your initiatives forward?

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 29:35

It has been excellent, I must say, because I think for me, one of the biggest challenge when it comes to grand success, so way two different things, grand success and the awards. When it comes to grand success, there is a lot of challenges to overcome, related to the kind of work I'm involved in, which is. communities. The main challenge for me is that we cannot, I cannot show the productability that comes with the Western study design. So for example, if I was just running a study with Caucasian population here in Australia, I could produce two or three studies and have four or five papers. But when I'm running it with the community, my intention is to co design it with them. So it is their study. I don't hold it as mine. I'm sharing that as well.

rahul-mehra_1_04-18-2024_180544: 30:27

Yeah.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 30:27

So it takes longer to develop a research study, to recruit people, to run it, to then, you know, all those processes. So when you go to a grand round, when they compare that, Oh, your counterpart has produced publications and stuff like that. And you have not even managed to, then it, your scoring declines. So I think that challenge has always been very difficult to overcome for me. Um, but what the awards really did was that it raised the. Limelight on the topic, which I'm very grateful for because I think though the recipient of that award or the name is mine, it doesn't really belong to me. It belongs to all the people who have shared their knowledge and their information with me who have been comfortable and confident enough. For me to carry that ahead, but also other people like colleagues and family and friends who have supported that journey. So what the awards did was it brought some limelight onto the topics. What that translated was that getting an opportunity to speak at meetings globally, as well as nationally and talk about it. I think the more I have. Made it sound more not, um, difficult topic. Like it's not something which is, which people should shy away from or feel like, oh, that's too hard. It's something really simple, like having a friend from a different background. It's not challenging at all. And I always say that I'm here. I'm here to help with anything that needs help like ethics or whatever it takes. I'm there to support. I think that has allowed for the conversation to extend. And now I see a lot of other, um, you know, states and different clinics approaching for do we build this for our particular community? Like we have refugees here. What can we do differently? We have this community here. How can I tackle this? So the interest has grown a lot, which I think all due to the grants and the focus it draw from that. Yeah. So very helpful with that cause.

amit-gupta_1_04-18-2024_083542: 32:35

I can now connect the dots, right? So you were actually in India receiving an award. For your contribution in this space and that's where you met Rahul

rahul-mehra_1_04-18-2024_180544: 32:45

That's right.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 32:46

Yes.

amit-gupta_1_04-18-2024_083542: 32:46

were able to organize this conversation. So, yeah, I think awards leads to you know, getting that attention, which then leads to having more conversation on this very important subject.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 33:01

Yeah, absolutely. And

rahul-mehra_1_04-18-2024_180544: 33:02

Yeah. So,

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 33:03

mindful that the work that I'm doing not your Instagram worthy, TikTok worthy topic, it's real people content. It's going to take more years than my life can afford. I'm very mindful of that, but I'm very happy also in knowing that I could push the envelope a little bit. was all the goal was that, you know, always learned it from my parents that if you are ahead in the line, you always give hand for people who are coming behind. So in this context, I always feel grateful that I was able to push that envelope a bit also normalize it and take out the fear of what's going to happen. By being here in Australia, really, to, you know, represent the communities and say, I'm here to help. This is not a challenging topic. It's not a difficult topic. Let's make it simple. The more we do this, the easier it will get. So that's all the hope that, you know, in this lifetime, we make it easier.

rahul-mehra_1_04-18-2024_180544: 34:02

Dr. Manasi, let's push the envelope a little more and request you to, you know, give some advice to other healthcare providers who are looking to incorporate mental health equity into their practice.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 34:13

Sure. Now, again, I think really, Try and understand the people that you see, try and understand what their main challenges are. sometimes I have noticed in my own care practice and research that because of whether it's Google or whatever, people are often accepting that when you have mental health challenges or when you have chronic pain, this is something I have to manage lifelong. But they're dealing with different sort of presentations and different types of complications in life where they need someone to just validate that and say, yes, that can happen. I know it can happen, I believe you. I think that is also a key role that healthcare can provide. So my advice would be, listen to your cohort, understand what their problems are, bring a couple of community members on board to whatever your panel is, or form a group, form a working group, a model where you have a working group, invite people from community to have a chat, then keep them involved as you build any process, you build a research or you build a practice, you know, structure, anything, keep them involved so that they can take it back to the community and say, look, guys are doing this. be supportive of this. So they become your channel for communication. I think these are very important things. And if someone keeps that in mind, that's about it. Keep a good intention and keep at it. I think it's a very important topic to, to explore.

rahul-mehra_1_04-18-2024_180544: 35:49

Is there some sort of you know, a training program or some sort of a certifications that physicians can go through for mental health equity in incorporating that?

