Essential tools Mental Illness Prevention & Mental Health Awareness

This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs. Register@Allce.com Counselortoolbox you I'd like to welcome everybody to today's presentation on strategies for the prevention of mental illness or for the development of mental health or whatever you want to say. We're going to identify strategies for the prevention of mental illness, including community education, early intervention services, community resource development, improving accessibility and cultural sensitivity, enhancing protective factors, and using what I call problem solving courts in order to break the cycle. So let's go ahead and move on. Now before we get into this a little bit, some of you might be thinking, well, I'm a therapist, I don't really do prevention. Prevention, remember, is not just about preventing all mental illness. If you've got somebody who comes into your office and they've got depression, for example, okay, well we've got to deal with that. But let's prevent them from additionally developing substance abuse issues and anxiety disorders and, you know, all this other stuff. So let's prevent it from causing any more problems while we work on dealing with the issue. So from a secondary prevention sort of viewpoint, we do do prevention. Another thing to remember is that prevention is an awesome marketing tool because a lot of people, you know, they don't want to pay for counseling. They don't want to go to counseling that got stigmas about counseling. But if you do workshops at businesses or in libraries or, you know, wherever, community fairs to educate people about, you know, mental health and the promotion of mental health and avoid that word mental illness right away because people tend to look at how can I improve my life? And they're more willing to go to your booths or whatever if you've got ways to help people, 10 ways to help people be happier or something, handouts, they will keep those handouts and you can have your information on the bottom. So if they start struggling, they say, oh, that person had, you know, some really common sense stuff to say, I want to go see them. Presentations that you do in libraries, the same sort of thing, you get your name out there. And then when people do need help, they will likely turn to you. And a lot of times, you know, it depends on the place. But you can also create handout for prevention sort of things, prevention sort of topics. And you can pass them around at doctor's offices and other places so they can hand them to their patients as a service. But it also has your information on it. So prevention can be a good thing and you can use it creatively. So let's kind of back up a little bit. If we're preventing mental illness, first we need to figure out what causes it. Well, if we knew that, we would have, you know, a bazillion dollars. But we know that stress can cause. And when we use the term mental illness, we're talking about emotional dysphoria. You know, I'm not necessarily talking about anything that meets the level of DSM diagnosis. It can be subclinical levels of symptomatology. But those symptoms that we're talking about, stress can cause them. You know, you're stressed for too long, you can get exhausted, you're not getting enough sleep. Stress can also cause anxiety. We generally use those terms interchangeably. So we want to look at people's stress levels. How can we help them reduce their stress? And there are cognitive ways, of course, but as we get into it, I'm going to encourage you to share ways that you think you can help or that you already do help people reduce their stress. So there's cognitive, but then we also need to look at the wraparound stuff that biopsychosocial. How can we help them reduce their pain, reduce their stress? About finances, you know, we can make referrals to community organizations, which is why community strengthening is so important. Poor nutrition can also contribute to mental illness. The body doesn't have the building blocks to make the neurotransmitters. You're going to be out of luck. So we need to make sure that people have access to, to decent nutrition. And I always say that. I'm not telling you to be like a nutrition freak, a nutrition Nazi, so to speak. What I'm telling you is to eat colorfully, eat real foods, try to make sure you've got vegetables at least at lunch and dinner. You know, it's hard to get a vegetable in at breakfast and make it palatable. But encourage people to try to gradually improve their nutrition. It doesn't have to be a wham, bam, overnight thing because most people won't stick to that one change a week. Start drinking a little bit more water, start adding an additional vegetable in every day. You know, my kids know that every, every meal for, well, lunch and dinner, they have to have something green. And my son usually defaults to peas. My, my daughter's a little bit more open about the green vegetables that she'll eat, but they have to have something green. So poor health is another thing that can cause mental illness. If you lose your abilities because of your poor health, if you can't sleep because of your poor health, if you can't do the things that you wanted to do because of your poor health, all of those things can contribute to depression and anxiety, anger, all that stuff. Medication side effects. We need to educate people about the side effects of their medication. And yes, I know the pharmacist hands out the the sheet and those sheets just go on forever. And the side effects sound a whole lot worse than whatever you're trying to treat anyway most of the time. But we do want people to be aware of the big ones that relate to mental fatigue, confusion, difficulty concentrating, apathy. If you start feeling those shortly after you start taking a medication, consider whether it's a medication side effect and consider whether it's one that will go away once you've been on it for a few days, or if it's an enduring side effect that you need to talk with your doctor about. For example, when people start taking SSRIs, a lot of times they have all those symptoms. Fatigue, confusion, kind of foggy headedness. They kind of feel loopy for the first and sometimes nausea for the first three or four days until the serotonin levels stabilize in their brain. But generally after that it's fine. So if you educate them, then they may push through the side effects and get out to the other side. But if it's an enduring side effect, like for me, heaven forbid I should have to be on painkillers. I can't function. I take one Benadryl, the kid's dose of Benadryl and I'm drooling on myself. Medication side effects. If I had to be on anything sedating for a long period of time, you know that we would have to address that somehow because I wouldn't be able to function and I would tend to be med non compliant. Low self esteem can cause symptoms of mental illness. If people feel bad about themselves, they can feel helpless, hopeless, unlovable, fear, rejection, feel out of control of their lives. Which brings us to a lack of personal control. When people feel disempowered, they tend to feel more anxious, which makes sense because our body wants to protect