Mental Health

June 2023 | www.futureofpersonalhealth.com

Our nation’s children and teens are in crisis, but you can do something about it

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Mental health is not that thing in the back of the closet anymore.

Read more on Page 06

Taraji P. Henson & Tracie Jade Jenkins on confronting mental health in the Black community

The Future of Addiction Medicine is about personalized care for people and their loved ones

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July is BIPOC Mental Health Awareness Month Resources inside & online at futureofpersonalhealth.com

Why the 988 Lifeline Is a Critical Resource

their fingertips.

Social Workers are mental health providers. Learn more about this 125 year old profession.

Yamile M. Martí Haidar, Ph.D. Associate Professor of Professional Practice, Columbia University

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Compassion fatigue is common among mental health professionals. But it is treatable.

Beverly Smith, Ph.D. Interim CEO and Executive Director, American Mental Health Counselors Association

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Learn how you can help the teen in your life with their mental health.

Tramaine

President,

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We see that people are struggling with mental health and substance use conditions. With mental health in the spotlight now more than ever, I’d like to share the progress in our efforts to transform the nation’s crisis care system — starting with the 988 Suicide & Crisis Lifeline.

The longer-term vision for 988 is to build a robust crisis care response system across the country that links people who are struggling to community-based providers who can deliver a full range of crisis care services if needed, like mobile crisis teams or stabilization centers, in addition to connecting people to tools and resources that will help prevent future crisis situations.

We know building the nation’s crisis care system will take time. We have far more work to do. But I am hopeful about the forward direction our nation is heading.

Compassionate care on-call

Since transitioning to 988 in July 2022, the 988 Suicide & Crisis Lifeline, formerly the National Suicide Prevention Lifeline, has helped more people than ever before. Anyone experiencing emotional distress, thoughts of suicide, a mental health or substance use crisis, or anyone caring for someone who may be struggling now has someone to talk to 24/7. Trained crisis counselors are ready to provide compassionate care by calling, texting, or chatting.

As we are overseeing this monumental effort and working to address the gaps in crisis care, we believe the 988 Lifeline is bringing hope to people in crisis. In its first year, 988 has expanded its capacity to answer many more calls, with far faster response times. This means more people are getting the help they need, when they need it.

We’ve also seen exponential growth with text and chat, and we know this has been key in providing timely service to youth and young adults.

We’re currently operating a pilot program with specialized services for LGBTQIA+ youth and young adults who want the option of connecting with a counselor specifically focused on meeting their needs.

And we acknowledge the importance of being able to speak in your native language, especially during a time of crisis. The 988 Lifeline currently provides live crisis calling services in English and Spanish, and uses Language Line Solutions to provide translation services in over 250 additional languages. And this summer, we’re adding Spanish chat and text services.

Later this year, we plan to expand videophone options for people who are deaf or hard of hearing.

Lifeline investments

The significant investments of almost $1 billion from the Biden-Harris Administration have helped strengthen the 988 Lifeline capacity, resulting in many more people in crisis getting the help they need. Since launching in July 2022, the 988 Suicide & Crisis Lifeline has had about 4 million contacts through calls, chats, and texts.

And the transition to 988 is only the beginning. The Substance Abuse and Mental Health Services Administration has a bold vision for the future of crisis care in our nation. It is built on the belief that everyone experiencing a crisis should have: Someone to talk to. Someone to respond. And a safe place for help.

We want to help the millions of people around the country get the help they need to recover and live meaningful lives.

WRITTEN BY Miriam E. Delphin-Rittmon, Ph.D. Administrator, Substance Abuse and Mental Health Services Administration

The word “crisis” can mean so many different things to different people. Whatever an individual’s crisis looks like, help is at

EL-Amin Vice

Mental Health First Aid (MHFA), The National Council for Mental Wellbeing (NCMW)

Publisher Shannon Ruggiero Managing Director Julia Colavecchia Production Manager Taylor Daniels Lead Editor Dustin Brennan Cover Photo Lyndon French All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

Are you struggling or in crisis? Call or text 988 or chat with a trained crisis counselor at 988lifeline.org

Young People Need Our Help. So Do the People Who Care for Them.

specific needs and wants. From their perspective, they know it when they see it and are otherwise suspicious of those that they believe lack authenticity or could be motivated by self-interest.

Optum is a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.

However, youth say when they feel seen, heard, and validated that they are more likely to trust another person. For most youth, though, this means keeping only a close circle of select confidants that rarely includes designated conventional caregivers.