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 36:01

There are quite a lot of programs. I haven't done anything specifically apart from my PhD and my work with the Harvard Medical School, but that was more to design. Projects, which are at a national or a global scale, but there are a lot of mental health first aid programs. We know from Australia, we are given a list of, um, you know, organizers who provide the certified courses. And it's usually a day or two day program where you learn how to handle if someone presents with a mental health condition, but I'm sure every country does have some sort of programs on board. It's just about finding out where it is you. Or create, invite someone from outside and run a workshop in your hospital or your clinic on, okay, what's the research saying, what this person has been doing. Just get a different perspective, understand from them. I think that would be very helpful.

amit-gupta_1_04-18-2024_083542: 36:57

That's another new

rahul-mehra_1_04-18-2024_180544: 36:58

Thank you.

amit-gupta_1_04-18-2024_083542: 36:59

mental health first aid, right? Whenever we think of first aid, I'm always thinking of a band aid or, you know, somebody's got an external injury and that's where first aid is being used. But now when I think of this and I, I can see you know, the relevance of first aid, especially in the mental health segment. So can you.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 37:20

Yeah,

amit-gupta_1_04-18-2024_083542: 37:23

a story or a, you know, an experience from your work that has inspired and motivated you to invest all this hard work in this category.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 37:36

I think for me, the start really was that I myself got burned in a fire accident when I was in my 10th standard. Um, I still remember very clearly the horror I saw on my parents face because they thought I was lost in that accident. And so my whole, um, agenda from that on forward was that whenever they asked me anything, I would say I'm perfectly fine and I would smile. And. I think I started looking at chronic pain when I started practicing was that there's so much of layers of it. As you grow older or depending on the way life is going, different circumstances, different stresses, it changes. It changes with you and it grows with you. Um, and it presents with very different sort of challenges. And there's never a moment where are ever educated that look, this will bring this on as well. So these are some of the things that you need to prepare, or these are the skills that will make you more resilient, or, you know, just empower you to manage it better. And that's where I think my interest started with trying to understand Why why these things are not taught in medical school? What is it that, why are we overlooking it? When that was like the number one issue in clinical practice. So that led to whole of this journey. I think when I look at CALD communities or I look at indigenous communities in Australia, I'm just amazed at the resilience. I mean, there are moments when you feel, when you hear the stories is that nobody has. them this excellent pain or mental health management plan but they're still going on with life with full jest. Like there's the ability to overcome, up and live and push for a meaningful life is just it amazes you. that also kind of feeds into the fact that okay, if people can show you that, then there is a merit in pushing for this and trying to help people who need voices. So, these are two things which I think are really key and I also see as a outsider coming into a new country and going into different countries. I have had the opportunity to look at different healthcare systems and how they function. Um, I often feel that society has changed so much the last 20, 30 years from what I grew up thinking of as family is way different to how families are now. so our science needs to reflect that we cannot be pushing with the same One mom, one dad, and, you know, two kids sort of an image. We, that's very de servicing to the community. I think we really need to replicate what we see in the society, in the science we produce. This mismatch just, I cannot comprehend it sometimes. And so are the factors that I think really motivated me to say that I'm going to work in this and look at from a deeper perspective.

rahul-mehra_1_04-18-2024_180544: 40:48

Right. Dr. Manasi, we heard a lot from you and it was a very deep dive experience into, mental health equity with you. So finally, we'd like to know what are the next steps for your research and programs and are there new areas you're planning to explore in the near future?

