Healing A Broken Mental Health System: Sanna Khoja On 5 Things That Can Be Done To Fix Our Broken Mental Health System
An Interview With Stephanie Greer
Economic inequality significantly contributes to mental illness and acts as a barrier to accessing mental health care. Universal basic income could help individuals meet their basic needs; this would greatly reduce the negative impact of social inequities. Meaningful change in mental healthcare can only occur when we level the playing field.
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 Sanna Khoja.
Sanna Khoja (she/her) is a South Asian Licensed Professional Counselor (LPC) who specializes in working with individuals affected by anxiety, burnout, ADHD, and childhood trauma. She offers virtual somatic therapy and coaching for adults in Texas and is trained in various modalities, including Brainspotting, Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and therapy rooted in self-compassion. Sanna’s deep understanding of the unique challenges faced by the South Asian diaspora and immigrants fuels her passion for providing culturally sensitive mental health support.
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 am a Pakistani American living in Houston, Texas. My parents immigrated here in the 1980s, so I was born in the U.S. and was raised in a small town. I lived with multiple generations and extended family members under one roof. Growing up in a big family was tough. My childhood lacked stability and guidance at times. My parents were also more conservative then than they are now which led to conflicts between us — they desired to preserve our culture and I desired to assimilate and belong. These conflicts definitely led to positive changes in my family over time though. There was a point when my profession was a rebellion against the expectations of my parents; now they are so proud of me and value what I have chosen as my path in life.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“Letting there be room for not knowing is the most important thing of all. When there’s a big disappointment, we don’t know if that’s the end of the story. It may just be the beginning of a great adventure. Life is like that. We don’t know anything. We call something bad; we call it good. But really we just don’t know.” ― Pema Chödrön, When Things Fall Apart: Heart Advice for Difficult Times
Growing up, there was a lot of “not knowing” amidst the chaos of living with 10+ people. This uncertainty resulted in me developing a fear of facing discomfort! This quote helped to remind me that uncertainty is an integral part of life and a way of being. The uncertainty principle helps me embrace the humanness in what I do in everyday life, and as a professional counselor. When I try to control or predict what happens (two behaviors that support the avoidance of uncertainty), I am not as effective as a counselor. It is liberating for both the counselor and client to accept uncertainty as a part of the process.
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?
The healthcare system as a whole is unfortunately flawed, and the mental health sector faces several specific challenges. These include a lack of emergency mental health services, control exerted by insurance companies over access and duration of care, inconsistent treatment quality, therapists being undervalued, undertrained, and underpaid, excessive reliance on psychiatric medication, addressing symptoms rather than core issues, burnt-out psychiatrists with inadequate time for patients, and a deficiency in trauma-informed care, especially within hospitals.
Additionally, the narrative that mental health is solely an individual’s responsibility allows the government and profit-driven corporations to perpetuate business as usual. Systemic issues such as racism, sexism, xenophobia, and economic inequality embedded in healthcare structures further hinder access to adequate care. The separation of physical and mental health in the U.S. often leads to putting blame on individuals rather than demanding comprehensive reforms from the country.
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?
Absolutely, amidst all of the challenges within our mental health system, there are a few things I believe we get right. For one, community-based support groups provide a vital space for individuals facing mental health struggles to share experiences, foster a sense of belonging, and access empathetic support — people need to feel seen and heard by other people who understand what they are going through.
The presence of school counselors is also a bright spot, as these professionals play a crucial role in early intervention and support for students dealing with various mental health issues; however, school counselors are often spread too thin with competing priorities — supporting student’s academic success, alongside their mental and emotional needs can be challenging.
Additionally, community mental health clinics serve as entry points for individuals seeking professional help. These clinics often offer a range of services, including counseling and psychiatric care, at a more affordable rate than other facilities, addressing the need for accessible, localized, and culturally sensitive mental health support.
While there are several things we do “get right”, it’s imperative to recognize that these bright spots operate within a broader system that does require change.
While there are several things we do “get right”, I’d like to see us move towards a system that not only maintains these elements but also expands and integrates them more comprehensively into the overall mental health infrastructure to meet the growing demands and complexities of mental health care in today’s world.
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. Universal Health Insurance:
Universal health insurance — first and foremost. Access to mental health care should be a right, and measures such as defunding insurance companies that consistently deny coverage and underpay clinicians would enhance the quality of care provided in psychiatric hospitals, outpatient clinics, and private practices. On top of that, living with the reality that one bad accident or illness could cause life in medical debt is an added stressor that impacts the daily life and decisions of so many Americans, especially those who don’t earn a liveable wage, to begin with. This in and of itself negatively impacts an individual’s mental and emotional health.
2. Addressing Economic Inequality:
Economic inequality significantly contributes to mental illness and acts as a barrier to accessing mental health care. Universal basic income could help individuals meet their basic needs; this would greatly reduce the negative impact of social inequities. Meaningful change in mental healthcare can only occur when we level the playing field.
