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Hello again friends!

I'm Jason Edens, your host of Lakeland Currents.

Thanks for joining the conversation today and thanks for your ongoing support of Lakeland Public TV.

Both physical and mental health are essential to our health and well-being, not only as individuals, but as a society as a whole as well.

However, are we doing enough to support the mental health of our friends and neighbors?

Well, here to help us better understand the mental health services available in Crow Wing County, are my two guests today.

Kara Griffin is the coordinator of Child and Family Services and Tami Lueck is the Adult Services manager.

Tami and Kara, Welcome to the program.

thanks for making time.

Yeah thank you for having us.

Well first of all I want to talk a little bit about terms.

So what exactly is mental illness and how is that different, or the same, to mental health crises or short-term mental health issues?

Is that the same thing, Kara?

Yeah, so we could look it up in, I suppose, the Webster dictionary right now, but I, in just common terms, I would state that mental illness is when our overall mental health or well-being is causing disruption in multiple areas of our life; so whether it's untreated depression or anxiety and we're not able to, as a youth, go to school and carry on our day and participate in the activities at school, the disruption might look like avoiding - taking a test and acting out in class or even refusing to get on the bus at home.

Another area of disruption might be at home - so acting out, not wanting to go to bed, refusing to comply with chores at home, throwing a fit when you go with mom to the grocery store.

So when you have multiple areas, that's when it's time to seek some type of professional intervention and that would be more defined as mental illness.

Okay.

Now, how common is mental illness in our society, Tami?

So nationwide it's about one in four adults have a mental illness, and in Crow Wing County through our community health survey we also see that very same picture; so about one in four adults, and that doesn't include our kids, but we know that that number is probably very similar.

That's a significant percentage of the population.

Right, and what we know is that these numbers are under-reported so it's likely even higher than that than the one and four, and our county survey so when Tami said the nationwide number, we tend to think Well, maybe not here in Crow Wing County, right?

We're not seeing those same numbers.

In fact, we are - and we've had three (3) consistent county survey numbers with adults 18 and older that reflect one in four are struggling.

Well, you said it's underreported ,and that brings up this whole notion of stigma, right?

Is mental health not discussed as frequently as it should be, or not addressed as often as it should be, because of a stigma?

Yes, I think that people still really feel like it is somehow kind of a character flaw and so they feel like they maybe can't disclose or that somebody will think that I'm, I'm not not coping well enough, or I might be ... Maybe they might be hesitant about being put on medication or having to go see a counselor or a therapist, thinking that maybe that's bad in some way.

I do think that it's just a scary first step, I think the number is somewhere around, typically people wait five to ten years before they seek mental health treatment.

So they start having, potentially, those symptoms or those things going on in their life but they tend to hesitate on getting help, reaching out and getting the help, over the span of five to ten years.

Someone can suffer, that's a lot of pain and suffering, and potentially there could be other consequences, right?

I mean, if it's not addressed in that time period?

What happens if someone is suffering from a mental illness or having mental health issues and it goes unaddressed?

What are some of those unintended consequences, either to them as an individual, or to the community?

Well, of course , you see a loss of relationships, if somebody is, is struggling with depression or anxiety and they're not able to go to school, or as a parent not providing that unconditional love or support to your kids when you're in pain yourself.

There's there's a loss of a relationship - you might not be able to sustain your employment so there's that financial ..that even as an entire community we feel.

If we don't have productive employees showing up for work each day due to their mental well-being not being stable, then we're losing productivity as a society, so there's multiple factors that happens to all of us, to family and friends, to see somebody suffer with untreated mental illness, it takes a toll, and it's hard.

So that early detection, that awareness, we say the holidays is a great time, you're getting together with your family and friends, to have those conversations - to say "how are you feeling?"

We're all, we've all been under a lot of stress right now.

The pandemic is a great opening to say "the pandemic is taking its toll , and how are you doing?

how are you feeling?"

"Are you able to get out of bed in the morning and feel like you're okay?

and it's okay if you're not", you know.

"what can I do to support you, Can I take you to appointments?"

