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Mental Health

Conscious Service in Mental Health

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Nowadays, we are experiencing an almost epidemic of mental health challenges. Most of us will be touched by mental illness in some way, at some point in our lives. Whether this shows up as an experience with a loved one or a struggle that we encounter in our personal lives, the challenges of mental health are many.

We live in a fast-paced society with greater and greater demands on our time, attention and energy. This alone can lead to an imbalance in our lives that affects our basic self-care and eventually our overall sense of well-being.

Most of us can expect to be touched by loss and grief throughout our lifetime, which comes with its own unique type of mental and emotional challenge as we come to cope and heal from significant changes in our lives. When we are not in a state of balance to begin with, it is common that the process of loss and grief could potentially become complicated in nature.

Turning to alcohol and other drugs as a coping strategy can make us vulnerable to developing more significant mental health challenges. If we are using substances to escape our lives and our feelings, we are on a slippery slope indeed. Most of us know this and yet, there are staggering statistics to indicate that the power of an addiction or addictive tendency can be highly seductive.

Quick fixes, avoidance, and the general resistance of discomfort in our society do not support the slowing down that is often most necessary when faced with mental health and emotional challenges.

Vocations of Service

For those of us involved in Vocations of Service, we might experience a susceptibility to the development of stress related imbalances, emotional exhaustion, and mental health challenges. We know that there is a high risk of burnout in any helping profession. But, let’s remember, high risk does not mean it’s inevitable.

Linda Stalters

How we care for our own mental health is just as important as being present for others who may be experiencing their own challenges.

There are also those individuals who have been diagnosed with mental illnesses that are not part of what any of us might expect to experience in our lifetime. Bipolar disorder, schizophrenia, major depression are just a few examples of common mental illnesses that people are experiencing today. As Service Providers, it is up to us to learn about various mental health challenges while remaining open and curious to the personal and subjective experiences of those living with it. These people are our greatest teachers when it comes to learning what will most serve.

Resistance Creates Isolation and Suffering

Stigma about mental illness whether formally diagnosed or part of a natural response to something traumatic makes accessing support and services that much more challenging. Our resistance to talking openly about mental health creates a barrier to the very energy and support we all need in order to strengthen our emotional and mental capacity and open up to healing.

We tend to think that mental illness is all in someone’s head. They are crazy and insane ~ not living in the real world. And that in some way, there must be something inherently wrong with them to have this “condition.” Or better yet, maybe, they are being punished for something.

Mental illness makes us uncomfortable. We have made leaps and bounds with regard to opening the discussion and we still have a long way to go. I think the fact of the matter is that so many more people are experiencing mental illness and mental health challenges that we are forced to begin talking more about it. It is no longer the plight of those on the fringes of society ~ those people we can simply ignore so we fool ourselves into believing that we are somehow immune to it ourselves.

Suicide rates are on the rise in our society. People are choosing to take their lives in response to overwhelming pain. For a long time, suicide has been a taboo subject ~ one that we don’t really want to talk about. But, we must. We must make it acceptable to talk about the emotional and mental suffering that many experience with as much ease as we discuss the physical challenges that people live with.

No one is to blame when it comes to mental illness and at the same time, we can all take deep personal responsibility for our own health on a holistic level and for our capacity for compassion when it comes to serving those who find themselves in the thick of a mental health crisis.

Linda Stalters is a retired advanced practice registered nurse and CEO of Schizophrenia and Related Disorders Alliance of America (SARDAA).

Linda has broad ranging experience as a clinical practitioner, educator, advocate, organizer, and speaker. She is committed to driving improved patient care through education, patient advocacy, and clinical practice.

Hearing Voice of Support is Linda’s latest initiative to promote acceptance, support, hope, treatment and recovery for the millions of people living with schizophrenia and related brain disorders.

Let’s talk about mental health. We all have a stake in this.

