>>THE HOLIDAYS IN GENERAL CAN BE A STRESSFUL TIME.

AND ANXIETY LEVELS MAY BE UP AS WE HEAD INTO OUR SECOND HOLIDAY SEASON DURING THE PANDEMIC.

SOME MAY BE FEELING ANGST, WONDERING IF IT’S FINALLY SAFE TO GATHER?

OTHERS, ISOLATION OR DEPRESSION, AS TRADITIONAL CELEBRATIONS ARE CANCELED AGAIN.

JOIN THE LIVE DISCUSSION AS MENTAL HEALTH EXPERTS SHARE TIPS ON HOW TO NAVIGATE THROUGH THE END OF THE YEAR.

TONIGHT’S LIVE BROADCAST AND LIVESTREAM OF INSIGHTS ON PBS HAWAII START NOW.

¶¶ ¶¶ ALOHA AND WELCOME TO INSIGHTS ON PBS HAWAII.

I'M OLENA HEU.

THE LAST TWO MONTHS OF THE YEAR ARE PACKED WITH VARIOUS HOLIDAYS: THANKSGIVING, HANUKKAH, CHRISTMAS, NEW YEAR’S.

FOR MANY, IT’S A JOYOUS TIME TO GATHER WITH FAMILY AND FRIENDS, BUT FOR SOME, ESPECIALLY THOSE WHO ARE ISOLATED, THE HOLIDAYS ARE NOT ALWAYS FESTIVE.

EVEN DURING SO CALLED NORMAL TIMES, THESE UPCOMING WEEKS CAN BE FILLED WITH FRENZY.

ADD COVID TO THE MIX AND CELEBRATIONS DURING THE PANDEMIC CAN PILE ON EXTRA STRESS FOR THOSE WHO ARE ALREADY STRUGGLING.

WE’LL GET TIPS FROM OUR PANEL TONIGHT ON HOW TO MANAGE ALL THE DIFFERENT EMOTIONS THAT COME WITH THE HOLIDAY SEASON WE LOOK FORWARD TO YOUR PARTICIPATION IN TONIGHT'S SHOW.

YOU CAN EMAIL OR CALL IN YOUR QUESTIONS AND YOU’LL FIND A LIVE STREAM OF THIS PROGRAM AT PBSHAWAII.ORG AND THE PBS HAWAII FACEBOOK PAGE.

NOW, TO OUR GUESTS.

UILANI KIAHA IS A BEHAVIORAL HEALTH SPECIALIST FOR THE DEPARTMENT OF EDUCATION, SERVING THE PUBLIC SCHOOLS ON MOLOKAI.

SHE ALSO WORKS AS A CRISIS MOBILE OUTREACH TEAM MEMBER THROUGH ALOHA HOUSE AND IS PART OF THE SUICIDE PREVENTION MAUI COUNTY TASK FORCE.

DR. CHAD KOYANGI IS THE PSYCHIATRIC MEDICAL DIRECTOR AT ADVENTIST HEALTH CASTLE.

HE’S ALSO A STREET MEDICINE PSYCHIATRIST AT THE INSTITUTE FOR HUMAN SERVICES AND HAS BEEN WORKING WITH THE CHRONICALLY HOMELESS WHO ARE MENTALLY ILL FOR MORE THAN TWO DECADES.

KATHLEEN MERRIAM IS A LICENSED CLINICAL SOCIAL WORKER AND A CERTIFIED SUBSTANCE ABUSE COUNSELOR.

SHE WORKS FOR THE DEPARTMENT OF HEALTH AND IS CURRENTLY THE MENTAL HEALTH SUPERVISOR OF THE WINDWARD COMMUNITY MENTAL HEALTH CENTER IN KANEOHE.

AND JENNA ALTOMARE IS A PARAMEDIC WITH THE CITY AND COUNTY OF HONOLULU EMERGENCY MEDICAL SERVICES.

AFTER WORKING IN THE FIELD FOR 20 YEARS, SHE NOW SERVES AS THE SAFETY SPECIALIST FOR EMS AND IS THE PROGRAM COORDINATOR FOR THE EMS PEER SUPPORT TEAM.

THANK YOU YOU WILL FOR JOINING US THIS EVENING.

REALLY APPRECIATE YOUR TIME.

AND YES, HOLIDAYS ARE UPON US.

MY FIRST QUESTION I WOULD LIKE TO ADDRESS IT TO KATHERINE TALK ABOUT WHAT YOU'VE SEEN FAR AS MENTAL HEALTH AND HEALTH WISE IN OUR STATE SINCE COVID.

>> THANK YOU.

THANK YOU FOR PAYING ATTENTION TO MENTAL HEALTH.

WE'RE VERY, VERY FORTUNATE THAT PBS IS FOCUSING ON IN THIS EVENINGMENT MENTAL HEALTH AFFECTS ALL OF US.

AND ESPECIALLY WHEN WE'RE LOOKING AT IT'S TIME FRAME.

WE HAVE BEEN ENDURING DIFFICULT TIMES.

COMING UP ON A COUPLE OF YEARS.

AND SO I THINK THE CONCERN IS THAT WE CALL IT OFTEN, COMPASSION FATIGUE OR BURNOUT.

OR THERE'S LOTS OF NAMES THAT CLINICALLY A LOT OF PEOPLE ARE SUFFERING FROM ANXIETY AND DEPRESSION.

AND SO FREQUENTLY, WE'RE EXPERIENCING THESE VERY SYMPTOMS.

DON'T KNOW WHAT THAT IS FROM.

IT CAN BE THAT WE'VE BEEN ENDURING THIS FOR SUCH A LONG PERIOD OF TIME.

SO I THINK THE IMPORTANT TO PEOPLE PAY ATTENTION TO FEELINGS.

BEHAVIOR CHANGES IMPORTANT TO SEEK HELP.

PAY ATTENTION.

TO OUR MENTAL HEALTH.

MANY PEOPLE ARE NOT COMFORTABLE TALKING ABOUT MENTAL HEALTH.

BUT IT IS A PART OF OUR WHOLE BEING.

AND SO WE'RE REALLY HAPPY TO TALK ABOUT THAT THIS EVENING.

SO JUST TALKING ABOUT IT, AND SHARING YOUR FEELINGS, SEEKING HELP WHEN NECESSARY, VERY, VERY IMPORTANT.

>> I AGREE.

HAVING THE DISCUSSION GOING TO MAKE A DIFFERENCE.

SO DR. KOYANAGI, YOU ACTUALLY SPECIALIZE WITH THOSE THAT ARE HOMELESS AND IN THE COMMUNITY.

WHAT HAVE YOU BEEN SEEING LATELY?

>> I THINK THE PANDEMIC HAS BEEN ESPECIALLY HARD ON ALL PEOPLE AND ESPECIALLY A LOT OF HOMELESS INDIVIDUALS.

STILL ON THE STREETS.

UNFORTUNATELY, BECAUSE OF THE PUBLIC HEALTH MEASURES OF STAYING AT HOME, AND A LOT OF THE HEALTH CARE SERVICES HAVE PULLED BACK DURING THE PANDEMIC.

SO A LOT OF THE FOLKS WERE GETTING MORE FACE TO FACE SERVICES FROM OUTREACH WORKERS, CASE MANAGERS, CASE MANAGERS UNFORTUNATELY THOSE INDIVIDUALS HAVE HAD TO KIND OF BE ON THEIR OWN AND HEALTH SYSTEM HAS KIND OF SWITCHED TO A KIND OF TELEHEALTH REMOTE MODEL AND SO FOR VERY HARD TO FIND SOME OF OUR PEOPLE WHO ARE HOMELESS AND CERTAINLY, GETTING THEM TO CONNECT WITH PEOPLE WHO ARE TRYING TO HELP THEM VIA DIGITAL BOX VERY DIFFICULT AT TIMES.

SO WE JUST HAVE TO HOPE FOR CONTINUED SERVICES FOR THESE INDIVIDUALS AND HOPEFULLY, WE'LL BE MORE FACE TO FACE VISITS IN THE FUTURE.

>>Olena: I WOULD IMAGINE THAT FOR A DEMOGRAPHIC, MIGHT NOT HAVE THE CAPABILITY TELEHEALTH WITH THE COMPUTER OR CELL PHONE.

>> EXACTLY.

PANDEMIC HAS SHOWN US THAT PEOPLE WHO HAVE RESOURCES, WHO HAVE COMPUTERS, CELLPHONES, HAVE TABLETS, ARE ABLE, HAVE BEEN ABLE TO STAY CONNECTED WITH SERVICES THAT THEY NEEDED.

HOWEVER, THE PEOPLE IN POVERTY, PEOPLE HOMELESS, DON'T HAVE THOSE TOOLS.

DIVIDE BETWEEN HAVE AND HAVE NOTS MUCH BIGGER AND MORE CONCERNING.

>>Olena: THANK YOU.

ON THE ISLAND OF MOLOKAI, WHAT ARE YOU SEEING THERE WITHIN YOUR COMMUNITY?

>> I WANT TO SAY, I'VE SEEN A LOT OF PEOPLE COME TOGETHER DURING THIS TIME.

