We Have Come a Long Way, But There Is More Work Ahead

Fred: 00:00:00

Foreign.

Kent: 00:00:05

Hi, my name is Kent Corso, and I'm your host for this episode of One Minute Can Save a Life. While I am a licensed clinical psychologist, none of these guests are my patients, nor does anything I say constitute medical advice.

The views conveyed during our conversations do not reflect the views, positions, or policies of any private or public organization. This is simply a series of conversations with people who have some connection to hardship, suicide, mental health, or loss.

There's so much we can learn from one another.

Kent: 00:00:36

So let's get started today. Our guest is former Wyoming State Senator Fred Baldwin. Why don't you say hello, sir?

Fred: 00:00:45

Good evening. How are you today, Doctor?

Kent: 00:00:47

Tell us a little bit about your experience in the legislature. I believe you were representing the southwestern part of the state for a few years, right?

Fred: 00:00:56

I was actually in the legislature for 10 years. I represented most of Lincoln county, all of Sublette county, small portion of Sweetwater county, and a small portion of Uinta County.

I started in the House. I served in the House for two years and then eight years in the Senate. And I just. This is my first year out, as my wife likes.

It's the first year I've been able to shovel snow, been home. So it's my first year home in 10 years.

Kent: 00:01:21

Sure. She appreciates that you're there to shovel it.

Fred: 00:01:24

Yeah.

Kent: 00:01:24

Well, just for our listeners, in order to help them understand your relevance to the topic of mental health and suicide, I am so excited that you were willing to come on our podcast because you've been deeply involved in the committees that were working on mental health. You are a physician's assistant by training. You've also got some experience as a first responder, as a firefighter.

So one of the most important things when we want to effectively reduce suicide and do a better job improving mental health in communities is to rely on our leaders and to understand their perspectives. And I think you've got a very unique perspective, Fred.

So I'd love to hear you just share what you see happening in the state as far as mental health and suicide, since you've been deeply involved in this work for about a decade. Would love to hear how far we've come.

Fred: 00:02:14

You know, I would love to say we've really advanced. And at one point during the last 10 years, I think we were improving and things were getting better.

And unfortunately, I think we sort of slipped a little bit. But. And I would give myself a little more credit than the decade because I've worked as a physician assistant for.

I don't even want to say how long, because it's a really long time. It's over 30 years. So I've been dealing with mental health quite a lot.

And of course, early on in my career, I took, you know, all the training I could get in mental health, and I deal with it a lot in my office. But most recently, myself and Representative Larson served as the chairman of what was called the Mental Health and Vulnerable Adults Task Force.

We actually did that for the last two years. We came up with a lot of good ideas and a lot of good things, though unfortunately, they didn't all survive the process.

But we've talked about a lot of things. You know, I think that there's a lot of reasons and you know that better than I, why it's evolved and why we've slipped a little bit.

And I think particularly in Wyoming, in our small little communities, may be a bigger problem in some of the more urban areas. That's just my thought. I think we're a little more isolated. And as one of my patients told me, you got to be tough to live in Wyoming.

Kent: 00:03:27

Absolutely.

And as a pa, just so that our listeners understand, many may not be aware, but physician's assistant, if you're working in primary care, which I think you were, is that correct?

Fred: 00:03:38

Primary care and emergency care.

Kent: 00:03:40

Okay.

So both the primary care system and the emergency care systems are really the default mental health systems, because both Wyoming and all of the states tend to have issues with access, timely access to mental health services.

When people feel sick, they go to the doctor and they also tell them about their depression or their anxiety or their marital problems or whatever mental health concern they have. So while some people might scratch their heads and say, why would a primary care physician's assistant know so much about mental health?

It's because you were treating it whether you wanted it or not. That's where people show up to share those personal concerns they have.

Fred: 00:04:22

Right, Right. And you may or may not have heard the statement I made on a PBS interview a while back after a mental health conference.

Actually, we talked about physical health and mental health, and they're not exclusive. They're tied together. So when somebody comes in with a physical complaint, it may very well not be a physical complaint at all.

It may be tied more to mental health and more of a psychological issue. And they're tied together. They go hand in hand. And so you can't treat one without treating the other. Sometimes more one than the other.

Kent: 00:04:54

Exactly. It's funny when people say, well, where does depression happen? Where does anxiety happen? Where does loneliness happen?

