Why you should take Mental Health First Aid

I’ve been over the numbers more times than I care to think about: Roughly one in five Americans actively suffer from some sort of mental illness. Statistically speaking, every time you are in a room with five people, at least one of them is in the middle of some sort of mental health challenge.

That, in my mind, means all of us have to do a better job of being able to help care for our friends who are in pain or undergoing an acute mental health crisis. I’d argue to also means you should investigate taking a Mental Health First Aid class.

What is Mental Health First Aid?

Mental Health First Aid is a formal program, run by the National Council for Behavioral Health. According to its website, Mental Health First Aid “teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders in your community.”

The website wants to make Mental Health First Aid “as common as CPR.” And that’s a great idea, and a necessary one.

What does the course involve?

Per the website, Mental Health First Aid will teach participants “risk factors and warning signs for mental health and addiction concerns, strategies for how to help someone in both crisis and non-crisis situations, and where to turn for help.”

Mental Health First Aid covers a variety of topics, including depression, anxiety, trauma, psychosis and substance abuse orders, and how you, as a normal person, can help someone who is experiencing some sort of mental illness.

There are actually different course types for adults and youth, which can be very helpful for young people who want to learn how to do more.

Who should take it?

Anyone who interacts with people!

Yeah, okay, that might be a little broad. Narrowing the range a bit, I’d argue that this course should be taken by anyone who regularly interacts with people that may be experiencing some sort of mental health crisis. This includes social workers, teachers. customer service representatives and more.

Of course, it goes beyond that. If you have family or friends who suffer, and often find yourself feeling completely powerless, this course can help you learn the skills necessary to help your loved ones get through whatever they are experiencing.

Where can I find a course?

How convenient!

The course isn’t a small commitment – it’s usually around eight hours, so it requires some time. That being said, is it worth it? Yeah, I think so. All of us probably know what it’s like to have a friend who is in agony that we can’t touch. Mental Health First Aid can help people learn the tools necessary to get their friend or family member through that hard moment. For those of us who hate that helpless sensation, this can be a useful tool that will give us the power and skills to care. If that’s something you’re interested in, I’d say this is well worth it.

 

Does CBD help with depression or anxiety?

In 2018, Donald Trump signed the Farm Bill into law. Among other things, this piece of legislation made legal much of the sale of CBD and hemp, as well as research into this area. – This opens up an array of new potential research, but CBD may have a positive impact on depression and anxiety.

What’s CBD, you ask? First, what it’s not: Marijuana. It is not marijuana. CBD is short for cannabinoid oil, and it became legal to be sold after the 2018 Farm Bill was signed into law.

Specifically, CBD is extracted from hemp plants. It works be manipulating your Endocannibinoid System, a part of your body which regulates a variety of bodily functions, including, potentially, your mood.

Here’s an important point though: While some research has been done, more research is DESPERATELY needed in order to determine CBDs usefulness, effectiveness, proper dosages, long-term impact, etc. At the moment, it is not widely regulated by the FDA, though the FDA has sent out cease and desist letters to some companies which have falsely marketed benefits yet to be proven by research.

Indeed, as of yet, there is no formal regulation when it comes to CBDs marketing or ensuring the quality of ingredients. For example, a 2017 Penn State study surveyed 81 CBD products and found that 70% were mislabeled. As such, if you’re going to purchase CBD, your best bet is to ensure that the label notes it has been independently tested. This means that a product has been evaluated by a 3rd party, and that 3rd party has determined that’s it’s labeling is accurate.

Okay. Enough about the legal disclaimers and warnings. What does the research show?

According to one 2014 study, CBD and Marijuana may show anti-depressant like effects. That finding was replicated in 2018, when a study showed that CBD has “anxiolytic, antipsychotic and neuroprotective properties” and may be useful in fighting a slew of problems, including PTSD and depression.

There’s additional research available, but it does seem clear: There’s opportunity here.

While CBD is not marijuana, and will not get you high like marijuana, some forms of CBD (namely Full Spectrum CBD) do contain trace amounts of marijuana. As such, if you ingest this type of CBD, you may feel some effects. Furthermore, it is possible for Full Spectrum CBD to show up on a drug test – so DON’T TAKE IT if that’s an issue for you.

