Nancy Miller: Let's Talk About Mental Health
One in five teens and adults suffer from mental illness. We connected with Nancy Miller over Zoom in early February to learn about her journey to founding 1N5, an organization focused on making a difference in how we talk about mental health. Knowledgeable and passionate, Nancy shared how thoughtful conversation and early education can help eliminate the stigma around mental illness and allow people to get the help they need. We were struck by how many programs she has helped create in Cincinnati to educate about mental health, open the way for conversations about mental health, and provide a community for those impacted by mental illness.
Interview by Melanie Schmid. Photography by Stacy Wegley.
Trigger warning: This interview contains references to suicide.
Can you give us a little background on your personal story?
I grew up here in Cincinnati and am the oldest of five siblings. Within my own family, I have two daughters – one works as a defense attorney in Philadelphia, and the other works in the fashion industry in New York. Prior to founding 1N5, I had a wonderful career in marketing and market research at Gardner Business Media for about 23 years.
I lost my husband to suicide in 2008. It was a shock to all of us. He had a big personality. He was loud and goofy. And it came out of the blue. After this, I spent about two years educating myself about what I had missed, and then it became very clear to me that mental illness starts very young. By the age of 14, 50% of mental illness has surfaced. By the age of 24, 75% has surfaced, and today it takes 8-10 years to actually receive care and service.
Tell us about the Warrior Run. How did it start and what factors allowed it to grow?
After my husband died, about 12 of his friends created what they called the Jim Miller Memorial Mile, and for two years it took place in Mariemont. The first year there were about 400 people there, and then the second year there were about 200 people. At that point my kids were 17 and 19, and they told me “Mom, this is going to go away, and we will have done nothing.” They really put that pressure on me to do something. I went back to my husband’s friends and asked for their help turning this into something more impactful for the community, and they all said yes. The very first 5K Warrior Run was in October of 2010, and had about 600 attendees. 100% of the funds raised went to the “Surviving the Teens” program (which is now the “Adapting for Life” program), at Cincinnati Children’s Hospital.
When we started the Warrior Run, I wanted it to be different. I approached Doug Olberding, organizer of the Reggae Run, and asked for his help. He was a great resource for me. First and foremost, we wanted it to be family-oriented. The experience included the 5K run, along with a celebration with food, kids’ games, information booths, a movie at dark, and most importantly: community. We wanted people who struggle with a mental illness or support an individual with a mental illness to feel like they could come together and be surrounded by a community that understands.
We saw a lot of growth when we started doing teams and inviting schools to join us. Many families would create a team to support someone in their life. We created the high school and college challenge, enabling schools to form a team to raise money, with 100% of those proceeds going back to their school for mental health education. We started getting a lot of schools involved in that way because they didn’t have the funding to provide mental health education, and that gave them a vehicle to do so. We did the race in person this last year, and it was much smaller, due to the pandemic. But when we did it back in 2019, we had about 3,500 in attendance
How has your role with the Warrior Run and 1N5 changed over the years?
I was still working full time, so I would go to work all day, and then at night I would work on 1N5. At that point it was still just the Warrior Run, so it was an annual event. For about four years that was my focus. Those 12 friends of my husbands were still working with me. We had a well-oiled machine; everybody had their job, and we could put that event together quickly with very few meetings.
As the race continued to grow and we were able to donate more and more money to Cincinnati Children’s Hospital, I became more involved in the discussion of the “Surviving the Teens” program. Around 2014, we looked at the fact that that program needed to be revamped.
There was a student at the University of Cincinnati named Brogan Dulle who was missing for eight days in 2014. They finally found him on Memorial Day weekend; he had died by suicide. I went into work the next day and wrote an email to Santa Ono, who was the president of the University of Cincinnati at the time. Referencing Brogan’s story, I told him “We need to use this energy for good.” The phone rang, probably within two minutes of sending the email. On the other line, I hear “Hi, this is Santa. We need to talk.” I met him at his office, and he shared his own personal story with me. He told me he was diagnosed with bipolar disorder in his twenties and had attempted suicide twice. He also said he had never spoken about this but said he would talk about it for me. He suggested we have an event, and he would share his story.
We were able to get the event together in 2016, and the event itself was called “1N5,” and that was the first time we started using that name. [1N5 refers to the statistic: One in five teens and adults suffer from mental illness.] He shared his story at the event, left around 9:30 p.m., and by 10:30 p.m., it was everywhere. It was on the front page of the Cincinnati Enquirer, and it had gone all around the world. People started coming out of the woodwork to help me. I quit my job and started doing this full time.
One of the groups that came forward was TiER1 Performance in Northern Kentucky. They asked how they could help, and I asked them for assistance in working with Cincinnati Children’s to revamp the “Surviving the Teens” program. With their help and the partnership of Cincinnati Children’s, it is now completely revamped, and is called “Adapt for Life.” We set a goal that we wanted to go from being in 24 schools to being in 75 schools. That year we were able to donate $150,000 to Cincinnati Children’s, and now we’re currently up to about 85 schools in Greater Cincinnati that are implementing that program.
Tell us about your mental health education programming in schools. How does that work?