Elizabeth Bishop is the creator of the Conscious Service Approach designed to support helping professionals to reconnect with and fulfill their desire to make a difference in the lives of those they support. Following the completion of a diploma in Developmental Services and a degree in Psychology and Religious Studies, she completed a Masters in Adult Education through St. Francis Xavier University, providing the opportunity to test and refine the elements of the Conscious Service Approach. Elizabeth is the host of Serving Consciously, a new show on Contact Talk Radio.

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Global

Turnkey: A Co-Housing Experience in an Italian Public Service for Addiction

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Turnkey is a term used in the economic field, but it also fits well in a social rehab project. The idea comes from the need to give some answers to the problem of those patients that experienced a long term therapy in an addiction rehab center for 3 or 4 years.

In the Italian welfare system, the outpatient service team -work (doctor, psychologist, educator, nurse and social worker), operating in the addiction recovery can schedule long term treatment in the residential rehab centers. In some cases, this long time permanence is something obliged, because of the serious addiction and also for the lack of different life perspectives after the recovery.

These kinds of patients need more therapeutic help in order to return to civil society in order to find  meaningful social membership. Usually, these clients have no meaningful familiar connections, no job, and no significant friendship.

In the last years, our social services system has become more careful about the use of public money. They noticed social workers more equipped to provide therapeutic interventions using a holistic approach in order to spare economic resources. Social workers are more capable to assist patients in reaching a better life condition by using their abilities toward social integration.

The Project

Five years ago, the program’s director asked for the professional team to think about a solution for the rehabilitation of the” long term patients”.

I started wondering about the meaning of poverty which is not only economics but it also the satisfaction of primary needs. It’s the lack of healthy relational bonds which weakness a lot the patients coming out of the drug addiction recovery programs.

I also noticed that this relational deficiency is a modern human condition; in the weakest social situations the loneliness is something that “destroys the mind “.

So I got an idea: I proposed to my director to start thinking about a possible apartment for a temporary co-housing for at least two patients.

He liked the project and submitted the plan to the municipalities which have the competence in the social side of rehabilitation. The municipalities agreed to the project and financed it.

For the patients in long term recovery, the rent was paid through the financing with the municipalities (an average of 6.000 Euro a year for 4 years, renewable), whereas the utilities and the others cost of the house has been in charge to the occupants.

The management of activities like the admission of the patients, the guaranteed respect of the therapeutic contract, the check of daily life and the help in the money administration, are some of my specific competences as a social worker.

In my job role, I had a significant part into find fitting persons for the project who were able to live together. I also contributed to choosing the people eligible to live in that specific therapeutic situation.

I helped the patients to organize their new life and to establish minimum rules of mutual life in the apartment. The project is strictly tied to the learning of the skills required to come back to live a regular life.

For example:

– living together is an opportunity for the patients to learn mutual respect

-cleaning the home and paying the utilities is a way to come back to daily responsibility and autonomy.

– having a good neighborhood relationship is a way to learn again to have good relationships without drug addiction to interfered an apartment, next to the main social and sanitary services of the town.

The results

Since 2011, we housed 11 clients in the apartment with an average of one year placement. We should consider that one year in a residential rehab center cost 30.000 euro each person.

Eight of them returned was able to manage a regular social life, their addiction, a job, maintain social relationships which helped them to achieve a dignified lifestyle.

Two persons are still in the co-housing situation, one of them has a regular job, and he is searching for an own house. Only one person abandoned the treatment.

This intervention is a daily challenge for our team; it gave us good results in the recovery outcomes like independence, citizenship, struggle against the stigma and improvement of personal resources.

We also have spared a significant amount of public money while offering to our clients a higher quality of life.

The creativity and the professional skills mixed together with the help of other colleagues in the multidisciplinary teamwork made this project an effective strategy to help patients overcome their circumstances.

So, I can call myself a responsible social worker, because I help to improve the personal resources in my client’s life. I was mostly inspired from the basic professional principle “start from where the client is”.