WRITTEN BY Dr. Yusra Benhalim Psychiatrist & Sr. National Medical Director, Optum Behavioral Health Solutions

As a child and adolescent psychiatrist, I help children and families understand and manage mental health conditions and substance use disorders. As a senior national medical director at Optum Behavioral Health Solutions, I help put clinical puzzles together to create behavioral health solutions that connect children and families to the care they need. Too often, however, both of my roles are keenly focused on addressing a crisis, rather than preventing one.

This challenge isn’t going away. As is widely documented and reported, American youth are increasingly struggling with their mental health and well-being.

Learning to reach today’s youth

Driven to improve care options, we recently completed extensive research — including one-on-one interviews — to better understand the lives, needs, desires and values of youth ages 13-26 who are experiencing behavioral health symptoms, conditions, and treatment.

One of the key things we

learned is that traditional intervention paths and solutions are not working for this generation as well as we had hoped:

• Primary care physicians generally see individual youth too infrequently to identify mental health concerns, much less make referrals for them.

• Teachers, coaches, and other community leaders may have more interactions and influence with youth but are not always privy to such concerns or professionally equipped to address them.

• Many youth say they are reluctant to confide in their parents and caregivers because they don’t want to burden them, fear they will overreact, or don’t believe they can help.

• From a social determinants of health perspective, many youth do not have ensured access to one or any of the above.

Our research also revealed that when youth do seek care, they expect their care experiences to be tailored to their

Compounding these challenges, the world has changed. Youth no longer need to rely on their caregivers or nearby community resources for support and information. With instant access to a global network, they can easily circumvent traditional pathways in search of validation, answers, and support online. Unfortunately, a quick search may or may not take them to legitimate or credible sources of information critical to their health and well-being.

Tackling the youth mental health crisis

The good news is that innovative help is on the way. At Optum, we are leveraging the results of our in-depth research and analysis to design new pathways to connect with and engage children, adolescents, and young adults through the people, places, and things they interact with and trust.

By earning their trust and creating new support systems that meet them where they are, we can make the most difference in the right ways.

Social Workers on Frontlines of the National Mental Health Crisis Need Your Support

Our nation is experiencing a mental health crisis.

Blame the pandemic, which increased social isolation, anxiety, and economic stress on families. Or the divisiveness of our political system. Or the fact our nation is reckoning with entrenched systemic racism, higher rates of opioid addiction, and never-ending gun violence.

Just watching the news about issues like these can be stressful. No wonder all these factors have eroded the mental health of many Americans, prompting more people than ever to seek therapy.

Social workers are on the frontlines of this mental health tsunami. Social work is one of the fastest-growing professions in the United States, and more than 120,000 social workers work in mental health or treat people with substance use disorders, according to the Bureau of Labor Statistics.

According to a recent public opinion survey from Ipsos, 1 in 6 Americans say they or a family member have been helped by a social worker. The most common setting where Americans are meeting social workers is in mental health, the survey said. And happily, 81% of the survey respondents said the social worker improved the situation.

Taking action

However, social workers need help in addressing the crush in demand for mental health services. Here is what you can do: Our youth are reporting more mental health issues. One way to address this need is to get more social workers in schools, where they can help students overcome issues like bullying

and anxiety before these issues get out of hand. The National Association of Social Workers recommends at least one social worker per 250 students, and in distressed school systems, one social worker per 50 students. Unfortunately, few school districts meet this standard.

988 suicide and crisis lifelines are being set up across the nation to help people deal with mental health issues and to prevent deaths by suicide. Social workers often handle these telephone lines. Make sure your state and local 988 lines are properly funded.

Social workers enter the profession primarily because they want to help people. However, salaries could be higher (the median salary for social workers was just over $50,000 in 2021). The Ipsos survey found that half of Americans believe social workers are not paid enough. To address shortages of social workers providing mental health services, policymakers must support increasing their salaries.

Urge Congress to pass legislation that supports the social work profession, including the Improving Access to Mental Health Act, which would help add more clinical social workers to the mental health workforce by raising Medicare reimbursement rates. Social work can also be a risky job, so urge your members of Congress to support legislation that would improve safety for social workers.

The nation’s social workers are already an integral part of our nation’s efforts to improve the delivery of mental health services. They just need support from the public and lawmakers to keep doing the life-affirming work they do.

Anthony Estreet, Ph.D., M.B.A., LCSW-C CEO, National Association of Social Workers

A Holistic Approach to Mental Health and Well-Being

Social workers are the No. 1 mental health providers in our country. Their intersectional approach incorporates, mind, body, and environment for solutions to mental well-being.

As social workers, we provide services with an understanding of how systemic inequities impact our lives — this makes us mental health providers who are also strong advocates, policymakers, community liaisons, and so much more.