Furthermore, you should not take any CBD product without consulting with your Doctor or medical professional first. While common side effects of CBD are relatively minor, there can be more problematic impacts for people with Parkinson’s, liver issues, or pregnant/nursing women.

Now that we’ve gotten the warnings out of the way: Is their potential for people with mental illness and CBD? I’d say yes. Anecdotal evidence and some research seems to indicate the potential for relief. Again, more research is needed. Again, don’t do anything without talking to a Doctor or medical professional first. But, yes. More research is now being conducted, this area does prove promising.

 

“Deaths of despair”

I wrote last week about how the particularly sharp rise in suicide and mental illness among our youngest is particularly alarming, arguing it doesn’t bode well for our society if our youngest are becoming so sick so young.

USA Today ran a related story last week about a similar topic, making an argument which has been made repeatedly – that the rise of mental illness, suicides and drug overdoses are all tied to the same basic cause – they are “deaths of despair.” From the article:

“Drug-related deaths among people 18 to 34 soared 108% between 2007 and 2017, while alcohol deaths were up 69% and suicides increased 35%…The analysis of Centers for Disease Control and Prevention data found the increases for these three “deaths of despair” combined were higher than for Baby Boomers and senior citizens.

It’s also worth noting that mental illness, drug and alcohol deaths are higher in certain states than others, and within those states, higher in areas which are struggling economically and offer less hope for the future.

I’ve said it before, and I’ll say it again – the rise of mental illness and suicides goes deeper than brain function and chemistry. We now live in a society where young adults – and younger – are losing hope and increasingly turning to substance abuse to cope. This portends poorly for the future.

What’s the solution? Part of it, of course, has to involve dealing with mental health. As I’ve written about in the past, there is a critical need for more mental health practitioners, fairer insurance practices and targeted programs which seek to destroy mental health stigma. These are answers which I often gravitate towards, as they’re public policy related. They have been studied. There are best practices with answers that, while maybe not “concrete,” can reasonably be expected to make a difference in the problem.

The truth – the full solution – is far more complicated than that.

If we’re using phrases like “deaths of despair” in casual conversation, something is fundamentally broken in our society. We now have entire generations of young adults and kids who are growing up in a world that they simply cannot handle. It goes deeper than mental health, and while all the solutions above that I mentioned are real, they can only address a problem after it has arisen. The preferential way of dealing with deaths of despair is to stop someone from ever reaching that point.

What’s causing these deaths? My random musings, based on available research and the commentary of those far smarter than me: An economy which leaves too many Americans out in the cold, smothering student loan debt, an overwhelming degree of information which leads to a pervasive sense of hopelessness about current affairs and the state of our planet, technology which gives the illusion of connections while pulling us further apart, overwhelming demands on our limited time and resources, a lack of physical activity…I mean, where do you want to start or stop?

The whole concept behind “deaths of despair” are instructive in my mind, because they make it clear that depression is about so much more than mental health. It’s about the state of the family, the economy, the world, and we’re never going to be able to adequately get our arms around this problem without dealing with it holistically.

I wish I could answer in an upbeat way, but this concept is terrifying. We’re poisoning the well, and it’s up to all of us to try to change the universe in which we live to make it a better place, not just for ourselves, or for our family, but for everyone on this planet.

The Canary in the Coal Mine: Mental Illness in College Students

NPR has great article on the mental health “epidemic” in colleges, inspired by The Stressed Years of Their Lives by Dr. Anthony Rostain, which looks at the mental health crisis among college students.

College students, like other demographics, are seeing major increases in mental illnesses. Among the rather depressing (no pun intended) statistics:

  • 44% of college students report symptoms of depression, but 75% of those students do not seek help.
  • Suicide is the 3rd leading cause of death among college students.
  • 80% of students report that they feel stressed on a daily basis.
  • 9% contemplated suicide in the past year.

Why is this jump so acute among college students? In the NPR interview, Dr. Rostain notes that there are a variety of new stresses an impacts on college students today, including a post 9/11 world, the remnants of the great recession, the rise of social media, school shootings, etc. These have all led to an explosion in depression and anxiety, as has the increased pressures which college students face to succeed.

