Coronavirus (COVID-19): Press Conference with Karestan Koenen, 06/10/20

You’re listening to a press conference from the Harvard T.H. Chan School of Public Health with Karestan Koenen, professor of psychiatric epidemiology at the Harvard T.H. Chan School of Public Health. This call was recorded at 11:30 am Eastern Time on Wednesday, June 10.


MODERATOR: Dr. Koenen, do you have any opening remarks?

KARESTAN KOENEN: Sure. Thank you folks for joining the call. I see some names I recognize, folks I’ve spoken to recently. I wanted to say a couple things. I think most people have talked me or interacted with me before. So as Nicole said, I’m a professor of psychiatric epidemiology. Really, my work focuses on, has really focused on traumatic stress, traumatic events and the effects on mental and physical health.

So very relevant to – it seems increasingly relevant, but, you know, maybe never as much as now. I wanted to mention two mental health forums we have coming up, and these will be on the school calendar. But on Wednesday, June 17, at 11:00 a.m., our mental health forum, which we started in the wake of the COVID-19 pandemic. The topic at 11:00 a.m. on June 17 is global perspectives on intimate partner violence. So it’s not really been the focus of media attention in the last couple of weeks, but there have been specific issues related to that in COVID-19. And then very relevant to current events at 2:00 p.m. on Wednesday, June 17, we are having our mental health forum on racism as a traumatic stressor.

And so in terms of things I’ve seen recently, I’m happy to talk about anything people ask questions about. But some of the stuff we’re observing or looking at recently is sort of the burn out effects of being in week – I don’t know where we are now, I’ve lost track, maybe week twelve in Massachusetts of the shut down, although technically, I guess we’re reopening, mental health effects of reopening. And, of course, the murder of George, George Floyd and the sweeping protests. And then finally, something I’ve been thinking a lot about is the getting more discussion is policing and mental health and some issues with how police respond to the mentally ill. But anyway, happy to answer any questions folks have. Thank you.

MODERATOR: Thank you, Dr. Koenen. And it looks like we have our first question.

Q: Good morning. Thank you, Dr. Koenen, for doing this. If some other hands don’t come up, I’ll tie up for half an hour. OK. So, I wasn’t actually planning to ask about this because it’s a story I’m working on. I was gonna call you separately, but here we go. Hopefully no reporters will beat me to the punch on this story. Lots of people are wearing masks and doing other things to be careful, in part because they know it protects other people. So I would assume, certainly for people I know and some others that there’s some empathy involved in these acts. Meantime, white people are protesting, even if they might not be directly affected by racism, racism and injustice, obviously in the same way that black people are. And so I would, again, think there’s some empathy involved there. Don’t know if this is an area that that you want to tread into but my question is, do we run the risk of some sort of empathy fatigue? And what might that look like?

KARESTAN KOENEN: Oh, that’s an interesting – you always have interesting questions.

Q: I’m sorry.

KARESTAN KOENEN: That’s OK. That’s good. That’s a compliment. It’s good in terms of – so I am not an expert. There are people who study, I’m sure there are people who study empathy. But let me think about this for a second.

Q: Perhaps, perhaps come at it from a standpoint of motivation, forget about empathy, because I’m going to need to go from start to finish on this. You know, what gets people to do things for the good of others, obviously, is a piece of this.

KARESTAN KOENEN: Right. Yeah, well, one of the things that sometimes we lose sight of is that, you know, connecting with other people from birth, but also so evolutionarily as humans connecting to other people is really a basic human need. You know, we think of the basic human needs, like food or water or shelter. But actually connecting with other humans, that’s critical for if you look at infants on how they develop, interaction, for example, with the mother figure or whatever is critical for how the brain develops. So our interacting and our ability to connect with others is really hard wired as humans.

And so I think we may find it, sometimes I think we all get so cynical and I study I mean, I study trauma, so I study all the bad things people do to each other. That’s what I spend my day studying. But just as much as humans can be really terrible to each other, we are actually built to connect with each other. And so it actually does – and if I step back from it and from my little micro-world, it doesn’t surprise me that people are motivated to do things that help other people. And in fact, there’s a whole sort of field of studying altruism which shows that actually connecting to other people, doing things for other people make us feel better.