Our training prepares us to recognize the multiple identities that a family, individual, and community have and how they are all interconnected. We are often the one professional in the room who knows about the diagnosis/ condition, the family composition, identity, culture, religious beliefs, support systems, history of trauma, economic status, and many other elements that impact treatment and well-being.

The power of context

In my clinical experience, I have witnessed firsthand the importance of context and how it affects the prognosis and intervention.

I worked with a family whose child was diagnosed with obsessive compulsive disorder. The child lived with his mother, father, and two younger siblings. The father was not fluent in English, which led the family to rely heavily on Mom to connect to services — oftentimes with no translator or a native language provider. They had a two-bedroom, one-bathroom apartment.

The child was washing their hands constantly and sometimes locked themselves in the only bathroom in the apartment for hours. This created additional hardships — the parents were sometimes late for work on top of the time they needed to take off for appointments; they had to constantly purchase soap to serve the need of their child; and everyone in the household had a

different way to cope with their reality: mom was accommodating, dad would try to set limits, one sibling was upset, and the other was confused.

This diagnosis would have impacted any family immensely. The socio-economic status, limited space at home, language barriers, and lack of knowledge of resources compounded the difficulty and shaped the way in which we would support this family.

A total approach

Social workers in this case considered this context, as we are trained to better work with the individual by understanding the environment they live in. This framework helped the team responsible for supporting this child design interventions that would also support the family members who were incredibly devoted to their care.

The wrap-around approach included cognitive behavioral therapy for the child; psychoeducation for the whole family; building relationships with the school to better advocate on the child’s behalf; and couple’s therapy sessions for the parents, while also connecting them to the other resources available to them from additional service providers.

Our mental health and well-being does not exist outside of the environments we are part of. Social workers understand and work with individuals, families, and communities because we believe the answers will always be within the source.

As we celebrate 125 years of the social work profession as we know it, let us continue to lift up the work of social workers and their contributions to the field of mental health practice.

Yamile M. Martí Haidar, Ph.D., M.A., LMSW Associate Professor of Professional Practice, Columbia University

How Taraji P. Henson Is Confronting the Mental Health Crisis

Actress Taraji P. Henson has teamed up with her longtime friend Tracie Jade Jenkins to help Black communities access barrier-free mental health and wellness via the Boris Lawrence Henson Foundation.

Taraji P. Henson got used to the notion of talking openly about mental health at an early age. Her father, Boris Lawrence Henson, was upfront and honest about his struggles with post-traumatic stress disorder in the wake of the Vietnam War.

“It takes a lot of courage to live your truth and be unapologetically you, and he taught me that at a very young age,” said Taraji P. Henson, the star of “Empire,” “Hidden Figures,” and “What Men Want.” “I think — in fact, I know — that’s made me the actress I am today, and I think it’s why people are kind of drawn to me the way they were my dad.”

While Boris Henson, who died of cancer in 2006, was transparent about his mental health, he struggled to access the resources and help he required. His daughter is not ignorant to the fact those struggles still exist today.

Community of caring

Henson created the Boris Lawrence Henson Foundation (BLHF) five years ago, with the goals of bringing conversations about mental health even further into the mainstream, and giving underserved populations barrier-free access to mental health resources.

When seeking someone to head up the foundation, Henson didn’t hesitate to bring on board Tracie Jade Jenkins, one of her best friends from the time the two were in their early teens. Jenkins has long been a leader in the national discussion on mental health and in

fundraising for non-profits.

With the BLHF, Jenkins sees an opportunity to confront “triple or even quadruple pandemics in the Black community,” she said. “We’re looking at disparities in pay, disparities in healthcare, social injustices, all of these things that impact our mental health every single day.”

Spaces for change

In addition to these longstanding issues affecting the Black community, the COVID-19 pandemic created a new detriment to mental health.

“The Surgeon General just came out with a warning that isolation is killing us as quickly as smoking cigarettes,” said Jenkins, citing a recent report that widespread loneliness poses similar health risks as smoking 15 cigarettes a day.

“That’s an epidemic.”

One of the ways the BLHF is confronting the loneliness epidemic is through a partnership with the Kate Spade New York Foundation, which has supported the Boris Lawrence Henson Foundation Self-Care Wellness Pods. The pods are physical structures on college campuses where students can access mental health, self-guided practices, workshops, and seminars.

“This is an opportunity for us to reconnect,” Jenkins said, “for us to get away from those rooms, those headphones and silos, and get into a space where we can reconnect and remember what it’s like to actually speak to one another through the exchange of physical energy.”

