Healing A Broken Mental Health System: Justine Carino of Carino Mental Health Counseling Services On 5 Things That Can Be Done To Fix Our Broken Mental Health System
An Interview With Stephanie Greer
Longer paid maternity leave for parents, also parents who are self-employed. Women and babies are dying due to postpartum mental health issues. This issue gets completely ignored in our country.
The current state of the mental health system is a conversation that echoes in the halls of policy-making, the corners of social advocacy, and within the private struggles of individuals and families. As we continue to witness an unprecedented need for robust mental health support, the shortcomings of the existing system become more glaring. It is within this backdrop that we seek the insight of those who are at the forefront of behavioral health. In this interview series, we are talking to behavioral health leaders, policymakers, mental health practitioners, advocates, and reformers to share their perspectives on healing our broken mental health system. As a part of this interview series, we had the pleasure of interviewing Justine Carino, LMHC.
Justine Carino is a licensed mental health counselor, anxiety treatment specialist and host of “Thoughts from the Couch” podcast. Justine currently maintains a group private practice in New York and helps individuals and families decrease symptoms of anxiety and depression, recover from anxiety disorders, improve their relationships and set better boundaries. Justine has over 10 years of experience and uses both cognitive behavioral therapy techniques and family systems techniques when working with her clients. She also has a signature program for stressed out working moms called “The Path to Peace.” This support group offers a step-by-step stress relief system that helps reduce anxiety, set better boundaries and create a personal mental health routine for moms trying to do it all. Justine’s advice has been featured in various media outlets such as Cosmo, The Huffington Post, News 12 Westchester and The Self-Helpless Podcast. Her services can be found on www.carinocounseling.com and you can find her on Instagram @_thoughtsfromthecouch_
Thank you so much for joining us in this interview series. Before we start, our readers would love to “get to know you” a bit better. Can you tell us a bit about your background and your childhood backstory?
I grew up in a small town in upstate NY with my parents and older brother, surrounded by the Shawangunk mountains. I spent most of my time at the dance studio. I was a trained competitive dancer and throughout my childhood I was found rehearsing for shows and competitions and spent summers training at various dance intensives, such as The Joffrey School of Ballet. I had a close crew of 9 girlfriends that I have known since preschool and elementary school that I still see frequently today. My Puerto Rican grandmother was like a second mother to me because she helped out with childcare, since I had two working parents. I can still smell her rice and beans.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“This too, shall pass.” This reminds us that everything is temporary, both the good and the bad. When things have been hard, I always remind myself that we are resilient as humans and we find ways out of dark times. I grew up with an alcoholic father who still struggles with his addiction today, so our family has seen some really dark days. Sometimes circumstances have been so overwhelming as an adult child of an alcoholic and I have felt like I’m living in a nightmare, but even the hardest days get a sunset and we rise again.
Let’s now shift to the main part of our discussion. It is often said that “the mental health system in America is broken”. What does that statement mean to you? From your perspective what is “broken” today?
There are so many things that add to this broken system. First of all, there is limited access to good resources. At least where my private practice is located, most of my colleagues are full and can’t take on more patients. I have had a consistent waitlist for the past three years. This is just for the most basic level of care! When I’ve had a patient in crisis due to suicidal thoughts or self-harm behaviors, it’s been impossible to get them into higher levels of care such as inpatient or partial hospital programs. These programs also have long wait list and if a patient is lucky enough to get into one of these programs, then the insurance company dictates how long their length of stay can be and they are often discharged way too early.
Insurance is a whole other issue. Insurance companies don’t pay their providers what they are worth and will often find any small reason not to pay for a therapy session, so many psychiatrists and other mental health professionals decide not to get paneled with insurance companies and only take private pay. Unfortunately, this leaves only individuals with the financial means to have access to good mental health care. People who can’t afford a psychiatrist who is trained to diagnosis and prescribe specifically for mental health issues then get prescriptions from their primary care physicians who take their insurance, but these physicians do not have the proper training in treating a mental health diagnosis. Insurance companies also dictate how many sessions a patient can have per year and even deny coverage for some diagnoses. Big companies such as Better Help are trying to resolve this issue by offering cheap and easy access to online mental health support, but they don’t pay their therapists much so the therapists have to treat an obscene amount of patients to make an income and then they burn out and leave. The patient is then handed over to the next therapist so continuity of care is impacted as well.
Lastly, our teen and young adult suicide rates are off the charts and students need much more access to support.
College campuses don’t have enough staff to support the high demand for young adults seeking mental health support at their institutions. If the student’s parents have the means they find them a private therapist. If they don’t, colleges often limit the number of counseling sessions to 2–3 sessions per semester.