itself, fight or flee when there's a threat. Well, if you feel disempowered, then the entire world kind of feels like a threat. So we want to help people establish self efficacy, isolation and a lack of supportive relationships. Not all relationships are created equal, don't get me wrong. But we are not meant to live as hermits. So having a few positive social relationships extroverts tend to need more relationships. We tend to have 15 or 20 friends that we do stuff with. Introverts like my husband, they have one or two people that they're just like super close with, but that's plenty. They don't feel like they're missing out on anything by not knowing everybody in the neighborhood. But having those relationships is a great buffer against stress. What else, what else do you see or do you think, can you think of that might cause mental illness or symptoms of anxiety, depression? And we're going to stick with the mood things right now. I mean, we know that some things have an organic cause, like schizophrenia and bipolar. But, you know, looking at what would trigger a bipolar episode, we know that any of these things can trigger a bipolar episode. Unsafe environments is another thing that can cause symptoms of mental illness. Because you're not sleeping, you're constantly on guard. You're on alert. That threat response system, HPA access is activated. So you're never getting good restorative sleep. You're never able to actually rest. So you start getting worn down. And that means that your body, your immune system is going to go down, you're going to get sick more often. It's just ugly. And a history of family violence or abuse. It's another thing that if you have those memories like we talked about with trauma, if you have a history of trauma of any sort, if you haven't recognized it and addressed it, and even after you have, it's going to potentially occasionally be triggered and you might have an anxiety moment, but instead of being an anx, it's just a moment. But yes, a history of trauma can cause, and it can cause the development of PTSD and other things. So we do want to be aware that we want to reduce those adverse childhood experiences, reduce the frequency with which people are traumatized in our society, which will help improve mental health. So what's needed to be happy? I love Maslow. It's simple. It's to the point, physiological. They need good nutrition so their body can rest, repair, keep the immune system going. They need a safe place to live. They need a roof over their head. They need medical care to keep their body running. You don't drive a car for 150,000 miles and never take it into the mechanic. So you need to make sure that people have access to good medical care to keep their body machine running. Safety. Is that safety so you have a good, safe place to sleep, Safety in your relationships so you don't feel like people are attacking you emotionally or physically. And safety from yourself. And this is one thing that we forget about a lot. But I put safety down here because if you've got that internal critic in your head constantly telling you that you're not good enough and nobody's going to like you and you're a screw up, it's going to be hard to develop honest relationships based on love and belonging. It's going to keep your self esteem low. So safety from yourself so you're not putting yourself in a place where you've got all that negativity either physical things that you do that could endanger your safety or and more to the point, emotional cognitive things that you do that make it feel unsafe in your own head because you feel like you're constantly being attacked by that negative voice. Love and belonging is the next thing. In order to form healthy relationships, you have to be kind of healthy yourself. I mean, you don't have to be perfect, none of us is, but you have to have kind of an idea of who you are and what you stand for. And you know, we won't go as far as self esteem, but you have to have a self concept and you have to kind of like yourself because people who don't like themselves really don't form those authentic relationships as well. Not saying it can't happen, but we do need to be loved. We need to be loved by our caregivers, you know, from the very beginning. We need unconditional positive regard. Don't all get it, but it's good to have. So we want to teach that. We want people from the time they're, you know, less than knee high to a grasshopper, we want them feeling that they're loved and they're wanted and they belong, all of that. If they start getting that as a child, other people telling them, you're worthwhile, you're awesome, then they're going to start building their own self esteem and go, you know what? These people say? I'm pretty good, I think I'm pretty good. Things are pretty good. And then eventually maybe self actualization. Not everybody gets there, but this is what we want to work on. And these are all things that we can work on and counseling and prevention. So community education. We need to educate all individuals in the community about the effectiveness and social and economic benefits of prevention. Let's do things to take care of ourselves. How many times have you wanted to take a week off to rest and relax and go on vacation and you said, no, I really need to work, I need this, that or the other, I need to do all these other things. And you never take time to relax. Then what happens? You start getting worn down. Stephen Covey refers to it as sharpening the saw. You know, you need to take time to rest, rejuvenate, restore, in order to prevent problems later. Prevention. Reduce healthcare costs because of disease. You know, when we get stressed out, when we get worn down, our immune system goes down. People's weight can start causing things like diabetes and high blood pressure and sleep apnea. All those things can be correlated with increased weight. Smoking, alcohol, and chronic pain all can be reduced with some interventions. And we're not talking just cognitive again. We're talking holistic approaches to mental health. Enhancement, reduced absenteeism. If your employees are happier and healthier, they're going to be there, and they're going to be more productive. They'll have more energy and be in a better mood. So they're there, they're more productive, and morale is going up score. And they're going to have improved relationships. And we know that those relationships also serve as a buffer against stress. So as relationships improve, stress buffer improves, which is going to reduce stress even more. So when we talk about education, you know, I want to go through a couple of points, because the way we teach, you know, if you're doing those workshops, the way we teach is at least as important as what we teach child education. Children are curious and eager to learn. They have an inherent desire to make sense of themselves, the world, and others. So I'll give you an example. My son, he was about a year and a half, and we were at my grandmother's house for his. I guess he must have been two for his birthday. And he knew he wasn't supposed to touch the TV at home, but we were at Grandma's, so he wasn't sure what the rules were. So he was going to try to