Episode 201 - Mental Health & Resiliency with Dr. Seema Parmar of the Cleveland Clinic

Dr. Seema Parmar is the Director of Health Intelligence and Insights Director for Advisory Services at Cleveland Clinic Canada. As such, she stays ahead of the curve on health trends that impact businesses, and offers thoughtful and practical solutions to improve the well-being of employees and their families.

 To find out more about Seema’s work and the services offered at Cleveland Clinic Canada to help Canadians live healthier more active lives, go to https://my.clevelandclinic.org/canada/services

Resources:
Crisis Helplines

• Suicide Crisis Helpline: Call or text 988 (in Canada and the US)
• Wellness Together Canada
  • Adults: Text “WELLNESS” to 741741
  • Youth: Text “WELLNESS” to 686868
  • To support someone in distress: 1-866-585-0445
• Kids Help Phone
  • Text “CONNECT” to 686868
  • Call 1-800-668-6868
• Hope for Wellness Helpline: 
  • For all Indigenous people   
  • Call 1-855-242-3310
  • Or chat online at www.hopeforwellness.ca

Online Resources To Find A Mental Health Professional 

• Psychology Today
• Better Help
• MindBeacon
• Canadian Counselling and Psychotherapy Association
• Layla
• Eldercare Locator (acl.gov) (services for older adults and their families)
• FindTreatment.gov (US)

Today's Incredible Sponsor is

Transcript

Sandy Kruse: 0:02

Hi everyone. It's me, Sandy Kruse of . For years now, I've been bringing to you conversations about wellness from experts from all over the world. Whether it be suggestions in how you can age better, biohacking, alternative wellness, these are conversations to help you live your best life. I want to live a long, healthy and vibrant life, never mind all those stigmas that, as we reach midlife and beyond, we're just going to shrivel up and die with some horrible disease. Always remember balanced living works. I really look forward to this season. Hi everyone, welcome to Sandy Can, nutrition, health and Lifestyle Queen.

Sandy Kruse: 1:05

Today I have a very special guest, dr Seema Parmar. She is the Director of Health Intelligence and Insights Director for Visory Services at Cleveland Clinic, canada, and we are going to talk all about mental health. It's such an important episode, everyone, especially this time of year. I don't think I know anyone who doesn't experience a little bit of the January February blues laws, whatever you want to call it. If you live in the climate that I live in, we have very little sunshine, and a lot of that has to do with it as well. So stay tuned, check out the show notes, because all the information that you're going to want is going to be in the show notes. Please do share this episode with anyone who you feel might benefit. Follow me on all of my social media channels. I'm going to be doing a little more on Rumble. I'm on YouTube. I am on Instagram, tiktok, facebook you can find me anywhere.

Sandy Kruse: 2:22

I'm also currently writing a book. This is a little bit of an arduous task, but it is a passion project and it will really align with my podcast, because I'm trying to bridge the gap between science and soul. Yes, a lot of my training is about the science, but after all these years, I've come to realize that if you follow only the science, you're really missing an integral part to your wellness, and this book will outline a lot of the esoteric practices that I really believe in, I engage in and, of course, it's not going to be everything for everyone, because I focus on bio-individuality. I'm also going to put important tests that everyone must have done and see. That's where the science comes in. Now, remember, it is going to be written from a woman, midlife woman's perspective, so some of it may not be applicable, but a lot of it is really just to help you enhance your life and be proactive with your health and, of course, age better. So look out for it.

Sandy Kruse: 3:51

I'm also creating a course Well, I'm calling it a course. It's actually not a course, it's more of a master class the essential thyroid guide. Why? Because thyroid is my specialty. And listen people, I know I'm not a doctor, I do not have an MD, but I can tell you that I probably know more about thyroid wellness and thyroid health than most general physicians out there. I know that's the sad truth, but it is the truth, and I had to fumble through a lot of this because I don't have a thyroid, and so I've learned a lot. I've also, of course, taken certifications in endocrinology and thyroid, so there's that as well. So look out for these things. I'm really trying to provide more. Hmm, okay, how about this Less transient content?

Sandy Kruse: 4:57

One of them is my podcast. My podcast does not end. I still get downloads from old episodes. I mean, I think the one about fasting is still my highest downloaded podcast episode yet, and that was, I think, two years ago now. So you know I'm looking to create content that's lasting. A book is one, my course is another.

Sandy Kruse: 5:27

Anyway, enough rambling. Definitely go and rate and review my podcast. It's so easy, you guys and it helps me to get amazing guests each and every week, like Dr Seema. She's just such a lovely and knowledgeable person. I loved my conversation with her. But if you go to Apple podcasts, if you use Apple podcasts, I think you can rate in Spotify as well. But if you go to Apple search Sandy K Nutrition, my podcast will be there. Hit the show Sandy K Nutrition, scroll down. It'll say write a review, provide me with a few kind words and five stars, and that is going to give back to me for this content that I provide to you, for you, each and every week. And now let's cut on through to this amazing interview with Dr Seema all about mental health. Hi everyone, welcome to Sandy K Nutrition Health and Lifestyle Queen. Today with me I have Dr Seema Parmar. Parmar, did I pronounce it right? Parmar.

Dr. Seema Parmar: 6:40

It's very phonetic.

Sandy Kruse: 6:42

Okay, good, good, good. Dr Parmar holds a PhD from the Johns Hopkins Bloomberg School of Public Health and is a leader with Cleveland Clinic Canada's advisory services, a team of physicians, wellness experts and strategy consultants who help organizations improve employee health and manage organizational risk. Seema, is it okay if I call you Seema? Is that okay? You should call me Seema. Okay, good, good. We are going to talk about mental health. I understand this is a huge topic. We're going to try and do this in about an hour and make it really just relatable content. I want to note at the beginning that most of you know my podcast is strictly for educational purposes only. You must see your own practitioner. If this is something that we talk about, that you need to investigate. This is not medical advice. I definitely wanted to preface this conversation with this little disclaimer. I want to welcome you, seema. I am so happy to have you. We chatted a few times now and I'm really excited for this talk.

Dr. Seema Parmar: 8:09

Me too. It's been great getting to know you, and I'm so excited to talk to your listeners as well.

Sandy Kruse: 8:15

Give us a little bit of a background of your history, how you got into this field of health and medicine.

Dr. Seema Parmar: 8:23

Sure, I guess I'll start with talking a bit about public health. That really is my passion. But I think for a lot of people, when they think of public health, they think of vaccines, outbreaks, and that's the realm of public health. But it's really much broader. It includes health of populations, and some of it is about disease prevention and some of it is just about keeping us well. For me, it's not that.

