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Public Health Column for the Times-News

Responders for youth mental health

Published: Wednesday, August 5, 2015

By KIMBERLY HORTON
Health Department columnist

When we notice our child or someone we coach or teach or even a neighborhood youth beginning to have difficulty coping with ordinary life, displaying changes in mood or personality, changing sleeping and/or eating habits and withdrawing socially, what do we do?

Because of the stigma of mental illness, we might dismiss the symptoms as being caused by excessive stress or a stage or just being a teen. We reassure ourselves that it will pass, and we let it go. But intuitively we know something is wrong and want to help, but we have no idea how to even start.

Yet our response is critical, especially when you consider that in the United States over 20 percent (or one in five) children, according to the National Institute of Mental Health, either currently or at some point during their life, have had a seriously debilitating mental disorder.

Or that 50 percent of all lifetime cases of mental illness begin by age 14, and 75 percent by age 24. Approximately 50 percent of students age 14 and older with a mental illness drop out of high school. Sadly, suicide is the third-leading cause of death in youth ages 10-24, and 90 percent of those who died by suicide had an underlying mental illness.

In North Carolina, 20 percent of middle school students and 14 percent of high school students have considered suicide, according to the Youth Risk Behavior Survey Injury Data 2011. Over 34 percent of middle school students and around 30 percent of high school students say they feel alone in their lives.

More than 20 percent of high school students in our state have taken a prescription drug like Oxycontin or Demerol without a doctor’s order.

The repercussions of mental illness continue because youth with unaddressed mental health issues will have difficulty transitioning into adulthood. A recent study published in JAMA Psychiatry stated that children and teens with a psychiatric disorder had six times higher odds of having health, legal, financial and social problems as adults.

Those with mild symptoms who are unlikely to be diagnosed were three times more likely to struggle with life as adults. In Henderson County, we’re not unaware of or indifferent to the problem. In fact, access to mental health care was one of the top health priorities determined by the county’s 2011 Community Health Assessment. The 2014 State of the County Health Report, which is a yearly update of the CHA, states that mental health services in North Carolina continue to face many challenges, especially for the uninsured.

One of the challenges is a lack of knowledge about what services are available. So even though we may want to help, we don’t know how to respond. What should be our response?

If we think strategically about what could have an immediate and direct influence on mental health — especially the challenges that affect youth — there’s no question that the web of inter­ actions a young person has with adults in school, clubs, sports, church, law enforcement, neighborhoods and the family is primary.

What if we as individuals had the confidence and skills to respond when we see worrisome symptoms in a youth? Are you a neighbor, teacher, coach, youth church leader or parent? With training, you could be the first responder to keep a “crisis” from developing into a crisis.

You could be the person who knows how to help a youth articulate his or her needs. You could be one to provide appropriate support and resources and to connect to other caring adults. But perhaps you’re wondering how you would learn these skills.

One resource is Youth Mental Health First Aid, an evidence-based education program intended for adults to learn how to help young people experiencing mental health challenges or crises and substance use disorders. This training, often offered for free, is an eight-hour overview of the unique risk factors and warning signs of mental health problems in adolescents ages 12-18 and also for ages 18-25. The course covers a range of common disorders and potential crises along with the key skills needed to help someone who is having a panic attack, is contemplating suicide or is struggling with substance abuse.

The course doesn’t teach you to diagnose but to notice that something is happening to someone who may be in the early stages of developing a mental health problem or in a mental health crisis.

Adults learn a five-step action plan, known as ALGEE, to help youth in crisis and non-crisis situations: A – Assess for risk of suicide or harm L – Listen nonjudgmentally G – Give reassurance and information E – Encourage appropriate professional help E – Encourage self-help and other support strategies.

I had the opportunity to participate in the course in June, and when it was over, participants stated how helpful this course would be for others such as teachers and coaches or anyone who interacts with youth.

Trained individuals would have a unique opportunity to significantly affect the mental health issues of youth in our county.

Each of us could be a first responder.

This type of communitybased support is a key component of the state’s effort to improve services for individuals in mental health and substance abuse crisis as part of the N.C.

Crisis Solutions Initiative and the Department of Public Safety Center for Safer Schools. It could be a key support in Henderson County if enough adults who interact with youth are taught to be alert to risk factors and warning signs of mental illness and have the confidence to approach and offer assistance. Early intervention is the key.

Will you consider being a first responder for youth in Henderson County?

Smoky Mountain LME/ MCO (Local Management Entity/Managed Care Organization) offers community trainings for Youth Mental Health First Aid and Adult Mental Health First Aid at least once each year in our county. Smoky is always willing to work with an agency if there is a need for the training, but a minimum number of people is needed for the training to be effective. If you’re interested, please contact Michelle Tyler with the Smoky Mountain Community Collaboration Department. Call 1-800893-6246 x 5125 or visit the Smoky Calendar of Events at www.smokymountaincenter. com.

For more information, about Youth Mental Health First Aid visit http://crisissolutionsnc. org/mentalhealth- first-aid. To read the 2014 State of the County Health Report, go to www.hendersoncountync.

org/health/index.html and click on the Community Data link.

Anyone in western North Carolina who would like more information about finding mental health services or who needs help in a mental health or addiction crisis can call Smoky for free, 24 hours a day, at 1-800-8496127.


Kimberly Horton is the communications manager at the Henderson County Department of Public Health. She can be reached at khorton@hendersoncountync.org.

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