Yeah, I think some self-disclosure sometimes is helpful too, like, "hey, I've been really feeling pretty anxious during the pandemic", or whatever that is, and that can sometimes then help lead to more open conversations with family and friends, I think.

So this this whole stigma idea, that was really interesting, because I guess what I'm hearing you say is there's some self-blame, or some self-shaming, and that leads to a reluctance to seek help.

Is that right?

"Yeah" So how do we deal with that?

I think we have to continue to work on how this is really not any different than if I'm treating my diabetes and that seems to be an area that like this is an area where we don't, we don't look at it the same way.

Or I'm battling cancer, when I'm battling mental health or my mental illness, that its just seen as like this, like you said, kind of shameful.

Well, it's not shameful and there's a way to treat this, and being able to just talk about it more openly without feeling like there's this shame that comes with it.

I think that's a big piece and and then some of the prevention efforts that, I think have been that we've been working on locally, building up resiliency in our kids, working on the Make It Okay campaign that we've done.

How do we have these conversations so people feel comfortable having them.

Well, I want to learn more about the Make It Okay campaign, but I want to ask you a little bit more about what you just said.

It's interesting to me that we don't have shame, you know, if I break my arm> I'm not ashamed necessarily, I guess it would depend on how I broke my arm, but generally speaking, with physical health we don't experience the same degree of shame so it seems like it's separate but unequal in terms of the way in which we address physical as opposed to mental, health.

Why is that and what can we do about that here in Crow Wing county, of course, but just more broadly?

Well, what you just described - when you break your arm I physically see that you have your arm in a cast.

I know, and likely have experienced that, or have had somebody around me that has experienced a broken bone, or on the treatment of cancer that Tammy mentioned, you know when somebody's going through cancer treatments, we say "oh it's , it's they have a lot of courage" and we can see the physical changes sometimes if they lose their hair or weight changes you see that, and it brings out more empathy.

We're not there yet with mental health, it's silent, and there's also maybe the stereotypical thought when we think of unstable mental health, we think of somebody that is, that physically looks unstable, right?

So there's this, this stereotype that we have as for society, or that it's people that are mentally ill are those that are in the criminal justice system, or they don't have a home and we see them on the side of the road homeless, and asking for donation.

In reality, mental health is a mental illness, just like cancer, it can impact and happen to anybody so there isn't just that stereotype, and so that might be part of the reluctance to come out and say "you know, I'm struggling with anxiety or depression" is maybe that lack of hope as well, but the reality is - there is hope, and there are treatment options.

So how does someone know if they're struggling with a mental health issue?

What are the warning signs?

Do we, I mean, we're not qualified to self-diagnose necessarily, how does that process work?

What should someone do if they suspect they might be struggling with a mental health issue?

I would just say I think its important to just maybe talk to somebody and you know just to say "This is kind of what I'm dealing with."

I mean, they could talk to their primary care doctor.

That would be a great place to start.

I know with my kids, that was one area where, when they struggled with some anxiety, we talked initially to our primary care doctor.

So I think that is a good place.

I think just even talking to a friend can be helpful, to say, "Does this seem normal, would this seem right?

I think that can also help, so I think that's a good place to start.

The other place would be - We have a website called communityofcare.org and lots of really good information on there to just kind of see, like you can read, you can find some information, you can learn about resources, so I think it's another way to see.. like is this fitting with what I'm experiencing?.

School counselors, I think there's a lot of options - a teacher.

I always think, maybe it's your pastor or a clergy within your church that you feel comfortable with.

I think it's just finding that person that you maybe feel safe with.

Your spouse?

So just finding somebody that maybe you can say "I've been kind of feeling this way and does that seem like you know, does this seem like more than maybe what is kind of just your typical like "I'm having a little anxiety today".

Well, if that goes on, or if you're depressed, if you kind of now start feeling like you can't get out of bed or I'm kind of struggling to function in my everyday life or it's starting to impact relationships, I think that's where you can kind of say "maybe I have something more going on here."

"So those are some of the warning signs, potentially, right?"