To implement our mental health education programming in schools, the school or a champion from the school reaches out to us first, so it’s grown very organically that way. If there isn’t a champion or advocate in the school, it won’t work. Normally someone will approach us and say they want to start working with us. From there, we assemble a committee of an administrator, the student service manager, school counselors, etc. As I said, I’m a market researcher so information is critical, and that also helps us make that argument that this is needed. When you have data from an individual school, you can look at where the holes are, and how you start to fill those holes. We start with a climate survey with the students, staff, and parents and then from there we make recommendations on our programming.
There are some fundamental programs we want to be in place like Q.P.R. (Questions, Persuade, Refer) Gatekeeper Training, where you’re teaching gatekeepers about what the signs and symptoms are, how to have the conversation, and what the resources are. We want them to ask questions, we want them to persuade the person that they need to get help, and then we want them to help that person get the help they need, with resources. You must have those language skills to have that kind of conversation, and you must practice. Another program we want all schools to have is the “Adapt for Life,” program through Cincinnati Children’s. It’s a four-day education program, normally for eighth or ninth grade, and it is so fundamental for those kids to have that knowledge at that age. From there we build programs on top of those foundational programs, based on the school’s individual needs that we’ve discovered through that data collection.
We feel very strongly as an organization that the youth is going to change this conversation faster than the adult population, so I love working with the kids. We do what we call the “Youth Council for Suicide Prevention,” partnering with Cincinnati Children’s Hospital. We have about 50 kids from all different high schools in Cincinnati who we assemble and meet with during the school year, and that’s one of my favorite programs because we’re encouraging them to come up with new ideas. We want them to challenge what we’re currently doing in the schools. How could we do it better, or how could we look at this in a different way? They really push us, which I love. I’m not their age, I’m not in school. Things are very different than when I was in school. For us to assume that we know what’s going to work for them is just wrong. Considering the typical high school or college experience, it is meant to be a huge growth opportunity, and socially fun. They’re missing all of that. When you think long term – what kind of implications does that have, especially socially, mentally, and emotionally?
There is an undeniable public stigma around mental health. Why does that stigma exist?
It’s been around for a long time. If you look at the language that has historically been used about people who have a mental illness, it’s very negative: “Those people are crazy.” As a result, if you have a mental illness, that’s a scary thing to think about. You wonder “What’s going to happen to me? How are people going to react to my illness? Are they going to treat me differently?” I think that especially through the pandemic, we’ve seen a loosening of that stigma because so many people’s mental health has been impacted. Several celebrities and sports figures have come forward to share their own personal mental health struggles, normalizing that conversation, but we still have a long way to go.
Recalling that earlier statistic - a child who has a mental illness typically won’t receive service or care for about 8-10 years. To compare this to physical ailments, if you had a broken leg and you waited eight years to get service, you would lose your leg, but we don’t think anything of the fact that we don’t take a child to get the help they need if we see the symptoms when they’re 12 years old. The longer that service is delayed, outcomes are not as good. The sooner you receive service, the outcomes can be much more positive.
Regarding the reason for that delay, a lot of times what people say is “They’re teenagers – I thought that was normal.” This mentality is why we’re trying to do so much education for people to really know those signs and symptoms. It’s not normal for a child to not be able to connect with people. It’s not normal if they get really angry, or they get really sad, or sleep a lot. These are all things that can be observed and brought to the attention of a doctor to provide help. Pediatricians are starting to have mental health screens as part of the normal well check, which I think is essential. We say this all the time: You need to treat the brain just like you treat any other physical part of your body.
What has been your proudest moment or greatest accomplishment in your time working with 1N5?
The best moments are the reactions you get from people who have participated in our education programs and it all clicks for them. As an example, we had a woman participate in our Q.P.R. Gatekeeper Training. She works for a big national engineering services firm. She went home following her training, and wrote an email to the president of the company, saying: “You require all of us to get C.P.R. I guarantee hardly any of us are in the situation where we are with somebody that has a heart attack. But I can tell you almost every day we’re with somebody who has a mental health condition. I believe our entire company needs to take this training.” Due to her advocacy, they said yes! We’re starting with the local Cincinnati staff and will then expand the training out to all 5,000 employees nationwide.
What are your goals for 1N5 over the next several years, and how would you define success?
I would love for all schools to have programming in place. In addition to this, we want to explore community gathering points and find those pockets of higher need. We’re looking at expanding to be a part of the education programming already existing in churches, and we’re wanting to expand more into corporate work forces. Of course, the ultimate goal is normalizing that conversation around mental health as much as we possibly can.
We’re also putting a lot of focus into the mental health workforce itself. Many people are leaving this field because it’s a very stressful job, and the compensation isn’t always great. We want people to enter the field and remain in the field. If you try to go out in community right now, it’s at least a six month wait to see a mental health provider.
Success to us would mean people are having these important conversations around mental health, allowing those struggling with mental illnesses to feel more supported.
What’s giving you hope at the moment?
The Bengals have really helped a lot! The Bengals have lifted the spirit of the whole city! [laughing]
I do think that the amount of people who are being educated in the mental health space has really increased, which is great. I think we’re talking about mental health a lot more, so I’m very encouraged by that. That gives me hope.
Tell us about an influential woman in your life?
There are a lot! I’ve had so many great mentors over the years. One person who has been in my life for about 8 years is Judy Van Ginkel, who ran Every Child Succeeds. I was very lucky to have been a part of a traveling group that she organized, so I’ve been on about six trips around the world with her. She’s just an amazing human being who did amazing things with Every Child Succeeds. It’s been so helpful to be able to share ideas with each other and to have her as a mentor.
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