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Hello my name is Kathryn Power I’m the director of the Center for Mental Health Services at
the Substance Abuse and Mental Health Services Administration. Even though the month of May
is over, May is Mental Health month and Older Adults month so we wanted to take some questions
from all of you about mental health issues. I have several questions that I’m going
to read to you that I recevied from individuals who are interested in the topic and then give
my best answer to the question. I’ll start with the first question – I’m part of
a nonprofit group planning a conference on suicide prevention and mental health. Our
question is how do we start educating the community about mental health even though
our county suicide rate is well above the state average. We want to make sure we don’t
create more anxiety by talking about suicide too early in the process. First of all the
question is very timely and relevant to what is happening in America. We are very concerned
about suicide as a public health problem and particularly we are concerned about it because
often times people don’t want to talk about it. So the fact that you see the need to bring
your community together to talk about suicide is hugely important. One of the most important
ways to begin to get your community together is to consult with the Suicide Prevention
Resource Center or SPRC http://www.sprc.org/. You can find that on SAMHSA’s website. As
a technical resource center they can consult with you and your community and the unique
features of your community to help you think about how to bring people together to start
the conversation. Much will depend on ethnic and racial composition of your community.
Much will depend on histories of suicide in your community. So you can look and those
factors and the Suicide Prevention Resource Center will help you do that. There are programs
also available such as Mental Health First Aid http://www.mentalhealthfirstaid.org which
is a wonderful way to get a community thinking about and organizing around building a higher
level of emotional health and that can then lead to discussions of suicide. So I hope
you take advantage of SPRC and move your community forward.
The second question we received is – how do you prevent mental illness? My daughter
has psychotic episodes, I know that the medicine prevents these episodes, but was there something
that we could do to prevent this particular illness? The majority of lifetime mental illnesses
start at a very young age. And half of all diagnosable mental illness start before the
age of 14 and three-fourths of them start before 24. You have a very vulnerable time
of development for children in which we need to look carefully at what is happening to
their lives. In looking at mental illness there are some that are preventable but there
are others that are not preventable. In the Institute of Medicine Report http://www.iom.edu/Reports.aspx
that came out in 2009 basically talks about the range of illness that we think we can
do something to prevent and the range of illness that are not considered preventable at this
time. But that in fact there are certain kinds of interventions, supports and services that
might reduce the kinds of symptoms that might affect the individual. In this particular
case, if there is a history of psychotic episodes or psychosis that’s a very serious illness
and it is in fact probably at this point in its development not considered preventable.
Since when you have a first psychotic break at that very tender age of 11, 12, or 13 or
14 the time really to take a look at trying to intevene is earlier than that. And often
times we find that if we take a look at promoting positive protective factors and reducing negative
risk factors for young children we can hopueflly eliminate some of the more severe symptoms
of mental illness or we can help that individual with coping strategies starting at a very
young age. So I would suggest that as you talk with your physician and talk with your
daughter you figure out ways that you can have activities and opportunities to help
her manage her illness. That is one way of thinking about prevention in a positive way
that helps the trajectory for illnesses such as psychosis and bipolar that are in fact
severe illnesses but can be effectively managed. The third question we have today is – how
can I stimulate more social cohesion in an Inupiaq Eskimo Village? This is a very unique
question in a sense that there are differences among cultures about the way in which we talk
about mental health, emotional health, but I particularly applaud this question because
someone is looking very closely at the issues of social cohesion. Social cohesion is a construct
that talks about bringing every individual and family into a community and having a series
of connections among those community members. And the notion that someone is paying attention
to stimulating social cohesion I really applaud the question. Let me tell you what I think
you might want to do. First of all, it is very important that you understand the unique
culture and you consult with your tribal elders. Often tribal elders are those people who have
experience with a lot of community efforts that might have been lost over time. So there
might be some traditional opportunities. For example, some of the tribes particularly in
Alaska do fish camps, they do berry picking they do traditional ceremonies and celebrations
that help bring together. And those celebrations in themselves promote social cohesion, but
you can use those opportunities to talk about and educate the community about why mental
health is important. Now the concepts of mental health and the language of mental health and
the way in which it is framed may be different depending on each culture; particularly in
American Indian and Alaskan tribes. So in looking at what is important to you is it
the connection with the earth, is it the connection with each other, is it the connection with
the melding of the mind, the body and the spirit? All of these themes are very important
to Alaska Natives and American Indian Tribes. So try to consult with your elders. Look at
some indigenous celebrations that might be available for you to start talking about your
emotions and mental health status. And then take a look and talk with some of the other
Alaska Native communities in your region to see what they have tried and what has worked.
I sincerely applaud the question on looking at social cohesion in American native and
American Indian tribes. In particular, in Alaska, which is of course isolated and far
away from the lower 48 and the tribes may in fact do things that are quite different
based upon geography and culture. So good luck in your efforts and I look forward to
answering more questions in the future.