Access for all

Even if there isn’t a physical BLHF space in your area yet, the foundation still offers programming and resources to promote better mental health for all.

“One of our immediate goals over the next five years is to provide 1 million hours of free mental health services to the Black community. We offer free therapy campaigns yearround, and people can take part from the comfort of their own homes,” Jenkins said. “We also offer resources like The Unspoken Curriculum that helps teachers and administrators talk about racism and bias in schools."

“Ultimately, our goal is to eradicate the stigma around mental health in the Black community.”

That’s a tall task, but Henson and Jenkins are willing to do whatever they can to break down the barriers to better mental healthcare, and give people in all communities the tools and resources they need to have these difficult and important conversations.

“This is not something we can ignore,” Jenkins said. “Mental health is not that thing in the back of the closet anymore. It should be a priority in every home, in every business, and every conversation.”

“And we need to give each other grace,” Henson added. “Everybody’s fighting a battle.”

Written by Dustin Brennan

Learn more about the Boris Lawrence Henson Foundation at borislhenson foundation.org

INTERVIEW WITH Taraji P. Henson Actress, Founder, Boris Lawrence Henson Foundation

INTERVIEW WITH Tracie Jade Jenkins Executive Director, Boris Lawrence Henson Foundation

From left to right, Taryn Bird, Dr. Quinton T. Ross, Tracie Jade Jenkins, Taraji P. Henson, Dr. Joyce Lloyd-Davis, Brenda Brown Dillard and Aleah Robinson at the ribbon-cutting ceremony of the first Boris L. Henson SelfCare Wellness Pod at Alabama State University | Photo by Marvin Bowser

WRITTEN BY Beverly Smith, Ph.D. Interim CEO and Executive Director, American Mental Health Counselors Association

Why Caregivers Are at Risk of Compassion Fatigue

The tripledemic of COVID-19, influenza, and RSV has had a devasting impact on our country. In many cases, this tripledemic has served as a catalyst for people to seek support from behavioral healthcare providers, such as Licensed Mental Health Counselors.

Mental relief is desperately needed given the catastrophic levels of individual and collective human suffering. People of all ages are still suffering secretly during this national mental health crisis both at home and in the public domains of the workplace and schools.

According to Mental Health America, the impact on young people has been particularly stark, with 11.5% currently experiencing severe major depression.

What is compassion fatigue? Licensed Mental Health Counselors (LMHCs) show sympathy and empathy as vital caregivers, providing psychotherapy to those suffering. However, because of their role in helping and healing others, they are likely to experience compassion fatigue.

Compassion fatigue results in feelings of physical, emotional, and psychological exhaustion for the caregiver. These feelings are directly linked to repeated exposure to other people’s trauma, grief, and stress. In fact, compassion fatigue is often referred to as secondary trauma since the caregiver is traumatized vicariously.

The caregiver experiences trauma through the lens of the lived experiences of the sufferer and through their

own life’s context. In essence, the caregiver is exposed to the traumatized person and not the actual traumatic event. The caregiver could be a physician, teacher/professor, pastor, first responder, or military personnel. Although an individual’s traumatic experiences are filtered through the lens of trained helping and healing professionals, psychotherapy professionals are not immune from experiencing compassion fatigue as caring and the ability to show empathy are the fundamental aspects of the role.

Often, compassion fatigue can be viewed as an occupational hazard as the caregiver repeatedly and overwhelmingly bears witness to another’s suffering. Consequently, compassion fatigue could impact the caregiver’s capacity to show appropriate sympathy and empathy toward the person they are caring for.

Compassion fatigue has various additional symptoms, which may include anxiety, anger, irritability, feeling numb or detached, loss of sense of purpose and fulfillment, feeling exhausted and depleted, feeling isolated and withdrawn, and changes in sleeping and eating patterns. Compassion fatigue symptoms are similar to the symptoms of burnout (a component of compassion fatigue), but their origins are different.

Compassion fatigue stems from taking on the suffering and pain of others. Burnout stems from being overworked, feeling that they are not being adequately appreciated or appropriately valued, and possibly not having enough resources to perform necessary tasks.

In short, compassion fatigue is primarily related to re-experiencing the trauma of others, whereas burnout is more about the inability to cope with environmental stressors of workplace conditions.

Treatment is available

The good news is that both compassion fatigue and burnout can be effectively treated. LMHCs can help adults and youths to increase their ability to cope with stress and trauma through mindfulness and meditation, as well as practicing self-compassion and other self-care techniques.