AND THEN THERE IS ALSO THINGS THAT HAVEN'T, BUT I FEEL LIKE THE MAJORITY IS TRYING TO COME TOGETHER AND HELP EACH OTHER.

SO I FEEL LIKE THIS IS PROBABLY BEEN SINCE THE PANDEMIC HAS HIT, MOST LIKE FOOD DRIVES THAT WE'VE HAD, MOST REACH OUTS AS MUCH AS POSSIBLE, AND LIKE IN CREATIVE WAYS, DRIVE THROUGHS DRIVE THROUGHS ARE HUGE.

DRIVE THROUGH BIRTHDAY PARTIES.

DRIVE THROUGH WEDDINGS.

DRIVE THROUGH BABY SHOWERS.

I THINK AT THIS TIME, PEOPLE ARE GETTING MORE CREATIVE AND ALSO SEEING HOW MUCH PEOPLE CAN TOUCH, BUT ALSO SOMETIMES WHAT THEY'RE MISSING OUT ON IT.

LIKE FIRST BABY LUAU, SUPERHUGE AND MOST LOCAL CULTURES, AND HERE, ESPECIALLY ON MOLOKAI, IF YOU HAVE EVER BEEN TO A PARTY, OF ANY SORT, HERE, THE FOOD IS AMAZING.

BECAUSE THEY, YOU KNOW, MAKE IT THEMSELVES.

GATHER AND DO ALL OF THAT THOSE THINGS THEMSELVES AND I JUST FEEL LIKE A LITTLE BIT OF THAT IS HAS LIKE YOU DON'T GET THE FUEL EXPERIENCE.

YOU ONLY GET PARTIAL.

BECAUSE IT'S QUICK DRIVE BY.

BUT I CAN SAY WE'VE SAVED A LOT MORE MONEY.

WITH DRIVE THROUGHS RATHER THAN THE HUGE PARTY.

THE SOCIAL INTERACTION YOU USUALLY GET AT A BIG GATHERING I THINK THAT HAS DEFINITELY AFFECTED PEOPLE IN DIFFERENT WAYS.

BUT I'VE ALSO SEEN THIS BECOME MORE RESOURCEFUL.

>>Olena: NICE BRIGHT SPOT TO SEE PEOPLE PIVOT AND COME UP WITH INNOVATIVE WAYS TO DO SO.

WERE YOU NOTICING ALSO THAT PERHAPS THE COMMUNITY WAS IMPACTED, WERE THEY STAYING HOME AND ISOLATING OR WERE THEY KIND OF JUST DOING THINGS AS THEY NORMALLY WOULD?

>> I THINK DEPENDS ON THE FAMILY.

I'M NOT CAN'T SPEAK FOR EVERYONE.

CAN ONLY SPEAK FOR THE EXPERIENCES THAT I EXPERIENCE.

BUT BEFORE WHEN THE PANDEMIC HAD FIRST HIT, WE WERE ORDERED TO STAY HOME.

AS WORKERS.

COULDN'T GO AND REACH OUT TO PEOPLE.

MOBILE OUTREACH, COULDN'T GO THEM RIGHT AWAY.

DIFFERENT PROTOCOLS BEING PUT IN PLACE.

AND THEN AS WELL AS FOR THE SCHOOL SETTING, LIKE WORK FROM HOME, THAT WAS REALLY HARD FOR ME.

IT WAS A LOT MORE DISTRACT BECAUSE EVERYBODY WAS LIKE WORKING FROM HOME.

THEN I KNOW THAT WAS A HARDSHIP FOR US IN A SENSE BECAUSE ELECTRICITY WENT UP.

USE EVERYONE ON THE SAME WI FI.

SAME AREA AND MOLOKAI, WI FI CAN BE SPOTTY HERE AND THERE.

SO I THINK IT AFFECTED PEOPLE IN MANY DIFFERENT WAYS.

BUT FOR OUR FAMILY, I WOULD SAY THAT WE STAYED WITH EACH OTHER A LOT MORE.

SO THAT GAVE US MORE TIME TOGETHER.

WHICH WE USUALLY IN THE REGULAR WORK WEEK, WOULD HAVE LESS TIME TOGETHER.

SO I DON'T KNOW IF THAT WAS ALWAYS GREAT.

SO IF MAYBE IF OUR FAMILY WASN'T DOING SPECIFIC THINGS TO KEEP OURSELVES HEALTHY, IT MIGHT NOT HAVE BEEN A HEALTHY ENVIRONMENT.

SOME OTHER FAMILIES MIGHT HAVE BEEN EXPERIENCING THAT DURING THE PANDEMIC.

BEING ON LOCKDOWN OR LOSING THEIR JOBS.

HAVING TO BE HOME.

HELPING THEIR CHILD IN SCHOOL.

EACH FAMILY MIGHT HAVE EXPERIENCE THINGS DIFFERENTLY.

BUT WITH WHAT CHAD SAID EARLIER ABOUT CERTAIN POPULATION IS NOT HAVING ACCESS, I THINK THAT THAT WAS LIKE MAJORLY APPARENT WHEN THE PANDEMIC HIT.

OH, OH, YEAH.

EVERYBODY CAN COME ONLINE.

SO MANY FAMILIES WITHOUT WI FI, WITHOUT A DEVICE, ONE OTHER STEP THAT THE SCHOOLS HAD TO DO.

SCHOOLS ALSO DID LIKE MEAL, THAT WAS REALLY HELPFUL.

I BELIEVE.

FOR FAMILIES WHO NEEDED THAT FOOD.

LIKE DIDN'T REALIZE THAT BREAKFAST AND LUNCH AT SCHOOL WAS KIND OF HUGE.

I HEARD FROM THE KIDS, BREAKFAST AND LUNCH DURING THE DRIVE THROUGH TIMES.

BETTER THAN THEY REMEMBER IN PERSON.

COOL FEEDBACK FROM THE KIDS.

>>Olena: FAMILIES DID CERTAINLY APPRECIATE THAT.

ALSO WANTS REMIND VIEWERS OPEN TO YOUR QUESTIONS.

YOU CAN LOG ON TO OUR FACEBOOK, EMAIL THEM, ALSO CALL THEM.

IN IF YOU HAVE ANY QUESTIONS FOR YOU ARE PANEL.

MOVE OVER TO JENA BEEN WITH THE CITY & COUNTY OF HONOLULU EMS FOR 25 YEARS.

WHAT KIND OF CHANGES DID YOU SEE IN THE CALLS THAT YOU WERE RESPONDING TO OVER THE PAST COUPLE OF YEARS NOW?

>> WITH THE PANDEMIC, THINGS KIND OF GOT REALLY CRAZY.

LIKE OUR CALL VOLUME SKYROCKETED FOR A WHILE.

I GOT COVID.

I GOT TO GOT HOSPITAL.

EVEN THOUGH SYMPTOMS WERE REALLY MINOR.

GO TO THE HOSPITAL.

GET CHECKED OUT.

JUST TOOK UPON THEMSELVES SAYING THEY NEEDED TO GO.

FOR A WHILE, WE HAD TO KIND OF PUSH OUT MESSAGE OF ONLY IF IT'S AN EMERGENCY.

CALL 911.

BECAUSE WE WERE JUST GETTING SO FLOODED WITH CALLS.

AND THEN IT KIND OF TAPERED OFF FOR A WHILE.

WASN'T TOO BAD.

>> RECENTLY THINGS STARTED PICKING UP AGAIN.

GETTING SLAMMED OVER AND OVER RECENTLY WITH DELTA.

NUMBERS WENT UP.

PEOPLE CALLING ALL THE TIME.

IT WAS DIFFICULT FOR GUYS.

HAVING TO WORK REALLY HARD.

>>Olena: WHAT WOULD YOU SAY THE TOP TWO CALLS ARE REGARDING?

>> SHORTNESS OF BREATH.

LIKE GENERALIZED WEAKNESS, COLD SYMPTOMS.

COVID SYMPTOMS.

>>Olena: JUST THOSE THAT FEAR THEY MIGHT BE COVID POSITIVE AND DON'T KNOW WHAT TO DO.

CALL 911?

>> YEAH.

>>Olena: WHAT WOULD YOU SAY THE PROTOCOL SHOULD BE WHEN SOMETHING LIKE THAT HAPPENS?

>> IF YOU'RE JUST HAVING MINOR SYMPTOMS, THAT IF BEFORE THE PANDEMIC, IT WAS FLU SEASON, YOU WOULD JUST STAY HOME.

HAVING COVID SYMPTOMS.

STAY HOME.

SYMPTOMS STAY HOME.

HAVING SHORTNESS OF BREATH, GETTING ALTERED STUFF LIKE THAT, THAT'S THE KIND OF STUFF WE WANT YOU TO CALL FOR.

YOU NEED TO CALL US BECAUSE WE WANT TO GET YOU HELP SOONER THAN LATER.

BUT IF IT'S SOMETHING THAT YOU NORMALLY WOULD HAVE STAYED HOME BEFORE, THEN THAT'S THE TIME YOU CAN JUST GO SEE YOUR OWN PERSONAL DOCTOR.

JUST TELEMEDICINE WITH THEM.

>>Olena: THANK YOU.

STARTING TO GET YOUR VIEWER QUESTIONS.

WE APPRECIATE THAT.