"Right."

Yes, struggling with getting to sleep at night, struggling with staying/ remaining asleep, and if that continues, if you're not able to get out of bed, if you notice that you're on edge for an extended time.

Tami made a really good point of our primary care physicians , whether as a youth - so as a parent, that you're noticing some maybe different changes in their behaviors or their emotions or their mood, and you're not able to single it out to a change in schedule, or hormonal, just make a call to the pediatrician.

If you're an adult, send a note to your primary care physician and just be open about what you're experiencing.

Talk to somebody, that is safe, and a trusted individual.

It might be your partner, it might be a friend, it might be a co-worker.

Be open about what you're experiencing.

"So in your estimation, primary care doctors are trained to refer people appropriately so they are an ally to the work that you do.

Is that right?"

"yeah."

I would say that our local physicians do a very nice job with screening and having that as part of their regular checkups.

"Is there room for improvement" "Oh, we can always improve, right?"

"Indeed."

Yeah, all of us and and as a society our biggest improvement would be that we can talk about it, and making sure that when I say a safe individual, that we're identifying that "I'm a safe individual providing self-disclosure on what you're experiencing" so that we can help each other out and that, part of that, like prevention, or where we can improve upon is.. each one of us has the ability to build our mental well-being ourselves and potentially, whether it's prevent, or to help with, the anxiety or the depression that we're experiencing and that's building up our resiliency, our attitude for gratitude, our healthy activities, being physically active, eating healthy, having good support systems, enjoying our work place, because we know that we spend half of our days at a work environment, so making sure that it's a healthy work environment for ourselves.

There's a number of ways that we can build up our cup, so to speak, our well-being cup.

So tell us a little bit more about that because of course, again, when I think about physical health, I know that eating right and exercising regularly of course helps me foster physical health.

What exactly are those strategies for fostering mental health and well-being?

I mean, I think some of the same things, making sure we're getting enough sleep, talking to people openly about how I'm feeling, exercise, also very good for our mental health as well, I'm trying to think of just some other things like..(I've had a loss of thought!)

Well, I think of some of the county wide strategies that we've had towards building up resiliency, like the Make It Okay campaign, is the campaign to reduce the stigma, so having those conversations.

Then you have the Building Up Resiliency and we have the Attitude Of Gratitude so Crow Wing has these resources, they're free and available to the entire community.

So we have Attitude of Gratitude - that's practicing three great things, it's having a notepad and at the end of your day writing down three things that you were grateful for and you practiced that for a number of weeks and you the research has shown that you will see an improvement in your mental well-being.

Another one is the Sleep Tool Kit.

We know that through all stages of life ,sleep is important for our physical health, like you mentioned, as well as our mental health, and that sleep tool kit talks about from birth to end of life, and strategies and tips for maintaining a healthy sleep habit.

Another resource that we have out there is Workplace videos, so videos that are not just work places but maybe it's organizations or places of worship that they can incorporate into their practice and into their personnel or into their team meetings.

Short, because we all like short videos, and short videos that people can walk away with tips and tricks and there's a number of other resources out there on the Crow Wing Energize site.

(crowwingenergized.org) That's just one website that is out that we can use.

And that's available to our viewers right now.

I wanted to ask you about the pandemic, you brought it up, (yeah) and of course I think we're all, to a certain extent, feeling anxiety about the pandemic, whether it's our own health, our family health, the future of the pandemic, all of these things, right?

They have a compounding effect, I certainly have been grappling with it, and at the same time we also have this, this other potential source of anxiety.

It's a very politically acrimonious environment right now.

Is that affecting mental health at the community level?

Are you seeing more cases?

I mean, what evidence do you have that this is affecting mental health , or not, ?

Yes, I think we're seeing, we are seeing some more cases.

I also think some, we're seeing it in some other areas as well.

So when we think about substance use, we're seeing an increase in our substance use numbers again and then also with mental health as well, with our adults.

