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Keep Talking About Mental Health

By Contributor
Opinion

Opinion

By State Rep. Aaron Saunders

 

I grew up in a home where it was OK to ask if you were OK, mentally or physically, at the dinner table. This was not common during the 1980s, when a stay in a psychiatric ward could be a mark against you for life, but my dad was a psychologist, and my mother, a teacher.

They knew the importance of conversations with their boys about feelings, expectations, and disappointments and not just a skinned knee and how you got it.

I was reminded of this recently during a visit to the newly renovated adolescent unit of MiraVista Behavioral Health Center in Holyoke. Its recent reopening brought back on line 16 much-needed inpatient beds in Western Mass. for youth ages 13 to 17. The redesigned environment enhances delivery of care and healing for this population, in which recent government data estimates that nearly 50% have had a mental-health disorder at some point in their lives.

Massachusetts, with its Roadmap for Behavioral Health Reform, introduced last year a Behavioral Health Line to call 24/7 and network of community behavioral-health centers that provide broader access to mental-health services for those in crisis. The state, too, has added inpatient psychiatric beds to ease Emergency Department boarding that continues for all age groups.

We, as legislators, need to ensure that there is ongoing funding for such services and adequate reimbursement rates for such beds, as well as for addiction-treatment programs. Mental-health and substance-use disorders co-occur frequently, and it is important for both to be treated.

We also need to continue to consider policies that address staffing shortages and issues like educating students and their families on the importance of mental healthcare.

Yet, there is another barrier — stigmatization — around lessening disabling behavioral-health conditions. Massachusetts has a campaign that seeks to educate that addiction is a chronic illness and not a personal choice, but stigma and misinformation continue to prevent individuals with behavioral-health issues from seeking treatment.

You can’t legislative away all stigma. We all need to be better-educated that mental illness can be treated and that there are steps to be taken to prevent poor mental health from progressing to where it interferes with daily life. This is what I reflected on during my recent visit to MiraVista.

I hear from my constituents of the need for services close to home and, in applying the lessons learned from my parents in asking my own three children about their feelings, I get a look into their day in an age when bullying and pressure to engage in unhealthy behavior can come from anywhere.

We all need to be more open to talking with our families, friends, and healthcare providers about our mental health and that of those in our care, as this, too, is part of the roadmap to raising emotionally healthy children and staying emotionally healthy, too.

 

State Rep. Aaron Saunders represents the 7th Hampden District.

Recovery Ready Workplaces Face Addiction Challenges Head-on

By
State Sen. John Velis and Ramona Rivera-Reno
Healthcare News

‘It’s the Right Thing to Do’

State Sen. John Velis and Ramona Rivera-Reno

State Sen. John Velis and Ramona Rivera-Reno say being a Recovery Ready Workplace is good for employees — and the bottom line.

 

State Sen. John Velis knows something about addiction and recovery, having experienced both in his life. And as chair of the state Legislature’s Joint Committee on Mental Health, Substance Use, and Recovery who also serves on a national mental-health task force, he’s keenly aware of the intertwined challenges of recovery and employment.

That’s why he firmly believes the Recovery Ready Workplace initiative offers businesses a roadmap to not only help employees with the biggest challenges of their lives, but to help their business succeed at the same time.

“If you don’t have a healthy workforce, if you don’t have a workforce that is there, in the here and now, to do their job, you’re going to see that in your productivity — more specifically, loss of productivity,” he said.

So helping employees struggling with mental-health issues, addiction, and other challenges is certainly a bottom-line issue, he went on. But, more importantly, it’s a human issue. “It’s important to do it for many reasons, but most importantly, it’s the right thing to do.”

Velis shared these thoughts at a recent employer-appreciation breakfast presented by MassHire Holyoke’s Pillars of the Community Workforce (PCW) initiative, during which several local businesses were honored for their pledge to become a Recovery Ready Workplace — a national program he believes is more crucial than ever.

“What I know with absolute certainty is that the pain that’s being felt out there right now, the number of people dying, the number of people struggling with their mental health, is unprecedented,” he said, adding that this issue “absolutely transcends age, socioeconomic status, race, ethnicity, everything. There is pain out there.”

A Recovery Ready Workplace supports its community by recognizing recovery from substance-use disorder as a strength, according to MassHire. Companies that take the pledge actively work to maintain and support the employment of people in recovery and their loved ones, and creates a healthy and safe environment where employers and employees can work together to eliminate barriers for those impacted by addiction, reduce stigma and judgment of people in recovery, and start to shift attitudes and perceptions around these issues.

“What’s our mission? To create a culture of support for employers and employees that have been impacted by substance use and addiction,” said Ramona Rivera-Reno, executive director of MassHire Holyoke’s Re-entry & Recovery program. “And when I say create a culture, I’m talking about breaking down the stigma that goes with substance-use disorder.”

“What I know with absolute certainty is that the pain that’s being felt out there right now, the number of people dying, the number of people struggling with their mental health, is unprecedented.”

Reducing or eliminating that stigma is a critical step, she emphasized.

“We’re all in recovery from something, whether it’s recovering from surgery, recovering from the pandemic, recovering economically. There’s a lot of pressure on all of us. And we need to have the coping skills and the communication skills to overcome that as a community together. And that’s what the Recovery Ready Workplace is all about — educating employers, helping them educate their staff, adding it as a wellness benefit to their benefits. The more people you educate, the more communication you get out there, the more we’ll break down that barrier.”

MassHire Holyoke recently recognized

MassHire Holyoke recently recognized about a dozen local businesses for taking the Recovery Ready Workplace pledge.

MassHire notes that being a Recovery Ready Workplace does not mean accepting or enabling intoxication, substance use, or any unsafe conditions in the workplace. What it does mean is that the business:

• Acknowledges that addiction is an issue for many people by openly addressing the topic of drug and alcohol misuse, communicating about these issues in a non-judgmental and honest way to reduce stigma, and encouraging employees to discuss substance-use concerns and recovery successes in a non-punitive setting;

• Educates employees and customers about the disease of addiction and treatment resources and options;

• Offers policies and accommodations that support employees while rethinking hiring standards around gaps in employment, addiction-related justice history, and other considerations;

• Prioritizes safety by preventing employee exposure to unsafe conditions that could cause injury or illness that contribute to the development or recurrence of substance-use disorders, ensuring the workplace is an emotionally and socially safe and healthy environment for staff, and improving access to recovery supports; and

• Improves access to recovery supports by lowering barriers to seeking and receiving care for addiction, and maintaining recovery.

