The Opioid Epidemic

Mental Health First Aid in their blog Be the Difference is this month featuring articles on the opioid epidemic.  Some are very goo so I thought I would share them here. 
Polls Show Americans Understand the Opioid Crisis but Blame People with Addiction
This is a poll from Kaiser Foundation.  While this poll indicates people are paying attention to the problem, it also points to stigma still being an issue.  However the problem hits close to home.  Most Americans know someone addicted to pain killers.
#BeTheDifference This February: The Opioid Epidemic
This is a short article but makes a list of things you might do to help confront the opioid epidemic.  Some suggestions are read up by following their blog, and then sharing what you learn. 

(I will be adding more articles and ideas over the month)

Trauma: Signs of and Tips for from Mental Health First Aid

 The things to watch for are that some one has passed through a traumatic event, anger, sadness, hopelessness, withdrawal fatigue etc.

I thinks asking how you can help is important, talk as an equal is important, don't interrupt, don't trivialize, connect with resources if the person wants help, get help for suicidal or other risk behaviors.

**Documentary Review: In Our Community: Mental Illness: Diana Guido

In Our Community.  It is so difficult to lay your life open, but in this case Ms. Diana Guido does this and does it very well.  She is a peer support, substance abuse counselor for Santa Clara County.  She gives a very good over view of mental health services.  This includes a discussion of the WRAP course.  Wellness Recovery Action Plan is an evidence based peer support service in which attendees develop their person plan for wellness.  She also talks of being a Mental Health First Aider. This also is a national training to help encourage people to look out for each other.  She also educates people to the county's crisis and warm line, 1-855-278-4204.

**Pamplet Review: Helping Children and Adolescents Cope with Violence and Disasters

Helping Children and Adolescents Cope with Violence and Disasters: What Community Members Can Do
This pamphlet is available through the National Institute of Mental Health.  Trauma is an emotionally painful, shocking, stressful and sometimes life-theatening experience that may involve physical injuries but also can happen without physical injury.  (It includes witnessing events.)  This pamphlet lists the most common responses to trauma by age:
Children 5 and under: Facial expressions of fear, Clinging to parent or caregiver, crying or screaming, moving aimlessly, whimpering or trembling, returning to behaviors common to being younger, bedwetting, being afraid of the dark.
Children 6 to 11: isolating themselves, becoming quiet around friends, family and teachers, having nightmares or other sleep problems, refusing to go to bed, having outburst of anger, becoming irritable, starting fights, being unable to concentrate, refusing to go to school, complaining of physical problems, becoming depressed, feeling numb, doing poorly with school and homework, loss of interest.
Adolescents 12 to 17: Having flashbacks to the event, having nightmares or other slep problems, avoiding reminders of the event, using or abusing drugs, being disruptive, disrespectful or behaving destructively, being depressed, being angry, loss of interest in previously enjoyable activity, having suicidal thoughts.
In then provides ideas of what community members can do to help children following trauma:
Allow child to express their feelings and the event, but not forcing.  Listen to them, accept and do not argue with their feelings, help them cope with the reality of the experience.
Love and support your children, and be with them if possible.
Community members should identify and address their own feelings.
Use their buildings as gathering places.
Help identify resources and emphasize community strengths and resources that sustain hope. 
Reduce other stressors, avoid frequent moving, school pressures, transportation problems, being hungry.
Community members should help children that continue to show problematic behaviors find appropriate help.  Behaviors which should alert to finding help include: refusing to go places that remind them of the event, emotional numbness, behaving dangerously, unexplained anger/rage, sleep problems, thoughts of suicide. 
Important does: get food and water, get a safe place to stay, gel help from doctor if needed, contact loved ones, keep children with family, understand what happened and what is being done, know where to get help, meet your family’s needs.
Important don’ts: force people to tell their stories, probe for person details, say things like “It will be OK.” Say people deserved to suffer, tell others how others should feel or act, be negative
I was able to go to Los Angeles after the Northridge Earthquake and was located in a FEMA Center.  Mostly what we did was make sure people had water.  Coors had supplied water bottles for people to take.  We did anything to help people feel like they had a sense of control.  During this time I was also on the phone, and supported some of the people had experienced this trauma with phone support, the same for Katrina and other disasters.  Sometimes just a listening ear, and anything supportive statement so help the individual feel they have some control, when things don’t always make sense.
Remember, if you are worried, voice your worry.  It is OK to ask someone if they are contemplating suicide. 
Santa Clara County Suicide and Crisis line: 1-855-278-4204
National Suicide prevention line 1-800-273-talk (8255)