Speaking broadly, I think, unfortunately, that this rise in mental illness among college students is reflective of what is to come. We know that mental illness rates are rising across the board – but we also know that those increases are sharpest among young adults, and sharper still among the youngest of those surveyed.

This has potentially devastating implications as this generation continues to shift into the real world and the workplace. Combine this with the rapidly exploding shortage of mental health practitioners, and the unabated rise of suicides…and we’ve got a big problem. One which will dramatically effect all of our lives.

Fundamentally, I continue to believe that this is a problem which goes well beyond the boundaries of normal public policy. There are things we absolutely must do to expand treatment, access and affordability so that Americans can get the help they need and deserve, no question. But we have to ask ourselves the broader questions: What is causing this rise of depression and anxiety?

These are real issues, and important questions, and ones which must be addressed if we are ever to truly be able to reduce the rates of mental illness and stress which are so prevalent in modern society today. Do I have the answers? Hell no. But I know it’s a question we have to ask.

Bringing this back to where we started: We shouldn’t look at the rising rates of mental illness in college students as something which is occurring in isolation or among a generation which simply hasn’t entered the real world. Given the rise of mental illness across the board, and particularly among young adults, we have to acknowledge that rising mental illness rates in younger demographics has the potential to effect this entire world. What kind of pressures will my children face? Your grandchildren?

Pay attention to this one. It will effect all of us in the future.

 

Yes, people really are this stupid about mental illness and suicide

Sometimes, I find myself falling victim to the availability heuristic, and if you read this blog on a regular basis, I bet you do too.

For those of you unaware, the availability heuristic is defined as: “A mental shortcut that relies on immediate examples that come to a given person’s mind when evaluating a specific topic, concept, method or decision. The availability heuristic operates on the notion that if something can be recalled, it must be important, or at least more important than alternative solutions which are not as readily recalled.”

Why am I mentioning this now? Well, if you read this blog, I’m guessing you have an interest in mental health and mental illness. It’s probably a subject you follow closely and in which you are are well educated. I bet you have more evolved views on the causes and symptoms of mental illness and understand it’s complexities. And, I’d bet that the vast majority of people you interact with feel the same way.

Ahhhh, dear reader, allow me to share portions of an Email I just received. Among it’s gems:

  • “People commit suicide because they lack hope. True hope comes from putting your trust in the Lord Jesus Christ.”
  • “A troubled person who believes in evolution and does not know anything about the Bible, may turn to suicide as an escape.”
  • “If you want to reduce suicide, introduce the Bible back into school and stop teaching the fairy tale of evolution.”

First, a disclaimer, and let me make it crystal clear: The purpose of this entry is not to mock anyone’s faith or sincerely held beliefs. Rather, it’s to point out an absolutely ridiculous example of thinking. Faith absolutely assists some in the fight against depression and hopelessness. That’s wonderful. If that’s something which may work for an individual, I highly, highly encourage them to find a method of counseling which fits their views on religion, God and spirituality.

But the notion that prayer, Jesus or teaching creationism will cure depression and suicide for everyone is absurd.

Mental illness is highly complex. It often requires time, resources and multiple, simultaneous methods of treatment and lifestyle changes in order to fully address and treat. There is no one size fits all bullet. But what absolutely will not help is judgmental statements like the above, or the adherence to a one-sized fits all approach.

I’d also challenge anyone who makes a statement about reducing depression, mental illness and suicide to make sure that their comments are backed up by research. As I’ve noted in previous entries, there is a complex relationship between religion and mental illness, but as best I could find, there is ZERO relationship between teaching evolution and mental illness. Someone correct me if I’m wrong.

We’ve made great strides in the area of mental illness of late, but we still have a long long way to go. And absolute statements like the ones made above will do nothing but drive people further into the shadows.

There are people this uneducated out there, and I hope this is something we can all remember.

Mental health resources when you need advice, support or just to feel like you aren’t alone

A not-so-stunning mental health truism for you now: You don’t have all the answers. Neither do I. Neither do any of us. But together, we can maybe discover the truth, or at least lend support.