 

Making a Difference

Holyoke Mayor Joshua Garcia said the city itself is taking a pledge to be a Recovery Ready Workplace. He recognized why some companies would be hesitant to sign on, but agreed with Velis that it’s the right thing to do.

“Obviously, as a company, you have to make sure you have your systems in place to help navigate potential liability and harm to your company because that’s the bottom line,” Garcia noted. “But these are the folks that are helping you build that. So, whatever little bit you can do to help build people up, you’re going to see a return from those individuals that really appreciate the level of interest you’ve taken on them, and the risk you’ve taken on them.”

Rivera-Reno said companies and organizations that take the pledge agree to acknowledge and openly address the employees’ experience with drug and alcohol misuse in the process of recovery.

“A lot of people suffer from different things, whether it’s substance-use disorder, alcoholism, mental-health issues, and they don’t ask for help because the stigma attached to it. It’s a sign of weakness for a lot of people.”

“You’re free to educate your employees about the disease of addiction and treatment options in recovery support, and offer support. And there’s so many ways you can offer support.”

It can be as simple as offering a dollop of schedule flexibility. She cited one client who used to go to lunchtime recovery meetings, but could no longer do that at a new job. “So we had someone talk to the employer, and the employer decided, ‘well, you can come in early, and you can have a longer lunch and just stay later.’

“That makes a big difference to someone,” she went on. “Something simple like a flex schedule made all the difference. And that person’s still working today, and he wouldn’t have had the courage, I think, to do this if we didn’t have a recovery coach talking with him along the way, and if the employer wasn’t aware of our services and aware of what a recovery-friendly place is.”

Rivera-Reno called stigma a more deadly killer than cigarettes, heroin, or whatever substance because it keeps people in the shadows and keeps them from asking for help. Companies that pledge to help break that stigma, she said, are changing lives.

“A lot of people suffer from different things, whether it’s substance-use disorder, alcoholism, mental-health issues, and they don’t ask for help because the stigma attached to it. It’s a sign of weakness for a lot of people. It’s a sign of, like, maybe you’re not ready to work here. So by getting us into the different employers’ offices, talking about recovery as a community, we really make a difference in their lives.”

Garcia emphasized that, with the cost of turnover and difficulty retaining talent these days, it makes business sense for employers to support their employees who are struggling with some of these issues, rather than letting them fall through the cracks.

“Sometimes it’s not even the individual that’s suffering from personal addiction; it’s a son or a daughter or a significant other that impacts them and their performance in the workplace,” the mayor said. “So we’re taking a much more proactive approach when dealing with our employees to help them navigate these problems so that we keep our employees and don’t lose them.”

Indeed, MassHire emphasizes the bottom-line benefits of cultivating a Recovery Ready Workplace, including increased retention and fewer absences, a healthier and safer work environment, greater productivity and loyalty among staff, lower healthcare costs, and an enhanced reputation as a supportive, yet accountable organization.

And with 22 million Americans identifying themselves as people in recovery, it’s not something businesses can afford to ignore.

“You already have countless employees who are struggling with something, whether it be a substance-use disorder or something else,” Velis told those attending the breakfast. “You have that without knowing it.”

 

Breaking the Cycle

Velis ended his address on a personal note, and an encouragement to practice self-care. He said he was late to the event because he was bringing his son to daycare.

“Probably two or three years ago, I would have said to my better half, ‘I gotta go. I gotta be at work. I’m speaking at this event.’ And I don’t do that now because being a dad is the most important thing in my life, but also because I firmly believe when I go to bed at night that self-care is the most important thing every human being does — whether it’s going for a run, doing yoga, meditating, going to a 12-step meeting, or hanging out with my son.”

And that’s what Recovery Ready Workplaces do, proponents say, noting that recovery isn’t just stopping substance use, but taking a journey of growth, improvement, and perseverance. And that’s exactly the kind of employee companies taking the pledge value.

“If you were to look out at your employees and say, ‘raise your hand if you’ve ever struggled with a mental-health issue or a substance-use issue,’ you wouldn’t do that, but trust me when I tell you, many people in that room are struggling with it right now,” Velis said. “And when you welcome that, when you talk about it, when you let it be known that it’s OK, you’re doing a really beautiful thing.”

That’s because the stigma still exists, he added. “The three hardest words for any human being to say are also the most courageous words: ‘I need help.’ Behavioral health today is about meeting people where they are.”

MiraVista Chief Medical Officer Shares Advice for Summer Vacation

By Contributor
Healthcare News

Mental Health Shouldn’t Take a Break

 

 

Dr. Negar Beheshti

Dr. Negar Beheshti

How do students stay emotionally healthy during a long stretch of school vacation?

Dr. Negar Beheshti, a board-certified adult, child, and adolescent psychiatrist and chief medical officer for Holyoke-based MiraVista Behavioral Health Center and its sister hospital, TaraVista Behavioral Health Center in Devens, recommends a balance of structured fun and learning. She recommends as well that primary-care givers, be they parents or other guardians, do their due diligence to keep everyone safe and engaged in behavior that supports mental health.

With that in mind, BusinessWest asked Beheshti to talk about ways to make school breaks beneficial for students of all ages.

 

BusinessWest: What expectations around behavior are good to set during this time away from school?

Beheshti: This is a conversation geared to the child’s age. For example, children in elementary school may be doing a lot of summer-camp activities, and this is an opportunity to talk about appropriate behavior with other peers at the camp.

Should there be other informal activities for this age group more regulated by parents and guardians, it is good for primary caregivers to get to know them, advise their children to stay away from people they don’t know, and know that all activities are in a safe space, contained and chaperoned by an adult.

When you get to the tweens, they may not want the regular, structured routine of summer camp. However, it is still good to do some type of structured program, as it gives middle-schoolers the opportunity to continue social development and promotes new learning opportunities. Some school districts offer enriched learning programming at least part of the day that holds the potential to explore something new in a fun way.

