The Just Checking In Podcast

JCIP #370 - Carolyn Gorman

The Just Checking In Podcast by VENT

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In episode 370 of The Just Checking In Podcast we checked in with Carolyn Gorman. 

Carolyn currently works as a Fellow for an organisation called the Manhattan Institute

The Manhattan Institute is a non-profit, non-partisan think tank whose scholars and journalists are dedicated to advancing opportunity, individual liberty, and the rule of law in America and its great cities. 

They cover a range of policy issues including policing and public safety, housing, education, law, economics and more. 

In this episode we discuss Carolyn’s professional journey and her career up to this point, before we dive into a range of issues Carolyn writes and speaks about through the Institute. 

These include: the failures of the mental health system in the West, the deinstitutionalisation movement of the 1960s and 70s and the impact that’s had up to now and 'therapy culture'.

We also discuss the early screening of young people for conditions like autism and ADHD, what is the right approach? Can early screening be harmful for some children long-term? And can destigmatising these conditions ever have a downside? 

For Carolyn’s mental health journey, we discuss her psychology undergraduate experience at university and how it made her self-reflect on her own personality and development, her regret at not taking economics instead, and her argument against solely relying on lived experience. 

As always, #itsokaytovent

You can follow Carolyn on social media below: 

X: https://x.com/CarolynGorman_

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SPEAKER_00

Hi Venters, welcome back to another episode of the Just Checking In Podcast. I'm your host, Roddy Cocker, and this podcast is brought to you by Vent, a place where everyone, but especially men and boys, can open up about their mental health issues, break down stigmas, and start conversations. In each episode, I check in with a special guest. We have an atta and a chat about all things mental health, as well as anything and everything else they are passionate about. If it helps that person with their mental health, we discuss it. In this episode, I'm checking in with Carolyn Gorman. Carolyn currently works as a fellow for an organization called the Manhattan Institute. The Manhattan Institute is a non-profit, non-partisan think tank whose scholars and journalists are dedicated to advancing opportunity, individual liberty, and the rule of law in America and its great cities. They cover a range of policy issues including policing and public safety, housing, education, law, economics, and many more. Carolyn started out her career working as a researcher in Washington, DC on Capitol Hill as a research assistant for the Senate Committee on Health and Education. She then moved to New York, where she landed a job at the Manhattan Institute for the first time in 2016. She was responsible for establishing a portfolio on mental health policy at the Institute before she left in 2020 to work at financial services firm JP Morgan Chase for five years. She then moved back to the Manhattan Institute, where she still works today at time of recording. In this episode, we discuss Carolyn's professional journey and her career up to this point, before we dive into a range of issues Carolyn writes and speaks about through the Institute. These include the failures of the mental health system in the West, the deinstitutionalization movement of the 1960s and 70s, i.e. the closing of asylums and the impact that's had up to now, therapy culture, and much more. We also discuss Carolyn's work on the early screening of young people for conditions like autism and ADHD. We talk about what is the right approach, can early screening be harmful for some children long term? Can destigmatizing these conditions ever have a downside? And the problems with the diagnostic tools that practitioners use themselves. For Carolyn's mental health journey, we discuss her psychology undergraduate experience at university and how it made her reflect on her own personality and development, her regret at not taking economics instead, and her argument against solely relying on lived experience in the wider conversation. So this is how my conversation with Carolyn Gorman went. Carolyn, welcome to the Just Checking In pod. Thank you so much for letting me check in with you. I thought I'd found the last of the sane interesting people for podcast guests from Twitter, but there you were shining like a beacon. And I'm so glad I found you. A needle in a haystack that's basically on fire. How are you on this Sunday afternoon where I am, but maybe morning or evening where you are?

SPEAKER_01

Morning where I am. I'm in the US and I'm a New Yorker, but I'm a New Yorker based in Texas, so it's even earlier for me right now.

SPEAKER_00

You write and speak about so many interesting and spicy topics, and we're going to cover as many as possible on this podcast, Carolyn. So without further ado, are you ready to start the show and talk all about your amazing journey? Yes, let's go. Let's start your podcast, Carolyn, by talking about your professional journey first. So give me a whistle stop tour if you can. Tell me back to the beginning in 2014 when you enter Capitol Hill in Washington, D.C. for your first job as a research assistant for the US Senate Committee for Health and Education and the journey from there.

SPEAKER_01

Yeah, so I studied psychology undergraduate and I was very interested in memory, actually. Memory is very fallible, and I wanted to do research on that. But my dad was sort of like, what are you gonna do for a job? Like just go work for the government and get a pension. And I didn't know any better. And so I just thought, okay, what's the best government job? What's the most interesting government job I can get? And I found myself in in Washington, D.C. working on a Senate committee that has jurisdiction over health and education issues. And really, it's where I sort of had this like awakening, like, wow, the world is an interesting place and public policy, like what's going on around you, is an interesting thing to be thinking about. And I was very interested in the policy, the ideas rather than the politics. The politics I couldn't really care less about, but it was interesting to be working on a committee and understand that there were things people could agree on. And so I sort of became obsessed with what makes a good idea. And that brought me up to a think tank in New York called the Manhattan Institute. And Manhattan Institute has this ethos of sort of being a pragmatic, not armchair thinky think tank. And what we do is we study ideas, what makes a good idea, what makes a bad idea, and then we actually try to put those ideas into practice. And so there is a senator from New Jersey, his name's Corey Booker. When he was mayor of Newark, we worked with him on a prisoner reentry program. We helped stand up a new type of public school called a charter school in New York State. And after 9-11, we worked with the NYPD to implement new sort of counterterrorism ideas. So we're very much about like testing ideas, seeing what makes a good idea, what doesn't make a good idea, and then talking about it. And because we are sort of historically known as a free market think tank, and we're based in New York City, which is a very blue place, we I think have very sharp tools in that we have to sort of think about what is going to convince people this is the right idea, because free markets are not necessarily the ethos of New York City, although it is a big financial hub. I'll say politically, it's not really the ethos.

SPEAKER_00

When you joined the Manhattan Institute in 2016, as part of your job in this period for the first time, we'll get to the return in a second. Your main policy portfolio was mental health, obviously, very personal to this podcast. And then, and it was a first for the institute as well. So, what areas within mental health did you cover?