Depression, and mental illness in general, are fantastic tricksters. They make you think that you are alone, that you are unworthy of support and of love. That isn’t the case, of course. No matter who you are, you are intrinsically worthy of support, kindness and love. But depression makes you think otherwise – makes you think that you are weak and unworthy of all the good things in this world.

On moments where you feel that way, the best thing you can do is talk to someone who loves you or cares about you. Short of that – or in addition to it – there is the internet. I can’t believe I just wrote that sentence, but yes, the internet and some of its kinder corners can actually be incredibly valuable when it comes to finding support for your own issues or illnesses.

For example, have you been to The Mighty? It’s a website with forums and resources for a whole slew of topics – everything from disability to mental illness to other diseases. It’s a great community with good information, and more importantly, other people who are there for you and each other.

I’ve written in the past about Reddit, but that entry was more about how hilarious it can be and just make you smile. Reddit does have a dark side – but it also has a wonderfully supportive segments. Subreddits about depression, depression help or just for people looking for a self confidence boost are filled with supportive people.

If done right, mental health forums can be a great place to trade information, provide support and receive it. To that end, make sure to check out some of the better ones, including at PsychCentral, NAMI and Mental Health America.

Looking for real medical advice? Check out WebMD, The Mayo Clinic or the Substance Abuse and Mental Health Services Administration. These websites have scientifically-based information which can help you get a better idea of your symptoms and where you can find help. And, speaking of finding help, you can always check out Psychology Today’s Therapist Finder.

Also, cute puppy videos. Cause why not.

Look, I’m sure this goes without saying, but the internet is not a cure all for your pain. But it can at least get you moving in the right direction and thinking about better days ahead.

So, yes, go on the internet. See what you can find to help you get through this dark moment. That’s one of the many good things you can find there!

Veterans and Mental Health: A challenge which must be met

If you are one of my American readers, a very happy Memorial Day to you, and I hope you get to enjoy this three day weekend with your friends and family.

That being said, my hope with this blog has always been to educate, and I wanted to take a minute to do just that when it comes to Memorial Day. This day, which began to be observed after the Civil War, was done to honor veterans who have fallen in the service of the United States. I’ve always believed that the best way to celebrate this day is not just to memorialize the dead, but to do everything we can to prevent the living from joining their ranks.

As such, let’s take a quick look at the mental health challenges our veterans face.

The numbers, as you can expect, are brutal:

  • According to Mental Health First Aid, 30% of active duty personnel deployed to Iraq or Afghanistan need mental health treatment. However, of that 30%, only half actually get the treatment they need.
  • Post Traumatic Stress Disorder (PTSD) rates are fifteen times higher among veterans than civilians.
  • The depression rate is five times higher among veterans.

Tragically, suicide rates among veterans are also extremely elevated. According to a 2018 report:

  • From 2005-2016, there are roughly 6,000 veteran suicides every year.
  • That number has increased at a rate greater than the rate among the civilian population.
  • The rate of firearm suicides is higher among veterans (65.4%) than non veterans (48.4%).
  • Veterans who used Veterans Health Administration care saw a smaller increase in suicide rates (13.7%) than those who did not (26%).

These numbers are truly brutal. More to the point, they’re shameful. We need to honor veterans with more than gauzy words and the Pledge of Allegiance. These brave men and women truly do put their lives on hold in order to protect the rest of us left behind. They sacrifice. They deserve more than our respect and a day where we barbecue. They deserve our care.

What does that involve? As you can imagine, that answer is complicated, complex and expensive – and well above my pay grade. Broadly speaking, however, I’d argue there are at least a few things we need to do.

First of all, if you have a depressed veteran in your family, it’s important that you know that resources are out there to help. It’s also worth noting that the Veterans Administration is clearly trying to address this continuing problem. There has been extensive talk about overhauling the way we provide our veterans health care, and it’s clear that we need to do more in order to tackle this issue. Furthermore, multiple studies have shown that mental health stigma keeps service members from getting the help they need and deserve. As such, clear that the military, and society as a whole, must continue to tackle mental health stigma.

So, again, happy and solemn Memorial Day to you and your family. I hope that this blog entry has made you more aware of the challenges our veterans face and the unacceptable reality that we lose over 6,000 every year to suicide, and thousands more who suffer from pain-filled lives as a result of their service.