The state Executive Office of Education has a web resource page (www.mass.gov/info-details/summer-learning) on summer programs for youth that are a mix of academic and the recreational.

 

BusinessWest: What about older teens? How can parents and guardians balance their desire for freedom with safety and wellness?

Beheshti: Young people old enough to hang out with their friends without an adult chaperone should have some type of device that allows their primary caregiver to reach them. There are all types of devices today, from smartphones to smartwatches, by which you can regulate whom your child can contact and track their whereabouts.

Again, you want to do your due diligence as a primary caregiver, get to know any parents or other guardians involved, know your young person is in a safe place, and, if they are going out, where they are headed and when they will return.

Parents and guardians should prepare as well for some age-appropriate talks on the expectations and pressures of friendships and relationships and that discourage experimentation with substance use. Drug-overdose deaths of teens have spiked in recent years; underage drinking remains a serious health problem in this country, and studies on the impact of the legalization of adult cannabis show an increase in use among teens.

High school brings a little more autonomy for teenagers and the need for more candid discussions on dating and substance use, including that the minimum legal age for buying, transporting, or drinking alcoholic beverages is 21.

“Parents and guardians should prepare as well for some age-appropriate talks on the expectations and pressures of friendships and relationships and that discourage experimentation with substance use.”

There is value for a teen who is old enough to look for a job. It gives the ability to have more autonomy and more cash to spend and save, and is a good use of their free time.

Parents and guardians should continue their due diligence in knowing who their child is hanging out with in high school, where they are going, and when they will return.

College students can be bit of a conundrum because they are adults. Maybe it is time to say they are coming back home as adults, and you will hold them to that standard in terms of their personal habits around the house.

They are old enough to get a job. This, again, allows them more bandwidth in what they might want to purchase for themselves, help with cost-of-living expenses when they are home, and helps structure their time.

Having structure is key in helping young folks during the summer not get distracted and into risky situations, as is knowing their friends. Have their friends (new and old) over the house and meet them during the summer. There is no harm in meeting your children’s friends of any age.

 

BusinessWest: How can parents and guardians best initiate a talk around accountability and acceptability during vacation?

Beheshti: The best approach is often from an angle of curiosity. This makes it conversational rather than who, what, when, and where. For example, adults often share about each other’s friends just out of an interest, and this tact will likely have more traction with teenagers and young adults versus grilling them.

There is also value in saying to your young person, “I remember my summers when I was a teen, and how my parents (your grandparents) were, and I understand today their concerns for me back then.” The more transparent and sharing (within reason) parents and guardians are, the better chance for more open discussion.

 

BusinessWest: How important is adhering to routines like bedtime during summer?

Beheshti: There can be some leeway. For example, if you have a 9- or 10-year-old, the average bedtime should be between 8 and 9 p.m. If you want to push it to 10 p.m. during the summer and have them sleep a bit later, you need — about two weeks before the start of school — to get that back closer to their school-year sleep pattern so they don’t wake up super tired and have a hard time adjusting the first week of school.

You also want to make sure they are eating healthy, balanced meals during the day with plenty of exercise.

 

BusinessWest: Is it important to spend more family time together during vacation?

Beheshti: There is value in trying to schedule at least one week, maybe two if you have the luxury, for some vacation — even if it is a staycation — with your kids, even when they are high-schoolers. They may roll their eyes, asking why the family is doing something, but being together as a family is something you may not get to do a lot during the school year.

 

BusinessWest: What mental-health issues come up during summer for school kids?

Beheshti: Historically speaking, and the pandemic years aside, the inpatient child and adolescent psychiatric bed census drops during the summer for several reasons. There is less demand on young people during the summer. This means, if they have been managing a diagnosis of depression or anxiety, for example, their symptoms tend to be less severe with less pressure.

However, one cohort of children that particularly benefits from structure and routine are those with developmental delays, including those with related neurobehavioral disorders such as autism spectrum disorder. We see the same amount of prevalence of children with a neurodevelopmental disorder needing hospitalization during summer because their preferred school routines have gone away.

 

BusinessWest: Why symptoms might indicate to a primary caregiver that a child is struggling emotionally?

Beheshti: If you see a noticeable change from what’s typical in their daily activities, meaning their sleeping, eating, or day-to-day mood, pay attention especially if it continues for more than two weeks. This is true even in someone who does not have a previous mental-health diagnosis. Consider making a call to your child’s pediatrician or primary-care provider, especially if they are not established with a psychiatrist.

Parents and guardians — again, coming from an angle of curiosity — could gently ask a child about a noticed change. If they are eating less, for example, you might ask if there is something wrong with their stomach, or is there something else going on in their life? A conversational approach, starting young, can make communication easier as a child ages.

 

BusinessWest: What support is important during the summer for a young person who may be questioning their sexual orientation or gender identity?

Beheshti: You hope that young people who are going through these transitions have had support during the school year. However, some kids may not get this, and there is the potential as well for peer abuse or bullying. A peer counselor would be a good source of support, along with finding a therapist who is experienced in delivering culturally competent care to individuals who identify as LGBTQIA+.

The Massachusetts Department of Mental Health has a web resource page, Young Adult Resource Guide LGBTQIA+ Resources, at www.mass.gov/info-details/dmh-young-adult-resource-guide-lgbtq-resources.

 

For more information on MiraVista’s inpatient behavioral-health treatment for adolescents, as well as adults, call (413) 701-2600 or visit www.miravistabhc.care

Mental-health Needs Continue

By Contributor
Opinion

Opinion

By Negar Beheshti, MD

 

The emergency declaration of the COVID-19 pandemic may end on May 11, depending on the specific policies and guidelines of each country or region. However, the mental-health needs of individuals affected by the pandemic are likely to continue long after the official declaration ends.

The COVID-19 pandemic has caused significant stress and uncertainty for many people, including social isolation, financial difficulties, and concerns about health and safety. These stressors can take a toll on mental health, leading to symptoms of anxiety, depression, and other mental-health issues.