figure it out, apparently. So he walks over to the tv and he looks at the TV and he looks at me and he goes, no touch. I said, that's right, no touch. And he looks at me and he looks at the TV and he reaches out and he touches the tv and he looks at me and he goes, time out. I said, yep, buddy, timeout. And he toddled off into the corner and sat down for his. For his two minutes, and things were fine. But he had to figure out, you know, do the rules apply here? Children are that way. If you watch them, their minds are just like sponges. And they're like, trying to figure out what, you know, what makes the sky blue. And they have all those questions. So they want to figure out all the answers, which is great. So if you can present it in a way that's entertaining, that they're going to enjoy, which is not lecture, by the way, they're going to enjoy it more. When my kids are homeschooled and when Shannon was learning about the Newton's laws, you know, we put on our socks and we went sliding down the wood floor and then we took off our socks and we went and tried to slide down the wood floor to demonstrate friction and we did some more active things. So if kids can use their body to learn, they're going to learn more easily. Children are active participants in their environment and learn with all of their senses. So if they can smell it, touch it, even taste it occasionally and manipulate it, they're going to learn more easily. If you're teaching fractions, for example, if you give them, you know, measuring cups, or if you give them manipulatives, which is why every preschool and elementary school classroom has them. It helps children because they can't think and envision it. They need to kind of hold it and manipulate it. So remember the piagetin level of cognitive development of the children that you're working with. Children learn and express themselves through play, which is central to their well being and development. So if you want to teach communication skills, you know, maybe you can have them play some sort of game where the teams have to communicate. If you want to teach cooperation, you know, find a game and you can find them online. You know, I'm not saying I can come up with those off the top of my head, because I can't. I rely on Google quite a bit. But you can teach that each child has an individual pattern of timing and growth and development as well as an individual style of learning. So, you know, even if you've got three kids at home and Sammy was doing algebra when he was in fourth grade, but Jane doesn't pick up algebra until she's in sixth grade. And Sally, you know, algebra has never been a big deal for her. She's been doing it since she was, you know, in second grade. I'm exaggerating. You know, there's. They're not going to be doing it quite that early, but what kids learn at different stages is going to be quite different for a lot of people. So we don't want to say, you know, if they're having difficulty with fractions, for example, you know, it's not necessarily that it's a cognitive thing or not an IQ thing. It could be a cognitive thing for Them, they're not able to get there right now. So we want to pay attention. And if somebody's not learning something as well as we would like, just be patient. Children need to experience challenge, success, positive direction, and positive redirection more than failure or criticism to form a positive self concept. So we want to ask them, how do you think you could solve this? And give them kudos for when they come up with good ideas if they start doing things wrong. And this is one of the things that a lot of people do, and I got my minor in behavior analysis, so, you know, it kind of makes me cringe. But when people discipline a behavior, when they punish a behavior, they're eliminating it. Okay, well, that behavior was serving a purpose. So what does the person do instead? So if all you're doing, you have Johnny, and you're telling, Johnny, Johnny, don't do that. Johnny, don't touch that. Johnny, don't do that. John, you don't say that. After a while, Johnny's just going to sit there and go, I'm out of options. I have nothing I can do, because everything I do, I'm being told no. So positive redirection is helpful when somebody gets angry. Instead of biting or hitting or punching or whatever they do, help the child figure out what's a better response when they feel depressed, what can they do to help them feel better instead of, you know, sitting in a corner pouting or whatever. So positive redirection help them find something. Children learn best when active and interested, and they engage in a meaningful and relevant way. They can experience the enjoy experience and enjoy learning and get a feeling of success from it. So you want to be able to present it in manageable chunks to them. Children learn best when they experience warm, stable, personal relationships with their caregivers. So if you can get caregivers involved, that's awesome. You know, if you're doing a camp or something, you may not be able to. Children develop holistically and benefit from integrated experiences and education. So when we talk about happiness, you know, let's talk about, you know, what kind of foods can you eat to help you be happy? What kinds of exercises or things can you do? You know, going outside and getting sunshine, why does that make you feel happy? And sometimes you can ask them the why questions back, and they love that because then they can start thinking about all these potential options and you can work with what they give you. The brain learns best when having fun. When learning happens in a positive emotional environment, it's stored in the hippocampus. This is later transferred to the brain cortex where long term memory happens, affecting our ability to remember. But unpleasant events and fast learning are stored in the amygdala, the part of the brain that stores the anxiety, anger, what not to do, again sort of stuff. And it doesn't necessarily get translated. So if we make it enjoyable, if we help them relate it to things they already know, if we let them use multiple senses, they're going to learn it more. And if they learn it when they're 6, they're going to remember it when they're 26. So if we can help them start developing these skills early, we're going to be way ahead of the game at preventing mental illness. And children emulate positive models. They emulate most any model. So if they, if somebody is important in their life, like their parents, they are likely going to emulate them. So we want to make sure that parents have the skills and tools and are modeling that for the children for how to handle anger and stress and anxiety and how to take care of oneself, not just to deal with the yucky stuff, but how do you take care of yourself and prevent it from happening. Adults, on the other hand, are autonomous and self directed and goal and relevancy oriented. They want it to the point, how does it impact me? Why do I care? Adults already have a wealth of knowledge. You know, they've 18, 20, 40 years of experience. Well, that's great. So we want to look at how prior learning impacts current learning. You know, maybe they Learned some stuff 20 years ago that we