Mental Health

Mental Health Awareness Month is coming up in May so now is a good time to look at the state of mental health in our nation.  The National Alliance on Mental Illness (NAMI) has a wealth of information on its website (www.nami.org) that is reader-friendly and practical.

Nearly 1 in 25 adults live with a serious mental illness.  People tend to think of mental illness in terms of diagnoses such as bipolar, OCD, or schizophrenia.  But mental illness also includes more common issues such as depression and suicide.

Depression is the leading cause of disability worldwide.  Suicide is the third leading cause of death in youth ages 10-24. 90% of those who die by suicide had an underlying mental illness.  Depression and suicide have some symptoms and causes in common such as:

  • Genetics/family history
  • Drug and alcohol abuse
  • Chronic illness/pain
  • Trauma

Due to the widespread prevalence of depression and suicide, prevention and treatment are essential.  However, at least half of adults and children do not receive treatment for mental illness.  New research shows that abuse in childhood alters the brain to make adults more susceptible to depression (Reuters Health, https://www.reuters.com/article/us-health-depression-childhood/child-abuse-recurrent-depression-linked-to-similar-changes-in-brain-idUSKCN1RS251).  In the child welfare system two-thirds of children have mental health needs that warrant treatment while less than a quarter of these children receive services (Florida Atlantic University Study, https://www.eurekalert.org/pub_releases/2019-04/fau-uoc041519.php).

What can all of us do to address mental illness?  The best place to start is with knowledge and then translate knowledge into a willingness and ability to recognize and help those who are dealing with mental illness.

Mental Health First Aid is a one-day course for both professionals and lay people in learning how to identify, understand, and respond to signs of mental illnesses and substance use disorders in the community.  I took this course with a small- town police force and other first responders. The course has been invaluable in helping me respond to those I encounter with these issues.  An added bonus was understanding how first responders think about these issues.

Another excellent course is QPR training on suicide. The initials stand for Question, Persuade, Refer.  It employs the strategy of being strategically positioned as a gatekeeper to recognize and refer someone at risk of suicide.  Online training is available that can be completed in about an hour.

To promote mental wellness, one of the best things we can do is be a friend.  Isolation and loneliness are factors in mental illness and friendship helps mitigate those factors.  As we head into Mental Health Awareness Month, let’s all look for opportunities to be a friend to someone who needs mental health!

 

For information on the QPR Course: https://qprinstitute.com/individual-training

For information on Mental Health First Aid: https://www.mentalhealthfirstaid.org/

To view NAMI Fact Sheets: https://www.nami.org/Learn-More/Infographics-Fact-Sheets

 

Posted by Priscilla Martens, NFPN Executive Director

 

 

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Primary Prevention

Late last year, the federal Children’s Bureau (CB) published a memo on reshaping the child welfare system to focus on primary prevention.  When “reshaping” is the goal, this is an announcement that bears closer scrutiny.  Here is some of the text providing the reasoning:

“To reverse troubling trends of increasing foster care populations and reports of maltreatment, along with unsatisfactory outcomes, CB’s top priority is to reshape child welfare in the United States to focus on proactively strengthening families through primary prevention of child maltreatment. To accomplish this, CB believes strongly that primary prevention services must be located in communities where families live, where they are easily accessible, and culturally responsive. Those services should also focus on the overall health and well-being of both children and families and be designed to promote resiliency and parenting capacity.”

After noting that primary prevention is the least supported intervention through federal funding, the memo continues:

“Committing to a broader continuum of prevention services that emphasizes primary prevention is contingent on a change of mindset and reorientation of what child welfare is intended to accomplish. Child protection will always be paramount and will always be needed, but the system can and should be designed to protect children by keeping families safe, healthy, and together whenever possible before remedial efforts become necessary.”

While there is likely no dissent to keeping families safely together before remedial efforts become necessary, the difficulty lies in developing effective prevention programs within funding constraints.  Prevention already receives little funding from the federal government. Ironically, the new federal funding mechanism to match state dollars in the Family First Prevention Services Act does not include any funding for primary prevention.  Compounding the lack of funding, the US Preventive Services Task Force examined primary prevention programs, including home visiting, and concluded that there is not sufficient evidence to determine the benefits of these programs on preventing child maltreatment.

So where can we turn to find assistance with implementing primary prevention services?  The New York City child welfare agency (ACS) has published a concept paper on prevention services.   Here’s their goal:

Prevention services aim to support families in their communities, promote family stability and well-being, and reduce the need for placement in foster care. These services may include case management, counseling, and clinical interventions offered primarily in-home and in a manner aligned with the diverse cultures and needs of NYC families.

Providers will be expected to assess safety and risk, give families voice and choice, harness data to drive quality assurance, and address racial inequities and social justice.  Families will be supported through building protective factors and addressing trauma, economic mobility, assessing and improving family well-being, meeting concrete needs, and helping families build positive relationships and social connections.

New York City intends to contract for 3 areas of prevention services and providers will be required to choose a pre-approved practice model under each area as follows:

  • Family Support:

Mobility Mentoring

Solution-Based Casework

Family Connections

 

  • Therapeutic and Treatment Programs:

Brief Strategic Family Therapy

Child Parent Psychotherapy

Functional Family Therapy

Multisystemic Therapy

Trauma Systems Therapy

 

  • Clinical Enhancements:

Trauma Treatment (TF-CBT)

Mental Health (CBT)

Special Needs (NYC is seeking input on promising models)

 

April is National Child Abuse Prevention Month so we will be hearing a lot more about prevention in coming weeks.

 

To view the Children’s Bureau memo visit: https://www.acf.hhs.gov/sites/default/files/cb/im1805.pdf

 

The New York City Concept Paper is available here: https://a068-rfponline.nyc.gov/rfponline/jsp/RFPDownloadDML.jsp

 

Posted by Priscilla Martens, NFPN Executive Director

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