**Book Review: Youth Mental Health First Aid USA for Adults Assisting Young People

C 2012 Maryland Department of Health and Mental Hygiene, Missouri Department of Mental Health and National Council for Community Behavioral Healthcare.
This book was given to me as part of a training presentation by the same name.  This training is geared towards nonprofessional people, and provides assistance so they can offer help to their family members, friends, community members or others.  It compares this program to first Aid for a physical problem.  First Aid aims to preserve life, prevent further harm, promote recovery and resiliency and provide comfort.  Mental Health First Aid is geared to promote life when a person may be a danger to themselves or others, prevent the problem from becoming worse, promote recovery, provide comfort and support and help to identify or guide a person to appropriate resources and supports.  It does this through the “Youth Mental Health first Aid Action Plan.”  This plan includes five steps which spell out ALGEE.  1) Assess for risk of suicide or harm; 2) Listen nonjudgmentally; 3) Give reassurance and information; 4) Encourage appropriate professional help; 5) Encourage self-help and other support strategies. 
It includes a section on adolescence and young adulthood, and distinguishing these transitional steps which are part of normal development from mental health issues.  It then has a very large section on different mental health issues, and how to apply this model.  These include: depression, anxiety, eating disorders, psychosis, substance use and attention and disruptive behavior problems. 
It concludes with a how-to handle certain situations.  This includes suicidal thoughts, self injury, panic attacks, trauma, acute psychosis, aggressive behavior and emergencies from alcohol or drug abuse.
This workbook is a tremendous resource.  However, I would advise taking the course so as to have some practice in the techniques before trying them.

**Documentary:The Bridge (Suicide) and My Thoughts

https://www.youtube.com/watch?v=vhARXu3wWDc
This is a documentary that was presented on HBO.  It was a bit difficult to watch. I had to do it in several parts.  If this subject is a problem for someone, it would be best they not watch.  The Bridge is a 2006 documentary film by Eric Steel that tells the stories of a handful of few individuals who committed suicide at the Golden Gate Bridge in 2004.  They had two cameras filming the bridge  during daylight hours.
This movie was introduced to me at a training I attended this week at work dealing with "Mental Health First Aid."  In the training the presented just one story, of the individual who jumped and survived.  They trainers were making the point that perhaps if someone how, there were times when, if a mental health first aid intervention had been offered, the individual may not have jumped. 
This movie is very impactful.  I don't know how many suicides were taped in the making of this film, but there were several, and many were shown.  The movie becomes more personal as they talk to survivors of suicide, and then show the suicide.  There is one case where someone is able to pull someone back over the railing.
The movie contends that more suicides have taken place here than any other place in the world. 
I was impressed with the showing, and telling of the stories of people in pain.  Some suffered from depression, or other mental illnesses.  Some were homeless, some with substance issues.  There abuse were 24 suicides in 2004 off the bridge.  There were those with relationship issues, and those with loss issues.  It helped me as a mental health worker to step back, and see people as individuals in pain, rather than just callers, or clients. 
Before leaving this some words of advice from someone who has manned the suicide and crisis line, and after-hours line for most of my professional career, 30 years now.  Do not be afraid to ask someone if they are contemplating suicide.  Don't no be afraid to ask, because the asking might save someone's life.  But also be prepared to give some assitance if the answer is "yes." You can refer to a crisis line:
National Suicide Prevention Lifeline 1-800-273-talk
Santa Clara County Suicide Line  1-855-278-4204
You can explore self-help resources: a friend, a parent, a church leader, a coach whoever.
However: always take it seriously.  Do not minimize how someone else feels.  People hurt, and need support sometimes to make it through a rough period.  Professional help is available: 911, nearest emergency room, county mental health Santa Clara County 1-800-704-0500.
If you would have trouble seeing someone jump to their death, do not watch this movie.  It shows several jumpers, and follows some as they fall.