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Mental Health

Will Veteran Suicide and Mental Illness Rate Improve?

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Even in Afghanistan, I will seek pet therapy! – Rick Rogers (pictured above)

It was about 9 years ago.  I decided to put down the rifle and pick up the DSM. You see, I was an infantryman since I was age 17.  That means, since I was a child, I was literally trained to kill people.  Looking back at it, that sounds like a profound concept.

I am proud of my time in the military.  I am proud of my brothers and sisters who have ever answered the call.  But…  I am also worried.

As I said, 9 years ago, I decided to change my path.  I didn’t realize where that path would lead.  I seen multiple traumas and death happen to my fellow comrades.  I went through some trauma myself, but I still worried about others more than myself.  So, I decided to become a Mental Health Specialist in the military.

It’s been a long road going from Infantryman to Social Worker. There are a lot of learned attitudes and behaviors I had to change. Can you believe it? I literally had to learn empathy.  And that took a long time.

Just about anyone in the military knows that drinking alcohol is a part of the lifestyle. Everyone I looked up to drank and considered me a p**sy if I didn’t.  So… when I was sent to Germany back in the early 2000’s as a 19 year old kid, you better believe I drank. It was legal!

Looking back at my adventures between then and now, I don’t regret a thing. Yes, there were many embarrassing moments, and I have lost many friends along the way.  I also met some great people.  My alcohol use made my path rockier than anything else.

Many others have had this experience as well.  Between 1998 and 2008, binge drinking went from 35% to 47% of veterans, and 27% of that 47% experienced combat. 

Between 2002 and 2008, misuse of opiate prescriptions went from 2 percent to 11 percent in the military.  These prescriptions were mostly due to injuries sustained in combat, as well as the strain of carrying heavy equipment.

This concerns me. When I was young, I had a good time. Looking back, maybe it wasn’t.This might not be every veteran’s experience, but the culture encouraged substance use and discouraged getting help. There are others that would agree with me.

This could explain why 20 veterans a day on average commit suicide. This is actually down from 22 a day before the 2014 study from the VA.  However, it is a 32% increase since 2001. In 2014, veteran suicides accounted for 8.5% of U.S.’s adult suicides, and the rates were especially high among 19-29 year old compared to the older generation.

Let’s not forget about the infamy of PTSD. Up to twenty percent of veterans have suffered from this. Of course, those who suffer are more likely to admit their distress to a computer program than a battle buddy or their superior.  This, again, goes with the constant culture that causes our military to fear judgment.

These wars have been a constant the last two decades, and have cost all U.S. citizens a pretty penny. According to one report, the VA spends $59 billion a year on health care.  This number is 3 times as much as it was since before 2002.

And let’s not forget the cost this country has incurred for being in war for this long.  Well, we don’t really know an exact number.  The cost is estimated by many to be in the billions or even trillions.  This isn’t including the interest from borrowed money.

So, after looking at all these figures, I am overwhelmed.  How can I even make a dent in helping our nation’s veterans? The current administration is planning on increasing our presence in war zones.  I am expecting the rate of PTSD and suicide to increase once again.  Also, our country will continue to spend.  It seems to me that we are all participating in a death and mental illness factory.   The thing is, I didn’t even get to the physical injuries many of our combatants have suffered from.

I love our nation’s military.  I want every one of them to know that I am here to support them.  But most of all, we all need to be here to support each other.

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Mental Health

First Responders: Behind The Festive Season

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I’m a social worker. I’m a first responder spouse. With my partner, I advocate for improved mental health for first responders, including educating helping professionals to understand the culture, lifestyle, and demands of the job on both responders and their families.

I hear stories from police, paramedics, firefighters and frontline rescue responders and their family members every day. Tales of trauma, grief, and horror – and on the flip side incredible strength, resilience, courage and sacrifice.  It’s December and social media is full of excited conversations about planned gatherings and festivities for Christmas and the New Year. Those posts inspire this reminder.