Dr. Seema Parmar: 8:47

I think I've been in public health for about 20 years, I don't think when I was a teenager I really knew what it was or that it was a thing that I wanted to do, but there's a few things about it that I think have been the reason I've been drawn to it. They're very cordial. Who I am, one is learning and just growing. I think our world changes so much and so quickly. For me, just being able to learn and understand things that I don't understand has always been a big draw. A lot of public health is about understanding people and understanding behavior. That's always been interesting to me. The other thing that really has drawn me, I think, to things in this world is when you're surrounded by really good, kind and really inspiring people. A lot of folks at public health are those kinds of people that really want to have change. For me, there's also a big piece about just always wanting to do something that is, helping people who are going through hard times. I think for me, a lot of that came from our own family story. My parents came as immigrants. I was six. I had two older brothers. Both of my parents are brilliant and educated and were very successful. Then we got to Canada and a lot of new immigrants started to find jobs, worked a bit of wage, went back to school and things were really tough. But actually I think for me I had a wonderful childhood. A lot of that had to do with having, I think, a very stable and happy family, but also because we had a fantastic community of support. I had great teachers. I had a lot of people who were around. It just was always in me that this is how the world should be. We should always be helping, and a lot of what we do in public health is around that.

Dr. Seema Parmar: 10:37

In terms of my career and positions, I think that community piece has really stayed true and that's what's kept me in the field my first role and I've worn a few different hats. Sandy, we've talked about this. I had a winding path, but my first role was working in an elementary school in Northern Manhattan post-911, working in a health program that was based in an elementary school, with this pediatrician and social worker who were well ahead of their times, I think in 2001,. We were talking about yoga and meditation for teachers and we were talking about obesity in children. That's amazing Things that now we talk about, right, yeah, but it was kind of new and wacky and wild back then, which is so fun to think about now just how much it's come aboard.

Dr. Seema Parmar: 11:27

And it was, I think, a great experience for me to be in this community that was really struggling. There was a lot of violence in homes, there was a lot of loss post-911, but it was a community that really rallied together with dancing, with food, with music, and it really shaped and I worked with a powerhouse of teachers and principals and docs who were really there trying to support these kids. But I think a lot of what I saw there was people trying to work through a system that really wasn't created to support them, and that's yeah, and I think a lot of us can kind of see that now, doing our day-to-day right, the interactions between systems and what we end up doing. And so that's what led me to do my PhD work and I really wanted to understand system change. And I had another kind of really fortunate experience I worked with immigrant refugee women to understand their interactions with the health system and what really came out of that was that concept of community. Again, it was actually more than the kind of whether or not they were getting the screenings they needed. It was do they have social support, people who can come with them to appointments, help them with rides, help them with language?

Dr. Seema Parmar: 12:42

And then I got to the end of my PhD and there were all of a sudden a whole bunch of government cuts to a lot of programs that I thought were really valued and that hit me pretty hard. And a friend of mine had said why don't you try management consulting? And I kind of thought what are you talking about? Like that does not sound like me at all. But she introduced me to her partner and some folks who were working with a big firm and they were doing a lot of work in health care and so I moved over to consulting and this idea here was okay, I've done the academics, I've been in the community, but I just don't know how decisions are made, like how do people make decisions at the system level?

Dr. Seema Parmar: 13:21

And they'll spend about eight years there in this management consulting field really working with some decision makers and a lot of really good people who are trying to do good, but wrestling with the challenges of how do you think about cost, how do you think about quality, all of those pieces, and stayed there. And then when the pandemic hit, it was really interesting because all of a sudden the stakeholder shifted. Who was making decisions, who had influence? And employers became a really big stakeholder and they had not really shown up in the field of public health before. And so that's actually when I joined Cleveland Clinic, because they were doing these really interesting pieces with some big organizations that have a lot of influence on communities, on their employees, and so that's a lot of the work that we do now and I kind of say it's flipped a bit from business of health to the health of business, and that's a little bit of how I got to where I am right now.

Sandy Kruse: 14:21

Oh, interesting. Well, you've had a lot of exposure and you know, one of the things that actually really kind of I want to pull out of that conversation is how you're always learning. You're always changing your, I guess, fluid in your role, Would you agree?

Dr. Seema Parmar: 14:40

Oh, totally, I think that's actually what excites me, yeah, but it's academic and people right, you're always just learning. I love that.

Sandy Kruse: 14:48

I think that's key here. When you're talking about health care whether it's preventative or actually caring once you're sick, once somebody's taking care of you we need to constantly be up on the changes, because things are always changing. And with COVID we saw a massive change and you and I kind of touched on this in mental health. But when you talked about it with me earlier you had kind of hinted that it was always there. It's just that COVID might have been that whole. It just kind of all came to fruition at COVID, but it was always there, right? So maybe first touch on what is mental health? What does mental health mean?

Dr. Seema Parmar: 15:43

And I'll pick up on the story Sandy, because it's so true. Mental health has always been there, but I will say, even for me and in my experience, it was always something someone else did. Other people had mental health concerns. Other people were experts in mental health either. When I was in the elementary school, it was the social workers, the counselors. When I was doing my PhD, it was a whole other department that was mental health, and it was only when the pandemic hit that I started really internalizing that actually, this is about all of us and for me it was probably the same thing a lot of you went through. It was you're trying to work, you have kids at home, you have elderly parents, you're in this world of uncertainty. All of a sudden, you feel like you don't have control over things that you had a lot of control of, and I started recognizing that I wasn't myself anymore. Either I was exhausted and I still don't think I put my finger on it until I started actually studying and learning and working with mental health experts and it became really important, I think, to talk about the continuum which is mental health. So mental health is for all of us and it is a continuum that includes everything.

Dr. Seema Parmar: 16:56

I think on the one side, we really, when we talk about mental health, we also want to talk about all the things that make us healthy, all the things that make us happy and comfortable in our relationships and help us be our best. And then, as we start kind of shifting through this continuum, we go through this space that we call reacting space, and this is when you start seeing changes in yourself, changes in your attitude, changes in your energy, more negative feelings, and I think what's interesting is that this healthy reacting faces. They are things that all of us can go through. Some days you're healthy, sometimes you're healthy, some hours you're like that Absolutely Authentic shift. Right, yeah, that's okay, that is normal.

Dr. Seema Parmar: 17:41

But as we start shifting down the continuum and you start looking at the space around injuries and now we've talked about healthy, we're talking about reacting, now we're talking about injury this is when you start seeing that your day-to-day functioning is being impaired. It's not just these kind of things that you feel and you keep going. All of a sudden, it's much harder to keep going, maybe it's harder to get up in the morning, maybe your relationships are starting to suffer, and at this point, this is when you might start thinking about seeking help, but for a lot of us we don't really recognize when that point happens. But the piece that's here is is your day-to-day start functioning, being affected, and then, as we start advancing down to the other end of the continuum, is when we actually start talking about illness right, and so illness can be anything that has a diagnosis with it. It's also when we start talking about things like suicidality or substance use or some of these other pieces In the injured and illness space is really when we want folks to start reaching out for professional health.