found out isn't really true now. So we're going to have to dispel those myths. Or they may have lots of building blocks about health and wellness from when they were in high school or college, but they're not really using them right now. So we can help them kind of gather those building blocks and create something meaningful, create a plan. And we want to look at how current learning enhances or builds off prior learning. Because when you connect things to things people already know, they remember it more. If you connect things and they're just like, okay, here's this completely new concept and I'm not going to relate it to anything. They're going to sit there and look at you and go, okay, they'll try to remember. But if you relate it to something they know, something practical especially, then it's going to stick a little bit better because those memory pathways are already kind of there. So you're relating it to something, not creating a whole new interstate system over here. Adults are motivated to learn by social relationships. So if they're in a class with somebody they like, that's going to be more beneficial. If it's a fun class and they're engaging with one another, that's going to help them learn. They're motivated to learn by external expectations. So if the boss says, you need to do this, Social welfare. If I learn this, if I do this, is it going to benefit other people? Okay, well, I'm motivated. Personal advancement, you know, obviously, escape and stimulation. Sometimes we learn things just to get away. I learned how to crochet, so I have something to do to occupy my hands because I. I'm fidgety and I get bored easily. And cognitive interest. Sometimes it's just, you know, I wonder how that happens or I wonder why that works. I encourage people to learn something every day. But in order to motivate adults to learn about mental illness prevention or mental health enhancement, however you want to put it, we need to make it socially rewarding. Ideally, have some sort of external rewards for participation. Help them see how it not only benefits them, but also benefits their children, their friends, their relationships. Provide things that are fun in order to do it. I mean, in order to be happy. There are times where you want to laugh and have escape and stimulation. So let's put that in there. And cognitive interest. How does all this work? You know, how is it that what I eat actually helps me feel happier? You know, not everybody's going to have the same motivations. Not everybody cares exactly how it works as long as it does. But provide opportunities. If you're working with a seminar and you've got 30 people, you know, try to tap into all of these to make sure that you're motivating every person in the classroom. Barriers to adult learning responsibilities. I got too much to do. I just can't go to that workshop today. Or I can't do these techniques or read this chapter in this book because I've got too much going on. Lack of time, which kind of goes with responsibilities. Lack of money. You know, I can't afford to go on vacation right now. I can't afford to take four days off from work because I'm an hourly employee. Lack of confidence or interest in the things that you're suggesting. So have them come up with when you're happy. What's different? What things do you do that make you happy? So they can figure out what to do. If you're asking them to improve their nutrition, not everybody's interested in that. So try to figure out a way to get them interested, gamify it. If possible, have everybody bring in a new recipe each week or, I don't know, lack of information about opportunities. Some people don't learn, don't partake in educational things because they don't even know the workshop was going on. Or they have scheduling problems. If you're having the workshop at seven o' clock at night, they may not be able to get childcare, they may have difficulty with transportation, or maybe they're a nurse that works the 7p to 7a shift so they can't go to evening seminars and things. How can you accommodate that? And I will tell you, you can either have it at different times of day or you can record the session and then have it available for on demand viewing on a YouTube channel or something. Not as good as being there, but for people who are interested, that's one way that they can start accessing it. And then if they find that it's meaningful, they may seek to take time off in order to attend the seminar. You know, take off the first three hours of a shift. Case management when we're talking about community resource development, case management is one of the first things I think of, which is why it's the first thing on the slide. You can use volunteers that are based at the health department library, doctor's offices or churches. And there's a lot that goes into case management. I'm working on a couple case management classes right now. But if, especially if you're in a town where there is a university or multiple universities, you've got people who have to do volunteer hours coming out your ears. So encouraging people to get involved, and even if you don't encourage people to get involved in the community case management, you don't have to have special skills, you just have an in, have to have an interest and a desire to help people link with resources. I mean, that's it. It's actually pretty fun. But making the case management available so, you know, finding a place where people can access it and feel okay about accessing it. You know, they may not want to go to the health department, they may not want to go to a doctor's office or to a church, but they will go to a library. So having stations or satellite offices where case management can be done is always helpful. Work with state economic and workforce development boards, you know, obviously their job is to try to make sure that there are ways people can make a living and get education they need. But Putting in your 2 cents doesn't hurt because we want to make sure that People can are educated to get high wage, high demand jobs. They have jobs available to them and then they can get to the jobs. So many places don't have public transportation. So how do we help people get to work if they're living in a, you know, smaller town that doesn't have a bus system? Career 1 stops are wonderful. They're all over the United States. They offer job placement services. Some of them offer job coaching. They will help people look for jobs and find jobs that meet their needs. The career one stop is a place people can go. And I do want to let you know that there are what they call hard to place workers. People who've been involved in the justice system, criminal records, individuals in recovery from substance abuse disorders, people who are on welfare, individuals with poor credit, economically disadvantaged youth and adults who lack work histories or stable work histories, individuals who are dishonorably discharged from the military. All of those people can go to a career one stop and, you know, figure out how to get bonded. Because there's a federal bonding program where the federal government puts up a certain amount of money that says it's a guarantee that this person's not