FIRST ONE IS FROM TIM IN KAIMUKI.

HE SAYS, LEGISLATURE APPROVED CONVERTING LEAHI HOSPITAL IN MENTAL HEALTH ASSESSMENT FACILITY.

BUT THE DEPARTMENT OF HEALTH HAS FAILED TO OPEN IT YET.

SO HE'S ASKING IF THE PANEL CAN COMMENT ON THIS.

AND KATHLEEN, DO YOU WANT TO PERHAPS START?

>> I'M NOT CLEAR ON THIS SPECIFIC OF LEAHI HOSPITAL.

I KNOW THAT NEAR THERE, WE DO HAVE A STABILIZATION BED AREA.

WHICH IS CALLED PALIKANA LEAHI.

WING OF LEAHI HOSPITAL.

PROVEN TO BE VERY EFFECTIVE WHERE BASICALLY, CLIENTS THAT ARE KIND OF HIGH UTILIZERS I WOULD SAY, GOING IN AND OUT OF THE HOSPITAL AND THEY ARE GOING IN AND OUT OF JAIL.

REALLY NEED INTENSIVE CASE MANAGEMENT, GET THE CASE MANAGEMENT.

AND AT IDEA IS TO HAVE THEM REDUCE THEIR SYMPTOMS.

AND THEIR HOSPITALIZATIONS AND INCARCERATION WITH THAT KIND OF CASE MANAGEMENT.

AND THEY ARE IN A 24 HOUR SUPERVISED RESIDENCE AND IT'S A WING OF THAT LEAHI HOSPITAL.

THAT IS VERY GOOD MODEL AND IT'S BEEN REPLICATED ON THE BIG ISLAND.

WORKING WELL.

>> WHETHER THAT IS GOING TO BE EXPANDED TO OTHER AREAS, I DON'T KNOW.

WE DO HAVE THAT WORKING WELL THERE.

I'M NOT SURE THAT DIRECTLY ANSWERS THE VIEWER'S QUESTIONS.

BUT THAT IS SOMETHING I KNOW ABOUT LEAHI HOSPITAL.

>>Olena: THANK YOU.

TALKING A LITTLE BIT MORE ABOUT HOLIDAY AND STRESS AND ANXIETY AND DEPRESSION, WHAT KIND OF TIPS DO YOU HAVE FOR PEOPLE TO ACKNOWLEDGE THE PROBLEMS THAT THEY'RE HAVING AND WHAT KIND OF STEPS SHOULD THEY TAKE TO TRY TO MITIGATE THAT?

>> WELL, YOU KNOW, ONE OF MY FAVORITE ORGANIZATIONS IS AMERICAN FOUNDATION FOR SUICIDE PREVENTION.

WE HAVE HAVE A HAWAII CHAPTER.

THEY ALONG WITH NAMI, NATIONAL ALLIANCE FOR MENTAL ILLNESS.

PROMOTE SOME OF THE SIMILAR THINGS, MIND, BODY, SOUL AND SCENERY.

WHAT I LIKE ABOUT THAT IS IT TALK ABOUT SELF CARE.

WE HAVE TO TAKE CARE OF OURSELVES.

ESPECIALLY DURING THE HOLIDAYS.

WE WANT TO FOCUS ON OUR MIND.

>> WHAT CAN WE DO TO RELAX AND REGROUP.

WHEN WE HAVE THESE DIFFICULT DAYS HOW DO WE PACE OURSELVES DURING THE DAYS AND WHAT ARE WE DOING TO TAKE CARE OF OUR BODIES BECAUSE THEY'RE CONNECTED.

SOMETIMES WE DON'T PAY ATTENTION TO OUR PHYSICAL HEALTH.

WE'RE SO WORRIED ABOUT OUR MINDS.

AND WHAT IS OUR MIND DOING.

OUR SOUL, WHAT DOES FEED SOUL?

SCENERY HAS TO DO WITH ENJOYING THE BEAUTIFUL AREAS THAT WE LIVE IN.

AND KIND OF CONNECTING TO THE LAND.

THERE'S A LOT OF INITIATIVES NOW THAT ARE AVAILABLE TO HELP US PAY ATTENTION TO SELF CARE.

AND WE REALLY ARE CONCERNED RIGHT NOW, I THINK, ABOUT OUR COLLEAGUES.

WE'RE THINKING ABOUT THE PEOPLE THAT TAKE CARE OF US.

THAT HAVE NOW BEEN TAKING CARE OF US FOR THIS LONG PERIOD OF TIME.

AND MAYBE WE NEED TO LOOK AT THAT AND HOW DO WE TAKE CARE OF THEM.

BECAUSE THERE ARE A LOT OF FOLKS WHETHER THE DOCTORS NURSES, SOCIAL WORKERS, SUBSTANCE ABUSE COUNSELORS.

>> PEOPLE ON THE STREET TAKING CARE OF THE FOLKS ON THE STREET.

WHOEVER THEY ARE, PEOPLE THAT ARE THE CARETAKERS, HEALTH CARE WORKERS, WE NEED TO STOP AND PAY ATTENTION TO THAT GROUP AS WELL.

>>Olena: WHAT THINGS CAN WE DO IF YOU FEEL LIKE YOU'RE IN A CRISIS AND YOU NEED SOMEONE TO TALK TO?

>> THERE'S LOTS OF THINGS TO DO.

WE HAVE THIS SPECIFIC KIND OF COORDINATED ENTRY POINT HERE IN HAWAII.

CALLED HAWAII CARES.

WHICH IS A PHONE NUMBER THAT YOU CAN CALL.

I BELIEVE WE'RE GOING TO SHOW THAT ON THE SCREEN.

FOR OAHU.

832 3100.

THERE'S A TOLL FREE NUMBER.

FOR THE NEIGHBOR ISLANDS.

WHICH IS 753 6879.

AND THAT IS FOR ANYBODY THAT IS STRUGGLING WITH SOMETHING.

WHETHER THEY WANT TO FIND OUT A RESOURCE OF WHERE THEY COULD GO TO, WHETHER THEY ARE UNINSURE AND DON'T KNOW HOW TO GET INTO THE MENTAL HEALTH SYSTEM.

SO IT COULD BE A FIRST CALLER.

OR IT COULD BE TO REACH SOMEBODY THAT MAY BE THEY NEED A CRISIS MOBILE OUTREACH WORKER LIKE UILANI IS ON HER ISLAND MUCH SOMEBODY NEEDS TO COME TO THE HOME AND HAVE SOME KIND OF INTERVENTION.

THAT'S IS ONE WAY TO ACCESS SOME HELP.

>>Olena: MY UNDERSTANDING IS THOSE PHONE LINES ARE MONITORED 24 7?

>> 24 7.

CRISIS LINE.

IT'S ALSO ACCESS TO THE SYSTEM.

ACCESS TO RESOURCES, ACCESS TO PROGRAM CALLED KUMAKANI, WHICH HAS JUST BEEN DEVELOPED FOR COVID.

SO THAT PEOPLE CAN HAVE EXTRA SUPPORT THROUGH GROUPS, THROUGH TALKING WITH EACH OTHER, THROUGH PERSONAL COUNSELING, SO THERE IS A LOT OF RESOURCES AVAILABLE AN THIS WOULD BE THE TAPE TO TAKE ADVANTAGE OF IT.

>>Olena: ABSOLUTELY.

>> BECAUSE IT'S THERE.

>>Olena: SPEAKING FROM PERSONAL EXPERIENCE, I DID HAVE A FRIEND THAT WAS GOING THROUGH SOMETHING, AND I BECAUSE I WAS THE FRIEND THAT SHE WENT TO, FOR HELP, I DIDN'T KNOW EXACTLY WHAT TO SAY.

I'M NOT A THERAPIST.

I CALLED THE NUMBER TO TRY TO FIND OUT WHAT KIND OF THINGS SHOULD I BE SAYING.

WHAT CAN I DO?

THEY'RE VERY HELPFUL.

VERY HELPFUL.

>> GOOD.

GOOD.

THAT'S GOOD TO HEAR.

YES, PLEASE CALL.

>>Olena: DR. KOYANAGI, I WAS WONDERING, HOW DO YOU DIFFERENTIATE BETWEEN HAVING ANXIETY FROM HAVING JUST LIKE A FULL MENTAL BREAK DOWN?

DURING THE PANDEMIC TRAUMATIC EXPERIENCE FOR EVERY ONE OF US.

EVERY SINGLE PERSON ON THIS EARTH HAS DEALT WITH LOSSES AND LOSS OF LOVED ONES, LOSS OF JOB, LOSS OF HOUSING, LOSS OF COMMUNITY.

EVERYONE'S EXPERIENCE ANXIETY TO SOME DEGREE.

IT'S PART OF NORMAL RANGE OF HUMAN EMOTION.

AT WHICH POINT WE DECIDE SOMEONE HAS A BREAKDOWN.

IS WHEN KIND OF THAT NORMAL COPING STRATEGIES HAVE BEEN UNABLE TO DEAL WITH MODERN ANXIETY THEY WERE DEALING WITH.

AS A RESULT, PEOPLE CANNOT GET OUT OF BED, CAN'T INTERACT.

CAN PLAY WITH OTHERS.