Dr. Seema Parmar: 18:47

This is when you can't figure out on your own, how do you get back to the other side of continuum? And so I think it's really important to know that mental health encompasses all of that, and all of us can be on any part of that continuum at any point in our lives. I think it's also to know that what it looks like for you will be very different than what it looks like for me, maybe, right, based on our biology, based on our environment, based on our experiences, based on our parents and grandparents experiences. And so for me, when I start shifting from healthy and reacting you know, I know I'm irritable, right? I know I don't want to be showing up for as many things socially, as maybe you know I was in the past, right. For other people it might be. I'm not irritable, I'm just not like, I'm just disinterested. I started checking out, right. So each of us might look very different during this. So I think that's important. It's a continuum, it applies to all of us, but it looks different for each of us.

Sandy Kruse: 19:59

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Sandy Kruse: 21:35

You can check out all of the science by visiting aminococom. Forward slash skn for sandy-k nutrition. When you use that link and that code skn, you're going to get 30% off to try amino-Co amino acids for yourself. Can I ask you then? So some of the signs you mentioned a couple would be might be, again, everybody's individual and I love that you say that, because I'm a big believer in bio individuality. We can't paint everyone with the same brush. So I guess you could say, for somebody who is normally very outgoing and then all of a sudden becomes very introverted, that might be one sign for someone.

Dr. Seema Parmar: 22:33

When you start seeing that change, that shift, I'd say shift in your attitudes, shift in your energy behaviors and shifts in your relationships. Those are a few kind of axes that you could start thinking about.

Sandy Kruse: 22:47

Okay, okay.

Dr. Seema Parmar: 22:49

We'll get to sleep, but that's also a good signal. Often, sleep is huge, we start seeing changes in our sleep patterns, like, are we sleeping through the night and, you know, maybe it's just one night for most of us? All of us have kind of rough nights, that when it's the stained and it's much harder, or you're kind of chronic insomnia. These are things to be really concerned about.

Sandy Kruse: 23:11

And you know, I have to note this because a lot of my listeners are women who are even menopausal. So it's interesting the connection there because a lot of times menopausal women are diagnosed with depression. They have those sleep disturbances. They're not themselves and one of the physicians I interviewed who is an expert he's an OBGYN in the US A lot of physicians will diagnose menopausal women with depression. It is an approved drug for menopause instead of, you know, going the HRT route. So it's interesting. I just want to make that connection because a lot of those symptoms of mental wellness or mental health could coincide with big changes physiologically for our women especially.

Dr. Seema Parmar: 24:08

Absolutely, and I said it, different differs kind of based on our experience with an environment, but also our biology, because we know hormone fluctuations in women. And then why I think that's important is because I think often when we have these shift, sometimes we attribute it to ourselves like oh, I feel guilty that I was being irritable or I was short and made this comment, that there are things going on that are actually not really within our control. Yes, that I also want to kind of give us permission and space to say that's okay and that happens.

Sandy Kruse: 24:42

I love that you said that you know why? Because, as somebody who had thyroid disease, oh my God see, I could actually even get teary-eyed thinking about it. Because also, if you have something physically not working in your body, you know, like severe hyperthyroidism, well, comes with that anxiety. So you know there are palpitations being short, perhaps even a bad temper or hypothyroidism. You can't get off the couch, depression, right. So I think it's important to work with your doctor to rule out other things.

Dr. Seema Parmar: 25:26

Yeah, absolutely, and so that continuum piece, part of why we talked about it is there's one side where I think it's important for us to all know the things that can help us with coping, restoring, getting back to ourselves, and it could. That could also look different, and for me, I have a range of things sometimes as I actually want to be around people, I want to be around loved ones. I, you know, I want movie night with the kids. Other times it's like I want to be on my own, I want to sleep. Maybe I want to watch a really sad movie and cry. Yeah, we have a set of things that can help us navigate that healthy reacting. When we start getting to the other side, those tools aren't enough and that's when it's helpful to seek support right, and some of it might be some of these other treatments, right, that help with the physiological pieces, and some of it might be actually more on the mental health side.

Dr. Seema Parmar: 26:18

Right and the support there.

Sandy Kruse: 26:20

So I guess what you're saying there is, you know, kind of rule out, with work with your doctor to rule out other possibilities. But then what can happen obviously is either those things aren't ruled out or things just get worse and you need to seek help. I want to ask you do you know I'm not sure if you'd know this off by offhand do you know if the suicide rate went up after COVID?

Dr. Seema Parmar: 26:56

So let's talk about this.

Dr. Seema Parmar: 26:59

Yeah, this is a really important piece, I agree, and I think we have in some sense thought that we really opened up the conversations around mental health, and that's great, but there's some things that I think are still really hard to talk about, and suicide is one of those, yes, and is one of the ones where often there's this feeling of what could we have done before, right? So, in terms of rates, you know, if we look from with Canada, the US, we see slight different trends in the US. Actually, 2022 get record levels of deaths by suicide, more than any previous year, and a couple of things is one, when we look at men, the number of deaths are four times the number of deaths and women, however, women do have a much higher rate of suicide attempts, right. So there's a piece there, okay. The other thing that you know is a trend to watch is that it's also an older adults now, so we're seeing rising rates in elderly as well. So the highest rate of suicide in the US was actually in those 75 and over.

Sandy Kruse: 28:10

Wow, I didn't know that.

Dr. Seema Parmar: 28:14

And I think it's just showing that across the spectrum there's different things people are dealing with that maybe we need to consider the. In Canada it's been different in the sense that we didn't see a spike in suicides, but we have seen impacts in other places. So, for example, we've seen the rate of deaths due to unintentional injuries, which includes suicides, but it also includes things like overdoses, and that has gone off Right, and so there's a. There's a piece around, not just where people are mentally and whether or not they're able to get the support they need, but what are the types of coping mechanisms people are using when they're not supported with health, and with professional health or social community support.

Sandy Kruse: 29:03

So Canada saw a rise in addictions and deaths as a result of overdosing.

Dr. Seema Parmar: 29:12

Yeah, so and the overdosing you know across we have the opioid crisis of those pieces. But it's sort of open this idea that Drug substance use is more pervasive now and not always well managed and there's much higher risk in the types of substance, substances people are using. And these are all things I think from the public health side of me are things that you know they're preventable. There's something the world we can't prevent, but there's something for world we can if we can equip people with the right information and supports Right.