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 41:07

Sure. No, I think one of the key things that I want to push for in my future sort of plans is to look at prevention because we also see from our work that once you have a clinical diagnosis of mental health, your opportunities or the windows you get to intervene and the patient to comply to newer ways of management or, you know, self management becomes limited and limited. Okay. So, it's better off to start at an early stage. You look at a preventative program and you build it into your system in such a way that you educate your patients. okay, this is something that they should be mindful of. And I think that's where I want to work more now. Look at how I can build a preventative lens into all of these issues and, um, help patients, you know, not just have a life, but also a purpose driven life that, you know, Similar to what life throws at you, the conditions can also throw different challenges, but there are issues, there are programs that you can help you manage it. So this, you know, some sort of companionship in that sense with them.

amit-gupta_1_04-18-2024_083542: 42:21

But I think that plays along with, your philosophy of not just treating the symptoms, but going to the root cause, right? So this is this is a similar sort of interpretation where you're not just looking at, okay, treatment post, um, identification, but looking at how you can prevent it by addressing those root cause so that even, um, these sort of incidents are reduced the root level itself, right? So I think I

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 42:51

So true. Yeah. So true. No it's important. I think with the kind of pressures, have built around ourself in the modern society. I think mental health is going to be a challenge for everyone, either personally or with a loved one or a family member. So it's not something which is far off. It is very much here and very close to home. I think it makes sense to look at it from early on rather than waiting for someone to get a diagnosis and then down on how to manage it. It's better to look at it before. Definitely.

rahul-mehra_1_04-18-2024_180544: 43:31

So, Dr. Manasi, This is there's a question coming to my mind, a very quick one, you know, nowadays we see a lot of road rage happening and you know, people because of stressful environments at the workplace, you know, do you think these can also be covered under mental health issues? Or is it really something when chemically goes wrong, you call that a mental health issue?

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 43:55

Not really. I think it would, I'm not aware of the road rage thing, but don't think it would come under mental health, but definitely would have to look more into it.

rahul-mehra_1_04-18-2024_180544: 44:06

Stressful lives that we live, you know, a lot of ambition, a lot of ambition, a lot of wants in life. So does that also give you a mental stress and eventually mental health issues?

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 44:20

I don't think so. I have never read anything that kind of puts that link, but he has been very, um, sort of personality trait can often give you more distress, mental health issues, but just a lot more anxiety, a lot more performance. challenges where you do not kind of figure out where to stop and where to, you know, slow down. That can be a challenge, but I've never seen a link between mental health issues.

rahul-mehra_1_04-18-2024_180544: 44:54

Okay. So that, this was just for our viewers, you know, to, who might confuse between the two things. So

amit-gupta_1_04-18-2024_083542: 45:00

Now,

rahul-mehra_1_04-18-2024_180544: 45:01

that's great. That's great.

amit-gupta_1_04-18-2024_083542: 45:02

conversation, Dr. Manasi. I think it, It is a very complex subject. Our human brain is not a very straightforward thing to interpret. And I would like to thank you your team and all the community of the scientists who are actually working very hard in making sure that this world is a safer and a happier place to live in. And it is it is commendable that you're working both for. The indigenous communities, the immigrant communities and the way your research is helping people live better lives. So, I want to thank you on behalf of the Indian community, on behalf of our team and everybody who's watching. We cheer for your work and we would like to see you again on the podcast talking you know, about your work and all the new developments that you see in your space.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 45:55

Sure. No, thank you so much, Amit and Rahul. I think the platform that you have created is so fantastic because it you an ability to connect with people back home as well and share your work. So thank you for doing this really important work. And maybe this conversation leads to, you know, collaborations where we can look at Indian you know, hospital system or clinics who might be interested in partnering. So I'm hoping that then next time when we meet, I have a better answer for Rahul's question of how. The hospital system in India, because it's a different landscape when we compare it with Australia. So hopefully this conversation leads to that. Thank you so much for your invitation and the time to have this wonderful chat.

rahul-mehra_1_04-18-2024_180544: 46:42

No, we would definitely, you know, there is a way to contact UN for Indian hospitals or medical institutions to partner with you or, you know, something similar. We would definitely like to give those links in the description so that, you know, definitely people can use it.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 46:58

No, definitely happy to share my email and the LinkedIn and people can connect with me there.

rahul-mehra_1_04-18-2024_180544: 47:04

Sure. Thank you so much, Dr.

amit-gupta_1_04-18-2024_083542: 47:06

All the links will be in the description of this video. So people should be able to reach out to you from there.

dr-manasi-murthy-mittinty_1_04-18-2024_220542: 47:13

Sure. Sounds good.