In Australia, there will be barbeques and beer in sweltering heat by the pool or at the beach, a stark contrast to some of our global friends whose Christmas will be white, accompanied by outdoor play with snowmen and gift giving inside by the warmth of a log fire.

Despite the contrast in temperatures across the globe, there are those who work tirelessly behind the scenes of Christmas beer and New Year cheer. Police, paramedics, firefighters, and rescue personnel are unlikely to experience the festive season in the way most people do. They are on call to ensure the public’s continued safety, health and wellbeing. And so their festive season, regardless of location, is far more likely to include these scenarios:

  • Burglary, elderly occupant assaulted and taken to hospital
  • Multiple occasions of drug overdose at a teenage party, several individuals taken to hospital in serious condition
  • Alcohol fuelled violence, multiple serious injuries
  • Bush fire endangering properties, implement evacuation procedures
  • Car accident, children seriously injured
  • House fire, no injuries but the house is beyond repair and a family is left homeless
  • Notification of the sudden death of someone’s loved one

This is a typical “festive season” for first responders. Their families are at home – not with their loved ones as is traditional, but quietly accepting that their loved one is needed out in the community to keep others safe. Some days will simply be a bit lonely, other days will be filled with concern for their safety.

For many first responders, the festive season brings back memories of trauma past. That makes the lead in time to end December a difficult one, rather than one of anticipatory excitement. And then, of course, we have those who can no longer turn out because of physical or psychological injury. Their lives forever changed by the job. Perhaps this year they do get to sit with their families and share a meal, but at a huge emotional and financial cost inflicted by their injuries.

Finally, a harsh reality in first responder world: the first responder family members who tragically have to face this “festive” season alone. This time not by choice. Their first responder’s life either taken away by an incident on the job or by a sense of hopelessness all too common in those with psychological injuries.

The festive season of giving is a timely reminder that we as a global community are exceptionally fortunate to have first responders looking after us. Whether you’re in Australia, India, Alaska or England, these people give up their precious family time to keep us safe. Many are volunteers. They are human, just like us. Witnessing human suffering is hard at any time – but this time of year adds extra burdens.  Please drive carefully, celebrate carefully. And while we all sit in the protected bubbles of our own private Christmas and New Year celebrations- please spare a thought for all frontline responders and their families

In the spirit of the season, please acknowledge their sacrifice with a note, a smile, a thank you – so that in the midst of whatever trauma they’re dealing with, they will be reminded of the true intention of these times: goodwill, human connection, and hope.

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Mental Health

Having Difficulty Creating Worksheets and Activities for Your Clients?

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Nicole Batiste, Hub for Helper Founder – third from left

Tailoring worksheets and activities specifically for your client needs can be challenging for the best of therapists and counselors. For others, maybe you are a natural born artist moonlighting as a mental health professional dazzling clients with your creativity which helps them move one step closer to becoming their best selves.

According to the National Institute of Health, there is a direct correlation between the creative arts and health outcomes when used in a therapeutic setting. The study reports: “Use of the arts in healing does not contradict the medical view in bringing emotional, somatic, artistic, and spiritual dimensions to learning. Rather, it complements the biomedical view by focusing on not only sickness and symptoms themselves but the holistic nature of the person.”

What are my options with limited artistic abilities?

For those of us who are artistically challenged, it is imperative to identify resources and begin creating a therapeutic toolbox for practice. There is one resource that I would like to share which helps both the artistically challenged as well as the artistically gifted mental health professional.

According to its website, Hub for Helpers is an “online library for all licensed therapeutic professionals to access high-quality, interactive, low-cost materials for diverse client populations”.  Hub for Helpers also states that it hopes to lessen the burden of developing materials by providing low cost options to help mental health professionals find materials to best server the need of their clients.