SPEAKER_01

Yeah, so Manhattan Institute has covered urban policy typically. So issues like homelessness, criminal justice reform, housing. And so when I first came to the Manhattan Institute, my bosses sort of said to me, you know, we're thinking about making this topic more of an institutional priority. Tell us kind of where it fits in with the landscape and who is doing anything that's worthwhile on this topic. And it became very obvious to me very quickly that there were no one really thinking about serious mental illness. And that really fit in perfectly with our portfolio because at least in the US, individuals with serious mental illness are oftentimes homeless, oftentimes incarcerated, and really cycling through this sort of like institutional cycle is how we think about it of street homelessness, um, hospitalization, and arrest and incarceration.

SPEAKER_00

Sorry quickly as well, Carolyn. Serious mental illness is actually a proper term in the US, it's like a recognized term, right?

SPEAKER_01

That's right. And I'm glad you said that because I want to sort of like frame the conversation because mental health kind of means everything today. And so I think it's useful to actually spell out what we mean before we have any more of a conversation about it. So that way we can at least be on the same page for this conversation. So the way that I like to frame it is this a hundred percent of us have emotions and experiences that are not necessarily pleasant or enjoyable, but they are sort of a normal reality of human life. And then you have about 20% of people who have conditions that meet the clinical threshold for mild or moderate diagnosis. In the US, it's the DSM that we use. In the UK, it's the ICD. And so these are like anxiety and depression. So things that affect our lives, but they're not functionally impairing. And then there's about 5% of people who have a serious mental illness. And as you said, Freddie, it's a legal and regulatory term. It's not a specific diagnosis itself. But it denotes a disorder that is functionally impairing, typically chronic. And the best example really is something like schizophrenia or other psychotic disorders that just really are some of the worst conditions that you can experience, so difficult to help.

SPEAKER_00

When we were discussing this and your work off air, Carolyn, we discussed the deinstitutionalization movement, which took place in the UK and the US in the 1960s and 70s, specifically with the closure of what they were called asylums, right? So for the listeners in the UK, these asylums were characterized by these huge water towers alongside them. They were quite prominent, they were quite stark. They housed and treated the severely mentally ill, but there were also symbols around mental illness. You know, people were terrified of being put in one if they disclosed mental health conditions, you know, things like OCD or ADHD or all of these other conditions, which are, like you said, would not fall under the term of schizophrenia, but still had huge levels of stigma about them. And these asylums in the UK, as they were known, faced issues including overcrowding, understaffing, neglect. They were ultimately closed because of public scandals and then a shift in mental health care toward community-based support instead. And if you think about popular culture, whether it's horror films or video games, that setting of an asylum or former mental hospital is so prominent, right? You can list countless examples. Can you just tell me about the US history of them and in why, in your opinion, they've not been replaced in a positive way?

SPEAKER_01

Yeah, it's ironic actually, because when mental asylums were created, they were actually seen as a very different symbol. They were seen as a symbol of hope and a symbol of progress. And in the US, states spent enormous amounts of their tax bases on these asylums. They built them in these big, beautiful buildings with famous architectures. Frederick Law Olmsted, a famous landscape architecture, did the grounds for these places. And they were really seen as an alternative to carceral settings. So right now you hear a lot about how mentally ill make up a large portion of the jail and prison population, at least in the US, though I believe it's the case in some sense in the UK and Europe as well. And these asylums were really meant to replace that. The problem is they became, ironically, too popular. Anytime someone was aging, you'd put grandma and grandpa there because in the US, we didn't have nursing homes back then. So it was much less things like mild and moderate conditions like ADHD, but definitely if there was a problem and the family couldn't handle that problem, this was sort of the dumping ground for all of those individuals. The elderly is definitely a big population here. It was something like a third of the population. And the sizes, to your point, Freddie, became pretty incredible. One of the largest psychiatric hospitals in the US was in New York State on Long Island. And at its peak, it had something like 13,000 patients. I mean, it had its own zip code. So we are talking about real total institutions. That's a town. It is a town. It's a town. And it made up the economy of a lot of towns because anyone who was not a patient there, a lot of times would work there in the town. So, yes, these were massive places, definitely became overcrowded. In the US, there were scandals, but the real sort of downfall was a financial reason. The federal government essentially began paying for treatment in any other setting. And states basically did not want to continue paying for these asylums. And so they sort of opened the back doors, let patients out, and hoped that they got treatment elsewhere. But for someone with very serious mental illness, like I said, like schizophrenia, sometimes a higher level of care is needed. And so now we have psychiatric hospitals, but we have so few because of our financial environment. And they're nowhere near what we used to have. The average hospital size here, psychiatric hospital size here is like 108 beds. So that's a far, far cry from, you know, the 13,000 beds that used to make up one of these asylums.

SPEAKER_00

No, it's a very interesting conversation. And there's people who know far more than me on this subject about what the possible solution here. And it's probably going to be something uncomfortable, to be honest, because um I think the uh mental health system in the UK and the US is creaking and at times it's a breaking point. I've heard countless horror stories in the UK, but obviously a separate podcast. I want to do another quick whistle stop tour for your career now. So you become obsessed with quantitative data, you take a career shift, you move from Manhattan Institute to JP Morgan Chase, you stayed there for five years, but then in sports the phrases never go back, but you decided to not listen to that at all. You go back to the Manhattan Institute in 2024 and you take up the mantle of mental health as a portfolio again, right? So my next question here is about there's been a lot of work written in the critical psychiatry space about the expansion of mental health conditions in the culture. And you mentioned the DSM there, which is the US, I guess, like Bible for diagnostic conditions. It's called the Diagnostic Statistical Manual. There's been five editions of it so far, so we're currently on the DSM 5. And someone like Dr. James Davies is a big thinker on this, and he's criticized the DSM very, very heavily. And I often amend this quote from Disney Pixar's film The Incredibles, when syndrome, the supervillain says, when everyone's super, no one will be. If everything is mental health, nothing is, right?

SPEAKER_01

Look, you've got PTSD that's now in the DSM, PMS is in the DSM, restless leg syndrome is in the DSM, and PTSD, I should say, is a disorder that exists on a spectrum. Every disorder is.

SPEAKER_00

I call it an injury rather than a disorder.