3. Fair Compensation for Therapists:
According to the U.S. Bureau of Labor Statistics, the average salary for mental health clinicians is $56,230. Considering their rigorous education and training, licensed counselors with master’s degrees deserve fair compensation that reflects the value and impact of their crucial work. Fairly compensated therapists are also more inclined to commit to community mental health clinics, which ensures services can be provided to marginalized populations. Compensating therapists fairly also decreases the risk of turnover. Adequate staffing makes caseloads more manageable, significantly reduces the risk of burnout among therapists, and improves quality care and thus patient outcomes.
4. Specialized Mental Health Facilities:
The current practice of sending individuals experiencing suicidal ideation or psychosis to general emergency rooms overwhelms and understaffs hospital personnel. Establishing more specialized emergency rooms and hospitals dedicated to comprehensive mental health care would ensure appropriate and trauma-informed treatment for psychiatric issues.
5. Prioritizing Diverse Community Care:
Recognizing that healing is a communal effort, we must prioritize diverse community care. This involves increasing the availability of care tailored to local communities, including the recruitment of more BIPOC and LGBTQIA+ therapists, doctors, and nurses. Beyond traditional therapy and psychiatry, incorporating indigenous and cultural practices, rooted in history, offers additional avenues for comprehensive treatment options.
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?
If magically implemented, these changes would lead to universal access to mental health care, a decline in stigma, and a more equitable mental health workforce. Specialized emergency care would reduce overwhelm in emergency rooms, providing tailored trauma-informed assistance. Therapists’ fair compensation would reduce burnout, promoting job satisfaction. Local communities would witness increased availability of diverse care options, embracing holistic approaches to mental health. Addressing economic inequalities and holding entities accountable for mental health support would collectively signify a systemic transformation.
The positive generational impact this would create on our collective well-being is almost unfathomable.
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 am currently working on a few projects. The first is providing affordable online courses that are focused on somatic coping skills. I can’t provide therapy for everyone, but I want to offer accessible somatic healing for people all over the world. I am also working with a colleague on creating community-based therapeutic events in Houston, Texas.
You can follow me on Instagram or Facebook for updates and check out my website for more information.
@sannakhojalpc
You may also find updates on events with my colleague here: https://www.thetherapyspacetx.com/
I also admire Dr. Jennifer Mullan who is leading the field with her Decolonizing Therapy movement. Dr. Mullan’s work focuses on changes towards collective, ancestral, and non-pathological healing. You can learn more about her work at www.decolonizingtherapy.com.
How do you see technology shaping the future of mental health care and its accessibility?
Technology is enhancing the future of mental health care by providing remote access through telehealth, mobile apps, and online platforms, and by also reducing stigma. It’s especially helpful in expanding the accessibility of services for marginalized populations and for those who live in rural areas.
However, the challenge lies in maintaining a balance: ensuring the human-to-human connection is not undervalued, and addressing privacy concerns on some platforms associated with the collection and analysis of sensitive mental health data.
In your view, how do social factors like poverty, education, and culture affect mental health care and its effectiveness?
Social factors such as poverty, education, and culture profoundly impact mental health care. Without addressing basic needs like hunger, financial strain, or cultural stigma, the effectiveness of mental health interventions, including therapy, remains limited.
Lack of access to quality education can contribute to limited awareness and understanding of mental health issues to begin with. How can someone seek help if they don’t understand they need help in the first place? Or know where to begin in the process? To enhance mental health outcomes, it’s essential to address educational disparities and promote widespread awareness to create a more informed and supportive society.
Furthermore, improving diversity in healthcare professionals, particularly within BIPOC and LGBTQIA+ communities, is crucial for providing culturally appropriate care, reducing stigma, and fostering more inclusive healing experiences.
In light of the growing mental health crisis among young people, what innovative approaches or interventions have proven most successful for children and adolescents?
A few come to mind. Play therapy, which utilizes play as a means of communication, has proven effective in helping children express emotions and navigate challenges. Eye Movement Desensitization and Reprocessing (EMDR) has demonstrated success in treating trauma and anxiety in adolescents. Incorporating Mindfulness practices into school curriculums and community programs has also shown positive outcomes — these practices foster emotional regulation and stress reduction. Additionally, community-based initiatives that involve families and provide early intervention services contribute to a holistic and supportive approach to youth mental health.
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. 🙂
I would love to meet Fatima Farheen Mirza. As the author of my favorite book, “A Place For Us,” Mirza’s work holds a deep significance for me. This was the first book that made me feel seen and emphasized the importance of including diverse voices in storytelling. “A Place For Us” delves into the complexities of family dysfunction resulting from a bicultural life in America, resonating deeply with my own experiences.
Mirza skillfully portrays each character with a blend of complexity and compassion, making them feel incredibly real. The book allowed me to connect with the characters on a personal level, feeling as though I knew them and had lived aspects of their lives. Meeting Fatima Farheen Mirza would be an incredible opportunity to express my gratitude for her impactful storytelling and to discuss the profound impact her work has had on my life.
How can our readers further follow your work online?
They can find me on sannakhojalpc.com. I invite readers to engage, share their experiences, and suggest additional solutions on my Instagram and Facebook @sannakhojalpc.
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: Sanna Khoja On 5 Things That Can Be Done To Fix Our Broken… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.