Hub for Helpers was founded by Nicole Batiste, a school social worker in a Texas middle school, when she saw an overwhelming deficit in affordable, accessible, and ready to use materials for therapy. Nicole sometimes found herself spending more time planning meaningful things to do in therapy than providing direct practice.

Inspired by the response to her activities from her diverse client base, she decided to create a hub for therapeutic professionals to access numerous interactive materials conveniently. Nicole states the mission for Hub for helpers is to continuously provide top notch, affordable activities to ensure that we are indeed, “helping you help!”

How does Hub for Helpers Work?

Hub for Helpers provides a quick and easy way to access and save materials in your “My Hub” account. If you are wondering how it all works, here are the tips provided on their website:

  • We strongly recommend you sign up with us to create your personal Hub. It’s quick, easy and free!
  • Begin to browse our materials by searching by the many domains provided
  • All of our resources are multi-paged packets that guide you through each activity, if you so need it
  • Once you’ve chosen an activity, check out is easy, fast and secure.
  • You will then be able to download your resource, all of our resources are in PDF format.
  • Your resource will remain in your Hub to be used repeatedly at no cost.
  • Should you choose to become a subscriber, a $40.00 credit will be issued to you each month
  • If you are a corporate subscriber a $200.00 credit will be issued to you each month to use amongst your employees.

Hub for Helpers has provided three free activities for you to download here.

What else does Hub for Helpers do?

In addition to being an online marketplace to buy low-cost worksheets and activities, for the artistically gifted, you can also sell your creations in the Hub for Helper’s marketplace. For more information, visit https://www.hubforhelpers.com/become_a_seller/.

Sponsored Content by Hub for Helpers

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Mental Health

What is Trauma-Informed Care

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“What’s wrong with you” is typically our response to what we consider problematic behavior.  But what if we shifted our mindset in such a way that would enable us to ask a question such as “What happened to you”?

Trauma-Informed Care makes that possible.

The trauma-informed perspective is a new way of evaluating consumers’ experiences and shifts from the traditional approach of care that focuses on eliminating problematic behavior to a trauma-informed approach that focuses on getting to the root of the issues so that individuals may experience recovery in an empowering manner.

Research data reveal that trauma can – and indeed, does – happen to anyone.  As a precautionary rule, then, the trauma-informed approach requires that all administrators, clinicians and other relevant staff and volunteers interact with all consumers as though they have experienced some form of trauma throughout their lives.

Trauma occurs when an external threat overwhelms a person’s coping resources. It can result in specific signs of psychological or emotional distress, or it can affect many aspects of the person’s life over a period of time. Trauma is unique to each individual—the most violent events are not always the events that have the deepest impact.  Everyone perceives trauma differently…what may be considered traumatic to one person may not be perceived the same way to another.

Acknowledging what happened to a person will help providers generate a more accurate interpretation of a consumer’s experiences as opposed to thinking there is something wrong with them.  As such, the approach to care becomes one in which there is recognition of the multiple ways traumatic experiences impact individuals’ well-being.

It also permits the provider to focus on developing, implementing and monitoring policies, procedures and practices that promote healing and recovery. According to Steven Wiland, “Human service systems become trauma-informed by thoroughly incorporating, in all aspects of service delivery, an understanding of the prevalence and impact of trauma and the complex pathways to healing and recovery.”

The trauma-informed approach is a framework that can be adapted to meet the diverse needs of various organizational, systemic, and individual structures.  All trauma-informed systems operate under the realization of the widespread impact of trauma; there is a recognition of traumatic symptoms in people part of our organizations and systems; and a trauma-informed response that yields changes in policies, practices and procedures in order to avoid the re-traumatization of people we encounter in our organizations.