going to steal from them or whatever. And it gives employees a chance to prove themselves, you know, because there's a lot of people that, you know, make mistakes and they've learned from those mistakes, but then nobody wants to hire them and they can't prove themselves until they get a job. So bonding is really, really helpful. A lot of times they have to have a job ahead of time or, you know, an employer that's willing to work with them. And then they say, you know, so and so at this company will hire me if I can get bonded. And then the workforce development board can help them get that bond in place. But just call your career one stop and find out what the process is in your area. Universal EAPs are really wonderful and we all know employee assistance programs. You probably have one at your clinic. But if you can create one that's a universal, which means anybody and everybody can come to it, they can subscribe for a certain amount of money, like you know, $8 a month, which gives them access to maybe weekly workshops on health and wellness and, you know, other prevention oriented services, some communities have started using that and it's really beneficial. Tutoring. There's always a need for tutoring at the schools, at churches, you know, sometimes people at after school care, those types of places. So encouraging people to get involved with volunteering and tutoring and drop in childcare and affordable before and after school care. Let me go back to tutoring real quick for a second. Why did I put that in there? Because we've seen that as academic achievement goes down, depression and anxiety and a lot of other stuff goes up. So if we can provide tutoring, we can help youth maintain a strong self esteem, sense of self efficacy and succeed in life, which will help prevent mental health issues. Back to drop in child care and affordable child care. Parents, you get stressed out. I remember when my kids were in public school, you know, they go in at 8 and then they get out at 1. So and I had to be at work from 8 to 4, which means I had meant I had to leave at like 7:30. So I needed to do something with them before school and I needed to do something with them after school. And then all of the times that the schools are closed for this holiday and this teacher work day and yada yada, it can be really exhausting and expensive for parents to keep up with trying to, you know, make sure that their kids have a safe place to be. So having affordable care and drop in childcare is really helpful. We have a facility like that in the next town over from here. It's basically like respite care. I mean, if mom needs to go shopping and she doesn't want to have to take Junior with her, it's drop in childcare. But then for others, like mothers with postpartum depression, it can be a great place where they can drop their infant off, you know, old enough infant off, know that that infant is safe and be able to go to their therapy appointment or just rest, maybe get some sleep because Junior's had colic for three months or something. So drop in child care is really helpful at reducing child abuse and neglect and improving bonding and all kinds of other stuff. Wellness fairs and health enhancement opportunities are awesome wherever you can have them. At community events, you know, community fairs, those sorts of things. Art fairs, anywhere you can get a booth. It's a great place to put out information about health and wellness enhancement support groups. Encourage the development of support groups. If you have the ability to host some of them at your office, you know, that's a great place and you're a little bit more aware of what's going on. And I hate to say it, but the quality of the support group, support groups for survivors of suicide, for people with depression, people with anxiety. I mean, there's a whole range of different support groups. 12 step meetings, those can be there. Smart recovery, which is a cognitive behavioral approach to recovery. So all kinds of different groups can be offered. AA is pretty much everywhere, 12 steps, lots of places. Smart recovery, not so much. Really easy to get certified or trained and able to facilitate a smart recovery meeting. So that might be something to put out there. Meetups and gatherings. You know, the meetup program, I thought that was wonderful when it came out because it does allow people to connect with like others. What I found in this area is there may be, you know, 150 people in a group, but at any one meetup there's usually only six or ten people that go. But that makes it nice because you get to meet up and actually communicate with other people. So encouraging community gatherings, encouraging churches to do things to bring people together. You know, a lot of churches will have a lunch or a dinner once a week for the parishioners. And you know, that's a great place where people can gather and get social support. Opportunities for indoor recreation and exercise when it gets cold outside and dark and nasty, and the days are like, you know, six hours long and the rest of it's dark and you don't want to go outside, or if it's 115 degrees in the shade and you don't want to go outside and get that sunlight and interact with other people. Opportunities for indoor recreation. Some shopping malls will open up early before the stores open so people can walk and, you know, get their exercise in. So look throughout your community and see what options there are that are affordable and or free that people can take advantage of when it's hot, cold or rainy so they don't feel so stuck in their house and they can get some exercise which releases serotonin and all that stuff. Financial management and counseling. Finances are a huge stressor for a lot of people. So if we can help them figure out how to more effectively manage their money, it can help them manage their stress. And you may be going, well, that's basic. Or you may be going, yeah, money management isn't my strong suit. Either way, you know, not everybody was taught how to effectively manage their money. Balance their checkbook, price, shop, save money, all that kind of stuff. So if you can provide information or links to organizations that provide financial counseling, you know, reputable ones, that's always helpful. And you know, little again, little snippet videos on your YouTube channel go a long way. Encourage the development of clothing closets so people have clean clothes that they can wear and especially work clothes. You know, when you go for an interview, if you don't have a lot of money, it's expensive to buy a suit. So if you have, you know, clothes closets that actually specialize in having, you know, job readiness wear, that's helpful. Domestic violence awareness and prevention and sexual violence awareness and prevention. Increase the awareness in the community of what this is, what it looks like, how to prevent it, what to do if it happens. So more people are talking about it. It's not kept back in the shadows. The more aware people are that, hey, this isn't normal, even though that's what they grew up with their whole life, then they're able to step out and break that cycle. Improve accessibility by providing prevention