Sandy Kruse: 29:52

Yeah, because you know I actually talk about that a lot on my platform is numbing Right. So I mean, would you agree that that's an obvious cause for a lot of these substance abuse like alcohol? Did we see a rise in that, just even overall usage? You know there and see my, you know it's interesting because you see, on Tik Tok, this is when it kind of started, like this trend of let's just go and you know down a bottle of wine and you know it's. It's almost like that became normal. Yeah, maybe it was always happening, I don't know, but it's like a big trend, like you would even see, people would make memes about it and Girls Night, and it was all middle aged women, yeah Right.

Dr. Seema Parmar: 30:48

So Recently, canada has put forth revised guidelines for alcohol consumption, and a lot of it was anchored in looking at the literature over the past several years to see what's out there and actually put forth recommendations on it. I think the thing that has been interesting is part of it has been something like what you just said the use of alcohol as a coping mechanism versus the use of alcohol as a social Part of it, which then means you're starting to hear more daily drinking.

Sandy Kruse: 31:24

Yes.

Dr. Seema Parmar: 31:24

Yes, and some of those pieces right, rather than just social drinking.

Dr. Seema Parmar: 31:29

But it's also just caused, I think, a lot of us, whether it's individually in our social circles, whether it's with our, the organizations and clients that we work with, to revise how we talked about alcohol, how we introduced it into social activities or social functions and some of those pieces, and it was like it's when you start seeing substances being used as a coping mechanism, you know, to deal with underlying issues that require other supports.

Dr. Seema Parmar: 31:59

We do want to care, we do want to be thoughtful about that right, and so I think, on the substance use side, there's lots of reasons why we're seeing more kind of toxic substances and why they're leading to death and, the same thing, a lot of reasons are a combination of people's environments, that experiences and how they react and all of those pieces that are there. But there is something that I think we need to talk about, which is what are the tools people are using and are they healthy? Are they beneficial? Are they really helping you get back to the other, you know, to the healthy, reacting side of the continuum, versus to the injured, ill side of the continuum?

Sandy Kruse: 32:43

I actually recorded a podcast about this not long ago, just specifically for middle aged women. Because, you know, there's a big difference and I love that you said that. You made it very clear whereby, you know, I've always personally been about balance, but I understand that we are not all the same and sometimes balance is difficult to achieve for some people in certain areas and there's many reasons for that. But if you look, even if you look back, well, when we were living during COVID times, that was not balanced, so it was right. So if you think about that, it's like all of that blew up because people were at home and they're like what am I going to do? I'm sitting here working with my husband over there and my kids are doing school work in that corner, and so it was a really weird time for everybody.

Dr. Seema Parmar: 33:47

And you start thinking about the okay, what are the little treats I can do for myself, what are the little things I can do? And then I think now we're starting to say, okay, let's revisit what we think those treats are, yes, and how often we go to go towards those treats, because some of that treating became habit, right, and some of these things you don't see in the immediate, that you see in the long run. And so really creating that awareness and being a tune to why and for what reason yeah, you know you might be leaning towards substances. This is not an all or done thing by any means, just for each person to think about that.

Sandy Kruse: 34:28

Each person absolutely, Because I personally, I use my excuse, not my excuse, my, my own personal example of me being an ex smoker. I am not able to dabble in smoking. Back then, when I used to smoke, I loved it and I saw that it was a coping mechanism for me. So I get stressed out about this at work. I go have a cigarette, I get straight right. So it was 100% a coping mechanism and it was an addiction. So I had to break it personally. So this is why I like that. You say everybody's different and everyone is a unique situation as it relates to any substance. Like I can easily say Sema, I'm addicted to my one coffee every morning. Is it harming me? Is it harming my relationships? Is it in balance? Is it a coping mechanism? Not really, maybe a little bit. But do you see what I'm saying?

Dr. Seema Parmar: 35:33

So, weighing it, and the questions you just asked yourself are that point when we say do you need extra, do you need to be seeking support?

Sandy Kruse: 35:43

There you go.

Dr. Seema Parmar: 35:43

When it starts impair, it starts impairing your functioning and your relationships. So when some of these habits start making it harder to get up in the morning, harder to show up and work, harder to be yourself, harder to keep those relationships that you really value, that's when we want to be thinking about are we actually getting the support we need?

Sandy Kruse: 36:07

I have a question and I'm not sure if what you think of this do you think that some people might have experienced some sort of PTSD from COVID?

Dr. Seema Parmar: 36:21

So maybe we'll change that, because PTSD has them very unique and let's just talk about grief or loss, right?

Sandy Kruse: 36:31

Okay, what about trauma?

Dr. Seema Parmar: 36:35

I think trauma has its own dimensions as well. Okay, but the reason I say grief and this was really interesting to me, how we position this is because grief isn't often we think about grief as a loss of a loved one, but grief occurs for many, many reasons. So there is grief that your child did not have the experiences you hoped that they would have had.

Sandy Kruse: 36:57

Interesting.

Dr. Seema Parmar: 36:58

Grief because the way things used to be will never be that way again.

Dr. Seema Parmar: 37:05

There is grief because maybe you're a different person now than you were three years ago and so I think there has been a lot of grief and a lot of loss that has happened, that we all haven't necessarily tapped into, that we might be experiencing and how that's impacting how we show up today. I think that we're seeing that even in clients with kind of shifts in working structures that you also see shift in teams. The people who used to work maybe before you'd come every day and you've had that person that was sitting next to you and now you don't have that team dynamic. So there's a lot of. I like using the concept of grief and loss in some senses, because I think there is some part of us that we've all kind of gone through during the pandemic where there's been some grief, been some loss, trauma. I think I want to be careful for just because there are a lot of people who have different experiences of trauma and I really want to dilute that experience and what those needs might be.

Sandy Kruse: 38:12

That makes sense and I can speak from personal experience, hearing the word trauma right, the word trauma saying oh my gosh, I'm hearing this and it sounds like it's going to happen again. It's like trauma and fear. Is this going to happen again? Is this going to happen again? And it's almost like that fear that it's going to happen again, that we're going to be locked down, that there's going to be another pandemic, and that raises, I'd say, a lot of fear in a lot of people. Whether you had major issues from the lockdowns or whatever, it's going to raise that fear.

Dr. Seema Parmar: 38:57

I think it's the fear, but it's also a sense of a lack of control. I think for a lot of people and many of us, you could put things in, you did a lot of things and you were able to shape a lot of pieces of your life and then all of a sudden, this thing happened and it wasn't really in your control and all of a sudden there wasn't that much even in your life that you could control. And so I think going forward, what's happened for a lot of us is you have that. It's a fear, but it's also a bit of a hesitancy of what's next. What's that uncertainty that's coming? How do we actually move forward if we don't know what's going to be happening in the future and if what we do today, how that might manifest in the future, right, so there's a lot of emotions that I think the pandemic evoked for many people and I think we're still processing and learning from a lot of that.