Well, it all happens in the Brain in the mind. And so that's part of the body. The mind and body are very connected.

And it's amazing how sometimes something that is a more emotional problem will manifest as a physical problem.

Sometimes we see people who are very stressed or they're very anxious and they'll have all sorts of GI issues, so stomach issues or issues with their bowels. So you know that better than most of us. But also, as a first responder, you've seen quite a bit of mental health, correct?

Fred: 00:05:32

I've seen it in the patients that we respond to. I've seen it in our, in the first responders, very much in the first responder population.

It's a tough thing when you work at a grocery store during the daytime and you respond to some of the things that we go to.

It's, be it a car wreck or be whatever it happens to be, it's just not something you can walk away from and go right back to work at your grocery store. There's a lot of tension, a lot of stress, and unfortunately a lot of depression and a lot of mental health issues there.

Kent: 00:06:01

Right.

So it's funny because the first responders are the people who run toward all of those things that most of us run away from, whether they're fires, whether they're a criminal situation, or whether they're a motor vehicle accident. Although, as I understand it, in Wyoming, people are quite committed to helping one another.

If you drive by on the highway and there's a car in the ditch, you'll stop and you will ask them if they're doing okay. So. But our first responders tend to see much more of those kinds of situations. So we know they have higher rates of alcohol use.

We know they get poorer sleep because it's shift work. And often if it's volunteer, that's it's not their only job. We know that when you're working shift work, nutrition is hard to stick to.

It's hard to have good food habits or eating habits. And finally, we know that among law enforcement specifically, they have a five year shorter lifespan.

Fred: 00:06:57

Right.

And a much higher rate of number of things in all, the first responder, be it emt, firefighter, law enforcement, higher rate of divorce, higher rate of depression, unfortunately, a higher rate of suicide, a higher rate of many things, and probably all directly from the stress and from the lack of sleep, from the lack of good nutrition and just from the things they see. There's a good saying that in the fire service, you know, I got to get it right here. I hate to mess it up and give somebody bad credit.

But I wish my mind could forget the things that my eyes have seen. Or something to that effect.

Kent: 00:07:33

Exactly. And so there are many, many difficult things that that lifestyle involves.

And yet the lifestyle of people who live in Wyoming who are not first responders is also difficult. You mentioned loneliness before. The climate can be brutal. So let's talk a little more about how we're doing as a state.

You know, you mentioned that over the last 10 years we had one or two years where we seemed to be improving and now we seem to be back where we were before, which is unfortunately in the number one slot for having the highest suicides in the country per capita. What have you seen over your time as a pa, as a first responder and also in working with a letter? What. What have you seen as far as our progress?

Fred: 00:08:17

You know, we saw some periods of progress and I would tell you that right now probably the legislature is in a little bit of a regression. They're not doing as well as they once were. And there's a number of reasons for that.

But you know, as a legislative thinker, they like to think that if you put money towards things, you solve issues. And unfortunately that's not the case. The money has to be used in the right place and sometimes it doesn't take money at all.

But you're right, we started going down. We actually have been in the top five for a long, long time. But we got out of the number one.

I think we went as far as number three, which doesn't sound great, but that was a huge improvement from being number one for such a long time. There's been a lot of stress in the last several years with people losing jobs. The energy industry has suffered.

So that probably is a piece of it as well because that's where Wyoming centers. Most of its employment is in the energy industry. And that employment uncertainty certainly has something to do with it.

Kent: 00:09:13

Without a doubt. Without a doubt. And so I'm a bit of a persnickety behavioral type.

So when you say we were doing well, what actions have we been doing well either as a government, as just everyday citizens, as communities? Maybe it's the faith based community. What has been your observation?

Fred: 00:09:35

The single biggest thing that we've done well is we turn the spotlight on mental health. You know, it wasn't in the closet anymore. It wasn't hidden in the dark. We actually put a spotlight on it.

But you know, we improved our suicide hotline. We. And in faith based. It's funny you mentioned that even the faith based community has put more of a spotlight on mental health.

And in the legislative view, you know, unfortunately, sometimes, and I heard the statement once, it was about alcoholism, but it applies across several fields, is that it's a weakness.

Kent: 00:10:05

We.

Fred: 00:10:05

It's not a disease, it's a weakness. And I think we've shifted a little bit to where we recognize it's not a weakness per se, that it is a disease. It's.