SPEAKER_01

Yeah. I think we have to think about the expansion of the DSM in a way that recognizes there was, in many ways, good intent behind it. Anytime you have an expansion like this, it's been because there have been benefits associated with that. So we had after the Vietnam War a lot of veterans returning that had terrible symptoms, really bad nightmares that went on for a long time. They really struggled after that. And so this disorder of PTSD was created in order to help them access additional benefits. In the school system in the US, if you have a diagnosis of ADHD, you can receive access to educational benefits through the special education system. And so there's good intent in many ways when we talk about expanding the DSM, but we get away from what was originally thought of as mental illness, and that was really serious and functionally impairing mental illnesses. And so there is a trade-off, I think, to your point, Freddie, if everyone is special, no one is special. If everyone has a condition, no one has a condition, and then it becomes a lot harder for government to think about allocating resources. We like to think that there's, you know, unlimited resources, unlimited of everything, but there's not. There's unlimited time, there are unlimited people. And if we only have, you know, a certain amount of resources, we really want to try and get those resources to the people who need them most or who can't be helped in other ways. And that becomes a lot harder when we sort of expand these diagnoses. There's one other, I think, serious downside to doing this that doesn't get talked about a lot. Mental health treatments, which are typically therapy and medication, if you are very seriously mentally ill, they can be life-changing for the better. But they are not perfect. They're not magic bullets. And I think by expanding who we consider appropriate for these medications and therapy and interventions, we sort of end up making that a first-line defense for a lot of people who would get far more benefit out of some other intervention. And because these aren't perfect treatments, they can be harmful to people. And so we really want to think about using them judiciously, using them thoughtfully as opposed to sort of dumping them on everyone. And that has sort of been the direction that we've gone. And that causes more harm than good. So even though categorization seems like sort of a nerdy researcher topic, let's categorize people right. There's some serious importance to doing that because we want to make sure we kind of get people into the right bucket so that we can understand what is going to help them the most, if that makes sense.

SPEAKER_00

Yeah, very much so. And Dr. James Davies' book cracked the subtitle is actually Why Psychiatry is doing more harm than good. So you've you've almost parroted his book there. And it's interesting you say that because I think there are and there have been benefits to the expansion of the DSM, but there's also been quite nefarious motives as well. The corruption between big pharma and the psychological industry. And that's a separate podcast. And you mentioned ADHD there and the expansion of that. And I want to talk about early screenings now, because that's something you talk about a lot. And Susanna Sullivan wrote an excellent book called The Age Diagnosis, which I did a book review on recently. And she talks about how, you know, many parents might not want to place a diagnosis on their child, even though they might actually fit the diagnosis because they might not want to put limits on them. They might want to just, you know, keep them out of that. But then the schools won't give them the support without the diagnosis, right? Because they're so underfunded and they basically need definite confirmation. So that's a whole other minefield, too. You published a paper on this issue in January 2026. It was called Universal Mental Health Screenings in Schools, a critical assessment. What were your key findings and what is the state of play in your country, Carolyn?

SPEAKER_01

Yeah, so let me start with the state of play. We've really expanded mental health services into schools. The reason that we usually hear this is happening for is because this is where kids are. Kids are going to school every day, so it's a natural place to provide these types of services. Right off the bat, I actually think that's a really lazy argument because there are a lot of downsides to sort of replacing what schools are supposed to be doing with something that they're not supposed to be doing. Just for one, there are different privacy laws in the US for the education system and the healthcare system. And so we're right up against sort of like some laws that come in conflict. For number two, there are a lot of parental consent and parental engagement concerns. And if you take parents out of these healthcare decisions, then they have sort of less say in what's happening. And so that's something that we have to be thoughtful about. Like what is the role of the school versus the parent here? And in the US, we have a strong preference towards parental rights, towards parents making the decisions about what's appropriate for their kid. And then third, if schools are supposed to be teaching kids how to read and instead they're sort of trying to provide mental health services, how good are they really going to be at doing that when their staff aren't trained to be doing that? Even school counselors and school psychologists, they're not licensed in the same way that community mental health providers are when they operate in schools. They're simply credentialed by the education system. So right off the bat, we sort of have a question of whether or not schools are the right place to be doing mental health programming. And then when it comes to screening in particular, there's really zero empirical evidence to support universal mental health screening. And you know, by universal, I mean across a whole student body, a whole class or a whole group of students. And the reason that is, is because we don't actually have any biomarkers, any brain scans, any blood tests that we can do to demonstrate that someone has a mental illness as opposed to bad anxiety. So we're essentially looking at every single problem when we use a universal screening as a medical problem. We're looking at it through a clinical lens. And think about how often kids are like highly emotive or feeling distressed or just unhappy. It's all the time. We used to use the term angsty teens. I don't know if you if you ever heard that. Think about like nirvana, you know, like you had grunt teens who just like, you know, wanted to paddle.

SPEAKER_00

That was my era. That was our emo era.

SPEAKER_01

Exactly. We never say that anymore because now everyone has an anxiety disorder or depression. And so it's very, very easy to confuse that normal 100% of us have it distress with a clinical disorder. And that has a lot of downsides because to your point, Freddie, it really affects the way that we think about ourselves, the way that other people think about us and our capabilities. And a lot of times the education benefits that we get for having that diagnosis are not that worthwhile anyway. It's like a little bit of extra time on a test. And we're not thinking, I think, big picture a lot of times about, okay, what are we really hoping here? What are we trying to help people accomplish? And is it worth trading a little bit of time on a test for telling someone that they could have a condition that they don't have a lot of times that affects the way that they think about themselves forever. So I don't think that the juice is worth the squeeze here. And the empirical evidence also just says flatly, these don't work.

SPEAKER_00

You mentioned their false positives. And one surprising key finding for, in my opinion, anyway, from the report is that the screening tools that the US system uses generate overwhelmingly high numbers of false positives. So it flags many students who do not have a diagnosable condition with one. So I imagine, you know, just from the top of my head, that can lead to unnecessary referrals, it can lead to stigma, it can lead to misallocation of limited school mental health resources from a financial point of view. What's the issue with the screening tool then for my listeners? That it's basically finding needles in haystack which don't actually exist.