And one of the sort of pieces of advice many folks in mental health have been giving in the pandemic is something that can help you feel less isolated, even if you live alone or whatever and feel better emotionally is to do something that helps other people. So, like you said, wearing a mask. But, you know, things like, you know, leaving a sign for your delivery person or I mean, there’s all kinds of small things people in my community are doing as well as big things. So I guess that’s in terms of the motivation. I do think at a basic level of people are, as you know, are motivated and we’re built to kind of connect and help with each other, even though, you know, it’s easy to lose sight of that when we focus on all the terrible things going on in the world.

Q: OK, well, that’s actually a very helpful piece of the story that I hadn’t even gotten to thinking that. I just took this assignment last night, so. So this one, Dr. Koenen, I know is more up your alley. I’ll just give you the short question, but the answer is, I’m sure a deep and wide. Why does the phrase black lives matter make some white people so angry? And I saw this anger. I’ve seen it myself. And I’m sure a lot of people have seen it.

KARESTAN KOENEN: Yeah, that is good, that’s a good question. I don’t know that that’s more up my alley, actually, because I’m not sure I understand that. I don’t know if I have an answer for you. I don’t know if I understand that myself. I’ve seen it, too, more in the news reports than anything. My own experience being out in Boston, where I’ve attended some local and not so local Black Lives Matter rallies is the public reception we’ve gotten, again, in the places I am in Massachusetts has been incredibly positive. So, that is a good question. I’d probably like to talk to someone who actually had that negative reaction and understand, you know, how they’re perceiving it. But, sorry, can’t answer that one.

Q: No. No problem. I didn’t intend to hit you with either of those, but.

KARESTAN KOENEN: That’s fine. This is what an open media call is all about.

MODERATOR: Next question, please. Go ahead.

Q: OK, so, Karestan, is that how you pronounce your name?

KARESTAN KOENEN: Yes. Karestan, thanks.

Q: I‘ve got a question for you. Do you think there’s a downside to wearing masks in the open air in front of the entire community? Is there any downside to that? And if so, what do you think it might be?

KARESTAN KOENEN: That is a good question. I think the only – I mean, there’s clearly no – that’s a good question. You know, wearing masks is what our infectious disease colleagues and public health officials will recommend. I think that, you know, so it’s hard to see what the downside is. I know, personally, the downside I see is that for myself is more that you know, it sort of makes me sad to not see my neighbor, like be able to smile at people when I walk my dog and things like that. But I don’t know of any sort of real, other than other than my own personal experience, I can’t really speak to data on the downside.

Q: Yeah, well, it seems to me, given that the faces is evolved to express emotions and that we’re highly gregarious social people, it would seem to me that interacting with people, with a lot of people whose mouths are hidden would have a downside of of gradually increasing a sense of isolation and disconnection.

KARESTAN KOENEN: Yeah, I think that’s that’s an interesting point. One of the things I think about is there’s a TV show and website called Brain Games, and they actually have one of the empathy tests online, or at least they did – I haven’t looked recently. And there is are these experimental tests that people used to see how empathic you are. You can do these online. And those tests actually only show the eyes in terms of reading emotions. So we just did it. My son and I were reminded of this recently because he likes that show. And it reminded me. So we do definitely miss something not seeing people’s mouths, but we also, as humans, have really like evolved to be able to read expressions and people’s eyes as well. So, I do try to remind myself of that, although I do miss, you know, seeing people’s facial expressions, just like I miss hugging my neighbors, too. I definitely feel like that’s a loss.

Q: Thank you.


MODERATOR: Next question.

Q: Thank you, Dr. Koenen. In recent weeks, I’ve read about the long term effects of SARS and MERS, including like some long term mental health challenges that may be associated. And some of these researchers believe that those who’ve recovered from COVID-19 may have some these same challenges. Is this anything that you’ve discussed or know about?

KARESTAN KOENEN: Sure. So I think that we don’t have great data, I mean, given that the situation, right, with COVID is evolving and we’re really focused on the infectious disease aspects. But I certainly have heard from people in my life who’ve recovered from COVID and from people who have treated folks who recovered from it, that some folks are reporting – so some of it seems to be some PTSD like symptoms to having COVID. So the most vivid example of this from a friend. Their whole family developed COVID, he’s a physician. Anyway, she got it bad enough that she was in the hospital, she was not in the ICU or a ventilator, and she describes now when she has things that remind her of COVID, that she feels really panicked that she’s getting it again, even though she knows. Because it was so scary how sick she – the effect of the sickness was so scary that she actually thought at times she was going to die, even though, you know, again, she wasn’t in ICU or anything.