You know, a lot of those things are drug addiction and mental health and alcoholism. They're all different kinds of diseases, but they're not something you can just pull yourself up by your bootstraps and get past.

It takes a community to help you pass those things. So in my mind, that's the biggest thing, is that we've actually put a spotlight on it. We recognize it now as far as curing some of those things.

Suicide Hotline is a great thing, and we're doing well with that. We're not funding it as well as we should, but we've improved.

There's a lot of room for improvement, and I have high hopes that it's going to improve. You know, we can get to keep the spotlight there and get the programs and somehow get. Get the people here.

We need to get the help, you know, the number of professionals, which is difficult in Wyoming.

Kent: 00:10:56

Okay, so there are a few things you're saying. I'd like to just break them down a little bit to make sure I'm understanding them. The first is shining a spotlight on it. And when the.

It could be mental health, suicide, alcohol abuse, substance abuse. If we're not talking about it, we're certainly not going to be able to improve it. So awareness is key.

Another thing I hear you saying is procuring resources to be able to target and follow through with addressing those problems. The Suicide Hotline is a good example of something that you said is a great development, and it has been enormously helpful.

Fred: 00:11:31

But.

Kent: 00:11:31

But there have been periods, perhaps most recently, where we're not putting as much funding as we could toward that resource. One other thing I hear you saying has to do with kind of changing the conversation.

We're used to talking about pulling ourself up by the bootstraps, just sort of putting our head down and barreling through. But that's not always the solution. And in fact, what you've said in a moment ago is that we've got to leverage each other and rely on each other.

It's. It's about the community and how it helps itself. Am I understanding you?

Fred: 00:12:03

Yeah, you are. And that's exactly it. And it's not necessarily, you know, there's a lack of professional help in Wyoming.

We have a lack of professional counselors and psychiatrists and a lack of a lot of things in Wyoming. But that's not where it's all at. A lot of it's just in the community, and it's just.

And I'm preaching to the choir here, but it's a lot of just being able to communicate and talk. I give the example that I gave a little while ago. You know, two winters ago, we had a terrible winter here.

And I live off a county road by about a half a mile. And there were times during that winter I couldn't get to the county road.

And that sounds stupid, it's only a half mile, but we had so much snow that we just came to a point where our snow plows and our tractors, we couldn't get to it. We actually had to hire somebody from the community to come out with a commercial snowblower and blow us out because we couldn't get out.

And we like to think that we can always take care of ourselves and we don't need help. Mental health is no different. Alcoholism, drug addiction, but mental health in particular. Sometimes we just can't do it ourselves.

And the Wyoming way is, you know, be tough, take care of yourself, you don't need help. And the truth of the matter is we do need help. And that takes something by recognizing that you need help and by others to be able to.

Willing to recognize and be able to give help. And we're getting better at it. We're not there yet, but we're getting better at it.

Kent: 00:13:26

So in your view, we've got to understand that we do need help sometimes. And I think most people acknowledge that. I don't know that many people are doing home births for new mothers.

They're going to the hospital and seeking help. Right. When we're working on a ranch and a farm.

You mentioned before the show began, we were talking and you mentioned that they're building a nuclear facility in Kemmer. I believe so. People aren't doing that alone. They're working in teams.

They're using all sorts of professionals and technical types to make sure that things are done right.

So I think what I'm hearing you say is that Wyomingites already accept help in various contexts, but it's these personal things where there's this belief system or this tradition of not asking for help. And not only do we need to switch that and start asking for help, but. But we are Starting to ask for help, and it's actually working quite well.

Fred: 00:14:21

Yeah, I think you nailed it. And I think, you know, the typical Wyomingites, at least in the past, has been a little bit of a mask wearer.

They like to wear a mask and not show their really real feelings.

And I think we're getting better at removing that mask because people realize that there's help out there that other people are willing to help, and that's a huge step. That's the biggest thing we can do now. There's a lot more beyond that, but that's the biggest thing.

And that's maybe a whole culture change for Wyoming. It's something that we're not used to doing. You know, we can't just cowboy up on everything. Sometimes it takes our neighbors and it takes help.

Kent: 00:14:54

Right. And let's also tie this into what you said a few moments ago. There is a shortage of mental health providers within the state.

So on one hand, you're saying, let's encourage people to seek help. It's okay to seek help. But we're still facing that barrier, that reality that there is a shortage. So do we have to see a psychiatrist?