services at library workshops at libraries. Have workshops there. Provide reading areas where you've got, you know, a whole set of books on parenting. And yes, if you know, they use the Dewey decimal system, they're all together anyway. But if they've got to go search for them and find them in the, in the stacks, they're less likely to use them than if there's a shelf right by where the kids play that says parenting and it's just really obvious and they're sitting there, so why not look at the books anyway and have handouts that people can take home and, you know, read with them. Doctor and dentist lobbies. We spend a lot of time in there, so give people something to read that will benefit them. Health education curriculum in the schools. Work with school administrators to help them see the value of providing coping skills training and communication skills training in health class. Provide Online videos and PDFs on your own website that can help people benefit and learn. Employee assistance programs Encourage companies to use employee assistance programs because it does save a lot of money. They figure on average, for every $1 spent on employee assistance, they save $8. If you are a nonprofit, you can often get health minutes on television or radio news programs for free. You know, if you're a nonprofit, you can do a public service announcement message and get a little snippet of information out there during drive time to work. Community church, employee wellness fairs. We talked about those before and after school programs. Not only nutrition and we need to make sure that bellies are full so minds can function, but also wellness activities so helping people learn coping and communication skills and just little things that you can teach through fun games during the before and after school programs and possibly consider an SMS message subscription service so people can go to your website, subscribe, and they get a text message from you once a day that gives them a new tip for happiness. Early intervention services at schools or workplaces is great. I worked in the child mental health program for a Couple of years. And we did a lot of counseling at the school because parents were not able or willing, but usually not able to, to get the child to counseling services at the clinic for whatever reason, transportation, work, you know, whatever. So we had a lot more success actually connecting with youth at the schools. Same thing is true for workplaces. I mean, finding childcare for your kids while you go to therapy, drive across town, therapy and back, that's two hours of childcare minimum, can get expensive and it's also a hassle. So if you can provide wellness services and early intervention, psychoeducational groups and workshops at workplaces, it can be better. And you can also have, you know, just a counselor that comes in maybe once a week to a workplace that people can come in and just ask a question. You know, some people just have a simple question which they think is simple. It ends up being a 20 minute answer. But you know, they don't need five weeks of counseling. They just have this thing and they need some direction. You can provide phone or video, call a counselor, call a doctor, services. A lot of places are going to this method. Obviously you have to look at your state regulations for what's HIPAA compliant, what's billable, etc. But having services available virtually intervention groups in the evenings are on Saturdays if you're willing to do it. A lot of times you can get them filled up because people don't want to take time off from work, especially if they're hourly employees. Video based appointments, home visits, that gets expensive. Some insurance will cover it, especially for early intervention. So you want to look at it. Early intervention, especially for youth, you know, if you're working at preventing developmental issues is often paid for. So get with the insurance companies and figure out what you might be able to bill for. And if you can, do a home visit. At the clinic I used to work at in, in Florida, summer, spring, fall and winter break camps were cash cows. I hate to say it, but that's just the way it was. Because we could bill Medicaid for the intervention services, behavioral intervention services we were providing. I think it was called targeted behavioral intervention. But we billed in 15 minute increments and you know, we would have 15 kids there every single day. Parents knew they were safe. It wasn't costing parents much of anything, just their, you know, $2 copay or whatever. And the children were getting access to intervention services. So consider those sorts of things improve cultural sensitivity. And I'm not going to spend a lot of time here because we just did the cultural responsiveness training. But children are not adults and they're not teenagers. So present information in a way that makes sense to children that's cognitively appropriate. Teens are not adults, but they're not children. So you got to find a way to communicate the information in a way that's meaningful to them and keep them busy. They don't like to sit there, they don't like to be lectured to for the most part. So work with the teens and relate to things that are important to them. Their culture, the Internet, the TV shows that are popular, you know, be aware of popular culture, young adults, and I kind of put those in there. As your older adolescents, you're 18 to 25, college age, kind of students have their own issues and problems and dilemmas and stuff. Older adults, you know, 55 plus have their own culture and issues because they grew up at a different time than the people who are currently 18 and 20. Sometimes you can have a mixed group and it goes great. A lot of times, the more homogenous a group is, as far as culture goes, you're going to have more success. So you don't want to put children with teens and, you know, teenagers with older adults because they're going to be coming from two different worlds. You can talk about communication and bridging gaps and all that kind of stuff, but we're just talking about prevention here. LGBTQI2K is another place where we've got to be culturally sensitive. Race, ethnicity, religion, socioeconomic status. And a lot of times we don't talk about that in terms of culture. But what someone who is, you know, both people in the household are physicians or something and, or, oh, who is it? I don't know, somebody really rich. Think about somebody who has a whole lot of money. They expect different things and they run in different circles and different things are meaningful to them than someone who has a minimum wage job. They don't expect the same things when they walk into a lobby, for example, or the way they're greeted or whatever. So be culturally sensitive in your presentation so people feel comfortable, but also in what you're relating things to and etc. Occupation. You know, some people, some occupations are very insular. So being conscious of that, if you're working with law enforcement or first responders, they tend to be more insular than other professions. And be okay with that. You may, if you're working in substance abuse. I've had occasions where I've had people