So I think that that’s some of the things people have talked about with SARS and MERS. So people are saying that might be a factor in people with COVID. And then I think, you know, there’s just a lot about the disease we don’t know in terms of perhaps the neuropsychiatric consequences. So I do think it’s something we need to be aware of. And I’m sure, I know we’ll be studying and other people will be studying it. So I do think that is something of note. But and as you said, I mean, the other issue that folks found, there were some evidence with SARS of some longer term depression among SARS survivors and chronic fatigue syndrome and things. And so it’s hard to know if that’s a consequence of the disease itself or of, you know, the experience of having it where you feel like your life is threatened and then you’re quarantined and all these kinds of things. So, I do you think that’s something to be aware of, for sure.

MODERATOR: Do you have a follow up?

Q: No, thank you.

MODERATOR: I actually have a quick follow up on that one. So COVOID is a disease like other diseases. Is there something particular about COVID that makes people have more of a PTSD response to it as opposed to the flu where people do not seem to have as much as strong as that response?

KARESTAN KOENEN: Oh, that’s an interesting question. I think that, you know, that is an interesting question. I think that I don’t know. I mean, certainly like normal cold or flu, people can generally have like a PTSD response to a severe illness. So there’s, for example, there’s data on developing PTSD related to being diagnosed with cancer, having a heart attack or a stroke. So it’s true that, you know, having an illness, you feel like you see that experience is threatening your life can result in mental health consequences.

So I’ve actually never seen a study of like flu. But I think given the broader literature, it’s not surprising that something like COVID, which I think for people who get very sick from it, is experienced as life threatening. And then on top of that, there’s just so much we hear about people dying and so even you’re not that sick, you might be scared. You’re very aware of the threat to life. While for many of us having the flu, although the flu is deadly for some people, it’s not as – our head doesn’t mean you go there. We don’t really feel like our life is in danger. Does that answer your question?

MODERATOR: Yep, I think so. And also, just in my own personal experience, I work on COVID all day and then COVID is on the news, so it’s just kind of inescapable. So that may also have something to do with it, that you’re recovered, but then you’re constantly reminded of it and how bad it could be.

KARESTAN KOENEN: Yes, I think that’s probably, I think that’s probably true. Exactly. You’re not surrounded, even in flu season, we’re not surrounded by, you know, media. I mean, again, whether you even if you’re in medicine, you’re not surrounded by it, like being on the news and, you know, sort of every minute of your day, you know, people talking about it. And it doesn’t affect every aspect of your life the way, you know, COVID shutdowns and stuff are affecting our lives now.

MODERATOR: Thank you. Next question.

Q: So I have been looking at the things that you intended to speak about on this call, which is great, so thank you for that. I don’t have specific questions around this, but I’d love to hear you talk about if you were gonna, you know, take your your life’s work, your research, the things you know, and and give us a few minutes on it. The mental health effects of police brutality and I ask the question for this reason. People are – some people who have experienced it for a long time, obviously, that’s why we’re where we are right now. Some people are experiencing it for the first time and some of those people never thought they, you know, would. We’ve got white people going to a protest getting smacked and they probably never in their lives until now did they think something like that would happen to them. So those must be two really different experiences, you know, the sort of chronic threat of police brutality and maybe experience with it, and then all of a sudden, you know, my first experience and then also thirdly, people watching all this happen who maybe are having their eyes opened. And so mental health effects of those three things to the extent you are interested in discussing it.

KARESTAN KOENEN: Sure. Again, you always ask the tough questions there. Sure I’ll start and if people have – I can see if hands are raised and people want to interrupt, so I don’t just ramble on, but yeah. So I guess you’ve raised sort of several big areas. So taking one example of someone who is, like you’re saying, people who are just sort of either experiencing police brutality for the first time are waking up to it some way because they now see it on TV or something that they hadn’t before. One of the things that we talk about with trauma is that it shatters our assumptions about the world. And so some people may be experiencing that.

For some people, this is new information or a new experience. One of the fundamental things trauma does is shatters trust. So whether it was there, and we often don’t realize how much we trust, you know, how many things in our lives we trust because we trust that, you know, we walk outside, it’s going to be safe. We trust that, you know. We make all kinds of decisions in our life that are based on trust. And when that’s shattered, it can feel really destabilizing. It can feel confusing and it can feel like, kind of make people kind of feel like their foundations are shaken.