CAN'T DO THEIR JOB.

SOMETIMES PEOPLE CAN GET SO DESPONDENT, BECOME HOMELESS OR SUICIDAL.

BECOME UNSAFE TO OTHERS.

SO IT'S SPECTRUM OF ANXIETY BUT BECOME A POINT WHERE PROFESSIONAL CAN TELL THAT SOMEONE IS CLEARLY OVER THE LINE AS FAR AS NEEDING THE MORE INTENSIVE HELP AND POSSIBLY ACUTE HELP.

>>Olena: WHAT KIND OF ADVICE DO YOU HAVE TO SOMEONE ALONE MAYBE DOESN'T HAVE SOMEONE ELSE THERE TO HELP THEM?

>> THAT'S A TOUGH QUESTION.

SOME OF THE A LOT OF THE FOLKS I DEAL WITH, THEY HAVE NO SENSE OF COMMUNITY.

NO WAY OF COMMUNICATING WITH OTHERS.

NO TRUSTED PERSON TO TALK TO.

NO FAMILY.

ONLY WAY TO GET HELP WOULD BE TO EITHER SEEK OUT PLACE WHERE HELP IS READILY GIVEN LIKE CHURCH OR HOMELESS SHELTER OR CARES LINE.

IF THAT PERSON IS NEEDS MORE HELP THAN THAT, PROBABLY GO TO EMERGENCY ROOM OR URGENT CARE CENTER.

>>Olena: UILANI, I FEEL LIKE I MIGHT HAVE SOMETHING TO PIGGYBACK ON THAT.

US THINKING THAT A LOT OF RESOURCES ON THE OUTER ISLANDS, ARE LIKE PEOPLE MIGHT BE ON OAHU AND THINKING, WE DON'T HAVE RESOURCES.

THEN YOU GO TO MAUI COUNTY, OR ANY OTHER OUTSIDE COUNTIES AND YOU'RE LIKE, WE REALLY DON'T HAVE THE RESOURCES.

THEN GO TO SMALLER ISLAND, AND YOU REALLY DON'T HAVE THE RESOURCES.

AND SO I THINK WHAT I FOUND IS I'VE BEEN HELPING FAMILIES TO KIND OF RECOGNIZE THE SOURCES OF STRENGTH AROUND THEMSELVES.

>> THAT THEY DIDN'T THINK THAT THEY HAD.

SO I THINK IT'S REALLY GOOD FOR US TO LOOK FIRST, IF WE CAN, IF WE'RE HAVING THOUGHTS OF ... >>Olena: I THINK WE MIGHT BE HAVING >> WE MIGHT BE HAVING SOME AUDIO ISSUES.

TRY CONTINUE UILANI.

>> SORRY.

>>Olena: WE'LL COME BACK TO YOU.

MY APOLOGIES.

I THINK FOR SOME REASON, THE AUDIO IS CUTTING OUT.

BUT MOVING ON >> IF I COULD PIGGYBACK WHAT SHE WAS SAYING.

SO DONE WORK IN VARIOUS NEIGHBOR ISLANDS INCLUDING MOLOKAI AND MAUI AND HAWAII ISLAND AND I THINK SHE WAS TRYING TO TOUCH ON THE POINT THAT SOME OF THE MORE RURAL SMALLER COMMUNITIES EVEN THOUGH THEY HAVE LESS RESOURCE IN TERMS OF TECHNICAL EQUIPMENT AND COMPANIES AND PROGRAMS, WHAT I'VE NOTICED CLEARLY, CONSISTENTLY, IS THAT SMALLER COMMUNITIES HAVE A KIND OF GREATER SENSE OF COMMUNITY AND GREATER WAY OF KIND OF BANDING TOGETHER TO FIND WHAT PEOPLE NEED AND TO KIND OF TEAM UP AND HELP EACH OTHER OUT.

>>Olena: BEAUTIFUL.

I SEE KATHLEEN NODDING THERE.

>> SORRY.

CAN YOU HEAR ME??

YES.

>> I'LL PIGGYBACK OFF OF WHAT CHAD SAID.

SO I THINK WHAT I WAS MY MAIN POINT WAS LOOK AT YOUR ... >>Olena: I THINK WE'RE HAVING THAT MOLOKAI AUDIO ISSUE.

I'M SO SORRY.

YEAH.

OKAY.

WE CAN'T HEAR HER AT THE MOMENT OF THE WE'RE GOING TO WORK ON IT.

AND KATHLEEN, DO YOU HAVE SOMETHING TO SAY ALSO PERHAPS ON HOW THE COMMUNITY IS BANDING OR IF YOU HAVE FAMILY MEMBERS?

>> WELL, I LOVE WHAT HAS BEEN SAID SO FAR.

>> DO THINK THAT BECAUSE IT'S BEEN SUCH A TOUGH TIME, PEOPLE HAVE GOTTEN VERY CREATIVE ABOUT HOW WE SUPPORT EACH OTHER.

AND IN SOME WAYS, FAMILIES HAVE GOTTEN CLOSER.

AND WE HAD TO FIND JUST VERY SPECIAL CONNECTIONS KIND OF AT OUT OF DESPERATION.

THERE HAS BEEN A BEAUTIFUL SIDE TO THAT AND COMMUNITY ORGANIZATIONS, PARTNERSHIPS, HAVE GROWN AND KIND OF BLOSSOMED OUT OF NECESSITY.

AND SO THERE IS THIS, ON ONE SIDE, THERE IS BEEN SOME TRAGEDY AND A LOT OF GRIEVING AND REAL HARDSHIPS.

ON THE OTHER SIDE, THERE IS SOME BEAUTY AND HOPE AND PULLING TOGETHER AND STRENGTHENING.

ABSOLUTELY.

>>Olena: IS THERE ANYTHING THAT YOU KNOW OF AS FAR AS RERESOURCES THAT CAN PEOPLE AS WE HEAD INTO THE HOLIDAYS ASIDE FROM THE 24 7 HOTLINES?

>> WELL, I WOULD DEFINITELY SEEK OUT SOME OF THESE, I'VE BEEN SOMEBODY TURNED ME ON TO AN APP ABOUT KEEPING CALM.

AND SOMEBODY ELSE WAS TELLING ME ABOUT A FITNESS OUTLET AND I ALSO JUMPED ON KUMA KANE TO CHECK OUT GROUPS.

THAT LOOKED INTERESTING.

I THINK ANYTHING TO DO WITH SELF CARE AND SELF IMPROVEMENT IS I THINK THIS IS A GOOD TIME TO DO THAT.

BECAUSE OFTEN, WE AGAIN WERE CARING ABOUT OTHER PEOPLE.

HOLDING OTHER FAMILIES TOGETHER.

TRY TO PAY THE BILLS AND KEEP JOBS TOGETHER.

AND SO IF WE JUST TAKE OUT A LITTLE BIT OF TIME EVERY DAY, TO RELAX, RECHARGE, REFRESH I THINK THAT'S A REALLY GOOD HELPFUL THING FOR MENTAL HEALTH AND PHYSICAL HEALTH.

>>Olena: ABSOLUTELY.

SO MANY APPS OUT THERE.

YOGA AND MEDITATION.

WHATNOT.

I ALSO WANTED TO SEND OVER TO TALK FROM FIRST RESPONDER PERSPECTIVE.

WHAT ARE SOME WAYS THAT YOU GUYS ARE TRYING TO COPE WITH THE STRESS AND THE WORKLOAD AT THIS POINT?

>> I THINK A LOT OF OUR GUYS HAVE THEIR FAMILIES THAT THEY BOND WITH, AND THEY SHARE THEIR STRESS WITH THEM.

OR WE ALSO HAVE OUR PEER SUPPORT THAT HAS DONE WONDERFUL JOBS REACHING OUT TO OUR GUY.

TAKE PROACTIVE APPROACH CALL OUT AND REACH OUT TO THEM OF THE SHARING PEER TO PEER.

HELPS.

UNDERSTAND THE HARDSHIP.

FINDING STRESS OUTLET.

WHETHER IT'S EXERCISING OR GOING TO CHURCH, OR GOING HANGING OUT WITH JUST FRIENDS, IF YOU CAN HAVE THAT TIME TO LEAST YOUR STRESS.

IT DOESN'T BUILD UP OVER TIME.

SO LIKE FOR ME, I GO SURFING EVERY SINGLE WEEKEND.

I MAKE THAT PRIORITY.

IF I DON'T GET MY SURF, STRESS LEVEL DOESN'T COME DOWN.

REALLY MAXED OUT NEXT WEEKEND NOT AS HAPPY A PERSON.

BUT YOU KNOW, YOU JUST TAKE THAT TIME TO MAKE THAT THE PRIORITY.

OUR GUYS ARE PRETTY GOOD ABOUT MAKE SURE THAT THEY CAN DECOMPRESS.

>>Olena: EXCELLENT.

>> GOOD POINT.

WE GOT A PANDEMIC PUPPY.

AND SHE HAS BEEN THE BRIGHTEST LIGHT.

SO YOU KNOW, NOT SAYING EVERYONE SHOULD GET A PUPPY.

BUT KNOW, DEFINITELY HELPS.

SO UILANI IS BACK.

LET'S SEE.