Do we have to see a physician in order to seek help? Or can it be our good friend, our pastor, our spouse, our brother, sister?

Fred: 00:15:24

In Wyoming, it would be a physical impossibility to see a psychiatrist because there aren't very. But very few in the entire state. So it's everybody. It's all the above.

It's your pastor, it's your bishop, it's your priest, it's your pa, it's your doctor. If there happens to be a counselor or a counseling center in your community. And there's not in all Wyoming communities.

I wish there was, but it's all the above, which is why it's so important to get everybody tied into the system and get that spotlight, especially brightness. So all those people are aware of what's going on, and they play a part in helping the community and helping those that need help.

Because it truly is a community thing. It's a village thing, if you will. It takes everybody to make the system work because all those highest levels are not available in all Wyoming.

Matter of fact, most Wyoming, most of those levels are not available.

Kent: 00:16:16

It's amazing.

Sometimes, even though mental health, suicide, alcohol abuse, substance use, even though they're very complex topics, and when a human experiences them, they're very complex and they can be very burdensome at the same time, sometimes the simplest solutions are the most effective way that we can target problems. So for example, we know that connectedness reduces suicide risk within a community.

And we also know that it's pretty hard to connect in sub zero weather, when there's 5 to 10ft of snow, when you can't get out of your house, if the cell phone or the. Even the landline phones aren't working right.

So the environment in Wyoming is so unforgiving and so tough, but yet the solution is one that is available. So how can we better boost connectedness? How can we use each other as that source of strength, that resource?

Because, let's be honest, they do say misery loves company, but misery loves company when that company is just like you. Right? We like to rely on others who are very similar to us, who either see the world the same way or really know what it's like to walk in our shoes.

So I think I've thrown about three or four questions out there to you, Fred, but how do we boost connectedness? How do we just do this in a very simple, straightforward daily or weekly way?

Fred: 00:17:49

Yeah, yeah, you did hit on a number of points there. And you know, it brings to mind the thought that people don't think that other people understand them.

You think you're unique and that nobody else has the same experiences and to realize that they may not have had your exact same experience. There are people that understand.

And once you can talk to somebody and be able to share those things with the priest or whoever that might be, it opens up a channel where you can then continue that conversation.

And that's the biggest key, is that in talking with people, whoever that might be, that you can talk with, to realize that there's a lot to learn about people. You know, people think they know Fred Baldwin, but do they really know Fred Baldwin? And probably not.

But once you can make those channels available, then it becomes easier or makes the system more effective and it makes it easier.

And you sometimes can get rid of some of those tendencies to think that you're alone and there is no help and there is no hope because somebody understands you, somebody's listening. So that's really the key is to make those channels available. I sound like a counselor here, but I'm not.

But somebody you can talk to and somebody that will listen to you. Because I think too many people feel alone and they don't feel like there's anybody that they can talk to.

Kent: 00:19:02

I love what you're saying there.

It's not only find someone who you can talk to, but what you're saying is that once people do unload or download or vent or share their personal stuff with someone else. Sometimes there's sharing back and they realize, wait a minute, I'm not the only one struggling with this.

In fact, it's likely that everyone around you is probably struggling with this, but they don't talk about it. And so this idea that when we don't talk about stuff we assume it doesn't exist is nonsense, right? It's garbage.

Everyone has stress, everyone gets sad from time to time. Show me a marriage where there isn't a fight or argument or heated discussion and you know, I'll be shocked. That's life. Life is difficult, right?

Marriage takes work, relationships take work. Even faith takes a lot of work. My goodness.

So it's not that the other people around us who aren't talking about it don't have any hardship or challenges, it's just that they're not sharing it.

But when we do share it, not only does it feel good because it resonates with another person, but we start to lean on each other and that support goes a long way.

Fred: 00:20:11

You know, I think we tend to think of, you know, stressors as major events and major things that happen. And that's what's a major event to one person is not necessarily major to somebody else. What's minor to me may be major to someone else. And I.

That's hard for folks to recognize. You know, my family, without sharing too much personal information, we've been through some huge traumas.

I have a son who went through a tremendous trauma, but to meet him, to know him, you would never know that unless you actually sat down and talked with him.

But at the same time, I think that another 18 year old somewhere else might be struggling with something that I think is minor, but in their mind it's just as major. It's a big deal. So, you know, the degree of stress is unique to everybody's mind, I think.