So it’s you know, it’s not necessarily a mental health, quote unquote, problem, because it’s normal to be upset about, you know, when your beliefs about the world are shaken, when your faith in things that you make or trust in something you may have trusted in your whole life. You may have assumed that if, you know, if I go out and protest that I will be respected and people will listen and then that doesn’t happen. Or even worse, you’re attacked, then that can really, like I said, it can shake your foundations and feeling a lot of grief or anger or distress and anxiety about that is really normal. And so I don’t want to call that any kind of mental health problem. But it would be, you know, it’d be normal to just be feeling really distressed and maybe very destabilized and sort of just questioning everything because it’s very similar to what we would see with any kind of single, we call a single incident type of trauma.

And then when you’re talking about more longer term trauma, we think about communities that have been marginalized and brutalized for centuries. That, you know, that is a horrible but a different kind of experience, because in that situation, people have developed strategies in order to survive a situation. So it’s not a situation where necessarily assumptions about the world are shattered because people you know, we hear this now when people talk about, you know, their, you know, African-American men I know talked about how when they were 12 or 13, their parents sat them down and said, well, this is how you need to operate. This is how you need to behave now. And so it’s you know, it is a very different experience for people who have lived with these types of experiences or traumas their whole life versus those who have them versus those who this is new information for.

And so in some ways, it kind of parallels, in terms of my own work at parallels people who experience what we call like single incident or sort of experienced a traumatic event like an assault or something for the first time, have had a decent life, but then have that kind of experience versus chronic trauma, which when we study it, we study things like child abuse or maltreatment or partner violence that goes on over many, many years or across generations and that has that has many other different kinds of effects. So that’s kind of a rambling answer, but hopefully I got some of the things that you’re interested in there.

Q: It is the chronic, I’m not sure trauma is the right word. So, you know, I mean, what I’m hearing and this is a gross oversimplification, is that a lot of black people, the things done to them are not always as traumatic as a beating, obviously, but it’s these smaller things that add up and that are constant. And maybe they’ve experienced a beating from the police or they know someone who has. So it’s more about that, I guess that constant threat.


Q: And so talk a little bit about that. What does that do to a person? Because what I’m trying to get at here in more than one story that I’m going to be doing is, is this coming back to this white people not understanding what black people are going through.

KARESTAN KOENEN: Yeah. Yeah. So the constant. Yeah, I mean, I think you hit on it, living under constant threat and then even if you haven’t had the experience directly to your self, you’re reminded of the threat, these smaller experiences can remind you of the threat. And we see this in, like my colleague David Williams, work on everyday discrimination or we call it micro aggressions, where you’re sort of reminded, not sort of, you’re reminded, these quote unquote, smaller things remind you of the bigger threat you’re facing. And in terms of,  yeah, I mean, that’s a huge question in terms of what that does to someone.

I think that, you know, what we’ve heard people talk about is that communities and families and individuals adapt to those kinds of threat. So the example I give, like what parents tell their kids, you know, what family members tell each other in terms of how to keep each other safe and how to cope with this and I would call it a trauma. In terms of the definition of trauma, just to be a little bit academic for a second, in terms of the DSM, which is the psychiatric manual we use to diagnose mental disorders, has a definition of trauma in it. And the definition is the experience of actual or threatened death, including directly experiencing the event, witnessing the event in person as it occurs to others, or learning that the event happened to a close family member or friend.

And I think that the police brutality but many other events experienced by people of color in this country that if you read the definition of trauma fit under trauma and if you think that it includes learning about that event happening to a close family member or friend, then that trauma affects whole communities because you hear about someone who has, for example, you hear about some in the community who’s been killed by police or the study – there was a big study in The Lancet about how even just hearing about beyond the community of where they know someone individually, such as George Lloyd’s murder, how that affects negatively the health, the mental health of African-Americans much more broadly, whether it’s in the state or nationally, when they hear about these killings. So I feel like I’m getting off the topic. But maybe, Rob, if you want something more, you can redirect me.

Q: No, no, that’s – I’m just doing a little bit of background here, so, thank you.