LMHCs can help employers, schools, and community organizations to identify and adopt trauma-informed practices to help mitigate re-traumatization to promote resiliency, as well as increase productivity, satisfaction, and performance in all spheres of life.

Equally important, these efforts can help to address the societal stigma associated with mental healthcare in both our micro and macro-communities.

There Is No Time to Waste: Addressing America’s Youth Mental Health Crisis

We have long known that America’s youth experience a range of mental health challenges.

WRITTEN BY Jody LevisonJohnson, Ph.D., LCSW President and CEO, Social Current

According to the National Alliance on Mental Illness (NAMI), 1 in 5 children ages 13-18 will be diagnosed with a serious mental illness. NAMI also reports that since the start of the COVID-19 pandemic, suicide has become the second-leading cause of death among young people. Public health officials are sounding the alarm, including U.S. Surgeon General Vivek Murthy, who issued a public health advisory about the youth mental health crisis.

This is unacceptable. The stressors facing our nation’s youth are complex. Social media has led to a rapid rise in isolation, cyberbullying, and self-criticism. In addition, societal traumas, such as racism, gun violence, and natural disasters, consistently take their toll on young people’s sense of safety, security, and certainty.

Importance of intervention

If mental health issues go untreated, the impact can be significant, altering the life course for young people and their families. Studies from the National Conference of State Legislatures show as many as 70% of youth in the juvenile justice system and up to 80% of youth in foster care have significant mental health issues.

What if these conditions had been identified and treated? Would the paths for these youth and their families have been different?

The message is clear — we must prioritize access to a comprehensive, coordinated, upstream network of mental health services and supports, and this must be done in collaboration across all systems that interact with youth, including child

welfare, education, juvenile justice, mental health, and primary care.

These services must be community-based, traumainformed, family-driven, youth-guided, culturally and linguistically competent, and available across a wide range of geographic locations. We must pay special attention to young people of color, who are disproportionately overrepresented in more restrictive settings and less likely to receive the treatment they need.

Despite a focus on mental health for decades, we continue to see a youth mental health crisis of epic proportions. We must do more than sound the alarm — it’s time to take action. Our society must ensure that those interacting with children are aware of the signs and symptoms of mental health conditions, normalize the experience, and offer guidance on how to seek support.

We must invest in supports that strengthen families and build protective factors against poverty and economic stress. We must continue to expand high-quality, community-based mental health services for youth and their families that ensure timely and appropriate access.

Services must be tailored to the unique needs of young people and their families. We must work to curtail and interupt systemic racism and bias, which perpetuate health inequities.

And we must advocate for policy shifts that will improve youth mental health, such as universal access to health insurance, coverage for mental health treatment, and concrete economic supports and programs that prevent and address childhood trauma.

Building momentum

The good news is that mental health issues carry less stigma than they did three decades ago. The pandemic has helped us understand that there are times in which all families experience stress, and it is OK to seek help.

We are also seeing historic investments in mental health care for youth, with federal dollars going toward community supports, school-based interventions, training, telehealth, and technical assistance to support the provision of behavioral healthcare in pediatric practices. These are just some of the important investments that must be sustained.

With the CDC reporting suicide rates among young people increasing by 57% over the past decade, the time is now. We simply have no time to waste.

Social Current is a national nonprofit whose mission is to advocate for and implement equitable solutions to society’s toughest challenges through collaboration, innovation, policy, and practice excellence. Social Current offers best practice COA Accreditation standards that help ensure quality mental health services are available through community-based organizations.

To learn more, visit social-current.org

Addressing the Global Crisis in Youth Mental Health

A 2022 survey revealed that more than half of the American public believes there is a crisis in youth mental health.

The data supports that belief, painting a bleak picture of the mental health status of our nation’s youth and of young people across the world.

WRITTEN BY Lisette Burton, J.D. Chief Policy and Practice Advisor, ACRC

Though the information makes it clear we do indeed have a crisis in youth mental health, people may tune out, be in crisis overload, or believe that the problem is just too big to solve.

So, what can we do? With global attention focused on the urgent, often unmet, behavioral and mental health needs of children, we need to elevate what is working, revolutionize how children and families access care, and invest in quality.

Elevate what works

In addition to effective psychiatric and addiction services, we must do better in our efforts to address grief, trauma, ambiguous loss, loneliness, and other less-considered contributors to declining youth mental health. As a neighbor, teacher, coach, counselor, mentor, parent, or other important person in a child’s life, you can make a difference. Research has shown that relationships are at the core of mental well-being.