SPEAKER_01

So I was saying this a little bit before, but basically, we don't know what causes mental illness. We don't have a way to tell for sure that you do have a condition. What these screenings are are basically brief questionnaires. So somewhere between five and 20 questions that try to ask a student how often they've been distressed in the past two weeks. That could be a lot of people, and that can change on any given day. And also, kids are just really suggestible. If you ask a kid if they've been upset, a lot of them, just for sake of like being a kid, will say, Yes, I've been upset. And so you now have a lot of kids who are checking these boxes in a way that would identify them as someone who's struggling. But we already know almost always who the students that are struggling the most are, because we do a lot of other things within the given school day aside from the screening to make sure we know who's having a hard time. We have teachers who just pay attention to these kids. We have parents who pay attention. We have a lot of other sort of actual screeners that we use for different education benefits. The US has a special education system and they are meant to identify any student that has a potential disability, whether it's mild or not. And so this is sort of redundant to all of that, these universal screenings. So the type of students that they're capturing are not students who really need any additional support because they're struggling the most. We're sort of capturing like the most mild cases. And so because of that, we're capturing the most likely cases to not actually have a mental health condition, but really to have just a bad day when they took that, or they're struggling right now with something that's going on at home. And we really want to be careful about considering those kids to have a mental health condition when they don't. The last thing that I want to say is a lot of states have begun thinking about screening, and a lot of school districts have been thinking about this type of screening. But what isn't clear is what happens afterwards. There's no commitment by the schools to provide services to these students. They aren't legally obligated to do that. And so we now have a student who's been identified. It's unclear whether or not their parent has been notified. It's unclear whether or not they've been given services. But all we know is that the student now understands themselves to potentially have a problem. And then we're not doing anything to help them. So talk about a way to freak out students for no potential benefit.

SPEAKER_00

I want to move on to something which I've covered extensively with previous guests, Dr. Ashley Frawley, Carolyn, which is therapy culture, right? Listeners can go check back in with those episodes if they want to. Um, one common thread that comes up a lot, and even with some guests I've interviewed actually, and it's something that I do disagree with, is that everyone should go to therapy, right? Or everyone should try therapy. And I think that fits into this one size fits all approach. I'm one size fits one very much, so as we both, I'm sure, agree on, Carolyn. In your research, though, something I found very interesting is that you found that the efficacy of something like CBT helped me a lot. I did other therapy methods too. It's only compared to other therapeutic methods or nothing at all. Why does that exist? And what should the data compare to, in your view, to tell a better picture?

SPEAKER_01

Yeah, that is typical. So I just want to say in healthcare, we tend to overdo it the most with things that we think are the safest. And so, at least in the US, but I think we've sort of outsourced this attitude a lot just through our culture, and that culture sort of gets viewed through TV and movies and media and news. We've sort of outsourced this idea that therapy is good for everyone, as you've said. And we've done that because we think it's a pretty safe intervention. And so we've really overdone it because of that. Therapy is moderately effective. For youth, it's much less effective than for adults. But the sort of gold standard is what you mentioned cognitive behavioral therapy. And this is a type of therapy that tries to help people change the way that they are thinking when they're thinking about some type of experience in a way that's not very productive to them. So, are they catastrophizing something? You know, I can't get a date, and so no one is going to ever want to date me. Really, you might just be living in like the year that we're living in, where no one's getting dates. Or like, this isn't a you problem here. This is a cultural problem, right? But a lot of times in the empirical research, even when we have sort of gold standard research methods, like a randomized control trial, you have CBT only compared to other types of therapy. You don't necessarily have it compared to a jobs program or in schools, a gym class or an art class.

SPEAKER_00

That can be therapy. So our previous guest said, you know, art can be your therapy, football can be your therapy, the gym can be your therapy.

SPEAKER_01

Having a religious community can be a therapy. Having Sunday dinners with your family can be a therapy. You know, these are all things that really sort of like help us feel more connected. The Knicks are therapy. Look, I was just a New Yorker. I'm a New Yorker and I was just in New York on Wednesday for game four. And I mean, there is nothing like feeling like you are a part of something, running around the streets, high-fiving and hugging strangers and cheering.

SPEAKER_00

I'm surprised New York is still standing.

SPEAKER_01

Honestly, I wasn't out late enough to see all the destruction. But, you know, those types of things are therapeutic in a sense because they really make us feel like we're part of a community. And obviously, we're not going to have a randomized control trial that's comparing CBT to like a NYX win. But I think it's important to recognize that we are sort of limiting our envisioned interventions. This matters a lot, I think, with kids, because if you have a kid who can't read and they're struggling in school, and the first thing we say to them is, oh, you might have a health condition, a mental health condition, as opposed to saying, How's your teacher? How are your classes? How's your ability to read? Then we are off the bat going to be thinking about the wrong intervention for that kid. A kid might benefit more from literacy programs than they would from therapy, but if we just assume that it's a mental health problem, we're not going to give them the right intervention. Talking to a therapist for someone who's lost their job and is stressed about paying their bills is going to be way less effective than just getting that person a job so they can pay their bills.

SPEAKER_00

I want to move on to family now, because you quoted Tolstoy to me off air in his 1878 novel, Anna Karenina, who said, quote, all happy families are alike, each unhappy family is unhappy in its own way. How has that shaped your view of relationships, marriage, and family?

SPEAKER_01

Yeah, I think we have come to think about dating and partner and love as this movie. Exactly. And, you know, happiness is when reality meets expectation. I think we need a better alignment here. Like, what are we expecting? No one is going to be perfect, nothing is going to be perfect, but we can still create real deep, meaningful relationships with people who aren't perfect. And we're gonna have to figure out how to do that because, again, no one is perfect. This is sort of one of the issues that I have with therapy culture, actually, if I can say this. There's been a lot of trepidation about therapy estranging family members. As soon as you've had a couple therapy sessions, it seems to be the question always comes back to like, how's your relationship with your mom? Let me tell you, my mom and I, we have butt heads for a long time, but you know, she is not perfect, I am not perfect. And I think the older that I get, the more I realize she did so, so much for me and my three other siblings. And for me to ever think that it would be worthwhile to stop talking to her just because, like her and I have butt heads would be totally wrong. She loves me more than anyone in the world. I feel very confident saying that. And I would be giving up a serious source of love just because I sometimes don't get along with her. And my mom's gonna kill me for even saying that we don't get along. We get along so well, mom. I love you if you're gonna listen to this. But I think we have to admit that we're not perfect. And so if we are willing to sort of give up relationships because someone else isn't perfect, what do we expect people are going to have a relationship with us for? Like, what flaws are we okay with people, you know, leaving us over in terms of our relationships? So I think this idea that sort of like all happy families are alike, each unhappy in their own way, we need to think about like everyone has problems, everyone's not perfect, but that's sort of what makes for uh an exciting and meaningful life.