MODERATOR: Well, if anybody has a question, please raise your hand by clicking the blue hand icon or getting in touch with me. Otherwise I have other questions and I will keep asking them. So one of the things you talked about is parents sitting down and explaining, in particular, parents of children of color sitting down and explaining to their kids the different ways that they may need to act than maybe their white friends need to act in certain situations. So going from that, how how should we talk to kids in general about police brutality and how do we help kids understand that these are the people who are supposed to protect us and to help us when we’re having problems and yet there there can be problems with that trust as well. And I know this isn’t necessarily your focus of research and there’s somebody else, if this was normal, you could always tell me to go talk to somebody else right now, but since you’re on the call, how would you recommend talking to kids about this situation? And I know it also depends on ages and that sort of thing.

KARESTAN KOENEN: \Yes, it absolutely depends on many factors age, the age of – I’ll speak as a parent, I’m a parent of a 13 year old, so I’ll speak as a parent – the age of one’s own kid. What your kid is like, their personality, what affects how they handle information, what their experiences have been. So I would say I mean, I would advise people who want to, there is – I don’t wanna look at my phone while I’m on a call, but there are really great resources online on how to talk to kids about race. And I would maybe start there. And there’s a lot of recommendations about that. Also, there is resources on terms of what sort of videos to watch. I mean, PBS, has things. And also what you know, what movies. I’ve been myself – my son’s 13, so thinking about what movies. Movies are things to watch with him that will foster discussion. And I think in terms of this is a device, same advice we gave with people when they’re talking to their kids about COVID is that really a lot depends on the developmental age of the kid.

And one of the things is for older kids that I’m trying to learn a lot with my 13 year old to really is to listen. I am a professor so I can be kind of in his face, like telling him stuff all the time. But to really listen, to see what his questions are and what’s coming up for him. And then also, I guess that kids watch what we do more than what we say. Not that we say isn’t important, but they watch what we do. So I think as parents thinking about how we behave and what we do, how we show our values, how we talk about what’s going on with each other or with other adults and how we, you know, how we model it. That’s probably just – I think as parents, we worry a lot about what’s the right thing to say, but it really is so important. Our actions really, I mean, the old saying actions speak louder than words is really true.

So those are some like top top of mind answers. But there are a lot of really good resources online for kids of different ages and how a talk to them and different videos and things like that. The other thing I would encourage parents to do is to pay attention to whatever a lot of schools, I think most schools are doing something on this or have the schools still – private schools are out, my son’s in public school, but at least find out what your school is doing so that you’re in the loop about what they’re talking to your kid about, so that you can be kind of ready if they have questions or maybe just open it up and say, oh, you know, I know you guys had a call on or the thing on police brutality or call on this on race, what was it like?

And you might not get much answer depending on how old your kid is or how they talk, but at least sort of being in the loop on that, I think can be helpful to foster conversation in the future, because this is really something everyone is acutely aware of right now. But obviously, these issues have gone on for hundreds of years and need long term solutions, so it’s going to be conversations we keep having.

MODERATOR: OK, thank you. Like I said, I will just keep asking.


MODERATOR: Anybody else on the call, please feel free to chime in by clicking the blue hand icon. So one of the things I’ve noticed is that the timing between the pandemic, the social distancing and the physical distancing associated with that, and then also the protest. It seems like people have been pulled apart physically and that these protests are actually bringing people physically close together again. Now, I’m wondering if you think that maybe that physical isolation, that social isolation that came with the physical distancing maybe increased our empathy for each other and made us look at other people in a little more humane way.

KARESTAN KOENEN: Yeah, that’s actually that’s a great question. So I do think that the physical distancing has and our attempts to fill the void with the virtual, whether it’s Zoom calls or, you know, whether it Zoom work calls, or Zoom gaming or dinners or whatever we’re doing, or video dinners, has made us realize that the virtual can’t replace the actual physical being in each other’s presence. And so I do think that people have, you know, the, you know, God, to be corny, the phrase that comes to mind is almost like absence makes the heart grow fonder, like sort of it’s just made us more aware of how connected we are and sort of dependent we are on each other and how we miss even the small interactions like the, you know, talking to a neighbor without a mask. And so, you know, I think that it has increased, yeah. I think it’s increased our sense of connection to each other and that and thus, you know, maybe some empathy. It’s like exactly like you said.

MODERATOR: Thank you. Are there any questions that have been coming into your inbox that you think would be helpful to discuss in case other reporters have these questions moving forward?