WE WERE JUST TALKING LITTLE BIT ABOUT WHAT SOME TIPS ARE TO DEAL WITH STRESS.

>> SO HOW'S MY CONNECTION NOW?

>>Olena: I THINK GOOD.

>> OKAY.

I LIVE ON MOLOKAI.

THIS IS HOW IT IS SOMETIMES.

BUT SO SOME TIPS, I THINK ONE OF THE THINGS I LIKE DOING, THAT I FOUND HELPFUL, SOMEONE SHARED IT WE.

WEBSITE CALLED ACTIONS FOR HAPPINESS.

AND THEY HAVE THESE WONDERFUL CALENDARS THAT ON EACH DAY, THEY HAVE SOMETHING LITTLE.

TO DO OR TO SAY, IT COULD BE A POSITIVE SELF TALK AFFIRMATION.

COULD BE SOMETHING TO DO WITH SELF CARE.

IT CAN BE A SERVICE.

COULD BE A KINDNESS.

>> SOMETHING LITTLE YOU COULD DO EACH DAY.

AND I SHARE THAT PRETTY MUCH WOULD LIKE EVERYONE I WORK WITH BECAUSE I FEEL LIKE OUT OF LIKE THE SCHOOLS THAT I WORK WITH AND THE SOCIAL WORK, I WORK WITH, A LOT OF TIMES WE DON'T ALWAYS REMEMBER TO CARE FOR OURSELVES.

AND SO LIKE JENNA SAID, GOING SURFING.

THAT'S HER THING YOU GOT TO FIND YOUR THINGS.

EVEN IF YOUR THING IS TRYING NEW THINGS.

LIKE OR TRYING TO COOK OR BAKE OR PERFECT SOMETHING.

OR TRY SOMETHING FOR THE FIRST TIME AND MESS UP.

I THINK THOSE TIMES HELPS US TO NAVIGATE WHATEVER IS GOING ON IN OUR LIVES.

AND I KNOW THAT SOME FAMILIES I WORK WITH, THEY'RE IN SURVIVAL MODE.

SO THEY CAN'T EVEN THINK TO DO THAT.

AND SO I THINK SOME TIPS BESIDES IF YOU'RE NOT ABLE TO GET TO THE SELF CARE PART, IS TAKING SOME TIME FOR YOU.

WHATEVER THAT LOOKS LIKE.

IF THAT IS LIKE CLOSING THE BATHROOM DOOR AND SHOWERING FOR A LOT LONGER THAN YOU USUALLY WOULD, OR IF IT'S LIKE LISTENING TO MUSIC OR A LOT OF MY FRIENDS THAT ARE MOMS ARE LIKE WATCHING CERTAIN SHOWS ON NETFLIX AND.

TRYING TO PUT A PLUG IN FOR THAT.

FINDING WHAT WORKS FOR YOU THAT HELPS YOUR BRAIN AND YOUR BODY GET BACK TO CALM, LIKE SHE SAID, OR SO THAT YOU CAN FUNCTION.

FOR WHOMEVER YOU HAVE RESPONSIBILITY OVER.

OR SERVE.

OR JUST FOR YOU MAYBE.

>>Olena: DEFINITELY.

YES.

ABSOLUTELY.

DR. KOYANAGI CAN YOU TELL ME BENEFIT OF GETTING OUTSIDE.

>> SOME OF THE WAYS THAT THE PANDEMIC HAS AFFECTED US, IT'S TAKEN OUT OF OUR USUALLY RITUALS AND ROUTINES.

THAT KEEP US KIND OF GROUNDED AND PSYCHOLOGICALLY HEALTHY.

GOING FOR A WALK, CHURCH ON SUNDAY.

GOING TO THE GYM.

SO AS WE GET FURTHER OUT OF THIS PANDEMIC, HOPEFULLY, WE CAN HAVE PEOPLE BEING ALLOWED TO DO THE THINGS THAT THEIR RITUAL AND ROUTINE AND HOPEFULLY, THAT INVOLVE THINGS LIKE GOING BACK TO WORK AND SOCIALIZING WITH FRIENDS AFTER WORK AND GOING OUT TO EAT OR GOING TO THE BALLGAME.

AND CHEERING FOR THE SAME TEAM AND I THINK ONCE WE HOPEFULLY OVER THE NEXT THREE OR SIX MONTHS, GET MORE INTO OUR PREPANDEMIC ROUTINES.

HOPEFULLY START NORMALIZING OUR SOCIETY.

>>Olena: VIEWER QUESTION FROM MIKE FROM MAKIKI.

WOULD THE PANEL RECOMMEND TRAVEL OUTSIDE OF THE ISLANDS TO ALLEVIATE STRESS AND DEPRESSION?

MAYBE DOCTOR FOR YOU.

>> AS LONG AS WELL, I THINK PEOPLE NEED TO START RECONNECTING WITH THEIR FAMILY.

A LOT OF PEOPLE IN HAWAII HAVE OHANA ON THE MAINLAND.

HAVE NOT BEEN ABLE TO SEE THEM FOR COUPLE OF YEARS.

PEOPLE HAVE FAMILIES LOST LOVED ONES AND BEING ABLE TO ENJOY THE HOLIDAYS.

AND RECONNECTING WITH LOVED ONES.

>> AND SHARING IN THE COLLECTIVE LOSSES AND STRUGGLES THAT HAD HE EVER BEEN HAD FOR THE PAST 2 YEARS.

I THINK IT'S A GOOD THING.

>>Olena: THANK YOU.

WHEN YOU'RE RESPONDING TO CALLS, HOW OFTEN ARE YOU SEEING OUR ELDERLY OR KUPUNA WITH THESE KINDS OF ISSUES?

>> A LOT OF THEM, THE HARD FOR THEM.

BECAUSE IF THEY'RE HOME BOUND AND DON'T GET A CHANCE TO GET OUT AND CONNECT WITH THEIR FAMILIES, IT IS REALLY EASY FOR THEM TO GET LONELY AND SAD AND THERE'S TIMES WHERE PEOPLE CALL US BECAUSE THEY JUST WANTS SOMEBODY TO TALK TO.

YOU KNOW.

BUT YOU KNOW, USUALLY, DURING CHRISTMAS, DURING THE HOLIDAYS, WITHOUT THE PANDEMIC, WE WOULD HAVE A LOT OF TIMES WHERE YOU SEE A LOT MORE DEPRESSION OR A LOT MORE VIOLENCE AND STUFF LIKE THAT.

THAN NORMAL.

AND WITH THE PANDEMIC, IT KIND OF JUST AMPLIFIES IT TOO.

>>Olena: WHAT ARE SOME THINGS THAT NEIGHBORS OR FAMILY MEMBERS CAN LOOK OUT FOR?

>> JUST LOOK OUT FOR YOUR NEIGHBORS.

BE THAT PERSON, IF YOU'RE HOME BOUND, DO YOU NEED HELP?

CAN YOU GET YOU GROCERIES?

I'M GOING TO THE STORE NOW.

HEY, IS THERE ANYTHING I CAN DO FOR YOU?

THINK THAT IS JUST THAT LITTLE CONNECTION, YOU KNOW WHAT I MEAN?

YOU CAN STILL DO IT IN A SAFEWAY.

KEEP YOUR DISTANCE.

BUT STILL BE ABLE TO HELP SOMEBODY.

AND I THINK THAT MAKES A DIFFERENCE.

FOR PEOPLE.

JUST KNOWING THAT SOMEBODY ELSE CARES.

>>Olena: DEFINITELY.

>> I WANTED TO ASK, CAN I ASK JENNA ALONG THIS TOPIC.

ABOUT THE NEW PROGRAM INCORPORATING BUS WITH SOCIAL WORKERS AND EMTs AND REDSHIRTS AND TAKING THOSE CALLS.

>>YEAH.

SO WE JUST RECENTLY STARTED THE PROGRAM.

THE ACTUALLY A DIVISION UNDER THE HESD, HONOLULU EMERGENCY SERVICE DEPARTMENT.

SO IT'S ANOTHER DIVISION THAT WE'RE PART OF.

THEY HAVE BEEN GOING OUT TO TRY TO HELP A LOT MORE OF THE HOMELESS PEOPLE.

TRYING TO TAKE THEM FOR PLACE.

FOR EMS ALWAYS TAKE THEM TO THE HOSPITAL.

NOT NECESSARILY THE PLACE THEY NEED TO BE.

SO I THINK THIS PROGRAM IS HOPING TAKING THEM TO CLINICS OR TAKING THEM TO PLACES WHERE IT'S NOT NECESSARILY BURDENING THE HOSPITAL.

BUT STILL GETTING THEM THE SERVICES THEY NEED AND SO THEY'RE COMBINING TOGETHER WOULD LIKE THE SOCIAL WORKERS OR WITH NURSES AND KIND OF HELPING THE HOMELESS PEOPLE GET SERVICES THAT THEY NEED.

CHECKING UP ON THEM.

SOMETIMES IT COULD BE WE GET CALLED ALL THE TIME LIKE I NEED MEDICATION.

SO IT MIGHT BE A WAY TO HELP THEM GET THEIR MEDICATIONS INSTEAD OF GOING TO THE HOSPITAL FOR THAT.

>>Olena: GREAT PROGRAM.