 

Traditional Approach Trauma-Informed Approach
Lack of understanding about the prevalence of trauma and its impact Recognition of the prevalence of trauma and its impact
Elimination of symptoms/problematic behavior Recovery as a primary goal
Providing solutions from an expert position Collaborating with the consumer to agree upon solutions
Providing help to the helpless – providing no choices Consumers provided with choices and have autonomy
Reactive to behavioral cues – crisis driven Proactive – prevention of retraumatization – avoiding crises

In recognition of the pervasiveness of the experience of trauma, the trauma-informed approach involves the practice of prioritizing safety, trust, empowerment, collaboration, peer support, and culture through the adoption of policies and procedures embedded with these principles.

To get you started on imagining what Trauma-Informed Care might look like for your organization, take a look at examples of the traditional approach to care versus the trauma-informed approach to care as shown below.  Then ask yourself, how do we measure up?

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Mental Health

UA Study to Take ‘Deep Dive’ into Risk Factors for Veterans, Suicides

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University of Alabama researchers, America’s Warrior Partnership and The Bristol-Myers Squibb Foundation have partnered on a four-year, $2.9 million study to explore risk factors that contribute to suicides, early mortality and self-harm among military veterans.

“Operation Deep Dive,” funded by the Bristol-Myers Squibb Foundation, aims to create better understanding of the risk-factors, particularly at the organizational and community level.

Drs. Karl Hamner, director of the Office of Evaluation for the College of Education, and David L. Albright, Hill Crest Foundation Endowed Chair in Mental Health and associate professor in the School of Social Work, are the principal investigators for UA on the study.

Recent research has shown that neither PTSD nor combat exposure are good predictors of veterans and suicide, so researchers must cast a wider net, Hamner said.

“Previous research has focused primarily on individual-level risk factors, like prior suicide attempts, mood disorders, substance abuse and access to lethal means, but suicide is a complex phenomenon, and those factors don’t paint the whole picture,” Albright said.

The study is innovative in that it focuses on veterans across the spectrum of service, gender and lifespan, utilizing data from America’s Warrior Partnership and the U.S. Department of Veterans Affairs, new data collected during the study, and data from the Department of Defense.

For instance, female veterans, who are 2.5 times more likely to commit suicide than civilian women, will be spotlighted in the study.

Both the DOD and the VA will be vital in identifying veterans with varying medical histories, combat experiences and discharges from military services. America’s Warrior Partnership will also help fill the gaps in identifying veterans who don’t fit criteria for VA benefits, like National Guard or Reserve personnel who aren’t activated, or anyone who has a dishonorable discharge, which could be for a variety of reasons.

“The scope of this study is timely and so needed that we really believe we can move the needle,” Hamner said.

The first phase of the study is a five-year retrospective investigation of the DOD service use and pattern of VA care utilization to examine the impact of less-than-honorable discharges on suicides and suspected suicides, and the differences in suicides between those who receive and do not receive VA services.

“Helping to identify the trends or predictors of veterans’ suicide could help immensely in reducing suicide rates and provide much needed interventions for this community,” says John Damonti, president of the Bristol-Myers Squibb Foundation. “This project will take a deep dive to better understand what was happening at the community level to design better, more targeted intervention programs.”

The second phase will incorporate these findings into a three-year study that will include input from medical examiners, mental health experts, veterans and family members, and the community to conduct a “sociocultural autopsy” of all new or suspected suicides in America’s Warrior Partnership’s seven partnership communities, as well as in comparison communities.

The results will explore how community context and engagement affect prevention of suicides in veterans and “why some former service members commit suicide, while others do not.

“The overarching goal of the study is to understand triggers of suicide in order to prevent potential suicides before they occur,” said Jim Lorraine, president and CEO of America’s Warrior Partnership. “With each organization bringing its own areas of expertise and data, we can make a difference in the lives of our nation’s warriors, particularly the most vulnerable veterans.”

Both Hamner and Albright are committee chairs for the Alabama Veterans Network, or AlaVetNet, which connects Alabama veterans to resources and services. Alabama Gov. Kay Ivey recently signed Executive Order 712, which tasks the group in helping reduce and eliminate the opioid crisis as well as reducing the high veteran suicide rate.

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