Sandy Kruse: 39:48

Do you think that our as a society, our mental health has worsened since the pandemic, or do you think that maybe we're just talking about it more?

Dr. Seema Parmar: 39:59

I think that, and we kind of touched on this before. So as a society, there were a lot of things happening related to mental health even before the pandemic. I think the pandemic and what I mean by that is that any of these experiences whether it had been in stress from work or loss of loved one or any of these people that we've talked about all of those things were still there before. I think the pandemic really opened up conversations and awareness around it. I think seeing whether it was a celebrity or a leader stepped forward and started talking about their mental health was really important. It helps people feel a bit more normalized in it to say that yes, it's okay for all of us to struggle.

Dr. Seema Parmar: 40:57

I think there's still a lot of things, like we said before, that we're not talking about. I think it's still very difficult to talk about bipolar disorder or schizophrenia. I think it's still really hard to talk about suicide. I think it's still really hard to talk about substance use. So I think it's opened up conversations, but I think we're still a bit scratching the surface on. Are we truly getting to some of the mental health challenges that have been in our society all along, and are we really helping the folks who need the most support. Get that support.

Sandy Kruse: 41:34

Yeah, we touched on this privately when we talked about some of the really public suicides. We talked about Twitch. I don't think I know one person who didn't find that beyond shocking and sad and nobody understood it. Even we were saying, like our children, my daughter was shocked and we were all shocked because the appearance and that's what I think is probably the scariest thing for people who are not struggling is that we may not see that somebody's struggling.

Dr. Seema Parmar: 42:26

I think that's something that was really interesting. That came forth when we think about the pandemic, when I look at the public health angle but then I start translating it to some of the conversation we're having now is it's this idea of warning signals. There's so much to talk about all the warning signals that the pandemic was coming. There's so much people can say about what was reacted to and what wasn't all those things. I think that's true in our own lives as well too. But I think what is hard is that there's differences in experiences and differences in what we see for other people. It's equally important to know your own warning signs as it is to also be seeking out for other people. Sometimes we see warning signs and say, okay, I think something was different with that person, but we couldn't quite put our finger on it. We just let it slide.

Dr. Seema Parmar: 43:18

This by no means be commenting on the situation with Twitch, but what it really evoked for all of us is there are people who we think they not be struggling because they show up as happy and fantastic and thriving in the world and we don't know what's going on behind them. Likewise, maybe we do that the same for others. How do we know our own warning signs, but how do we also, proactively, when we see something that might be a warning signal in someone else, we're stepping in to actually provide that support and help out? I think that's. It's really hard to comment on one person's situation and what happened when we don't know the full context and we don't know what's going on. But I think it may feed a lot of us, reflect on ourselves. Are we okay? And then the people around us is everyone, even the people who seem to be doing really well? Let's just think and take a moment to check in and say are you really okay?

Sandy Kruse: 44:22

Right, I agree, but I also think we have to be careful because sometimes, as I'm sure you would see in your line of what you do, you have to be careful because if that person is really closed off, you could potentially risk your relationship with that person, right?

Dr. Seema Parmar: 44:44

Absolutely, and I think it brings up this is one of our learnings, I think as well in the last couple of years is that when we worked with clients, mental health is so top of mind that it was just really we started having a lot of conversations, or the range of organizations bringing in our psychiatrists to help facilitate these conversations, just to really open up the dialogue and reduce the stigma around mental health broadly.

Dr. Seema Parmar: 45:10

I think what we're learning now, too, is you have to equip both sides of the conversation so as we start talking about it, the people who are hearing about it also need tools to help respond and help engage right. So if someone is talking about self-harm openly to you, that is very difficult and not all of us are equipped to have those conversations. That's not something you're kind of just generally trained on right and there's risk to both people on that side of the conversation. So I think you're absolutely right that we need to not only open up the conversation to make people feel more comfortable talking about it. We also need to open up the conversation on how to handle it.

Sandy Kruse: 45:56

Yes.

Dr. Seema Parmar: 45:57

Someone speaking to you about these concerns. And the other thing that I think is really important is what can you do about it? Because that's a really hard part for people. Is you want to help? How do you connect to resources? What resources are out there?

Dr. Seema Parmar: 46:14

And accessing and getting support for mental health is very different than physical health. So one of my clients you said that I felt like I was kicking a frog until I finally found that person who really worked and helped me, and so it's not because of the kind of vulnerability and sensitivity that's involved in those relationships with the mental health professional or someone who's providing you support. It might take some time to find that fit. That's very different than when you go in to get your finger x-rayed right and that you need to get it done. So I think understanding how to access it.

Dr. Seema Parmar: 46:54

The other thing is treatment plans are clear for everybody, so it's not easy to say, hey, why don't you go do this for someone you don't actually know if that's the thing that works right?

Dr. Seema Parmar: 47:05

There's a lot of finding that fit of professional, of therapy, of medication, all those pieces and all of this, if they is. You know, if I could, I could advocate for. One thing is advocate for yourself and don't give up because it takes time. But also, when you're the support person for someone who needs that kind of help, it's not on you to be there professional therapist that you can help, to say, hey, maybe it's okay to keep going, or maybe we try someone else, or you know how do you speak up to get that help that you need. So those are a few things that we're working on. How do you kind of decree stigma and get people to talk about it? How do you equip people with resources and language when they're the person being confided in? Yes, and then how do you help people understand the existing support system and resources that are out there and how to navigate that whole, you know, mental health professional service system.

Sandy Kruse: 48:10

I think what you said there is really important. There's a lot of things that you said that were really important. There's there's two sides to the coin, especially if you're a parent. So, as an example, when my daughter was sick, I had no idea how do I, how do I talk about this with a five year old and a nine year old? So Toronto's Hospital for Sick Children Amazing, they had child life therapists. So I actually use that service because I'm like this is so foreign to me. But you know, obviously you take their advice and you use your own intuition as a parent, because I'm a big believer in everybody has a different parenting style. But get some advice from somebody who knows how to deal with these situations. Just like what you were saying about self-harm, like I wouldn't even know where to start on trying to help someone. But if I'm a parent of a five-year-old, I want my child to trust me, but I better get some advice from experts as well in the situation.

Dr. Seema Parmar: 49:24

I think the other thing that's also important, that we're learning there is those individuals who are on the receiving end. There's an experience for them as well, too. So there's risk, but there's also, like I've talked, you know, we talked to managers, for example, who are on the receiving end of multiple conversations like this.