While the end of the pandemic may bring some relief, it is important to recognize that the mental-health impacts of the pandemic may be long-lasting. Therefore, it is essential to continue to prioritize mental healthcare and support, both for those who have been directly affected by the pandemic and for the general population.

This can include accessing mental-health services, practicing self-care strategies such as mindfulness and exercise, and seeking support from friends, family, or mental-health professionals as needed. By taking steps to address their mental health, individuals can promote their overall well-being and resilience in the face of ongoing challenges.

Mental Health America’s 2023 ranking of states in terms of higher access to mental healthcare shows Massachusetts continues in a top position. The Commonwealth, which has made access a priority through its recent creation of Community Behavioral Health Centers, ranks second, as it did in 2022, in terms of such markers as access to insurance, treatment, and quality and cost of insurance.

Lack of affordability and lack of access are consistently among the barriers cited in seeking mental healthcare, so it is good to see the state maintain its ranking on access in comparison to other states. Massachusetts, through its Roadmap for Behavioral Health Reform, is working to reduce these barriers, and we here at MiraVista are proud that our opening nearly two years ago in the middle of the pandemic created additional inpatient psychiatric beds in the state for both adults and youth, as well as expanded inpatient treatment for substance use.

Still, the need for increased mental-health services — and the funding to support them — to meet demand continues both in the state and nationally.

The pandemic brought attention to the existing gaps in mental-health services and has spurred efforts to address them. It is crucial to recognize that the need for mental-health support and resources continues to exist post-pandemic, and individuals should be encouraged to seek help and support whenever necessary.

Our experienced clinicians deliver patient-centered and evidence-based care, helping those with mental-health and substance-use conditions to find their road to recovery in order to live a fulfilling life.

 

Dr. Negar Beheshti is the chief medical officer for MiraVista Behavioral Health Center in Holyoke and its sister hospital, TaraVista Behavioral Health Center, in Devens. For more information on MiraVista’s psychiatric services, visit www.miravistabhc.care.

MHA “Mental Health” Socks Are Here to Stay!

By
Daily News

SPRINGFIELD — Last spring, MHA started working with Lenny Underwood, a locally-based entrepreneur and founder of Upscale Socks (www.upscalesocks.com), to introduce two different sock designs with mental health themes to tie into the observance of Mental Health Awareness Month during May. Due to the popularity of the ‘Moving Forward’ and ‘Positive Steps’ sock designs, going forward both designs will be included in Upscale Socks’ year-round product line.

Significantly, MHA and Upscale Socks have jointly announced this change to coincide with Minority Mental Health Awareness Month, also known as BIPOC (Black, Indigenous, Persons of Color) Mental Health Awareness Month, which takes place in July.

“At MHA, we know that starting a conversation about emotional wellness and confronting stigma through understanding are important parts of Mental Health Awareness Month, but these are everyday conversations we need to continue having year-round,” said Kimberley Lee, VP Resource Development & Branding for MHA. “Of course we were thankful for the natural tie-in to Mental Health Awareness Month when we introduced the Moving Forward and Positive Steps socks. Now, as BIPOC Mental Health Awareness Month shines a light on the mental health needs of Black, Indigenous and Persons of Color communities, we are especially thankful for Lenny Underwood’s willingness to support MHA by continuing to include our two sock designs in Upscale Socks’ year-round inventory.”

MHA’s mental health themed sock designs are available at these links on the Upscale Socks website:

https://www.upscalesocks.com/product/moving-forward/

https://www.upscalesocks.com/product/positive-steps/

“Mental health is a topic that doesn’t get discussed enough, especially in the Black community,” said Underwood. “BIPOC Mental Health Awareness Month is a great opportunity for MHA and Upscale Socks to recognize that mental health awareness is not just something we acknowledge for a month or two each year, it’s a year-round commitment. These socks are a great conversation starter that can promote more dialog about mental health and the services MHA provides for anyone who may need support around their emotional wellbeing. As a black man in particular, I know it’s a conversation that needs to happen more often, more comfortably, and with more people in our community. If I can do my part to dispel myths and remove the stigma around mental health, I am happy to help.”

Pandemic Ratchets Up the Stress on Kids, Teenagers

By
Health Care Special Coverage

Youth in Crisis

Let’s face it — the past year of COVID-19 has probably been tough on you, in any number of ways that weigh on your peace of mind. But what about your kids? How are they doing? And … do you even know? That might seem like a flip or aggressive question, but a group of local teenagers who have been talking to public-health leaders about the issue say their parents aren’t fully hearing them when it comes to the impact of the pandemic. And that impact, in many cases, has been worrisome.

 

Alane Burgess began by stating the obvious.

“It’s not normal for kids to be home all the time.”

As clinic director of the BestLife Emotional Health & Wellness Center, a program of MHA Inc., Burgess is one of many healthcare professionals keenly invested in how the COVID-19 pandemic has impacted young people. And the picture is worrisome.

“They like to be out. They like to socialize. Most kids like to be with friends,” she said. “COVID forced isolation on a lot of people; they haven’t been able to go to school, to socialize, to be involved with activities they once loved, like sports. Community spaces haven’t been open.”

It’s not surprising, she added, that this isolation has contributed to an uptick in anxiety, depression, frustration, and a tendency to act out in negative ways.

Indeed, according to the Centers for Disease Control and Prevention, between April and October 2020, hospital emergency departments saw a rise in the share of total visits from childen for mental-health needs. Nationwide numbers on suicide deaths in 2020 are still unclear, but anecdotal evidence suggests an uptick.

“Kids are excited to go back and see their friends and have some sense of structure, to be in society again. But there are definitely a lot of adjustments to be made.”

But here’s the less obvious reality, Burgess noted: while the pandemic may be (and that’s may be) on its last legs and schools and other gathering places are slowly opening back up, that doesn’t mean the stresses of the past year will just fade away.

“Kids are excited to go back and see their friends and have some sense of structure, to be in society again,” she told BusinessWest. “But there are definitely a lot of adjustments to be made.”

When COVID struck, she noted, the shifts were quick and unplanned — kids were suddenly learning at home, and many of their parents were suddenly working there. It has been a challenging time, particularly for working parents with young children who need help with school.