in group and then I've had an attorney join the, join the group for some reason. And the attorney didn't feel real comfortable because like three people in the group had been as clients before. So you know, we had to work with whole bunches of dual relationship and boundary issues. But it was not a good fit for that particular session and disability. Make sure that your services are presented in an environment where people can see everything. You know, there's no glaring lights. If you're presenting written information, make sure you have options for people who can't see really well. Maybe large type. If you have the benefit of braille. Great. Very few people have that. Interpreters as necessary to make sure that people have access. Enhance protective factors by teaching and improving conflict management skills, stress management skills and social skills. I mean, a lot of times people get stressed because they feel stuck, because they feel trapped. So how do you manage that conflict? How do you manage that situation? How do you manage the stressors in your life? Everything from paying bills to toting your kids here, there and everywhere, and trying to get dinner made and, you know, whatever else you've got going on. Let's figure out what your stressors are and how we can minimize them as much as possible. And then social skills. If we're encouraging people to develop healthy, supportive relationships, they have to know how to effectively communicate, how to be assertive and how to have a sense of personal control and self efficacy. So they have the ability to set boundaries and say, I can't do that or I can help with that. So we want to help people work on those sorts of things, which will relieve a lot of stress and, and a lot of the triggers for depression and anxiety. Not all of them. We want to improve. And I put parenting supervision and self management because it really applies across the board. We want parents to have positive modeling, be responsive to their children, recognize positive efforts and achievements instead of just the only time that Johnny gets noticed is when he's being disciplined. We want to make sure that Johnny gets noticed when he does good things. Teach them how to provide constructive discipline instead of, you are such a lazy, you know, whatever. I get frustrated when I come home and you haven't even begun your chores, that's constructive. And then start talking from there to solve the problem. And having clear and consistent behavioral standards. The same thing is true in a work environment when you've got a supervisor who needs to model the kind of behaviors they want. Be responsive to employees. Recognize positive efforts, provide constructive feedback and have clear and consistent behavioral standards and self management. Practice modeling good stuff for yourself. You know, try to do the right thing, be responsive, be mindful of what your needs are and be responsive to yourself. So if you're having an off day, accept it and say, all right, this is not my A game. What do I need to improve the next moment? Recognize your positive efforts and achievements instead of focusing on all the ways you screw up. Yeah, we focus on that. But let's remember all the good things. You probably did 20 good things today, and then you had this one. Oopsie. Provide yourself constructive feedback. Instead of saying, you are such an idiot, say, you know, maybe it would be helpful we go through this at my house, because I will set things down in the most inane places, and then I can't find them and I'm running around and I occasionally say things like, I'm such a moron. So, yeah, my son picked that up when he was little. And when I would lose stuff, he'd go, mommy's a moron. I'm like, no, no, no, no, no, no, no. We don't want to say that. So you got to be careful what you say around your kids. But instead of saying that, I could say, what I need to do is put a basket on the foyer table so in the future I can put stuff in there. And have clear and consistent behavioral standards for yourself. Understanding that you want to give 100%, but some days 100% looks very different than it does on other days because you didn't sleep well or you're sick or whatever. But you hold yourself to a standard at school and at work. We want to enhance teacher, employers, and community self awareness of and response to potential mental health or behavioral risk factors. Psychological first aid is a great primer for helping people identify, you know, at risk workers or students. Enhance opportunities for school and work success because we want people to feel like they're succeeding. And it can be, you know, when my son was in first grade, he was in a reading club. And if you read the most number of books each week, whoever read the most number of books each week got to be on the morning announcements and they got a certificate and stuff. So they gamified it, but it gave him a sense of confidence and completion. Improve economic opportunities for people. So try to advocate with that board. Try to advocate with employers. If you have the ability to. To say, you know, really, if you could give this person a chance, I really think it would be a great thing. You know, obviously if you're a counselor, there's all kinds of HIPAA privacy laws and everything that you got to worry about. But we can educate employers about the effectiveness and how people with mental illness actually can make really good employees. You know, they're not defective. So, you know, educate and destigmatize with the employers so they're not closed off to the idea and ensure effective work. School life balance. Oh, it breaks my heart when I see some of my son's friends who come home from school and they literally start studying the minute they come home. They study until martial arts. Come to martial arts and then go home and study until like 11 or 12 at night, go to bed and then get up at 6am and I'm just like, oh my gosh. Because there's so much homework now. And I mean, even more than when we were kids, when I don't know how old you are. But you know, back in the 1980s and 90s, we had a lot less homework that needed to be done. So trying to advocate for people with the school board, you know, how much homework is really necessary and what does this excessive homework do to students? Mental and physical health if they're only getting five or six hours of sleep at night? And what are we teaching them? Because we want to teach them how to have balance and set boundaries and be able to rest and recuperate. Whoops. Wraparound services. Other things that we want to have in our arsenal that we can refer to, obviously we can't provide them health care access, you know, goes without saying. How can you get people access to health care? Where are the free clinics in your area? Where are the clinics that, you know, take Medicaid or whatever it is called in your state? Where can you refer people to? If you have patients that have fibromyalgia, for example, maybe you end up finding you've got six patients with fibromyalgia, finding which healthcare providers in your area have the best ratings or whatever for treating fibromyalgia. So you have a resource list for them. You're