We should also expand who we are learning from. Youth Era partnered with The University of Oxford to create and launch Uplift, a virtual mental health training and peer approach to supporting youth. Young people in Australia helped develop a research-based approach called FRESH (the “F” stands for fun!), focused on leisure education for young people with mental health challenges. Cross-cutting ideas and approaches that go beyond a single system will accelerate our success in improving youth mental health.

Revolutionize access to care

We need to create flexible, responsive service arrays to ensure every young person has access to mental health services when and where they are needed. That requires not just dollars but also people, in the form of dedicated, fully compensated professionals and support workers at every level of care.

Let’s build and sustain “no-wrong-door” approaches so children aren’t excluded from accessing care because they don’t have the right insurance, aren’t at the right level of distress, have too much or too little income,

or live in the wrong zip code. New Jersey has the only statewide Children’s System of Care, creating a single point of access for families in need. Localities in the United Kingdom are working on scaling the tested, effective No Wrong Door™ model. Besides increased stability and cost savings, young people have endorsed this approach, noting in evaluations that, “I am seen as an individual and not a problem.”

Invest in quality

Across the continuum of care, it should not feel like a game of chance when a youth and family select, or are referred to, a service provider. When providers and systems are transparent, accountable, and proximate to communities and families, people can make informed decisions about what will work best for them. There are known best practice principles that should be incorporated across all services.

If we invest in innovation, equitable outcomes, easing access to the right care at the right time, and centering the voices of those with lived mental and behavioral health experiences, we can solve the crisis in youth mental health.

Talking About Mental Health With Teens

We talked to Mental Health First Aid (MHFA) vice president Tramaine EL-Amin about ways to recognize if a teen is struggling with their mental health, and how to start a conversation about it.

What are some tips for starting a conversation with a teenager about the importance of mental health? In a non-crisis situation, here are some tips for starting a conversation with a teenager about the importance of mental health:

• Plan to talk privately about your concerns at a mutually convenient time in a place free of distractions. If the teen appears preoccupied or busy, you may want to wait until they are less distracted.

• Let the young person know you are ready when they are — do not put pressure on them to talk right away.

• Allow the youth to express their thoughts uninterrupted. When appropriate, ask questions, but do not push.

• Set aside your own beliefs

and reactions to focus on the needs of the youth to be heard, understood, and helped.

• Ensure you do not express any negative judgements and respect the youth and their experience.

What are some signs that a teenager may be experiencing a mental health challenge?

A mental health challenge is defined by Mental Health

First Aid as a major change in a youth’s thinking, feeling, or action that interferes with their ability to live their life; the interference lasts longer than typical emotions or reactions would be expected to.

Teens may not always know how to talk about what they are experiencing or ask an adult for help. That’s why it’s important for adults who interact with

young people frequently, such as parents, teachers, or coaches, to recognize the signs that a teen may be experiencing a mental health challenge, and how to connect them to appropriate support.

Potential warning signs that a teenager may be asking for help with a mental health challenge include:

• Withdrawing from friends, family, and social activities

• Frequently arguing with adults and/or purposely breaking rules; displaying aggressive behavior

• Losing interest in favorite activities and not replacing with other pursuits

• Difficulty remaining focused and maintaining concentration across a variety of tasks and settings.

INTERVIEW WITH Tramaine EL-Amin Vice President, Mental Health First Aid (MHFA), The National Council for Mental Wellbeing (NCMW)

I AM NOT MY INHERITENCE

While I was close to my mom growing up, my father was emotionally absent and only seemed happy when he was highly intoxicated. Like a ghost, he came and went. I only saw him briefly before he left for work and after he came home, or during the weekends as he binge drank in the living room. Then I’d see him the next week, when he repeated the cycle.

As I grew older, I learned that my father had suffered a lot and was a product of his environment. He was abused as a kid, mostly by his father. Both of his parents died young from drug overdoses. When my father drank, he became a different person

and could turn spiteful, mean, and abusive in the blink of an eye. He often fought with my mother and was verbally abusive to my older sister and me, or simply ignored me.

One night when I was around 12, my parents fought while my sister and I stayed in our separate rooms, trying to drown out the sounds of screaming, hitting, and thrown objects. The next morning, my mom, dad, and sister were all cuddling in my parents’ bed, waiting for me to join them.

As I stood there in confusion, my father excused himself to get something from the kitchen. When he was out of the room, I said, “I thought we were all mad at him?”

My mom and sister shared a scoff and an eye roll as my mother said, “Oh, come on, that was so long ago!”

“That was yesterday,” I said, as I started to feel like I was the only one who noticed a recurring problem.

While I knew, deep down, that my father tried his best to be a decent person, his issues triumphed over his attempts to change his ways. He sometimes went a day without drinking, and my mother and sister praised him for it, but the next day he’d be back at it. I soon realized he wouldn’t be able to quit unless he got professional help.