But transitioning back to whatever will pass for the new normal poses its own challenges, she said. “It was originally going to be two weeks, and weeks turned into months, and months became a year. Now, they’re going back out into a world that’s changed; it’s not going to be the same — there will be masks and social distancing and limitations on clubs and activities.”

Tamera Crenshaw says barriers to accessing mental healthcare are myriad.

Tamera Crenshaw says barriers to accessing mental healthcare are myriad.

Socially, certain young people — those with a more introverted personality — found they thrived in the remote setting, and are anxious about returning to campus, Burgess added. Others found the home setting to be an escape from bullying, and are palpably fearful about going back.

Meanwhile, some students, depending on how rigorous their remote-learning experience was, might find themselves overwhelmed or feeling academically behind as teachers play catch-up. Many students report coasting to passing grades, even very good grades, while feeling they haven’t been learning much.

And the economic struggles affecting many families who lost income or jobs — a definite stressor on kids — certainly aren’t over.

Tamera Crenshaw, a clinical psychologist and founder of Tools for Success Counseling in Longmeadow, said she’s especially passionate about mental health in minority populations, a demographic disproportionately affected by mental-health issues — because, again, those issues tend to be exacerbated by factors like economic stress, which have also landed hard on those populations during COVID-19.

Even remote learning has been a greater problem for communities of color because of issues of technological access and family strife over financial matters, she added. “Home isn’t necessarily the most conducive learning environment — and COVID just exacerbated it.”

An uptick in suicidal ideation is especially concerning, Crenshaw said. “Someone can have a baseline of thought, but when kids are actually expressing a plan or intent, it’s scary. And we’re definitely seeing an increase.”

Some of the factors are typical stressors on teens in any given year, but despondency has certainly been driven by greater economic instability, which can raise tension and anxiety in the home, as well as two competing factors: a longing to end a year of isolation and get back to school, and health fears about the safety of doing so, especially for kids who know someone who has died of COVID.

“These kids have not been forgotten, but even with a vaccine, they’re going to be vaccinated last,” she noted. “I can’t imagine there’s not a fear of going back into the school environment when they haven’t been vaccinated.”

The issues are deep and complex, and solutions aren’t easy. But, like most others in the mental-health field, Crenshaw says the first step to helping young people take charge of mental-health issues is clear and simple.

“You’ve got to name it.”

 

Start the Conversation

That means breaking through societal stigma surrounding these struggles.

“My mission is to destigmatize mental health,” Crenshaw said, noting that several factors contribute to that stigma and the resulting reluctance to seek help. “I want to help debunk that stigma.”

Beyond attitudes toward mental health, another barrier is financial — the challenge of accessing insurance that will pay for treatment, or, for those who don’t have it, navigating out-of-pocket costs while already struggling economically, she added.

“It was originally going to be two weeks, and weeks turned into months, and months became a year. Now, they’re going back out into a world that’s changed; it’s not going to be the same — there will be masks and social distancing and limitations on clubs and activities.”

A third factor is religious belief, specifically a belief by some churchgoers that mental-health professionals are at odds with faith, or that faith makes such help unnecessary. “We’re trying to educate churches and knock down that barrier,” she said. “I’m a woman of faith myself.”

Another factor is the simple fact of how few therapists of color are working today. Crenshaw’s team is largely women of color, but her practice is an exception — which is unfortunate because she knows people of color will often have an easier time trusting someone right off the bat when they can relate to them or see themselves in them.

This last factor might be a long-term struggle to overcome, she added, noting that she teaches classes in her field at Westfield State University, and none of the 17 students currently in one of her classes is a woman of color.

In fact, the mental-health and social-work fields in general are in need of more talent, said Jessica Collins, executive director of the Public Health Institute of Western Massachusetts (PHIWM). She agreed about the access issue as well, noting that mental health should be a basic support, not something available only for people who can pay for it — especially when families who can’t pay are often in greater need of those supports.

Recognizing the importance of these issues among young people, before the pandemic even began, the Public Health Institute facilitated the formation of a youth mental-health coalition in Springfield — one that brings to the table direct service providers like BHN and Gándara, Springfield Public Schools, local therapists, and, critically, a group of 11 teenagers who meet regularly.

The question at the center of the initiative is simple, Collins said. “How do we best support kids? It might sound basic, but it’s fairly new; there has not been an emphasis on the mental health of kids except in extreme cases, where the kids have to go into inpatient care.”

One takeaway so far is that teens don’t feel fully heard by the distracted adults in their lives.

“What we’re hearing, loud and clear, from our young people is, when they talk to adults, adults are not skilled at supporting them,” Collins said. “Adults are stressed, adults are stretched, and that just adds to this epidemic of young people feeling hopeless and alone and unsupported.”

That’s why the Public Health Institute is talking about what kind of training adults — those who work in preschool and school programs, but also parents — might need to learn how to better listen to young people and work through and respond to what they’re hearing.

Jessica Collins

Jessica Collins says parents sometimes get so stressed, they don’t realize how stressed their kids are, too.

“These big direct-service providers are really competitive, so to get them in a room to talk about how can we work together to better support families, instead of just competing for them, that’s fairly new,” Collins said, adding that Daniel Warwick, Springfield’s superintendent of Schools, has also been on board with efforts like this for a long time.

For example, when he saw a 2017 report by PHIWM about the hopelessness felt by local teens who don’t identify as heterosexual, “he was so upset about that, a few years ago, he mandated some training for all Springfield public-school adults to better support kids who are LGBTQ+.”

 

Take It Seriously

That’s a good example of listening to young people and then taking them seriously — which is one way to normalize mental-health needs, Collins said. “If you can’t talk about it, you can’t figure out for yourself what you need.”

And one thing young people need right now is reconnection. While many kids are tired of the technology-only avenues for connecting with friends, Crenshaw said, Zoom calls, text chats, and the like have been an overall positive in staying in touch. But she also encourages kids and families to take opportunities to see friends and loved ones in person, in a safe manner, when possible.

“You can go to the park; you can go outside with a soccer ball, wear your mask, and connect. Some families have said, ‘we can’t do this alone,’ and became part of each other’s bubble, taking turns doing homeschooling. We encourage these ways of connecting with each other.”