We need to do better. Our men and women in uniform deserve nothing more.

Five horrifying statistics about suicide today

As I wrote earlier this week, we’re in a bad way when it comes to suicide as a nation. Suicide rates are rising – badly – and we need to do more to address this ongoing crisis.

We need to have a better understanding about where we are at when it comes to suicide as a country. To that end, here are five things you should know about suicide in America, 2019.

Suicide rates are at near fifty year highs. After hitting lows in the late 1990s, suicide rates began to climb again. They are now at rates which haven’t been seen in fifty years, and have increased 33% since they hit their lowest point in 1999. More than 47,000 Americans died by suicide in 2017, making suicide the 11th leading cause of death in the United States. The number is so high that it has actually begun to drag down the average life expectancy of Americans.

Gun ownership and suicide rates are directly related. This isn’t to say that gun owners are more likely to kill themselves, but it does show a direct relation between the means of suicide and actual suicides. One study revealed that suicide rates are higher in states with high rates of gun ownership, and lower in states with lower rates. Another showed that firearms account for roughly half of all suicide deaths.

For every completed suicide, there are twenty-five attempts.

Women are more likely to attempt suicide, but men are more likely to complete it. This is, in part, due to the method by which each gender typically attempts suicide. Women are more likely to attempt suicide by drug overdoses and other less violent means, giving rescuers a greater opportunity to reverse suicide attempts. Men are more likely to use firearms and asphyxiation related methods, which are typically harder to reverse.

Suicide rates are highest in the Mountain West states, and lowest in the Mid Atlantic. According to the CDC, the states with the highest suicide rates are Montana, Alaska, Wyoming, New Mexico and Idaho. States with the lowest rates are New York, New Jersey, Massachusetts, Maryland and California.

If you are looking for more information about suicide, I highly recommend you visit the American Foundation for Suicide Prevention’s website. After all, the only way to stop a problem is to fully understand it.

Six Questions: An interview with Brad Barkley, Co-Author of Jars of Glass

Today’s interview is with Brad Barkley, co-author of Jars of Glass. From the summary:

Chloe and Shana want the same thing?for everything to go back to normal, the way it was before their mom went to the hospital. But both sisters know that things can never be the same. While Chloe wants their mom to come home so they can be a family again, Shana never wants to see their mother. And while Shana is trying to escape her problems by hiding under a new persona, Chloe is left trying to be the responsible one. Then things go from bad to worse, and the sisters are forced to band together and redefine what it means to be a family.

I really appreciate that this book takes a different look at what it’s like to have a family member with a mental illness. It also bounces between the two perspectives of the two sisters, which is different than usual.

1) Do you think that personal experience with mental illness is necessary to write a story like this?

I don’t think it’s necessary, no, as long as you are a writer who is willing to do your research and use your imagination. I mean, people write novels about the Civil War or living on Mars without having had any experience of that. But it might be a moot question. You know, one of the tricks that fortune tellers are taught is to say to customers, “You are related to someone in the military,” and you go away thinking, Wow, how did she know that? But the thing is, everyone, pretty much, is related to someone in the military. I think it’s the same thing here; pretty much everyone has had someone in their life with some kind of mental illness, either themselves or someone else. Sadly, mental illness casts a wide net.

2) This book is written from a slightly different perspective than most of the ones I’ve seen with mental illness – it deals with what it’s like to have a family member who struggles. What sort of point were you trying to drive home by creating a world like this?

In my mind, novels are not written to “drive home a point,” but rather to explore the lives of characters. Or to put it another way, not to provide answers but to ask interesting questions. The question here might be, “How does it affect your growing up if your parent is mentally ill?” Or, “How does it affect relationships with the people around you?” And not just in general, but specifically for these two girls. The “point” of any novel, I think, is to let us inside other people and their lives, to create empathy and understanding for other people.

3) What sort of feedback did you get from people who had been through similar situations?

We had letters and emails from teens saying that the book really helped them. But they don’t get too into the specifics of that. They feel a real closeness for the book, but the people who wrote that book are still strangers, so they aren’t going to go into too much detail. But it is gratifying to know that someone in a similar situation has felt like they were understood or that they had a voice because this book spoke for them.