THANK YOU DOCTOR FOR BRINGING THAT UP.

TALK A LITTLE BIT ABOUT CHILDREN.

>> AND PARENTS.

AND WHAT ARE SOME WAYS THAT WE CAN COPE, NOT ONLY DURING THE HOLIDAY SEASON, BUT ALSO WITH COVID, AND EVERYTHING THAT IS HAPPENING.

AND SO UILANI WHAT KIND OF TIPS DO YOU HAVE FOR PARENTS IN HOW TO BALANCE THAT?

>> SO I'M NOT A PARENT.

>> I'M AN AUNTY.

I WORK WITH YOUTH AND CHILDREN.

I HAVE A LOT OF EXPERIENCE IN MY OWN FAMILY LIFE WHERE MY MOM RAISED A BIG FAMILY.

COMES FROM A BIG FAMILY.

AND MY DAD ALSO COMES FROM A BIG MULTIFAMILY.

SO I THINK IN MOST LOCAL HOME, THERE IS EITHER A LOT OF, YOU HAVE A LOT IN YOUR OHANA, OR YOU HAVE JUST A LITTLE.

AND SO I WOULD SAY SOME OF THE TIPS IS I THINK ALL OF THEM ARE ACTUALLY DOING T AT LEAST HERE.

THEY'RE SPENDING MORE TIME TOGETHER.

BECAUSE THEY WERE GIVEN THAT OPPORTUNITY WHEN THE PANDEMIC HIT, AND THEN NOW, THAT THE WE'RE GAINING SOME KIND OF WHATEVER THIS KIND OF NEW NORMAL IS, CALLED, WE'RE GETTING SOMETHING DIFFERENT.

AND NOW, THAT THEY, STUDENTS HAVE TO COME TO SCHOOL.

PHYSICALLY BEEN A LITTLE BIT DIFFICULT FOR I THINK GETTING BACK INTO THE GROOVE.

WHEN THE DELTA VARIANT CAME N A LOT OF FAMILIES PULLED CHILDREN OUT OF SCHOOL.

DIDN'T LET THEM GO TO SCHOOL OR ACTUALLY LIKE WE CALL IT 4140.

THEY NO LONGER ARE IN THE SCHOOLS.

EITHER GO HOME SCHOOL OR TRY TO FIGURE SOMETHING ELSE OUT.

TRY TO DO LIKE A DISTANCE LEARNING.

BUT I WOULD ENCOURAGE LIKE FOR ME, I THINK EACH PARENT IS TOO THEIR OWN, I WOULD ENCOURAGE THEM TO IF IT WORKS FOR THEIR OHANA, TO KEEP THEIR CHILD IN SCHOOL.

BECAUSE IT'S ONE OF OTHER PLACES TO SAFELY LEARN AND SOCIALIZE AND PERHAPS REALLY AMAZING STAFF THERE, AND I ALSO WANT TO CONGRATULATE FAMILIES THAT HAVE BEEN DOING WELL DURING THE PANDEMIC.

I THINK FOR FAMILY WHO ARE STRUGGLING DURING THE PANDEMIC.

I FEEL LIKE THERE'S BEEN WAY MORE RESOURCES THAT HAVE COME THROUGH BECAUSE OF THE PANDEMIC.

EVEN WHEN RESOURCES WERE TAKEN AWAY.

IF THAT MAKES SENSE.

I THINK IT WAS TRYING TO MAKE FILL IN THOSE GAPS.

SO LOOK TO THOSE OTHER RESOURCES.

IF YOU NEED IT.

FINANCIALLY.

OR FOR YOUR MENTAL HEALTH.

OR EVEN FOR YOUR PHYSICAL HEALTH.

WHATEVER IT MAY BE.

>> I THINK REACHING OUT KNOWING YOUR RESOURCES IS PROBABLY THE MAIN THING.

I THINK SPENDING TIME AND FINDING FUN THINGS YOU LIKE DOING AT HOME OR AT THE BEACH WHEREVER YOU GO HAVE FUN.

REALLY ENRICHING.

WHEN I FINALLY GOT TO BE WITH MY FAMILY AFTER NOT BEING ABLE TO SEE THEM, MY FAMILY LIVES ON OAHU.

MAUI ISLAND AND BE BEING ABLE TO SEE THEM AND NOT HAVING THAT OPPORTUNITY LIKE PHYSICALLY IN A LONG TIME.

SO NICE.

SO MANY BABIES WERE BORN.

LITTLE THINGS HAPPENED.

DURING THE PANDEMIC.

THAT REALLY CHANGED A LOT OF FAMILIES SITUATIONS.

SO KIND OF WANT TO SAY THAT KEEP THAT CONNECTION SO THAT YOU KNOW, IF YOU DO LOSE LOVED ONES, OR PEOPLE ARE STRUGGLING, YOU'RE ALREADY IN THE KNOW.

YOU'RE CONNECTED WITH EACH OTHER.

AND KNOWING YOUR RESOURCES WHEN YOU NEED HELP.

>>Olena: THANK YOU.

AND KATHLEEN, OBVIOUSLY, HOLIDAYS ARE UPON US.

AND HOW DO YOU ENCOURAGE PEOPLE TO HAVE HOPE THAT THINGS WILL GET BETTER?

>> WELL, I HOPE THAT IS A PRIORITY.

BECAUSE YOU WERE MENTION CHILDREN AND YOUTH.

THEY ARE OUR FUTURE.

I THINK THAT IS REALLY VULNERABLE GROUP OF PEOPLE.

WE KNOW THAT YOUTH ARE PROBABLY THE HIGHEST RISK FOR THOUGHTS OF SUICIDE AND ACTUALLY DYING BY SUICIDE.

IF WE ARE AROUND YOUTH AND LITTLE ONES, I THINK WE HAVE TO TAKE SPECIAL CARE.

I'M VERY EXCITED ABOUT THE CHILDREN'S MENTAL HEALTH AS A PART OF, WHICH IS UNDER DEPARTMENT OF HEALTH.

JUST GOT A GRANT TO FOCUS ON TRAUMA INFORMED CARE.

WHICH MEANS BASICALLY, TO MAKE SURE THAT SERVICES ARE AWARE OF THE TRAUMATIC EXPERIENCES THAT MANY CHILDREN FACE AND SO IT'S REALLY LOOKING AT SYSTEMS AND ORGANIZATIONS AND PROVIDERS AND SERVICES TO MAKE SURE THAT THEY ARE AWARE OF TRAUMA AND CAN DELIVER IN INFORMED WAY ABOUT THAT.

AND SO I THINK THAT WHAT WE CAN DO IS TO BE AWARE THAT WE KNOW CHILDREN AND YOUNGER PEOPLE AND I SUPPOSE ALL OF US, PRETTY RESILIENT.

HEAR A LOT ABOUT RESILIENCY.

BUT TO ALSO BE AWARE OF THE FACT THAT WHAT MANY OF US HAVE BEEN GOING THROUGH, ARE TRAUMATIC EXPERIENCES.

AND IF IT'S NOT DIRECTLY, IT MIGHT BE WHAT WE CALL VICARIOUS TRAUMA.

CONSTANTLY SEEING OTHER PEOPLE'S TRAUMA.

AND THAT WEARS ON US.

PHYSICALLY AND PSYCHOLOGICALLY.

SO IN ORDER TO HAVE HOPE, I THINK HOPE HAS TO DO WITH WHEN WE BELIEVE THAT THINGS WILL GET BETTER, THAT WE SURVIVED THIS FAR, WE CAN SURVIVE IT MORE AND THAT'S ACTUALLY SEEING SOME IMPROVEMENTS.

WE'RE SEEING PEOPLE GET BETTER.

WE'RE SEEING LIFE AS WE KNOW IT.

COME BACK.

AND SO I THINK WHEN WE HAVE HOPE IN OUR HEARTS, THAT STRENGTHENS US ALL.

SO YEAH, I THINK LIKE THIS, THIS FORUM TONIGHT, IS A WAY THAT WE CAN BRING HOPE AN SHARE HOPE.

>> HOPE WE KEEP DOING THAT.

>>Olena: THANK YOU.

CAN YOU TELL ME WHAT THE STEPS ARE TO GET TREATMENT AND WHEN DO YOU THINK IT'S ESSENTIAL FOR PEOPLE TO BE MEDICATED?

>> SO IN TERMS OF MENTAL HEALTH, THERE IS SUCH A WIDE VARIETY OF AFFLICTIONS THAT PEOPLE SUFFER FROM.

>> SOME OF THEM CAN BE PSYCHOTHERAPY, SOME OF THEM MAY REQUIRE MEDICATIONS.

SOME CONDITIONS, LIKE DEPRESSION, MIGHT BENEFIT FROM BOTH AT THE SAME TIME.

SO GOOD STARTING POINT WOULD BE HAVING GOOD ASSESSMENT BY TRAINED PROFESSIONAL.

DOESN'T HAVE TO BE A PSYCHIATRIST.

AND BASED ON WHAT THE DIAGNOSIS IS, SEVERITY OF SYMPTOMS AS DESCRIBED BY THE PATIENT, PERSON MAY JUST REQUIRE TALK THERAPY OR NONMEDICINE RELATED DREAMS OR IF IT'S MORE SEVERE, THEY SHOULD REFER TO A PRESCRIBER OR PSYCHIATRIST OR APRN RX.