And don’t give up on trying to talk to your kids, Burgess said, even when they don’t feel like talking back.

“The most important thing any parent can do during these times is open a dialogue with their children and allow kids to have open communication,” she said. “What are they thinking? What are they feeling? Then we can guide them and help them through their own resiliency and make adjustments.”

Families can help combat their kids’ isolation, she said, by planning quality family time, even if it’s just having dinner together, around the table, every night, or scheduling a family game night every week. Those moments, she noted, can naturally help kids let their guards down.

“You want to have that quality time, that open communication to talk and listen to your kids and ask, ‘how are you feeling? What’s going on? What can I do to help make things easier?’ Sometimes, as a parent, we’re not able to say ‘yes’ to everything, but we can look for compromises and help kids make some of the decisions.”

The problem in identifying signs of distress, Crenshaw said, is that teenagers, even on their best days, often prefer to be isolated, or present a sullen demeanor. So how can parents separate normal teen ‘attitude’ from real warning signs?

“Are they communicating as much with you, or are they isolating in their rooms moreso than normal? Are they eating normally?” she asked. “Even prior to COVID, parents would say, ‘I didn’t know there was a problem — I thought that’s how kids are.’”

It doesn’t hurt for parents to simply ask their kids, directly, how they’re feeling, what’s working or not working in their lives, how school is going, and if they’re feeling more anxiety than usual. “If a teen is isolated in their room, that could be typical teen behavior, but maybe not.”

Physical signs may be visible, too, Crenshaw said, noting that cutting — what’s referred to in her field as ‘self-injurious behavior’ — and eating disorders are more common than some parents think.

But more often, the signs are subtler. “It’s just really knowing their disposition and what they’re involved in.”

Burgess said it’s important for parents not to go it alone if their gut tells them something is truly wrong.

“If you notice your kid struggling with severe signs of depression — really isolating, really struggling — definitely seek professional help. If your kid is talking about suicide or even just having a hard time getting back into interacting or adjusting, seeking professional help is always key.”

In the end, coming out on the other side mentally healthy — and that goes for parents and children alike — will take patience and resilience, Burgess added.

“There’s no guidebook for this. There’s no ‘COVID for Dummies’ book. We’re all doing the best we can to adapt. We’re all just going through an unprecedented time.”

 

Joseph Bednar can be reached at [email protected]

Creating an Environment for Recovery

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Opinion

Opinion

By Christine Palmieri

September is National Recovery Month. ‘Recovery’ is a word that gets used a lot in the world of mental health and addiction services, sometimes so much so that I think we can easily lose sight of what it represents. In my role with the Mental Health Assoc. (MHA), I often have the opportunity to talk to newly hired staff about the idea of recovery. We discuss what it means and what it can look like in the context of working with people who have experienced trauma, homelessness, psychiatric diagnosis, and substance problems.

When I ask new staff the question, “what does it mean to recover?” I frequently hear things like “getting better” or “getting back to where you were” or “having a better quality of life.” Although I tell staff there are no wrong answers to this question, secretly I think there are. They’re common and easy, but insufficient.

As with many things, I think it’s easier to talk about what recovery is by defining what it isn’t. For me, recovery isn’t a cure. It isn’t a finish line or a place people get to. It isn’t a goal that can be neatly summarized in a treatment plan. I believe recovery is a process that is unique and intimately personal to the individual going through it. Ultimately, though, I think the answer to the question “what does it mean to recover?” should be “it isn’t for me to say.”

I believe recovery is a process that is unique and intimately personal to the individual going through it.

As providers of services, or as loved ones, community members, and policy makers, I don’t believe it’s up to us to define what recovery means or looks like for people going through it. Each person needs to examine and define what it means to them. For the rest of us, I think the more important question is “what makes recovery possible?” When the question is posed this way, we are able to engage this idea of recovery in a much different and more productive way. This question offers the opportunity to share the responsibility and partner with those we support.

The analogy of a seedling is often used when describing this process of recovery, and one I use when I talk to our new hires about their roles and responsibilities as providers of service. Seeds are remarkable little things. For me, they represent unlimited potential. A seed no bigger than a grain of rice contains within it everything it needs to grow into a giant sequoia. But no seed can grow without the right environmental conditions. No amount of force or assertion of control can make a seed grow. It needs the right soil, the right amount of water, and the right amount of light.

In the same way, within each person who has experienced trauma, homelessness, psychiatric diagnosis, or problems with substances, I believe there lies unlimited potential for growth, and each person needs the right environment for the process of recovery to take place. As providers, loved ones, community members, and policy makers, we very often control that environment. Metaphorically, we provide the soil, the water and the light.

Soil is the place where recovery begins. It offers a place for the seed to grow roots, to gather strength, security, and safety. Soil is what keeps trees rooted tightly to the ground through storms. It is our responsibility to offer environments where people in recovery feel safe and secure, to try out new ways of coping and new ways of managing the difficulties and challenges that life presents to all of us.

Water provides a seedling with essential nourishment. We need to find ways to support people in recovery to discover what truly nourishes them. The work of recovery is hard. It requires taking risks and feeling uncomfortable. We cannot do the work of recovery for anyone else, but we can and should work to help people in recovery find the supportive relationships, meaningful roles, and reasons to do that hard work.

Light provides the energy necessary for growth. In recovery, I believe light is offered through the hope and understanding that every person has within them the potential to live a full and active life in the community, whatever that means for them. As providers, loved ones, community members, and policy makers, it is our role to shine the light of hope for people who have experienced discrimination, loss of power and control, and in many cases a loss of their identity. We hold this hope and offer this light because we know, without question, that recovery, however it is defined, is not only possible, but is happening, right now, all around us.

Christine Palmieri is vice president of the Division of Recovery and Housing at MHA.

You Make Today Better: A Candid Conversation on Mental Health

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In 2006, Jamie Tworkowski began his quest to end the stigma of mental health. Since then, his global non-profit movement has offered relief to thousands struggling with depression, addiction, self-injury, and suicide. He is the author of The New York Times Bestseller “If You Feel Too Much” and runs the nonprofit “To Write Love on Her Arms.”