SPEAKER_00

Before we reflect, we've talked a lot about young people already when it comes to mental health screenings and diagnostic screenings, I should say. But I want to specifically focus on Gen Z a little bit here because off air, you were keen to highlight this story from Texas of anti-bullying that became a very messy legal case. Obviously, sensitivities here that we should be respectful of. Just tell me what happened to the nuances around it.

SPEAKER_01

Yeah, so I think this is part of therapy culture, this sort of anti-bullying movement. I wanted to talk about it because I think it's one that's really under-identified and one that I'm writing about now. So essentially what happened in Texas was about five years ago, a boy for his 14th birthday party invited several friends over for a sleepover, I think three or four boys. And they did exactly the type of things you would expect at like a 14-year-old boy's sleepover. Freddie, I think you and I are around the same age, so you might remember MTV's jackass. You know, those types of things. Like they were shooting each other with BB guns. And one of the things was they joked that whoever fell asleep first, they were gonna fill a cup with urine and make one of the kids drink it. I think they dribbled a little bit of urine into a cup of Gatorade and tried to make one of the boys drink it. And anyway, he like barely took a sip and spat it out and they all laughed about it, whatever. But one boy recorded it. And a few weeks later, the boy who was sort of being teased a little bit, who fell asleep first, he got in a fight with the boy who recorded this incident. And the mother found out, and the mother went online and posted the video herself, essentially made this whole thing about how her son was being bullied. The son had no interest in this all blowing up, by the way, and eventually apologized to the boy who had this sleepover. The boy who had the sleepover, who wasn't even the boy who recorded, essentially was suspended from school. He started getting death threats. People were showing up at his house, throwing bricks through his windows. This is just the type of sort of like craziness that I think therapy culture and unexpectedly produces because we are so like you are evil and you are not. Everyone gets categorized in a way as victim or not victim. And then the person who was supposedly anti-bullying, the mother of this young boy, was a total bully herself in a way that ruined high school for this one boy. He ended up winning a major lawsuit against her and won, I think, over a million dollars in damages. But I think we need to be more thoughtful that like the world does not exist in black and white. And instead of thinking about everyone as victim and not victim or bully and not bully, we need to sort of take a step back and say, maybe we don't want to publish this thing all over the internet and just try and find a way to work things out ourselves. But this is the type of sort of like extreme behavior that I think the therapy culture sort of exacerbates because we all now have this massive incentive to be posting things online and to like accept this kind of victim mindset. And that does nothing good for society, for us to be claiming this victim mindset because we're going to get a lot of likes or followers because of it. Doesn't do anything for us. It doesn't do anything for people who are sort of really terrible victims. It kind of diminishes their experiences. And so I think we have a lot of serious cultural problems that we've got to start thinking seriously about. And being online and sterile culture are two of them.

SPEAKER_00

Yeah, that could have been sorted out in literally about five seconds. Tell the lad who recorded it to delete it, move on, everyone moves on. But yeah. It's a really difficult one because I was bullied for nine years, and anti-bullying as a term itself is obviously well-meaning, and everyone should be against bullying, right? But when it gets bastardized in this way, or when it gets manipulated or corrupted by bad actors, that's when it becomes a very dangerous minefield, isn't it?

SPEAKER_01

I think that is one of the reasons why this movement has become so popular, exactly what you've said. No one is for bullying. Everyone is against bullying. But I don't know if it helps to teach young people to be against bullies as opposed to teaching young people how to react and respond. And the reason I say that is because a lot of times bullies are, for lack of a better word, are really just trying to get a reaction out of us, right? Like they're trying to rile us up because they think that they have power over us. And I think if we help teach young people to just shrug more things off, they'll be able to better understand, okay, this is a real problem and this is not a real problem. This type of thing, they're just picking on me and like whatever. Like I can ignore them and then they're gonna stop because they're not getting a rile out of me. This type of thing, this is actually serious, and this needs more support or more intervention from adults. And this is exactly this type of therapy culture type of theme. We are not actually helping people understand what a big problem versus a little problem is. And when we don't understand what a little problem is, then little problems become big problems. That's bad.

SPEAKER_00

Let's reflect on your professional journey now, Caroline. So, first of all, what's been your proudest achievement on it so far?

SPEAKER_01

Well, I really just like working on the issue of serious mental illness and bringing more discipline to the conversation, bringing more people into the conversation and thinking about that because we're talking about a very complex population that needs a lot of different types of support. And we're asking a lot of families when we think about policy, we're just really not doing enough for these individuals and their families. And so continuing to just make sure people are thinking about this topic is something that I think is really important because it's so easy to talk about the sort of over-medicalization side. It's really hard to think about, okay, we can deal with that all day long, but there's still this other problem that really needs attention. And it's not just about getting everyone off psychiatric medications, it's about helping the people who really need psychiatric medications or can benefit from them, helping them so that we all can benefit as a society. I said I was from New York. This is sort of how I came to this issue. We've had several subway pushings in the past few years. So someone who's not getting enough treatment then might have some hallucination or delusion in their head that causes them to push someone in front of a subway train. That makes every New Yorker have worse mental health because we're all worried about taking the subway. And so we can do a lot for everyone's mental health by helping the person with serious mental illness and making sure that we continue to talk about that population and not just not all kids need therapy has been something that's been really important for me and why I came back to Manhattan Institute after a couple of years away in the first place.

SPEAKER_00

And as a final question before we move on, what has this journey also taught you about yourself?

SPEAKER_01

So I was raised Catholic, but sort of normy Catholic, like we went to church maybe on Christmas and Easter. But my Nana was very Catholic. And growing up, I would visit her a lot. And I would always go to church with her just as something to do together. Did I buy into things? I don't know. But once I started realizing sort of like how limited the therapeutic mindset is for improving our lives, I started thinking a lot more about what are the other kinds of frameworks that we have to think about the world. And I just started taking religion more seriously, I think, and just trying to understand like, okay, is this a good sort of moral framework? And I'm really glad that I did because I'm still a normie Catholic. You know, I don't really go to church every weekend. But I'm getting older. I just got married in this past August. My husband and I are thinking about kids. And now it's something that I do want to sort of carry on for my kids. And, you know, we're thinking about if we have a child, we would get them baptized, that type of thing. And it's really nice, actually, I think that I've kind of come around to see the benefits of this because it seems like an old school thing, but in many ways, it's like, why recreate the wheel? People have been thinking about this for thousands of years and it's helped bring a lot of joy to people's lives and keep families together. So maybe not such a bad thing for uh myself to follow either.