What about any bright spots? Do you think there are any elements that we get right in today’s world that we wouldn’t want to reverse unintentionally?
The bright spot is that mental health has a seat at the table now. Our culture today is much more in tune with the importance of mental health and the impact it has on every aspect of our lives. Therapists have podcast and instagram accounts, reality TV stars are filmed on the therapy couch, and now it’s kind of cool to talk about being in therapy! There is much less of a stigma around mental health.
In your opinion, what are the 5 most impactful things that could help heal the broken mental health system? These could be on any level including training, workforce, policy, culture, equity etc.
1 . Development of more mental health treatment centers that can provide longer and higher levels of care so less people have to wait for treatment.
2 . More education in the school systems to students around mental health and ways to cope with stress, anxiety and depression.
3 . Insurance companies having less rigid requirements for coverage or reimbursement to their members and insurance companies increasing their reimbursement to psychiatrists, psychologists and other mental health professionals for treatment.
4 . More education in the workplace about burnout, stress, and other mental health topics which would increase work performance.
5 . Longer paid maternity leave for parents, also parents who are self-employed. Women and babies are dying due to postpartum mental health issues. This issue gets completely ignored in our country.
If all of the items on your list were magically implemented tomorrow what change might we see in the world? What are the signs (big and small) that would show us that the system is being healed?
Plain and simple, people would have much more access to effective mental health care and more of an understanding on how to handle mental health issues properly. Suicide rates would decline, there would be more attendance in schools and the workforce, and less money would be spent on the treatment of medical issues because many are tied to struggles with anxiety, stress, depression and addiction.
What is a project you or others are working on today that gives you hope? How can our readers learn more about this work?
I have created an online stress and anxiety management program for working moms called “The Path to Peace.” Working moms today are struggling more than ever to try and manage their careers and motherhood and no one is showing us how we can take care of ourselves while doing it. We are finally saying “help, I can’t do it all” but are still expected to do so. So I want to give mothers the tools they need to effectively manage stress, anxiety and burnout and connect with other women who are in the same boat. You can learn more about that program here: https://www.carinocounseling.com/path-to-peace
How do you see technology shaping the future of mental health care and its accessibility?
I think its absolutely amazing that technology allows us to connect at a distance with individuals who want mental health support. It gives individuals more of a choice of who they want as a provider. I think virtual therapy is something that is here to stay. People are able to slip therapy sessions into their lunch schedules, breaks, and after putting their kids to bed without needing to leave the house. It makes it much more convenient and accessible.
In your view, how do social factors like poverty, education, and culture affect mental health care and its effectiveness?
Unfortunately, lower income individuals have limited or no access to good quality mental health care. They are met with long wait lists because of needing to utilize their insurance and if they don’t have health insurance or the means to pay privately, they have no access to care.
In light of the growing mental health crisis among young people, what innovative approaches or interventions have proven most successful for children and adolescents?
I combine both cognitive behavioral therapy and Bowenien family systems interventions. You cannot treat a child or adolescent without understanding their parents, the dynamics in their home and the history of their grandparents. This directly impacts who they are, the beliefs they create about themselves, how they understand their emotions and cope with stressors. Our families of origin are the template for how we relate to others, set boundaries with others and how we process our emotions.
Are there any books, podcasts, or other resources that have helped you understand or manage your condition better?
We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch, and why? He or she might just see this if we tag them. 🙂
Oprah Winfrey!!!! Because, she’s Oprah Winfrey 🙂 I don’t think she needs an explanation. She has been my mentor without even knowing it since watching her show every day at 4:00 pm after school with my grandma as a little girl.
How can our readers further follow your work online?
My website is https://www.carinocounseling.com/
Thank you for your time and thoughtful answers. I know many people will gain so much from hearing this.
About The Interviewer: Stephanie Greer, PhD is the Co-founder and CEO of Akin Mental Health — a company dedicated to guiding families on their journey supporting a loved one with mental health challenges like bipolar disorder, schizophrenia and severe depression. Stephanie is passionate about this topic from her own personal experience growing up with a mother who struggled with bipolar 1 disorder and found a path forward to overcome the obstacles and live well. Stephanie’s professional experience includes a doctorate in neuroscience as well as design research roles at Hopelab and Apple. Stephanie brings this personal passion together with her world-class science and technology background to support families across the US in their personal journeys supporting loved ones with mental illness. To learn more about Akin Mental Health and join our community, visit us at akinmh.com.
Healing A Broken Mental Health System: Justine Carino of Carino Mental Health Counseling Services… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.