Jamie will join forces with friend and mental health ally Chris Sullivan, best known as “Toby” on NBC’s top rated drama, “This Is Us.” Chris’ acclaimed portrayal of depression and anxiety has empowered a national conversation on these urgent issues.

Together, they will offer a lively conversation on self-care, recovery, and hope and will be available to speak to attendees after the talk.

Stigma Often Keeps Guys from Seeking Help for Mental Health

By
Joy Brock
Business of Aging

Man UP

Joy Brock

Joy Brock says organizations like the CONCERN Employee Assistance Program can bring mental-health resources to men — if they’re willing to ask.

Behavioral health is not a male issue or a female issue — it’s a human issue. Yet, the imbalance between the problems facing men and their willingness to seek help has raised alarm bells in the field over the years.

Suicide rates provide one of the starker contrasts, with men making up more than 75% of all suicide victims in the U.S., with one man killing himself every 20 minutes on average. Substance abuse — sometimes referred to as ‘slow-motion suicide’ — follows a similar track, ensnaring three men for every woman.

And, yet, men don’t want to bring up these issues, said Sara Kendall, vice president of Clinical Operations at MHA in Springfield.

“In our society, we have expressions like ‘man up.’ So many things in our culture are geared toward men being strong, and therefore, seeking any help — especially anything behavioral-health-related — been viewed as weakness,” she told BusinessWest. “It’s often difficult for men to feel comfortable talking to someone, so there’s a disconnect with how to help. We encounter that a lot.”

Joy Brock, director of the CONCERN Employee Assistance Program, which is affiliated with River Valley Counseling Center, has battled the same tendencies in her counseling and referral work.

“Oftentimes, men have this tendency to pull back and not discuss any mental-health stuff that’s going on with them,” she said. “They might be struggling with anxiety or depression or even social anxiety, but they’ll hide it.”

“Not all families sit down and say, ‘all right, as a guy, here’s how you handle this.’ They just tell you, ‘stop crying’ or ‘you’re being weak right now’ or ‘be a man.’”

Many times, the reluctance of men to seek help begins in their youth, with stereotypes that eventually harden into personality traits.

“We’re not all taught how to deal with situations growing up,” she noted. “We all come from different families, and not all families sit down and say, ‘all right, as a guy, here’s how you handle this.’ They just tell you, ‘stop crying’ or ‘you’re being weak right now’ or ‘be a man’ — all these social norms and stereotypes, which make it even harder when something’s happening to you.”

It’s a situation that’s exacerbated when one’s peers hold the same stereotypes, Brock added.

“Where do you go for help when you can’t go to your family and friends because they’re like, ‘oh, it’s not that big of a deal’? So some guys don’t talk about it, which is tough because it’s isolating. And if we hide it or pretend it doesn’t exist, it just keeps growing and gets to a place where you’re having breakdowns or meltdowns, or you’re getting suspended from work, and part of you doesn’t understand what’s going on.”

While difficult emotions — and clinical depression and anxiety — don’t always have a specific cause, there are some common stressors, she said, noting that divorce and unemployment can strike at the identity of men by altering their traditional roles and leaving them adrift, without pride or purpose.

It’s notable that men in small towns and rural areas have particularly high rates of suicide, and flyover states such as Wyoming, Montana, New Mexico, and Utah, as well as Alaska, have the highest rates of suicide in the country — a trend that has been linked to the decline in traditional male industries such as manufacturing, forestry, and fisheries, leaving large swaths of men in certain regions jobless or underemployed.

High rates have also been observed in veterans, young Native Americans, and gay men, with one possible common thread being perceived rejection by mainstream society, leading to strong feelings of alienation and isolation.

If there is an obvious trigger to feelings of depression or anxiety, Kendall said, it’s often easier to get men in the door to talk about it.

“The referral may come from a spouse. Oftentimes, a gentleman will come in and say, ‘I have to do this or lose my marriage, or lose my family, or lose my job.’ It’s tied to the fear of losing something. But once they’re here, they’re just as inclined to stay in treatment as females. There’s so much potential to help, if we can make it more comfortable for men to talk.”

Breaking Barriers

Besides cultural factors, Mental Health America notes three elements that may feed into the reluctance of men to seek help for mental-health issues.

The first is that awareness strategies are not targeted effectively to men. Research indicates that men respond more strongly to humor (especially dark humor) and, at least initially, to softer mental-health language. But, as Kendall noted, once men are engaged enough to learn more, there is often much less resistance to continuing the conversation.

The second factor is that men ask for help differently. Men are much more likely to accept help when there is a chance for reciprocity — that is, when they perceive an opportunity to help the other person in return, which wards off the feeling of weakness that is often associated with asking for help. Men also prefer to either fix or at least try to fix issues themselves when possible, before reaching out for help.

Sara Kendall says men tend to stay with needed mental-health programs once they begin, but getting the conversation started can be difficult.

Sara Kendall says men tend to stay with needed mental-health programs once they begin, but getting the conversation started can be difficult.

For this reason, Brock suggested that acceptance and commitment therapy (ACT) is an effective option for many men. Instead of putting the emphasis on talking about feelings, ACT stresses accepting the reality of one’s situation, choosing a direction, and taking specific action toward those goals.

“What is it you’re fighting for? What gives you meaning in your life? Let’s focus on that, while also acknowledging you don’t feel great about the situation you’re in,” she said. “It’s a different, more action-oriented approach, and works especially well for veterans.”

The third factor is the fact that men often express mental-health problems differently than women, leading to misdiagnosis.

Although both genders experience similar symptoms of some mental-health concerns, how they manifest and present those symptoms can vary. For example, women often respond to symptoms of depression by appearing disheartened, sad, or talking about feelings of worthlessness. Men, however, often respond with anger, frustration, impulsive behavior, or other manifestations that are often dismissed as normal male, acting-out behaviors.

“It’ll end up presenting like anger or sometimes irritability,” Brock said. “Sometimes they just get tired, they don’t want to do anything, they’re not motivated, or they’re pulling away from work or the things that normally interest them. Sometimes it’s physical — stomachaches or chest tightening, that kind of thing. Or they do a lot of risk taking or avoiding or trying to escape a situation. And they might use substances, like alcohol or drugs, to try to hide things.