not saying go to this doctor, you're saying here are six doctors that have really good patient feedback on health grades or whatever. Vision care. Vision care can be expensive. But if people can't see, they have difficulty driving, they have difficulty functioning as much as effectively at work, their penmanship is typically deplorable, which doesn't communicate a good thing to employers. Vision care is important. Dental care. Dental care really affects people's self esteem. I remember one client I had who was a veteran and he had lost all but one of his front teeth when he was over in Afghanistan. And you know, he was a nice guy. He was this big, big burly guy though I mean, 6, 3. I don't guess weight well, but he was a big guy, and he always used to wear this jacket that had the Muppet character Animal on it. And so I called him Animal. And he thought that was great, and it was wonderful. But I remember distinctly the day he came back from the VA when he had gotten his new teeth. I had never seen him smile until then. And from that point forward, I don't think I ever saw him not smiling. And he had so much more confidence when he was able to look at people and smile and not wonder if they were going to be like, oh, oh, my gosh. And again, because of his size, he was more imposing. And that just kind of softened everything up. So making sure people have access to dental care so they don't lose their teeth or they can get dentures or whatever to help them feel more. Feel better about themselves. Medicine. We need to make sure that people have the medicine they need. Nutrition. Went over that. Safe, affordable housing advocate with your local Housing and Urban Development Board. If there's not enough support. Safe, affordable housing. Sometimes it'll be affordable, but not safe. So what can you do about that? Advocating with law enforcement to do increased patrols through certain neighborhoods. Affordable child care. We already talked about transportation. Some people don't have a license. They lost it because of a DUI or something. Some people just can't afford a car payment or gas or insurance. So they can't. They don't have transportation. Well, they can't get a job and be financially independent if they can't get to work. So how do we help them resolve this problem? And again, you may be going, well, that's not a mental health issue. No, but it could contribute to a mental health issue because it leads to feelings of resentment and anger and irritability and helplessness because they can't achieve their goals and opportunities for community connection and involvement. Encourage your community to build community so people can go, yeah, I'm from Lebanon or I'm from Mount Juliet. And, you know, they're proud of it because they know that their community supports one another. And finally, problem solving. Courts. These are courts, obviously, judicial system. You do something, you come to the attention of the police, you get arrested, charges are filed. It can be for drugs, it can be for domestic violence, or it can be for something, but it was probably caused by a mental health problem by not being stabilized on medications. And that could be violence. That could be. You know, there's a lot of things that they used to cover in mental health court and, you know, Caveat. You know, most people with mental illness have run ins with the law and aren't violent in any sort of way. But there are some people who are much more productive and much more, much happier members of our community if they're med compliant. And what mental health court does is ensure med compliance and compliance with treatment plans to help people become sufficient productive citizens or self sufficient productive citizens. Benefits of problem solving courts, it increases treatment compliance. If I say, you know, I need you to come once a week for 10 weeks, they may say, okay. Or they may go, nah. If the judge says, you go once a week for 10 weeks or I'll throw your butt in jail, that has a little bit more bite to it. Yes, they're somewhat involuntary. So you've got to work from a different level of readiness for change. But it does, it's a motivator. And for those people who are motivated, if they start to kind of lose their motivation, then they think about it and they're like, you know what, I don't want to go to jail. I'll finish this out. It requires community and systemic buy in and support. So if you've got this problem solving court, then you've got more of those wraparound services that you can refer to because the community's already said, yes, we will participate. You don't get those grants unless you've got a good net to work with. It provides an array of services to address the underlying issues creating the problem. What's causing the drug use, what's causing the mental health issue, what might be prompting the domestic violence and how can we address it? By doing this, we reduce the cycle of problems, you know, because if we can help stop Sally from using drugs, which, you know, keeps her, her kids from learning about drug use as much, you know, they're going to learn about it a little bit anyway, then we may stop the cycle. If we provide Sally with new coping skills so she's happier and healthier, she's going to model those, her kids are going to pick them up and hopefully they won't have the same problems that she did. So problem solving courts can be really awesome. Obviously you don't want people to have to get to the point of being legally involved before they get help. But it's an awesome, awesome alternative to incarceration because incarceration doesn't do much. That's my 2 cents. Most of the time I see people go into jail, come out of jail, be out of jail for a little while and recidivate. So it helps reduce recidivism by providing people with the skills and tools they needed. Prevention is accomplished by providing accessible, culturally appropriate, age relevant education and screening services to prevent mental illness. People need safety, health, love, belonging and self esteem needs met. So think of Maslow. Community opportunities for economic self sufficiency, safe housing, community involvement and socialization are all beneficial. Those are huge protective factors. Communities that care, you know, and just saying Communities that care about one another promote greater growth and retention of residents because there's a sense of connection. Prevention on average saves $8 for every dollar spent and prevention activities benefit people physically, socially, emotionally and occupationally. Problem solving courts ensure that people who have begun to develop problems are connected with recovery resources instead of just incarcerated. So those are the ways, you know, some of them a little bit off the beaten path, you know, not all of the things that you were trained for in graduate school, but those are some of the things that we can look at in order to help our clients meet whatever goals they've set for what creates a rich and meaningful life for them. Are there any questions? Alrighty everybody. Have an absolutely wonderful rest of your Valentine's Day and I will see you tomorrow. 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