>>Olena: WHAT DO YOU TEND TO SWAY TOWARD IN TERMS OF TREATMENT?

MORE HOLISTIC?

>> MY PRACTICE IS BECAUSE OF THE WORK THAT I DO, MOST OF THE PATIENTS I HAVE, I TREAT, HAVE SCHIZOPHRENIA, BIPOLAR DISORDER.

OF COURSE WE TRY TO HELP THESE PEOPLE WITH HOLISTIC APPROACH WITH HOUSING AND PHYSICAL HEALTH AND DECREASING THEIR STRESS.

A LOT OF THESE FOLKS DO REQUIRE MEDICATIONS.

FOR THE REST OF THEIR LIVES.

MY PERSONAL EXPERTISE IS MORE TOWARD THE BIOLOGICALLY BASED TREATMENTS.

>> I HAVE A QUESTION FOR DR. KOYANAGI.

>> SURE.

I WOULD WORK WITH SOME WHO HAVE BIPOLAR AND SCHIZOPHRENIA.

JUST WONDERING, I MEAN, I KNOW SOME THINGS FOR THE CAREGIVERS LIKE PEOPLE WHO ARE HELPING THOSE WHO ARE DIAGNOSED WITH HEALTH DIAGNOSES.

MENTAL HEALTH DIAGNOSES.

ARE SOME PROBABLE PROGRAMS OR SOME THINGS THAT CAREGIVERS CAN HAVE?

ONE OF THE THINGS THAT CMOS OR TURN INTO WHAT'S CALLED CSM, WE CAN GO OUT AND HELP FOR THAT CRISIS MOMENT.

BUT I THINK LONGTERM, HOW CAN WE SUPPORT THEM AND HELP THEM?

>> FOR LONGTERM EDUCATION AND FAMILY SUPPORT, ONE OF THE MOST EXCELLENT ORGANIZATIONS IS NAMI.

AND THEY HAVE, THEY PROMOTE AWARENESS OF MENTAL ILLNESS ESPECIALLY SEVERE MENTAL ILLNESS.

SO THEY HAVE RESOURCES ON SOME OF ISLAND.

NOT SURE IF THERE'S ANYTHING ON MOLOKAI.

ON OAHU, THEY HAVE, THIS WONDERFUL SERIES OF EDUCATIONAL GROUPS CALLED FAMILY TO FAMILY.

SO EVERY FEW TIMES A YEAR.

SERIES OF ABOUT TEN OR 12 SATURDAYS WHERE THEY COME TOGETHER WITH DIFFERENT FAMILY MEMBERS AND EDUCATE THEM ABOUT ILLNESS AND HOW TO BEST SUPPORT THEIR LOVED ONES AND THINGS LIKE THAT.

I ALSO ENCOURAGE FAMILY MEMBERS OF PATIENTS TO ALWAYS AS MUCH AS POSSIBLE, TRY TO INSERT THEMSELVES INTO THEIR LOVED ONE TREATMENT.

A LOT OF TIMES, MENTAL HEALTH PROFESSIONALS TREAT THE PERSON JUST AS AN INDIVIDUAL AND DON'T INCORPORATE FAMILY WHEN THE PERSON LIVES WITH THEIR FAMILY AND FAMILY CARES ABOUT THEM.

TRYING TO BE A PART OF THEIR LIVES.

I THINK THAT IS VERY THING THAT IS IGNORE AND WE NEED TO TRY HARDER AS PROFESSIONALS.

INVOLVE THE FAMILY AS MUCH AS WE CAN.

I THINK TOO, SOME FAMILIES FEEL LIKE THEIR HANDS ARE TIED.

IF THEY'RE ALL FAMILY MEMBER EXPERIENCING PSYCHOSIS OR MENTAL HEALTH BREAKDOWN.

NOT EQUIPPED TO SUPPORT THEM AND THEY TRY TO GET HELP BY CALLING 911 OR HAWAII CARES LINE.

FEEL LIKE NOTHING IS HAPPENING, BECAUSE YOU KNOW, BY THE TIME RESPONSE COMES, SOMETIMES THE PSYCHOSIS EPISODE OR MANIA MIGHT HAVE LIKE SUBSIDED.

>> BUT THEN COMES RIGHT BACK AFTER HELP HAS TRIED TO COME.

SO JUST REALLY FEEL FOR A LOT OF FAMILIES WHO ARE GOING THROUGH THAT.

SO IF YOU ARE ONE OF THOSE PEOPLE, PLEASE KNOW THAT YOU KNOW, YOU CAN STILL REACH OUT AND I WOULD SAY, DON'T STOP REACHING OUT.

DON'T GIVE UP.

BECAUSE I THINK THAT IS CAN BE REALLY HARD ON SOME CAREGIVERS.

>> AND SOME OHANA WHO ARE STUCK.

>>Olena: THANK YOU.

>> SO GLAD YOU MENTIONED NAMI BECAUSE IT'S SUCH A GOOD PROGRAM.

AND THEY DO HELP WITH EDUCATION BECAUSE FAMILY MEMBER NEEDS SOME SUPPORT.

IT'S SO, ALL YOUR ENERGY KIND OF GOES TO HELPING YOUR LOVED ONE.

BUT THEY ALSO NEED TO THAT SUPPORT.

WE DO HAVE A STRONG NAMI HERE IN HAWAII.

THEY DO HAVE AFFILIATES ON NEIGHBOR ISLAND.

>> SO THANK YOU SO MUCH FOR MENTIONING THAT.

THERE'S ALSO I'M SORRY.

>>Olena: I WAS GOING TO SAY, FOR VIEWERS THAT ARE LIKE WHAT ARE THEY SAYING?

NAMI.

WHICH IS ACRONYM FOR ... >> NATIONAL ALLIANCE ON MENTAL ILLNESS.

>>Olena: OKAY.

>> THERE'S LOCAL CHAPTERS.

SAME WITH MENTAL HEALTH AMERICA.

LOCAL CHAPMAN.

MHA, MENTAL HEALTH AMERICA.

WORKSHOP AN DIFFERENT TRAINING YOU CAN GO TO.

FAMILY AND ANYBODY AND PROFESSIONALS.

NAMI IS ESPECIALLY FOR FAMILIES.

>> IT'S GREAT.

>>Olena: GOOD NONPROFIT.

WE'VE GOT SOME QUESTIONS ROLLING IN.

ONE IS FROM MARK IN KAILUA.

SAYS, WHAT SHOULD FRIENDS FAMILY AND COWORKERS DO WHEN SHE SEE SOMEONE SEEMS WITHDRAWN NOT THEMSELVES HOW IMPORTANT IS IT TO ACT?

MAYBE KATHLEEN.

>> OR DOCTOR.

>> WELL, YOU JUMPED ON IT TOO.

I THINK IT'S REALLY HELPFUL AND BENEFICIAL TO ACT.

SOME PEOPLE BELIEVE IF SOMEBODY IS SO PSYCHOTIC OR UNDER THE INFLUENCE, DON'T KNOW WHAT'S GOING ON, I REALLY BELIEVE THERE'S A THREAD OF SANITY KNOWS WHAT'S GOING ON.

>> I THINK IT DOES MAKE A DIFFERENCE TO GO AHEAD AND SAY HELLO OR BE KIND.

TO HAVE AN ACTIVE KINDNESS AND TO OFFER HELP.

AND YOU MAY NOT GET THE RESPONSE THAT YOU'RE HOPING FOR.

BUT I THINK IT MAKES A DIFFERENCE AND I WOULD ENCOURAGE PEOPLE TO ALWAYS GO AHEAD AND MAKE GESTURE OR A KIND ACT TOWARDS A PERSON.

>>Olena: DOCTOR, ANY THOUGHTS?

>> I WOULD ECHO THOSE SENTIMENTS.

YOU SHOULD GO OUT AND ENGAGE SOMEONE LIKE THAT.

WITHDRAWN AND WHEN YOU HAVE VERY MINIMAL SOCIAL SUPPORTS AND DO YOUR BEST TO SEE WHAT THEY NEED.

HOW YOU CAN HELP.

OR JUST BE KIND.

>>Keahi: JENNA, YOU'RE FIRST RESPONDER AND YOU RESPOND TO THE SCENE OF MAYBE SOMEONE THAT DID CALL FOR HELP.

WHAT HAVE YOU NOTICED AND WHAT KIND OF TIPS DO YOU HAVE FOR FAMILY MEMBERS AS WELL?

>> I GOT A LOT OF TIMES PEOPLE JUST WANT SOMEBODY TO LISTEN.

>> A LOT OF TIME WHAT THEY CALL US FOR.

WANT TO SEE THAT SOMEBODY CARES.

>> IT'S A CRY FOR HELP.

AND SO YOU KNOW, JUST TAKING THE TIME TO SPEND EXTRA TIME TO SEE WHAT THEIR MAIN PROBLEM.

IS NOT JUST TREATING WHAT THEY SAID THEIR SYMPTOMS ARE, LISTENING TALKING TO THEM TO SEE WHAT THE ROOT OF THE PROBLEM IS HELPFUL.