“If you’re no longer enjoying activities, if it creates disruption in your life, let’s talk about that. It’s no different than a pulled back keeping you from baseball games.”

“Sometimes we don’t recognize what depression is,” she went on, “because when you think depression, you think sadness, and for guys it looks way different. If you’re finding you’re more angry or irritable, that may be depression. And if you’re pulling away and isolating from other people, that’s depression as well.”

Because depression, anxiety, and related issues can wreak as much havoc on daily life as physical problems, if not more, it makes sense to seek help, Kendall said.

“If you’re no longer enjoying activities, if it creates disruption in your life, let’s talk about that. It’s no different than a pulled back keeping you from baseball games,” she explained. “We’re all in the same boat, and it’s OK to talk about it. Asking for help is not a sign of weakness.”

Dispelling the Myths

Joshua Beharry, a survivor of suicide, has become a mental-health advocate and the project coordinator of HeadsUpGuys, which provides men with advice and resources to identify, manage, and prevent depression.

“Fighting depression is difficult. Not only do you have to fight the illness, but you also fight the stigma attached to it,” he recently wrote for the National Alliance on Mental Illness website. “For men, the fear of looking weak or unmanly adds to this strain. Anger, shame, and other defenses can kick in as a means of self-protection, but may ultimately prevent men from seeking treatment.”

He outlined several common myths that stand between men and recovery from depression, including ‘depression equals weakness,’ ‘a man should be able to control his feelings,’ ‘real men don’t ask for help,’ ‘talking about depression won’t help,’ and ‘depression will make you a burden to others.” Understanding the falsehood behind all of these is the first step toward a healthier life, he added.

“Being unhealthy and refusing to seek treatment can put pressure and stress on those that care about you, but asking for help does not make you a burden. It makes people feel good to help a loved one, so don’t try to hide what you’re going through from them. What’s most frustrating is when someone needs help, but they refuse to ask for it.”

An employee-assistance program like CONCERN, which contracts with numerous area employers, is a good place to start, Brock said. It’s intended to be a non-confrontational environment where someone can admit they’re struggling and learn about resources — such as outpatient therapy, anger-management and substance-use support groups, and perhaps more intensive treatments — that can help.

“Sometimes it’s easy to hide things under drugs and alcohol, so that men don’t even know they have a problem,” she added. “Sometimes men have trouble being assertive and communicating their needs. But when they drink, out come the feelings.”

Primary-care physicians are also a good place to bring up issues of concern, Kendall noted.

“Most of us have one — it’s someone we know and feel comfortable with, who doesn’t feel as foreign or off-putting to call,” she said. “I feel like that’s the safest place to start. They know you physically, and mental health is just as important as your physical health.”

The doctor might provide a number of options, she added, such as an outpatient behavioral-health clinic like the BestLife Emotional Health & Wellness Center that MHA recently opened in Springfield. The important thing is to get the conversation started.

“How can we make it OK for men to talk openly about this part of themselves, which is just as important as their physical health?” Kendall said. “Men need to hear that it’s OK to talk about feeling anxious or depressed, just as they’d be concerned about having a back problem or a knee injury.”

Taking the First Step

The bottom line is that mental health is a critical part of life, both Kendall and Brock said. Not only do men attempt suicide far more often than women, they tend to use more lethal means, and are successful — if that’s the right word — about two-thirds of the time.

“I think it’s just hard to talk about what’s going on with us,” Brock told BusinessWest. “We’ve been trained that we have a life to live, we have to get on with it, and we’re supposed to be productive members of society. The reality is, life is not perfect, and it’s not smooth.

“With mental health, in order to get through it, you actually have to go straight through it,” she went on, “and it takes an extraordinary amount of courage and willingness to face something that is terrifying and extremely painful. Most of us would prefer to go out the back door and say, ‘yeah, I’m not dealing with that today.’”

Those who choose to take action — to man up, if you will — are typically glad they did. But the first step, facing the truth, is often the hardest.

Joseph Bednar can be reached at [email protected]

A Step Forward in Opioid-abuse Fight

By
Opinion

Opinion

By Cheryl Fasano

Last year alone, drug overdoses killed 72,000 Americans. According to the Centers for Disease Control and Prevention, that record number reflects a 10% increase from the year before. In Massachusetts alone, there were more than 2,000 deaths due to overdose in 2017. It’s an epidemic that we, as a community, must fight.

Gov. Charlie Baker recently signed into law new legislation that expands opioid-addiction treatment in Massachusetts. The new law has been described as “the most aggressive and progressive” in the country, and, given the crisis of opioid abuse in the Bay State, this approach is most welcome.

One aspect of the law that Mental Health Associates (MHA) believes deserves special recognition is a new set of standards and an established credentialing process for recovery coaches. A recovery coach is someone who has received specialized training to provide guidance and support for people who are just beginning their recovery and are especially vulnerable to relapse. Importantly, a recovery coach also has lived experience with addiction and is in long-term recovery.

When it comes to getting clean and staying clean, a recovery coach has ‘been there’ and ‘gets it’ in a way only someone who has experienced addiction understands. A recovery coach is a critical resource for an individual in recovery.

“You’ve got to find some way to help people stay in the game and stay clean once they get clean,” Baker said. “Creating a credentialing framework and making it possible for services to be reimbursed [by insurance] is a huge part of how we ultimately win this fight.”

MHA applauds the governor and state Legislature on the passage of this crucial new legislation. It makes us even more hopeful for the people we are helping through our recovery-support programs, which, for years, have included the very type of recovery coaches state law now recognizes and standardizes with regard to training and credentialing. The law’s provisions should help make the services of a peer recovery coach available to more people struggling to overcome their addiction.

So, overall this is great news, but it doesn’t mean we are in the clear. To win the war against opioid addiction, we must fight every battle relentlessly. We must improve education so people of all ages understand the life-threatening risks involved with opioids.

We must help people struggling with addiction to get the help they need to get clean and stay on their road of recovery. By working collaboratively, we can challenge the opioid epidemic and prevail — but we can’t let up.

Cheryl Fasano is president and CEO of Mental Health Associates.

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