Written by A Youth Communication Teen Writer

Abuse and mental illnesses plagued my family. At 18, I realized that I needed to seek help to break the cycle.

The Future of Addiction Science and Treatment

We talked to Dr. Petros Levounis, one of the leading authorities on the science of addiction, about what we’ve learned about addiction in recent years and how those findings can help people get on the road to recovery.

Why has the rate of addiction increased in the past few years?

Dr. Petros Levounis, M.D., M.A. President, American Psychiatric Association

The most recent data (April 2023) on deaths due to opioids has shown that, if anything, there is a bit of a decrease in mortality. So, this is good news, of course, but we remain cautiously optimistic about the opioid epidemic. Tremendous efforts have been made in terms of opioid treatment, and more specifically, medications for opioid use disorder, but there is still a lot of work to be done.

Also, during the pandemic, people with problematic drinking — but not quite the severe form of the illness — showed a decrease in their alcohol consumption. We understand that perhaps this was due to decreased socialization opportunities. At the same time, however, people who live with the severe form of alcohol use disorder saw a significant increase in their alcohol consumption. And of course, we’re very, very concerned about that.

What are some of the key indicators of addiction you can look for in yourself or a loved one? Keep an eye open for noticeable changes in yourself or your loved one. Are you noticing a change in performance at school or work? Are you or your loved one falling behind in responsibilities across the board? Is there a lack of enjoyment in the hobbies or activities they loved in the past? Have you noticed a change in sleep patterns?

A person living with an addiction to a particular substance or behavior often starts thinking about and craving for it 24/7. They spend tremendous amounts of time trying to obtain the drug, using the drug, coming down from the drug, and starting the process all over again.

What are some good strategies for starting and having a conversation about addiction with a loved one?

For someone living with a substance or behavioral addiction, there is often a discrepancy between where they are in life and where they would like to be. Sometimes this discrepancy can become evident in a

simple discussion about everyday life. What are they struggling with or missing out on?

One important point I should make: Even though families and loved ones can understandably get frustrated with someone who is living with addiction, it is almost never a good idea to use “tough love” interventions with someone unless you have the guidance of a professional. Such confrontational approaches typically cause much more harm than good.

Another thing we often hear is that if the person doesn’t want to help themselves, there’s not very much that can be done. In 2023, we have techniques and approaches to help these people, even if they don’t want to come to our office. It often starts with their families or loved ones. We can teach them motivational techniques to use at home and move the person toward a stage of thinking about making changes or taking that first step toward getting help.

Bottom line?

Treatment works and people get better. In 2023, we have more tools than ever before. We have safe and effective medications for tobacco, opioids, and alcohol use disorders; advanced psychotherapies for all addiction; and powerful 12-step programs that help people live healthy lives.

So, the bottom line is that if you are concerned about yourself or a loved one, have a talk with them and seek the help of a professional. It could be a psychiatrist, a primary care physician, or someone you trust. Have the conversation and open the door to recovery.

Lowering the Barriers to Substance Use Disorder Recovery

Today, substance use disorder (SUD) is recognized as a complex, chronic disease. More than 46 million Americans meet the DSM-V5 criteria for SUD, and it costs society billions of dollars and contributes to the more than 100,000 overdose deaths each year.

Yet our approach to SUD remains fractured, underfunded, and often punitive. Philip Rutherford, Chief Operating Officer at Faces & Voices of Recovery, a recovery advocacy organization, sat down to discuss the resources currently available to people dealing with SUD, what a “recovery-ready” country would look like, and what we can all do to help.

What misconceptions do people have about substance use and SUD?

SUD may start with a choice. But when we think about other chronic health conditions like hypertension, diabetes, or even cancer, there could be behavioral routes to those conditions as well. Smoking can lead to cancer, or a bad diet might lead to hypertension. But we typically don’t punish people or stigmatize them for those illnesses.

What should people know about treating SUD?

The most important thing people should know is that it is a treatable condition — recovery is actually a likely outcome if appropriate resources are made available. The trouble is, the overwhelming majority of resources goes to the first six months, maybe even the first 30 days. Those initial resources are important. We’re just not finishing the job. It’s really critical that we provide longterm, low-barrier resources to people where they live in their communities.

What does the national response to SUD currently look like? In the 1970s, there was a federal decision around something called deinstitutionalization. Prior to that, they just kind of put people in the state mental health hospitals and kind of left them in there. Deinstitutionalization said, “Hey, you can’t do that anymore.” It created the rise of community mental

health centers. Around the country, there is a network of community-based organizations. Some of these, called recovery community organizations, are places where people with lived experience help others. We also see — family-based organizations, faith-based organizations, and harm reduction organizations. All of these groups seek to promote recovery at a local level.