FAMILIES COWORKERS, STUFF LIKE THAT, IF YOU NOTICE SOMEBODY NOT THEMSELVES.

>> EVEN THAT SMALL GESTURE, TALKING ABOUT, HEY ARE YOU OKAY?

NOT YOUR NORMAL SELF.

WHAT'S GOING ON?

NORMAL SELF.

HAVING THAT SOMEBODY NOTICE, I THINK, MAKES A BIG DIFFERENCE FOR PEOPLE.

LIKE HEY, YEAH, SOMEBODY ACTUALLY DOES CARE.

NOT AS ALONE AS I THOUGHT I WAS.

>>Olena: DEFINITELY.

IT'S RESONATING WITH ME THAT YOU GO SURFING EVERY WEEKEND.

THAT IS LIKE YOUR THERAPY.

AND WHAT OTHER KIND OF THINGS DO YOU SEE FELLOW EMS WORKERS DOING AS PART OF THEIR THERAPY AS WELL?

>> YOU KNOW, WE HAVE A GROUP OF PEOPLE THAT GO TO THE LOHI AND THEY WORK THE FARM AND THEY JUST THAT'S THEIR TIME SPEND TOGETHER AND KIND OF DECOMPRESS TOGETHER AND WORKED LAND AND YOU KNOW, JUST DOING THAT KIND OF STUFF IS DOING REALLY GREAT STUFF FOR THEM.

THEY FIND THAT THEY DO THAT WITH OUR MICT STUDENTS.

THEY DO IT WITH JUST GROUPS OF PEOPLE THAT WORK ALL TOGETHER.

AND IT'S REALLY GOOD BONDING TIME FOR THEM.

>>Olena: WONDERFUL.

ANOTHER QUESTION FROM ERIC IN KALIHI.

HE SAYS, PLEASE TALK ABOUT HOW TO DEAL WITH THE ADDED STRESS OF HOLIDAYS THAT IS ALREADY STRESSFUL TIME.

>> UILANI MAYBE?

>> WELL, BEFORE I ADDRESS THAT QUESTION ON THE PREVIOUS QUESTION, MENTAL HEALTH AMERICA, IN HAWAII, ALSO DOES LIKE TRAINING FOR FIRST AID FOR MENTAL HEALTH.

AND SO THE LIKE A CLASS.

IF YOU WANT TO LEARN HOW TO HELP PEOPLE WHO MAY BE EXPERIENCING MENTAL HEALTH, THAT'S A GREAT CLASS TO GO TO WHETHER YOU ARE IN THE MENTAL OR BEHAVIORAL HEALTH PROFESSIONAL.

GOOD FOR ANY PERSON FEELS COULD HAVE BEEN DOING THAT.

>> YOU CAN LOOK IT ON WEBSITE.

THING TO DO ON THE HOLIDAYS FOR ME AND MY FAMILY.

ESPECIALLY SINCE THE PANDEMIC, TRYING TO SAVE AND DO THINGS AT LEAST FINANCE.

MORE LIKE A FINANCIAL QUESTION OR WHAT TO DO.

DURING STRESSFUL TIMES.

OF THE HOLIDAYS.

I ACTUALLY FEEL LIKE I'VE BEEN HAPPIER BUT THAT'S MY PERSONAL.

IF YOU'RE NOT EXPERIENCING HAPPINESS, DURING THE HOLIDAYS, FOR INSTANCE, IT'S HALLOWEEN JUST PASSED.

IT WAS SO EXCITING OVER HERE.

EVEN THOUGH WE'RE MOLOKAI.

IT WAS SO AWESOME.

SO PEOPLE DID SOME REALLY AMAZING THINGS.

YOU KNOW, ALTHOUGH THANKSGIVING IS COMING, LIKE I SEE PEOPLE ALREADY GETTING READY FOR CHRISTMAS.

SO I THINK DOING LITTLE THINGS, DOESN'T HAVE TO BE LIKE GO AND BUY A WHOLE BUNCH OF DECORATIONS OR HAVE TO BUY A WHOLE BUNCH OF GIVES.

UNLESS THAT IS WHAT YOUR FAMILY ALREADY DOES AND YOU CAN AFFORD TO DO THAT.

I THINK LOOKING FOR THE LITTLE THINGS, THAT MAKE EACH OTHER HAPPY.

LIKE THOUGHTFUL.

I LIKE THOUGHTFUL GIFTS.

SO DEFINITELY LIKE GIFTS.

DOES NOT HAVE TO BE WHERE IT WAS WORTH ALL OF THIS MONEY.

ALTHOUGH THOSE ARE GREAT TOO.

WITH YOU GET LIKE A THOUGHTFUL GIFT, KNOW WHO ARE YOU OR SOMETHING PERTAINING TO YOU GIFT FEELS GOOD.

TALKING ABOUT THAT, MAKE THOSE CONNECTIONS OR THINGS THAT ARE THOUGHTFUL.

COULD BE SIMPLE AND SMALL.

COULD BE ACTS.

DOES NOT HAVE TO BE SOMETHING TANGIBLE.

I THINK THERE'S SO MANY LITTLE THINGS WE COULD TO.

>>Olena: JENNA HAS A COMMENT.

>> YOU KNOW, I KNOW COVID HAS BEEN MOSTLY BAD THING.

BUT THERE HAS BEEN FEW THINGS THAT HAVE BEEN REALLY POSITIVE THAT CAME OUT OF IT.

I THINK FOR LIKE THE HOLIDAYS, HOW IT'S NORMALLY SUPERBUSY.

LAST YEAR, EVERYBODY PRETTY MUCH HAD TO STAY HOME.

KIND OF RESET BUTTON FOR US.

THIS YEAR, BECAUSE WE'RE STILL IN THAT TRANSITION OF HOW MANY PEOPLE CAN WE ACTUALLY HAVE IN A GATHERING OR STUFF LIKE THAT.

YOU CAN KIND OF TAKE THAT STEP AND DECIDE HOW BUSY DO YOU REALLY WANT TO BE?

BECAUSE LAST YEAR WE DIDN'T DO THAT MUCH.

THIS YEAR, MAYBE WE CAN DO MORE.

SPEND TIME WITH THE FAMILY.

DON'T HAVE GO INTO THE CRAZY BUSY MODE LIKE WE WERE PREPANDEMIC.

>>Olena: ABSOLUTELY.

>> I AGREE.

I'M THINKING THAT THIS CALLER IS ALREADY FEELING STRESSED AND SO MAYBE TO KIND OF GET A HANDLE ON IT NOW, IT WOULD BE IMPORTANT TO KIND OF PLAN AHEAD AND SAY, WHAT MEANING DO I WANT TO HAVE ON THANKSGIVING OR HANUKKAH OR CHRISTMAS.

WHAT IS MEANINGFUL TO ME.

MAYBE IT'S NOT GETTING CAUGHT UP IN THESE IDEAS OF WHAT HOLIDAYS SHOULD BE.

SO THAT'S NOT HALLMARK THAT MAYBE WE THINK PEOPLE HAVE.

BUT MAYBE, IT'S VOLUNTEERING AT A SMALL LITTLE PLACE.

THAT SAFE AND COMFORTABLE.

OR MAYBE IT'S HAVING A DAY OF GRATITUDE AND NOT BEING AROUND TOO MANY PEOPLE.

OR MAYBE IT IS BEING AROUND.

MAYBE DECIDE EXACTLY WHO DO YOU WANT TO BE WITH.

BUT PROBABLY DOING SOME PLANNING AND INTENTIONAL THINKING ABOUT HOW DO I KEEP MYSELF CALM AND NOT GET STRESSED, I DON'T WANT THE STRESS TO TAKE IT OVER FOR ME.

I DON'T WANT IT BUY INTO ALL OF THIS STUFF AROUND IT.

THAT CAN BE STRESSFUL.

I THINK IT'S A REALLY GOOD QUESTION.

HOW DO I NOT GET STRESSED ESPECIALLY BECAUSE THIS PERSON IS SAYING I'M ALREADY FEELING IT.

>>Olena: THANK YOU SO MUCH.

EVERYBODY.

WHAT I GREAT PANEL.

AND I THINK MESSAGE THE GREAT TAKE AWAY IS TO GIVE BACK AND TAKE TIME FOR YOURSELF.

MAHALO TO YOU FOR JOINING US TONIGHT, AND WE THANK OUR GUESTS, FROM MOLOKAI, BEHAVIORAL HEALTH SPECIALIST UILANI KIAHA, DR. CHAD KOYANGI, PSYCHIATRIC MEDICAL DIRECTOR AT ADVENTIST HEALTH CASTLE, LICENSED CLINICAL SOCIAL WORKER AND CERTIFIED SUBSTANCE ABUSE COUNSELOR KATHLEEN MERRIAM, AND HONOLULU EMS SAFETY SPECIALIST JENNA ALTOMARE.

NEXT THURSDAY IS VETERANS DAY.

OUR SHOW THAT NIGHT WILL FOCUS ON ISSUES OUR VETERANS ARE FACING AFTER SERVING THEIR COUNTRY.

PLEASE JOIN US THEN.

I’M OLENA HEU FOR INSIGHTS ON PBS HAWAI`I, ALOHA!