KARESTAN KOENEN: Sure. I mean, I think one of the questions that I’ve been getting some people contacting me about is sort of mental health effects of reopening. And I think they’re around a couple things. So one is that increased anxiety now that, you know, in some ways we all had this. It was like this threat of COVID. And then we had all this confusing information and then it was kind of clear things are shut down and then we’re home right now. And in some ways, being home is a you know, it’s as much as, you know, like I myself wanted to, you know, was ready, like, I can’t wait for reopening. You know, being home and having everything shot made somethings simpler. Like, I didn’t have to make certain decisions about where to go or how to go or, you know, whether I felt safe going here or there. And now with reopening, there’s a lot of people who may experience more anxiety.

So some of the mental health, rather than just being happy things are reopening, I think people find it feeling more complicated. And the other thing people have been asking about is with reopening, it’s almost like reopening grief, meaning like, yes, things are open, but they’re so different and not the same. And the things we enjoyed about them aren’t there. And so there is a certain kind of, I think, sadness about that that people are experiencing. So I think some of those, the mental health affects of reopening are something that we’re watching for now and again, haven’t been discussed as much because of everything else going on.

MODERATOR: OK, so one of the other things that I’ve been wondering about, your particular line of research is that it seems like you would just be traumatic for you personally to be delving into these topics. How do you deal with the trauma associated, your own personal trauma associated with your research?

KARESTAN KOENEN: Oh, that’s a great question, too. So that’s something I grappled with really early in my career. So I got into the whole area of trauma and PTSD as a result of my own trauma. And so it became, it was related to very personal experience. And so I sort of had to grapple with this from early on. And so I think there’s a couple different ways I manage it. One is I am an epidemiologist, but I’m also a clinical psychologist. And so my earliest training was in clinical training and I did do direct treatment with people. And that has had a very powerful effect on me, even though I don’t – I just co-wrote a treatment book but I don’t do a lot of treatment now. And the reason is, is because I saw people who had terrible traumatic experiences and recovered. And then I treatment with them.

So that gave me hope. So although people often ask me, how can you study trauma the whole time and it’s just really depressing? You know, every traumatized person that I interview or meet with or study is, you know, they are survivors because they’re still here with us. So there’s always some resilience. So I think that I’m realizing that I think I’m probably more of a sort of glass half full optimistic person, because that’s the piece I see when I interact with people who are traumatized or studying traumatized populations. And then the other pieces that for me personally, I’ve developed a lot of strategies over the years to manage these kinds of things. So, for example, one of the things I do is I don’t, I’m like careful with if I’m reading interviews with trauma survivors, that kind of thing, I don’t do that late at night. I sort of have a lot of kind of self care strategies around that in terms of what kind of material.

I know myself well enough to know sort of what upsets me. And I do things like, you know, exercise and have things I enjoy to make sure that especially like I close out my day with those things so that I’m not you know, I’m not going from studying trauma to like then expecting myself to fall asleep at 10:00 or 11:00 at night. And it’s one of the things in my group. I have a trauma research group and I do preach to my and try to interact with my students and train them on that. You need to learn to manage the material. And earlier in my career, I didn’t so well and I would find myself having dreams about other people’s traumatic events and things. So that kind of forced me, now a couple of decades ago, to find my own ways of setting some kind of boundaries and kind of transitioning away from that kind of material so that when I can focus on other things or, you know, whether it’s walking my dog or just doing sort of normal, normal, good things in life and not just focus on this if negative the whole time. I hope that answers your question.

MODERATOR: Absolutely. All right. It looks like that may have been the last question for today.

KARESTAN KOENEN: Okay, great. Thank you.

MODERATOR: Do you have any other final thoughts you’d like to share with us?

KARESTAN KOENEN: No, thank you for the really interesting questions. And just I saw that you put it into the chat. Just head up on our Web Forums next week on domestic violence and also racism as a traumatic stressor. We have two really terrific guest speakers as you can see from the announcement who actually this is really their area of focus and they’re both clinical psychologist. So they work on these issues broadly, but they actually do treatments on how to manage the mental health effects of racism. So I think it’ll be real interesting. I encourage folks to attend if they’re interested in that topic. And thank you. Thanks for everyone for making time to talk about mental health.

This concludes the June 10 press conference.

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