Dr. Seema Parmar: 49:45

We talked to their employees. We talked to frontline employees that are on the receiving end continuously, and you know why bring this up is if you are one of those people, you need to take care of me. You need to give yourself permission to take care of yourself too, because this is affecting you, too, absolutely. You know there's multiple layers. Make sure you know we want to reach out and support people who need care. We also need to advocate for ourselves, but we also need to see that when we're the caregiver or we're the support, we might need help as well.

Sandy Kruse: 50:20

I like that you mentioned that, because I think we forget that a lot of the time, especially when we're parents. We forget that. Okay, let's get into what we can do. We talked a lot about signs and how they're different. What I loved is that you talked about self-awareness. When you see you're different, like you know, I can recognize things, but sometimes it's in hindsight, right, Like you don't see it until you kind of come out of the fog. But what if you don't come out of the fog?

Dr. Seema Parmar: 51:04

Yeah, so a couple things, and I think these are some of the things that did come from the pandemic where we need to kind of be aware of this. So one in terms of the things that we can do. It's easy to say know your warning signs, but sometimes it's hard when you're in the midst of it to know what your warning signs are.

Sandy Kruse: 51:26

Yeah.

Dr. Seema Parmar: 51:27

There are a lot of things on mindfulness and journaling and all of those pieces and I think one of the things I want to say about why those can be important is they even just taking those few minutes it actually helps you be more attuned and alert to you.

Dr. Seema Parmar: 51:46

I love that you said that, so when things start shifting, you can feel that something is wrong, because when we don't give our space to do that, that's when we start feeling like we're losing time, right? So there are some very small, simple, simple things that I think are just important so you could keep aware of that. And then, if you know something is different, then you give yourself that permission to say, okay, something's off, I need to step in, and maybe it's just those. You're hanging out with your friends, you're taking that night to sleep eight hours with everything disconnected, whatever it is you need to do for yourself, but that's really important. I think that the other thing is that and this term kind of so mindfulness is a big term that's come out a lot.

Dr. Seema Parmar: 52:38

Another term is resiliency. We hear a lot about what that means, and that's been a really interesting one for me to try to unpack in practice and what it means, and there's a few things that I think are important when I think about that. So one resiliency means being able to bounce back when you fall. It yes, yes, and so that's that part about bouncing back, but I think part of it is also giving yourself permission to fall, because that is normal right To make mistakes, to stumble and it's hard, I think, especially with young folks today who kind of have a lot of things kind of visible via social media or all of these pieces, who missed a lot of those experiences during the pandemic, to kind of stumble and pick themselves up.

Dr. Seema Parmar: 53:29

Actually it is something you need to think about to say it's okay to fall and I'll do that sometimes because if you don't, when you fall you fall much harder and it's a lot harder to pick that up. So just even in that visual, give yourself permission that we all stumble so that when you fall it's okay, right, because I think we forget to say that. Okay, you know these days right.

Dr. Seema Parmar: 53:53

The other piece is when we start thinking about bouncing back. There's a piece that's individual and we've kind of talked about this, about you know what are the things you can do to build those reserves of energy so that you can bounce back up right. So all of the pieces, a lot of the things that you talk about in your lifestyle work as well, sandy.

Sandy Kruse: 54:16

So all the sleep the nutrition, the physical health.

Dr. Seema Parmar: 54:18

All of those pieces are part of building your reserves of energy, because if you're depleted it is really hard to bounce back. So once you fall, it feels like you're crashing right. And so giving yourself that permission to also build up your reserves, I think is really important. And in that it's all the kind of healthy things we talk about, it's also the things that make you happy, the things that give you joy. You know all of the anything, and it could be different for all of us.

Dr. Seema Parmar: 54:48

It could be I think we talked about it it could be dancing in your kitchen, yeah, yeah, absolutely Right, like you know, playing a game with your kids, all of those little kind of happy, happy things. I think that's really important. I do feel, and I wonder, because I've noticed it with my kids, that we had a couple years where, you know, people were masked and they didn't see anybody smile. Oh yeah, when we opened doors we didn't say, hey, hold the door open for that person. We said, okay, keep your distance, keep going. Yes, and I wonder, have we lost some of that just kind of happiness? So that's that second thing of building your reserves of energy, but just joy.

Sandy Kruse: 55:33

Right.

Dr. Seema Parmar: 55:34

The third thing and I mean this kind of points back to why I sort of went into depth with my stories that kind of community piece. I think community just so, so matters. And you know you look at society, you look at history, you look at different cultures that how do we support each other is really really important, right, and we did lose some of that sense of community. I think when the pandemic started, everyone kind of riled up and we were all like you know, everyone sort of felt like we're going through this collective thing together and then it started separating and we started seeing more divisions and more reactions and that feeling of collective community of how do we help each other out with all these little things.

Dr. Seema Parmar: 56:23

That's really important, because none of us can do this alone. And I can even stay for myself All those failure moments in my life. I know the people who are there and what they said and some of it, you know, changed my life right, and so you know how do we build back and just really reconnect with everybody in our you know, in our existing circle, but also the other people who are now in our lives. You know I talk about how sometimes it feels like we're forcing disconnection rather than connection when we talk about the divisions and how people feel right and what we see in social media.

Sandy Kruse: 57:11

Oh, there's a lot of divisiveness. Yes, all of that.

Dr. Seema Parmar: 57:14

So how can we lean towards connecting when we see differences rather than disconnecting, so that those are some of those pieces when we talk about action, that they're not revolutionary. I don't think I've told people things they don't know, but it's something that I think I constantly want to remind myself about in my world, but also that I just think is so important and I think we sometimes forget.

Sandy Kruse: 57:41

Yeah, I love that you mentioned all of it because, whether or not listen, there's going to be a lot of people that are going to listen to this podcast. They know who you are, they know your credentials and they're going to take that to heart. So I think it's important to repeat these things regardless. And the whole divisiveness like instead of community. I so aligned with that because we saw so much of that separation in all ways, in every way, through social media, through people, through physical, through, and it's like, oh well, you said that and you know I can't align with you and I like there's just so much of it. And community is so important, so important and prevention, and you know, one of the things that you mentioned journaling. I just have to. I have to just reiterate that you don't have. So I am an English literature graduate. Okay, I like to write and you don't have to like to write, to journal and what I? Exactly what you said.

