SF Chronicle: ‘Therapy is like going to the dentist’: Alex Padilla shares family’s struggles as mental health caucus launches

By Shira Stein

On their first date, California Sen. Alex Padilla and his wife, Angela, were waiting to order food when she said she needed to tell him something. Over the next few hours, she shared what it was like growing up with a mom who had “struggled with hospitals and doctors and insurance over the years” because of her mental health.

By the time the check came, Padilla said he told Angela, “I can imagine this is difficult for the family, it can be pretty sensitive. We’re just getting to know each other; trust me, I can be discreet.”

But to his surprise, that wasn’t what she wanted: She told him, in no uncertain terms, that he should use his position in the state Legislature to do something about it.

Now Padilla is taking that task to the U.S. Senate. He announced Tuesday that he and three other senators were forming the chamber’s first mental health caucus, a group dedicated to decreasing mental health stigma, improving quality of care and expanding the mental health workforce.

The caucus formed in the wake of a shock wave to U.S. politics: Sen. John Fetterman’s announcement, soon after winning a contentious race, that he had checked himself into Walter Reed National Military Medical Center to receive treatment for severe depression. Since then, he has received worldwide attention for his forthrightness on the subject.

Fetterman is one of 10 members of the new caucus, which includes five Democrats and five Republicans, although Padilla said he already has been approached by other senators who want to get involved.

For the first time, Padilla and his wife spoke in detail with the Chronicle about his mother-in-law’s bipolar 1 with schizoaffective disorder, the effect it has had on their family, and how senators sharing their personal stories could lead to change for people living with mental illness.

“It’s always been really important to talk about this with everyone, anyone that’s in my life,” said Angela Padilla, president of the mental health advocacy nonprofit FundaMental Change. “My family never approached it in a way that they wanted us to be quiet about it. Being raised in a Mexican family, sometimes there’s a huge stigma surrounding mental illness. And I know many other families that wouldn’t have approached it this way.”

Angela Padilla said it took time to find the right regime, but her mother, Maria Guadalupe Alcaraz, has gone eight years without an episode. She said it was key to find the right physician, one who took his time to “not just overprescribe, but to do all of the work involved in figuring out what’s the right balance.”

It was by coincidence they found that doctor. Angela Padilla was at an event where she reconnected with Alcaraz’s former doctor from years prior, Alex Padilla said. The doctor looked at the list of medications — six at the time, but constantly changing — and worked to narrow it down to the two that Alcaraz truly needed, he said.

Alex Padilla attributed his mother-in-law’s stability over the past eight years to consistency. “In the past, we had big life events that can sometimes trigger her. Like when (Angela was) pregnant with Alex, or like when we were getting married because it gets the emotions going, which gets the chemicals and the body chemistry going. So stability consistently has been very, very good for her.”

Getting on that medication wasn’t a given, however. It’s affordable, but it has a potential barrier: weekly blood work when you begin the regimen. “A lot of doctors won’t prescribe it because there’s a lot of work and commitment from the families,” Angela Padilla said, but for Alcaraz, it has “worked wonders.”

When the pandemic hit, Angela Padilla said she worried about her mother being affected by all of the changes. “And it was the opposite. She made it through the pandemic doing better than most people I know,” she said.

During the pandemic, her family’s world was uprooted when, in January 2021, Gov. Gavin Newsom appointed Alex Padilla to the Senate.

“All of a sudden, I’m traveling cross-country. So it’s one thing for a child to have separation anxiety when they’re at school or maybe the parents go out for dinner. It’s a whole other thing to be cross-country in a very visible job,” he said.

Angela Padilla said she signed up for therapy. “With my husband being across the country, it was really important for me to have somebody to talk to.”

She also kept a close eye on their three sons, Roman, Alex and Diego, who were hit hard, and sent them to therapy, too.

“They’re all experiencing different things. But for me, therapy is like going to the dentist. You go to the dentist twice a year or more to get checked up to get your teeth clean. To me, it’s the same thing,” Angela Padilla said. “When we see that they need help or they’re struggling in one area, we don’t hesitate.”

Their family’s closeness has helped them weather the storm of the pandemic, mental illness and the difficulty of a bi-coastal relationship. “Everybody who works anywhere near me knows my first call in the morning is always her, my last call at the end of the day. And just talking to Angela and the kids, for me, helps keep life in perspective,” Alex Padilla said.

Fetterman and Padilla aren’t the only ones to share their personal experiences with mental illness.

Sen. Tina Smith, D-Minn., spoke publicly in 2019 about her struggles with depression in college and as a young mother, telling the Minneapolis Star-Tribune, “It started to feel weird that I wasn’t just saying, ‘Hey, I’m relating to this personally,’ ” when she discussed the issue as a lawmaker, she said.

North Carolina Sen. Thom Tillis, the Republican co-chair of the caucus, said he, too, has struggled.

“One in five people experience behavioral health problems … I’m one of them,” Tillis told reporters Tuesday. “Back when I was diagnosed with a disease in 2007, there was a drug regimen that you could use to beat my disease into remission. That caused me to have pharmacologically induced mania for about two or three months, followed by profound depression for about six to eight weeks while I was coping, working in a job and raising a family.”

Their first priority is making sure provisions from the 2022 Bipartisan Safer Communities Act are properly implemented, Padilla said. The legislation included requirements to create mental health services programs in school, increase access to behavioral health telemedicine for Medicaid enrollees and additional training and funding for mental health services.

Padilla acknowledged that increased awareness means more people are seeking help and not finding available health-care professionals, so expanding the workforce needs to be top of mind.

Even for people who can afford it, “there’s simply not enough service providers, doctors, there’s just not enough of anyone who can give the type of support and treatment that a lot of people need,” Angela Padilla said.

“For all that we’ve done in recent years to elevate awareness, overcome stigma, encourage people to seek help, it’d be cruel to suggest that people seek help and that help not be available to them on a timely basis,” Padilla told reporters.

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