What would a truly “recovery-ready” America look like?

It’s where recovery is as prevalent as addiction. That’s the easy part. How do you get to that? We believe that multiple systems — healthcare, social services, education, legal, and other systems — conspire to get the help people need.

A practical example might be an early detection questionnaire at a doctor’s office that triggers the availability of resources to a young person. Unfortunately, today a lot of that is punitive. If a kid gets in trouble at school with substances, then there’s law enforcement, there are consequences. And those punitive consequences are often disproportionate in terms of race. What if, instead, early detection meant you got information? A recovery-ready America is a place where the initial detection of a problem triggers a healthcare response or a wellness response rather than a punitive one.

What can individuals do to help?

Faces & Voices of Recovery has a tagline: Advocate, act, advance. First of all, talk to policymakers, city council members, school board members — wherever you can go and lift your voice. It’s not OK that we have a treatable healthcare condition that is not being funded in the same way that other treatable healthcare conditions are. There’s also just acting. Where are the recovery resources in your neighborhood? Maybe you can volunteer there, maybe you can do something in your community.

Finally, advance the cause. We look at that as stigmabusting. If you know someone in recovery, and you hear people making jokes — speak up. Let them know that recovery works!

Substance use disorder afflicts nearly 50 million Americans. It’s time for a more organized and resource-rich approach.

INTERVIEW WITH Philip Rutherford COO, Faces & Voices of Recovery WRITTEN BY Jeff Somers

Recovery Happens: People With Substance Use, Mental Health Problems Regain Their Lives

The pandemic highlighted behavioral health challenges. Fortunately, there is hope, and SAMHSA funds and promotes resources to help Americans walk in recovery.

WRITTEN BY

Every day, Americans with substance use and mental health conditions embark on the path to recovery to regain their lives. The stakes have never been greater. During the pandemic, fentanyl contributed to fatal overdoses surging to a staggering 107,000 deaths over a 12-month period in 2021. Mental health problems have increased significantly, particularly among our young people. Americans from every background have been impacted. But, there also have been gains — developments that inform my job as the director of the Office of Recovery at the Substance Abuse and Mental Health Services Administration (SAMHSA) and that give me hope for our nation’s well-being.

Open dialogue

A cultural focus emerged during the pandemic: an

increased willingness in society to discuss mental health and the importance of self-care. Whether on traditional media or social media, more people have discussed how to remain connected to each other and to community. Like never before, America is bringing mental health problems and the promise of recovery out of the darkness and into the light in both public and private forums. And Americans are pursuing recovery. SAMHSA’s annual National Survey on Drug Use and Health found that, in 2021, 70% of adults (or 21 million Americans) who had a

Paolo del Vecchio, M.S.W. Director of the Office of Recovery, Substance Abuse and Mental Health Services Administration (SAMHSA)

substance use condition identified as being in recovery, with two-thirds of adults (or 39 million Americans) with a mental health condition reporting they were in recovery.

We have also learned a great deal about what facilitates recovery. SAMHSA recognizes that people need access to effective mental healthcare, as well as whole healthcare that addresses primary care needs along with social determinants of health, such as housing and employment.

SAMHSA’s grants support treatment and recovery support services nationwide.

A great example is our State Opioid Response (SOR) grant program. SOR funding has increased access to and retention in opioid use disorder treatment services, provided support for long-term recovery, and enhanced and implemented preventive services, which have been instrumental in addressing the opioid and overdose crisis.

Hope for recovery

Recovery is personal, requiring tailored, individualized care and supports.

SAMHSA leads efforts to promote behavioral health equity, particularly for underrepresented and under-resourced populations.

We also know traumas from a variety of sources — such as adverse childhood events, disasters, and violence — often precede mental health and addiction problems. SAMHSA works to prevent and respond to trauma and its effects.

Finally, we know the solutions to today’s crises require the involvement of people with lived experience — those in recovery and their family members. They bring expertise and experience to help improve the delivery of care. SAMHSA recently issued a Recovery Innovation Challenge to identify innovation advancing recovery and a set of model standards to promote evidence-based peer support approaches. There is hope. Recovery is possible. People, when equipped with evidencebased treatment and recovery supports, are able to regain their lives and contribute to their families and communities.

SAMHSA stands with everyone impacted by addictions and mental health conditions so that more people can begin their journeys, and experience the promise and joy of recovery.