4) The book goes back and forth between the perspective of two sisters; that obviously provides two different perspectives. What made you select these two specific perspectives from the point of view of the two sisters?

I wrote this with my co-author, so I really only had a hand in selecting the perspective of the older sister (the “even” chapters in the book, in Shana’s voice). Again, I think we wanted to explore a relationship between two siblings (both of us have a sibling), who are in many ways very different from each other, yet still love each other. As you write, characters kind of insist upon who they are, and my job is mostly to type and stay out of the way.

5) As you were writing from two perspectives, were there every moments where you thought, “Oh, damn, that’s not something that character X would say, that’s what Y would say”? In other words, was it confusing to write two different emotions, dialogue patterns, personalities, etc?

Well, that is part of the difficulty or fun of writing with a co-author. Of course, I “invented” one sister, and my co-author “invented” the other one, but I would have to constantly write her character into my scenes, and vice-versa. So we came up with one rule: we each have full veto power over our own character. In other words, I could say to Heather, “Nah, Shana would never say that,” or Heather could say to me “Chloe would never do that,” and then we would figure it out. But, over the course of three books, we only had to invoke that rule twice that I recall, so we were pretty intuitive about all the characters in the book and who they were.

6) Anything that you would change about this book, now that it has been years since publication?

It never occurs to me to think of books that way, or even short stories. I’m sure I could read through with a pen in my hand and a few things would make me cringe, and I would start marking this or that change. But a book is a finished work. It is complete in itself, and it’s also kind of a time capsule of where you were in life when you wrote it, and who you were, and all the ways you have moved on. Even if you could change it, why would you want to?

Suicide rates are rising in girls – with the highest rise among ages 10-14

I guess I should warn you ahead of time, but this entry has some absolutely brutal statistics. For those who may be disturbed by such content, please note that the following blog entry will review information on suicide, including methods.

A new study which appeared in JAMA examined whether or not the gap between suicide in boys and girls was narrowing. Broadly speaking, while women are more likely to attempt suicide, men are more likely to complete it. This is for a variety of reasons, but the most obvious one is that men typically use more violent means to commit suicide, and are thus less likely to be saved by medical professionals.

The results of the JAMA study were disturbing. It examined 85,051 suicides of children and teenagers, ages 10-19, between 1975 and 2016. The most painful result:

Following a downward trend until 2007, suicide rates for female youth showed the largest significant percentage increase compared with male youth (12.7% vs 7.1% for individuals aged 10-14 years

From the conclusion of the study:

A significant reduction in the historically large gap in youth suicide rates between male and female individuals underscores the importance of interventions that consider unique differences by sex. Future research examining sex-specific factors associated with youth suicide is warranted.

Further examination of the data reveals that the rate at which women were using hanging and suffocation for suicide were approaching the same rates as men. In other words, girls are starting to use more lethal means to kill themselves, a highly disturbing trend, and one that will lead to additional deaths.

A key and tragic consideration to keep in mind when it comes to suicides is that, for every death by suicide, there are an estimated 25 attempts. A rise in use of more lethal means of suicides means that more suicide attempts will result in death.

To put the above statistic another way: If every suicide attempt led to a death, we’d lose approximately 1,175,000 people every year.

Unfortunately, none of this information is all that surprising, though it is deeply disturbing to know that more 10 year olds are killing themselves at accelerating rates. A study which came out last months showed that the number of children going to the emergency room doubled between 2007-2015. Suicide is the 2nd leading cause of death of 15-34 year olds in America, and rates of mental illness are rising among young adults faster than any other age group.

Clearly, our young people are under more pressure than ever before, and clearly, we are failing them if we don’t do a better of job of addressing this crisis.

Back to the study above. One of the things I’d like to focus on – at least when it comes to trying to reduce this gap – is means reduction. If young girls are starting to use more violent means for suicide, we must do a better job of determining why, and what, if anything, we can do about it. There are public policy options when it comes to guns, but I’m not sure what you can do, if anything, when it comes to suffocation or hanging.

We have to do something. The only way to guarantee failure is not try anything.