SPEAKER_00

We've talked about your amazing professional journey so far, Carolyn. Let's go deeper and talk about your own mental health journey now. So I ask all my special guests on this topic this question first. Take me back to early life, teenagers, and looking back, were there any early mental health experiences, if any? Who's the Carolyn we meet here?

SPEAKER_01

Yeah, so it's a great question, actually. I had a friend that died when I was a freshman in high school, and that was definitely a moment that stands out to me because it was a moment that I really couldn't understand why it happened. It was sort of a freak accident, and I really struggled with that. And I just remember asking my dad about this and saying, like, how could this have happened? And not to be so, again, on the religious bent, because I think everyone needs to find their own path. But what he said stuck with me. He said, we just have to believe that there's a heaven, because if not, then it's a lot harder to come to terms with this type of thing. And it just always sort of stood out to me. So that was sort of one moment that I think stands out in terms of my mental health journey. And then another is sort of why I became a psych major in undergraduate school. I was in high school at the time when a lot of people started taking medications for ADHD. And I was a three-season varsity athlete in high school. And so to me, it didn't really make sense. It was like just go run around. Like, what are you doing? I never see you do anything active, like go touch grass or be outside.

SPEAKER_00

Hey, you as I touched grass before it was a thing.

SPEAKER_01

Exactly. Oh, gee, right here. And so I was really trying to figure out like, what are more behavioral interventions? I was very interested in behavioral interventions as opposed to pharmaceutical interventions. That's sort of why I thought psychology was interesting. And then I was also very interested in just human behavior in general. And I think it's very telling that the way I thought about mental health was not serious mental illness. And that makes sense in many ways because again. It affects every one of us, sort of like whether we're happy or feeling stressed or challenged. But these are all perfectly normal aspects of human life. And the number of us that really go through very serious debilitating disorders or develop those disorders are so much fewer and further between that. That's not sort of like the initial reason that we start thinking about mental health. I always wish I'd been exposed to economics sooner because I think that this is actually a more useful framework a lot of times to think about human behavior than psychology. What incentives drive people? How do prices affect people? And that sounds very not grounded, but incentives matter greatly. And the costs, not just financial costs, but social costs of things, I think really affect how we act. And so I wish I had been exposed to economics sooner because I think that that would have been a more interesting field to study than psychology myself personally.

unknown

Yeah.

SPEAKER_00

I mean, sometimes I wish I was better at maths, then I'd be a lot richer. But there we go.

SPEAKER_01

Yeah, it's funny. I never saw myself as a math person. I never saw myself as a data person. But I think the reason that I became attracted to those things is because I saw a problem that I wanted to understand better. And I saw those as tools to understand those problems.

SPEAKER_00

Something which you were keen to discuss off air, Carolyn, is the idea of lived experience, right? And this podcast is, you know, literally built off the back of people sharing their lived experiences, along with many other great things. Obviously, this is not a political podcast, but you know, one of the criticisms of, I guess, however we want to call it, social justice ideology, identitarianism on the left, has been this veneration or sometimes even worship of lived experience above all else, right? Yeah. And I don't agree with that. I think lived experience is obviously important, but it can't be the be all and end all for many reasons. Tell me why you believe there's a downside to lived experience by itself.

SPEAKER_01

Yeah, it's funny. When you first asked the question, you know, give me your mental health journey, I was very reluctant to want to talk about that because I think at the end of the day, this is what your podcast does. And so if it were just me that you were asking that, I would have flat out said no. I think because you ask all of your guests that, then that's right, more willing to answer. But I don't believe that I should be considered expert in talking about mental health simply because I have some lived experience with mental health or not. Is this something that I've spent a long time studying? Is this something that I've reviewed a lot of literature and read a lot of books on? That is to me a better reason to trust what someone has to say or consider what someone has to say than their own individual lived experience. And let me just say this to be clear: everyone's lived experience matters, and I don't mean to diminish that by any means, but my job is to consider what government should implement as policy for everyone, not just what policy should be based on one individual's experience. And at the end of the day, individual experience of one person is anecdote. It may not represent the experience of everyone, and it likely doesn't. And so it's really important to consider other types of evidence when we're thinking about what the policy should be for an entire population. And I do a disservice to the entire population by ever putting too much weight on one individual experience. Because imagine that experience is very compelling, but doesn't then match the vast majority of others. That then does a big disservice to the vast majority of others who had a totally different experience and would be not made better off by me as someone who tries to propose policies, considering only that one experience. And so it's simply about taking the wide range of evidence. One of the most important things that I do is interview practitioners on the ground and interview individuals on the ground. So I do a lot of work right now on school-based mental health programs. I can't tell you how many teachers, school psychologists, school counselors that I talk to. I mean, it's like every week money, but that sort of makes a holistic picture. And I pair that with other types of evidence when I think about big picture policies. And again, it's not at all to diminish one individual's experience, but it's about being accountable to people when you're proposing something that is supposed to be for everyone, really.

SPEAKER_00

Similar to our discussion on anti-bullying here, do you think that it's this barsardization or even corruption of the term lived experience by bad actors that has created this tension and friction? So, for example, something like Standpoint Theory, whereby people would say if you don't belong to X racial group and nationality, whatever it is, then you can't talk about X issue that affects them. So similar to Lived Experience, whereby you have this veneration of it in some circles, or, you know, even to the extent, you know, I'm a survivor of sexual abuse, the the criticisms of like the believe all women, for example, you know, I wouldn't say believe all men. I would say take every allegation seriously and hopefully find out if what they're saying is true or not. And then if it is true, punish the perpetrator severely and support the victim or victim survivor. Is that where you think we're going wrong here? Like lived experience on itself is fine, it's good, but it needs to be balanced alongside other factors and considerations and can't be politicized, basically.