Sandy Kruse: 58:49

It brings things to mind that otherwise could be buried in that busy day where you're getting the kids ready for school and then it's this activity and then you're going to make dinner and then it's like, oh, my God, I've been scrolling for an hour on TikTok and it's 10 o'clock and I got to get my sleep. And you see, I think when people don't stop and actually just be quiet, you know you speak about mindfulness and so many people will say to me Well, I can't meditate Like Well, neither can I. That's why I use tools like I use brain tap, I use newcom, and what it is is. I tend to have that brain that goes in all directions through the day. And so you know but we recognize that about ourselves that if we don't stop for however much time you can give, whether it's to write, whether it's to use a tool like I have to use, I can't.

Sandy Kruse: 59:48

I tried doing other things for meditation. These work for me and you got to find what works for you just to get that brain to slow down. And then all of a sudden you might be like Okay, I'm not okay and I haven't been okay for a while and maybe it's time that I reach out and get some help, because it's been a while that I haven't been like this, but I didn't notice because I just kept going and going. And then you know no judgment here but going and then masking through numbing, like alcohol or whatever else, and we get on that hamster wheel right.

Dr. Seema Parmar: 1:00:26

Totally, and I think the little piece of advice that was really great for me is, when you're journaling or thinking about those pieces, write about the good stuff too, not just about stuff. Write about the high as well as you know the other parts, because there's something about revisiting those moments that just reminds you. Right, it's that balance piece we talked about. Right, this isn't every day. Right it's. It's there's just having both of those pieces in there. I think it's so important.

Sandy Kruse: 1:00:58

Okay, I think we need to see, because I know it's going to be different in the US than Canada, but who do we reach out to? So there's, you know, there's, in Canada. We have Bell. Let's talk, we have a number.

Dr. Seema Parmar: 1:01:18

That's a camp like tell me how all that works.

Sandy Kruse: 1:01:20

Where do we go?

Dr. Seema Parmar: 1:01:22

Yeah, absolutely so. Very recently in the US they launched it and now we have it in Canada as well. There's the 988 suicide health line.

Sandy Kruse: 1:01:31

Okay.

Dr. Seema Parmar: 1:01:31

Right, so that's new. And the idea was that just three digits don't give me a long toll free number, just give me three digits that I can text or I can call to get help. Okay, so you know 988 versus the. We have our 911, we also have 988. So everyone should know that both across the border. I think we're going to figure out how to, you know, get that running and make the best use of it. But that's a very good resource. Just to know, off the top.

Sandy Kruse: 1:01:59

Can I ask you so that resource is for anybody, whether it's somebody who's afraid that someone they know is suicidal or doing some something that could potentially really harm them. Exactly, it could be for anybody.

Dr. Seema Parmar: 1:02:15

For yourself, it could be speaking support for someone else Okay. The folks on the other end are trained professionals that can help direct you. You know is needed, Okay, and it's text and phone. It's English and French in Canada. I think it's multi-linked in the US. I don't know the full range of languages there as well, but that's a tool that just came up recently that I think you know. We want to just normalize and make sure folks out there yes.

Dr. Seema Parmar: 1:02:45

Yeah, great, on the seeking professional, there's a lot of pieces locally, there's a lot of in. You know, sandy, I'm happy to kind of share a list. If you want to put it up at your point, I can put it in my show notes. Yeah, yeah, right, and there's a range, and it's interesting because it's there are, you know, culturally sensitive resources. There are resources just for men, there are resources for youth right.

Dr. Seema Parmar: 1:03:13

It's kind of depending on what you need, and so I think that's also important because I think I said before too, you know mental health is a lot less structured in some senses than some of the physical health pieces that we can think about normally. And so trying to figure out the right fit and what's meaningful to you, having a range of different resources that might be feel you may feel more comfortable with, is important.

Sandy Kruse: 1:03:39

Can I ask you a question about that? Does that mean that somebody could use one of those numbers and find, let's say if it's applicable, a psychotherapist or a psychiatrist, or yes or no?

Dr. Seema Parmar: 1:03:54

And a lot of them will have kind of counselors, or they will have folks that they can refer to. I think it's important to actually know, though, that there are a range of mental health professionals out there right, and we may not all need a psychiatrist right.

Dr. Seema Parmar: 1:04:10

Right right To arrange and we may find fit with the different types of professionals as well. And so what's good with a lot of these resources is they have multi-peak kind of disciplinary teams right With their teams that specialize in certain populations or supports, and so it's easier to access that know who some of these folks are if you're going through kind of a specific organization and you can get that help as well.

Dr. Seema Parmar: 1:04:38

A lot of organizations now, like employers, they have support in place as well. I think that kind of more challenging part is figuring out what support is most appropriate for you. So there's a place that's programs that you know, depending on the program itself, have a range of different resources, but there's also different tools. Like you talked about some of the meditation tools. There's things related to cognitive behavioral therapy, like there's a lot of there's online programs. There's actually a range of things that are out there, and so it's just becoming kind of familiar with that. But I can give you some of the ones that we have looked at that are specific to different populations as well.

Sandy Kruse: 1:05:20

Oh, that would be great. So are these like 988? Is there a fee for that? No, no, no. Neither in Canada or the US there's no.

Dr. Seema Parmar: 1:05:31

No, okay, it was the idea that, like exactly what you said, what do you do with? Your situation and 911 wasn't the right answer. Right, right, and so how do we? And then folks on the other end of 911 may not also be equipped to answer these questions, as we talked about earlier. And so that's you know where the orange is 988.

Sandy Kruse: 1:05:53

And people who do answer those calls. They can all it's. Is it specifically for suicide?

Dr. Seema Parmar: 1:06:00

It is, but there's also everything that kind of comes up to suicide. Like I will say, if we, you know, we talk about some of the numbers. So in Canada, I think, the rates are around 4500 suicides per year. But if you look at the number of suicidal thoughts, we and the most recent stats I saw, it's about 840,000. That's almost a 200 fold difference, right? So, yes, suicide, but there's a whole range of reason. You know when we start thinking from thoughts right through. You know where someone actually died by suicide right so it's.

Dr. Seema Parmar: 1:06:42

It's covered in a lot of, a lot of ground.

Sandy Kruse: 1:06:45

I think that's huge. What about internet? Because Cleveland Clinic is international, correct. So are there resources? Because I do have some listeners in Europe and you know, I don't know if there's resources in Europe as well for the Cleveland Clinic, or or you know, like I would just like to say that this conversation is so important, I want to put as much information in the show notes as I can. Yes, yes.

Dr. Seema Parmar: 1:07:14

So Cleveland Clinic we have, we're in Canada, we're in London, we're in Shanghai, we're in Abu Dhabi. There are most, I would say. Suicide has become such like it has been raised in terms of priorities that many governments, including the W and the WHO kind of broadly, that many governments are actually making this a priority right, and so it's not just that you go to a single system, like in the UK. They have a new strategy around suicide as well. So in each country there are things that are going on, based on the rates and and you know what we're seeing there as well too, and it will look different. There's there's other kind of nuances around credentialing of mental health professionals and some of those pieces, and so I don't want to kind of assert what might be happening. Yeah, you know, in other countries there is a well too, but I think it's important that when, when something that happens to an individual becomes a public health issue, that it's something that affects all of us.