And it may not seem like it's a big deal to me, but to you it's a huge thing and it may be life altering. And I think the only way to realize that is with talking with people and understanding the way that they feel and what feels big to them.

Kent: 00:21:11

Exactly. What came to my mind while you were describing that is that pain scale we do in primary care where it's a scale of 1 to 10. How much pain are you in?

Pain is a relative thing. What's painful for you may not be painful for me.

And of course in this context we're just talking about physical pain, but the same goes for emotional pain. Right? And to your point, unless you're sharing it, how do you know what it's like for that other person?

And how do you get that validation that it matters to your loved ones that you're doing well? And so if you're not doing well, they want to hear from you, they want you to rely on them, they want to be able to support you.

So I really love how you describe that. We've got about one or two minutes left.

So I think the last question I have, Fred, is what do we need to do more of what does the future look like for mental health and suicide prevention in Wyoming? What are the opportunities that are sort of in front of us that we should try to grasp hold of?

Fred: 00:22:10

You know, the biggest thing that I look for and the biggest thing that I want is that I don't want us to just turn a corner and say, yes, we talked about it, we're done. We threw $5 million at it. We're done. You know, I'm very hopeful to continue the. The mental health task force in the legislature.

I'm very hopeful that we'll continue the, you know, the suicide awareness classes in schools and at on the local level so people know what's going on. But the big thing is, don't want to put it behind us. I want to keep it out in front of us. I want to keep the lights on.

And I think that's the biggest thing we can do. It's going to take money.

You know, there's points and things that will take money, but if we don't keep a focus on it, then none of those things are going to happen. And I don't think it's necessarily a negative focus. I don't think we need to put out there that we're the number one in suicide.

I've heard that many times in many meetings in the legislature, and I think we all understand that. But I think the positive message is here's what we can do to recognize signs of suicidality.

Here's the things that we can do to recognize it and how to change it, and the more positive aspects more than the negative side. And I think that'll have a more positive effect as we move forward. Certainly I want to be number 50.

our problem in, you know, the: 2000

Now it's something else. Let's keep that out in front of us and keep it going.

Kent: 00:23:42

The tagline that came to my mind while you were talking is our work is never done. Right. It's this idea that, I mean, it's no different than national security.

We don't just throw money toward the military or national security and then sit back with our arms folded across our chest. Okay, we did that. We're done. We're secure forever. Right?

So when we think of these huge, complex issues, it takes time, it takes funding, but it also takes a lot of thoughtfulness about how to go forward in a way that we evolve. It can't be a one and done. It can't be something that is so confined to one moment in time. It has to be a process.

That's what I hear you saying a few minutes ago. You mentioned culture, which evolves like a process. So what I'm gleaning from your comments, Fred, is that we can't stop talking about it.

We can't check the box and say, okay, that box is checked. We have to expect that this is going to be a long slog.

Fred: 00:24:41

Yeah.

And I guess I would add to that, Ken, is that the answers may not come from a 70 year old or an 80 year old, or a 25 year old, or a 40 year old are an 18 year old. The answers are all across the board.

And I think that we miss a lot of opportunities and we don't listen, you know, to some of those kids in high school and younger. You know, I sat in on some suicide prevention things to some high school students from Jackson and from Sublette county.

And the things that those kids talked about were amazing. They had some great ideas and some great thoughts.

And I think that we need to not ignore those things, nor do we need to ignore, you know, the old guys like me. I think we need to be inclusive because who knows where those answers are going to come from because it affects everybody.

You know, the suicide rate is not just among the younger generation, it's not just among the older generation. It's everywhere across the spectrum. So the answers, that's where they're all going to come from.

And we got to, we got to dig into that well and make sure we're listening all across the board.

Kent: 00:25:41

That's a great note for us to end on today, is that we've got to look all across the board.

We've got to listen to people to better understand why they are driven to end their lives or why they're suffering so that we can find the most appropriate solutions for each of those members of our community. One size doesn't fit all. Well, thank you so much, Fred.

Really appreciate your perspective as a leader across the state, certainly within both medicine, within public service and within the first responder realm. Thanks so much for coming on.

Fred: 00:26:13

My pleasure, Chad. Have a good evening.

Kent: 00:26:15

Thank you for listening to this episode of one Minute can save a Life. Take care of yourself. Take care of your neighbor.

Kent: 00:26:21

Be bold.

Kent: 00:26:22

Ask the hard questions. Because if you don't, who will?