SPEAKER_01

I think that's right. I also think it's really difficult to make sure we don't sort of swing the pendulum too far one direction or the other. And I always want to assume best intent. Look, there's always gonna be bad actors in any field, in any, you know, area. It's just gonna be what exists. I want to think that the vast majority of people are not bad actors. And then I just want to think about okay, on the whole, how do we prevent the pendulum swinging too far one direction or the other? And I think that's why it's really important to just have some standard that you truly try to apply to everyone fairly. And it's not always going to be perfect, but it's going to be better than the alternative of preferencing one thing rather than the other, because times change and preferences change and people change and problems change, frankly. The type of problems that we see today might not be the type of problems that we saw 50 years ago. And so having some type of standard and trying to apply that fairly, I think overall is just going to get us better outcomes, knowing that there isn't going to be all winners all the time. There are always going to be some people who don't benefit or go through tough times or go through the system and the system doesn't work for them. But how can we help the most people most of the time? And I think we do that by sort of trying to maintain some fair standard as opposed to preferencing one specific experience or one specific demographic feature over others at any given time.

SPEAKER_00

Yeah, very much so. And this is something that Paul Bloom talks about in his excellent book Against Empathy, whereby too much empathy can create a vacuum where bad actors can exploit it. And for example, that can be in the form of, say, men who face false allegations of domestic abuse or even sexual abuse in the family court system. It's a really, really big problem here in the UK. I can't speak to it in the US.

SPEAKER_01

Well, Freddie, I just want to add to that because I think you made a really, really important point. A lot of times we try to do things out of empathy and we don't actually see the downsides to that. So I like to give this anecdote, which is maybe a silly anecdote, but I wish I had a better. I'm just very lucky I didn't have a lot of terrible experiences growing up. I was a very, very pretentious child. And it was because I came from a working class family, and I really just thought, unless I did well in school, I wouldn't get into college, and then I wouldn't get a job, and then it would be the end of the world. So I really wanted all A's in high school. And I had a student teacher my junior year who gave me a B. And this was like seriously the most devastating thing that ever happened. I didn't think I was going to be able to get into college after that. So, you know, I went to my teacher in the class that the student teacher was working in, and I said, Look, the student teacher gave me a B. Like, you have to help me change this grade. And she basically laughed at me and said, get a real problem. And this was like totally devastating to me. So I went home and told my dad, who also laughed at me and said, Yes, get a real problem. Don't go to your dad for stuff like that. Exactly. And, you know what, it's funny because I still joke about this with my dad today. Like, if I'm complaining about something that really isn't worth complaining about, he'll say something to me like, Carolyn, get a real problem. Like, do you need to get a real problem? And I interviewed that teacher a few years ago for a paper, and she could not believe that she told me to get a real problem. And she said she would be so scared to tell a child that today because she'd be nervous that she would traumatize them. And I told her, I said, you gave me something incredibly valuable, and that was perspective. You helped me understand that getting a B was really not a big issue, was not a big problem, like we were talking about earlier, sort of separating out big problems and little problems. If she had given me that A, I would have always thought that getting a B was a big problem. And then that would have really shaped how I looked at the world. And so sometimes we're trying to do things out of empathy. We're trying to not hold young people or anyone to a certain standard because we think it's empathetic to them. But really we're doing them a disservice by saying, we don't think that you can meet this bar of understanding what a real problem or a big problem is. We don't think that you can meet this bar for how we expect people to behave in society or operate in society. And in many ways, we do that out of empathy, but we're not doing that person a service by saying, we're basically telling them we don't think that you can live up to this standard. So I think anytime we think about doing something out of empathy, we should also be thinking, is there a way that we're actually not being very empathetic to that person by doing this?

SPEAKER_00

Yeah, the truth hurts. You met reality and tough love also hurts. And I say to people a lot, there's a lot of kind of like, oh, be kind, be nice. But when I hear people say be kind, I almost think they're actually saying be nice, because kindness isn't always what people want to hear. Kindness is actually telling people the tough shit. And I advocate for that a lot. You know, there is a phrase, it's sometimes cruel to be kind, and I think that is true, but people don't want to hear that.

SPEAKER_01

That's a great, that's a great way to think about it, Freddie. I'm gonna use that. Don't be nice, be kind.

SPEAKER_00

Let's reflect now, Carolyn, before we move on to our mental health chat. So if you could go back and talk to the Carolyn in high school who had just met reality for the first time, would that be? Or the Carolyn who was wondering whether to major in economics or psychology, or the Carolyn who had just started working on Capitol Hill in Washington, DC, what would you say to her, knowing what you do now, if anything at all?

SPEAKER_01

Look, it's cheesy, but I think nothing at all, because I've been able to sort of stumble into this really, really interesting career. And I don't think if I had changed anything, I would have done that. And, you know, all of our experiences make us who we are: the good, the bad, the ugly. And I think it's easy to say we want to prevent those things from happening, but that's sort of what makes us who we are and what we care about. And so, in many ways, I take all the good with the bad and not say anything to myself. I would maybe hide in a closet and try not to watch myself just totally fail or choke or do anything embarrassing that we all did when we were teens and like hate to look back on.

SPEAKER_00

We've come to our final topic of conversation on this excellent chat, Carolyn, and it's one I try and have with all of my special guests if we have time. It is a general Natter and quick fire chat about our mental health. So, firstly, how is your mental health out of 10?

SPEAKER_01

I would say 10 out of 10, and that doesn't mean that I'm happy all the time or that I'm sad all the time. That means I experience a range of emotions, and that is exactly how humans are supposed to function.

SPEAKER_00

What age were you when you became self-aware of your mental health for the first time and you realized that the feelings you were having weren't physical and they were actually in your mind?

SPEAKER_01

I have no idea, and that is my honest answer. Right now. It could be right now.

SPEAKER_00

One guest has actually said that to me, so I do enjoy this process. Can you remember the first or the most important conversation you've ever had with someone about your mental health or something associated with it? So if you can remember, what did you say? Who was it with, and how do you look back on it? Did it feel like the big moment and weight have been lifted, or on the other, something quite easy and normal to do?

SPEAKER_01

Um, I had a boss that was very strict with me. And afterwards I called a mentor about it, and this was like fresh out of undergrad. And she was like, look, this happens. Sometimes you get good bosses, sometimes you get bad bosses, and it won't be the last boss you ever have. So take it in stride. And I always will remember that conversation.

SPEAKER_00

What things do you find in life? They can be positive or negative that trigger your mental health. So it could be things people say, a sound, smell, sensation, or have you not figured all of them out yet?

SPEAKER_01

Deadlines. Deadlines are wonderful and horrible. It is good to feel stressed about a deadline because it gets you to do something. At least I feel that way. But sometimes I can be a little bit annoying to my husband when I'm like anxious and on edge and I take it out on him too much. So deadlines, good because stress is good to get stuff done, but sometimes we can be a little nightmarish when we're stressed out.