Sandy Kruse: 1:08:19

Yeah.

Dr. Seema Parmar: 1:08:20

Right, and it's a global public health issue at this point, right. So you're absolutely right that you know this goes beyond Canada and the US.

Sandy Kruse: 1:08:29

What would you say is the one common denominator that we've seen as it relates to mental health from across the world, or is that a really tough question?

Dr. Seema Parmar: 1:08:46

It's a tough question and I'll probably put a disclaimer around. You know what I, what I think? Yeah.

Sandy Kruse: 1:08:52

But no, but it's just like what do you think you're? You're in this industry, so it doesn't necessarily have to be a definitive stat.

Dr. Seema Parmar: 1:09:02

Yeah, I would say so there is. I think you start feeling angst when you have an expectation of what you think something should be and then life or reality falls short. So that gap between reality and expectation and somehow across the world maybe it's because of internet, social media, all these pieces we've, our, our, our that gap seems to have been increased, and I don't know because we've changed where our expectations come from of other people, of institutions, of ourselves, right? Or you know, we need to like, I don't, I don't know if it's lowering our expectations or just recalibrating reality on that, but there is something in that space between expectations and reality and acceptance, right, that is just part of life, right, that that they're.

Dr. Seema Parmar: 1:10:07

You know, for centuries the world has gone through hard times and for centuries we've been able to come through it. And you know how do we just kind of bring back that this is life, right? Like part of the expectations of life is that there will be things that are struggles, and part of what we know is those tough times also really lead to, you know, many good things afterwards. Oh, yes, so I don't know if that's really the answer, but like there is something in my mind about, I feel like these expectations and reality and reality. There's some kind of miscalibration that's causing angst in society right now.

Sandy Kruse: 1:10:51

I think what you're, what you're saying, makes so much sense. What the reason is, we can't quite pinpoint yet, but you know we can surmise a few things. You know, like I almost think I hate to say it because it probably sounds almost cliche now, but social media is a big one because we see the lives of so many people. It's almost like too much information coming at us and it may not be accurate information and reality information, so it's almost like a distorted piece.

Dr. Seema Parmar: 1:11:24

Yeah, because I think another big part of community and connection is trust, and if you can't trust information and you can't trust people, it makes it very hard to then think, okay, am I doing the right thing? And I think the challenge with social I think there's a lot of good things that come with technology and social media. By all means, I think it's really sparked this kind of grassroots movement in many areas, which is so important, and I really value giving a voice to people who may not have a voice, and I think it's really great about which is great. I think I worry that we may not all be seeing the same information and that actually forces some of that disconnection and divisiveness, right, because then it becomes really hard to have trust in others, also to have trust in your own knowledge and judgment as well, right?

Sandy Kruse: 1:12:24

Yeah, I love that you say that I actually talk about that, because you know I'm writing a book right now. I talk about critical thinking and being able to really kind of decipher okay this applies, this doesn't apply and being able to move through all this information that's coming at us. Yeah, so we live in a world of information right now.

Dr. Seema Parmar: 1:12:46

Right, so, a world of information and maybe not that much understanding.

Sandy Kruse: 1:12:50

Yeah, yeah, so yes, well, this, okay. Is there anything that we didn't touch on that you would like to mention? That we didn't cover off? This has been a great conversation, seema.

Dr. Seema Parmar: 1:13:05

We've covered a lot of ground.

Dr. Seema Parmar: 1:13:07

We have we have, I think, maybe, just probably like recapping some of the pieces around, like what I have learned that has been so helpful for me that I hope others can experience as well, as that understanding of the continuum and that acceptance of trying to. You know that we all may be on different parts of that continuum and time, and that's life and that's okay. But how do we recognize our own warning signals? How do we feel comfortable seeking support, you know, early and as needed and some of that might just be in our community of social circles, but some of it could be professional as well and don't give up, right when something is warning. When you have that warning signal and something is off and you know it's affecting you, just don't give up. And sometimes I think we talked a little bit about the caregiving too I think we forget that other people want to help us. We all feel there is a joy that comes from helping other people. So it's okay to say I need support and it's okay to reach out to people also.

Sandy Kruse: 1:14:16

I love that. So where can someone find the Cleveland Clinic? Is it just just tell us a little bit about the Cleveland Clinic?

Dr. Seema Parmar: 1:14:25

Yeah. So Cleveland Clinic is an amazing institute now maybe by us, but I think the things that people don't often realize about us is so we're large, we're based in Cleveland, we have over 70,000 caregivers, which is you know how we refer to our employees, and it really it has a very interesting story which resonates a lot with me personally. It started, you know, after the war, with four doctors who'd worked together abroad and when they came back to the US I'd have said, hey, we actually do better as a team in terms of patient care than we do individually. So why don't we come together as a team and look at that model of care delivery and so that idea of team-based multidisciplinary care and the importance of not just kind of the quality of treatment, that the patient's experience is very, very core to who Cleveland Clinic is broadly.

Dr. Seema Parmar: 1:15:31

Now, how we show up and what we offer in different geographies looks very different, and in Canada we're a real, I'd say we're a complement to the system. We really try to support where there are gaps. So one big part of the work that we do is around employers, as I spoke about, and some of that is more direct patient care, Some of it is more advisory services, which is the type of work my team does, where we really connect doctors and experts across this kind of multidisciplinary, you know, team of physicians and other clinicians and public health experts to really help our clients or organizations navigate some of these issues. So we have that part of it, but we also do a lot of the community, you know, whether it's testing or vaccines or any of those pieces that came up during the pandemic and so and we also have a sports medicine side as well. So it's all these kind of different pieces that are there, but I do think there's a lot that folks don't know about the type of work we do and how we support.

Sandy Kruse: 1:16:41

I will definitely put the website on in my show notes, along with all the other resources we talked about, and I really want to thank you and it was such a pleasure meeting you, Seema oh thank you so much, sandy.

Dr. Seema Parmar: 1:16:56

This has been great, and thank you for just having this podcast and a forum for people to learn and to share experiences. I just think that's no, it's a community.

Sandy Kruse: 1:17:08

Thanks, yeah, exactly. Thank you, seema. I hope you enjoyed this episode. Be sure to share it with someone you know might benefit and always remember when you rate, review, subscribe, you help to support my content and help me to keep going and bringing these conversations to you each and every week. Join me next week for a new topic, new guest, new exciting conversations to help you live your best life.