SPEAKER_00

Yeah, I'm like that. The stress is normally etched onto my face that people can always tell when I'm uh when I'm stressed about a certain deadline. And uh, I'm doing a diploma at the moment. And when I started it, I was really okay and I banged out most of the work in like a day. But like before I started it, man, I was stressed.

SPEAKER_01

Yep. No, that's usually what happens too, right? Like we think something is gonna be horrible, and then the best thing to do is just get started on it, and then we realize it's not that bad. But like we're all procrastinators, right? Like, even people who say they're not procrastinators, they're procrastinating.

SPEAKER_00

Yeah, the study nightmares are the worst. I've had one or two of those in my day, yeah. I've not missed this. Like I had it when I was in university, and I've not gone back to study for like 10 years, and I'm like, oh, I hate that niggle. The niggle in the back of my head's come back, man. Fuck this shit.

SPEAKER_01

That is literally my job. My job is basically to study.

SPEAKER_00

Don't envy you. What positive tools and methods do you use to improve your mental health, Carolyn, or help you feel better? Which ones have worked for you and which ones have you tried but haven't?

SPEAKER_01

Yeah. So right now, well, I think a lot about self-discipline, trying to be more disciplined because I think we have this therapy phrase, like put in the work. And a lot of people think like, oh, I went to a therapist once a week, I put in the work. But that really isn't, I think, self-discipline. And so I try to think about how can I make myself a better person. And I really think about that and I try different things. So right now, what I try to do every morning is I read a little bit of something. So I'm reading Marcus Aurelius' meditations, and then I also am reading a small bit of scripture every morning because between the two of those things, it gives me something to reflect on for the day. And then I try to hold myself accountable for doing that. By the end of the day, have I thought about what I read? Have I not? And some days are better than others, but trying to be disciplined enough to do it every morning and stick with it is right now what I am trying to do to better my mental health.

SPEAKER_00

You spoke about books there. What is the best book or, as I call it, mental health Bible you've read for your mental health? It can be fiction or nonfiction, and it doesn't have to be mental health related either.

SPEAKER_01

I just think reading is really great for mental health. And so right now, there's been a lot of news about how we're just reading a lot less. So actually reading and trying to do that is something that I highly encourage. I just reread The Great Gatsby, which I haven't read since high school, and that's great. Yeah, pick any book and just read it, really.

SPEAKER_00

I'm currently reading The Certainty Trap by Alana Redstone.

SPEAKER_01

I haven't read it, but you'll have to give me the synopsis afterwards and tell me if it's worthwhile.

SPEAKER_00

Well, I'm doing a book review on it, so I'll put out the book review pretty soon. So you'll see that.

SPEAKER_01

I'll read it then. I try to alternate between fiction and nonfiction, but I'm really impressed with fiction right now because I used to think I needed to read nonfiction all the time to make sure I was learning about something. But there's there's something about getting out of your own head and thinking about putting yourself into another story that I think is probably good for us all. We could probably do that more society-wide.

SPEAKER_00

Yeah, I read exclusively fiction when I was a kid and voraciously, and then I got to Uni and I didn't read any fiction, and I was like such a non-fiction-like acolyte. And then I started reading books by a guy called Mitch Albom. Yeah, yeah, yeah. And I read like all 13 of his books in like two years. He's Tuesdays with Maury, right? Yeah, yeah. That's his Percy, as the English slang term would say. Yeah, that's his goat. But yeah, I read all of them. The first one I read was The Five People You Meet in Heaven.

SPEAKER_01

Yeah, okay, great. Yep. Freddie, I'm gonna challenge you to read The Great Gatsby now.

SPEAKER_00

Oh no, American classic literature. You've got to do Okay, I'll add it to the TBR, but the TBR is like 50 books long currently. So it's got a way to go. Put it on your list, how about it? I will, I will. Not a great film, in my opinion, though.

SPEAKER_01

No, not that great.

SPEAKER_00

No. Memeable, but not great. Well, anything that's memeable is great in some way, right? If there was a mantra in life that summed up your mental health, what would it be and why?

SPEAKER_01

I said it once earlier, my dad says this a lot. Happiness is when expectation meets reality. And I think that's a good one to just keep in mind. Like, what are we expecting here? Like, it's not about settling, but it is about saying, okay, what is the reality of life? Like, what do I expect here? And if I don't win the lottery, can I still be happy?

SPEAKER_00

And never has a true word been spoken. What do you love about yourself?

SPEAKER_01

Um, I love that I genuinely believe everyone has something that they bring to the table that we can learn from. So I love talking to people and hearing about their lives and what they do on a day-to-day basis and what makes them happy and what makes them feel fulfilled. And everyone has something that they can add. I really believe that.

SPEAKER_00

And as a final question, Carolyn, you can answer it any way you want. What more do you think we have to do to ensure people from all backgrounds, all nationalities, all walks of life feel comfortable and safe in opening up about their mental health issues or just their general mental health and well-being, if most importantly, they want to do it?

SPEAKER_01

I think it would be naive to assume that I could answer that question well. So instead, I'm gonna end with go Bills. I'm a Buffalo Bills fan.

SPEAKER_00

So do you know what? No one's ever said I don't feel qualified enough to answer that question. So that is a great first, actually. There we go.

SPEAKER_01

Maybe more people should examine their own qualifications then.

SPEAKER_00

Carolyn, it has been a fascinating and brilliant conversation. Thank you so much for coming on the Just Checkin' In podcast and talking to me, pal.

SPEAKER_01

Thanks for having me, Freddie.

SPEAKER_00

Well, that's all we've got time for in this episode of the Just Checkin' In pod. A big thank you to Carolyn for being my special guest and for letting me check in with her. I'll put some links to where you can find out more about the Manhattan Institute and follow Carolyn on social media in the show notes. As always, thank you to all the vendors who checked in on this episode. Remember, if you've liked what you've heard, give it a share on social media by tagging us at venthelpuk. Tell your friends, family or work colleagues about us. Write us a review and give us a five-star rating on Apple Podcasts. Support our Patreon at patreon.com slash venthelpuk or make one-off donation to our PayPal. Those links are on our link tree. That's linktr.ee slash venthelpuk. We hope to check in with you again very soon. And remember guys, it is always okay to vent.