We're getting called in for screenings for individuals that potentially are a danger to self or others and those are really kind of what we talked about with them - kind of these deeper end services where people are just really struggling to cope so I think that anxiety and depression, isolation, all of those things I have been seeing during the pandemic have come forward and have really.. everybody..

I think a lot of us are experiencing them you know experiencing these things.

That's really interesting that you bring up this deeper end side of things so it's a continuum, right?

There are more severe incidences or cases than others.

I was reading an article just yesterday that California is trying to reduce wait times for people that are struggling with mental health issues.

How long does someone have to wait and if they have to wait a long time that seems potentially dangerous, so how does that work in our community?

It really depends on the type of service that you're looking for in regards to the wait times, so for example, if you're looking for individual outpatient therapy, there's multiple providers within Crow Wing county that provide that service.

Some providers might have a longer wait time than others.

Family therapy is an area that we don't have as many or as much of the availability that we would like to have for family therapy, so that's an area that we see in a longer wait, probably three to four weeks before we can get somebody in for family therapy.

But there's other alternatives or interventions that can be plugged in, so to speak, while somebody waits; such as Skills, so there's, in the kids world, we call it CTSS, we use a lot of acronyms, that is one thing about our system that when you talk about areas of improvement, that we have maybe more clinical or we shorten things up, which I actually enjoy just speaking in abbreviations, but it's Skills, it's therapeutic skills-based, so maybe working on more of the hands-on.

If a kid is struggling with a routine, a skills worker can come in the home and help the parent to set up what that routine looks like and giving prompts to help the youth go through that routine, so to speak.

Same thing with adults, a skills worker might help with setting up their medication so coming into the home.

Or if their, let's say, anxiety is they struggle with going out to get groceries because of just the fear of being in public and in a social setting.

That skills worker can help prompt them to go out and get groceries and maybe that first few times they're going with them and then maybe the next time it's just they're driving them, dropping them off, and that individual knows they're in the car if they start to maybe get into a more panic attack when they get inside the store.

So these skills workers, are they employees of the county, or are they offered through a different provider?

That would be community- based.

A number of our services.. so, at the county level, we primarily do case management, and we would be more at that level of multiple areas in somebody's life are disrupted, so they've often maybe already seen other services or they've delayed getting care and then we as a case manager would connect them with providers or service providers that can come in the home or outpatient.

If they do need a level of inpatient or residential care, we'd help facilitate that.

So the short answer, we do not have skills workers employed at the county.

I was just going to add a couple of things.. Just so you know that, or remembering that, many times our employers do offer employee assistance programs and so reaching out through that employer's EAP is another good way to get connected to services, because I think sometimes that you don't know where to go.

We talked about the communityofcare.org website.

We also have a "warm line" for adults and that, that's speaking to other peers, so peers in recovery, peers that have been suffering from mental health or mental illness themselves - there we have a "warm line" locally that you can access and utilize which might be a way of getting to maybe that three to four week time frame.

If I'm having to wait for, maybe, to get in to see a therapist, just talking to another peer who's experienced something that you have can be really helpful.

I think you're aware of our crisis services, we have our crisis line, and then we also have a crisis text line, that is 741 741, so I think there are some other ways in which you can get some of those "in-between" services or feel supported while you're maybe awaiting those more professional services, so I just wanted to mention those things as well.

"I want to learn a little bit more about mental health issues among our younger populations, how pervasive is it, is it similarly about 25 percent higher?

lower?"

Oh, it's similar to what we conduct as a county wide survey.

The state of Minnesota, in collaboration with the Department of Education, conducts a student survey, and they do it at different grades.

I cannot recall the exact grades, but so it's different points throughout those students school life and they're conducted every year and according to the 2019 student survey, now this is specific to Crow Wing county kids, 44% of the students reported that they had symptoms of depression and or anxiety that they had experienced that within the previous 30 days.

"That's staggering!"

"Yeah, that was very staggering.

I think an important message, if we have time to discuss an important message, is that's where that sources of the strength, you know, building up areas, the eight areas within a student's life, and the most important is that they have somebody to talk to and that was, that was pretty staggering to also see that as part of that student survey that approximately 16 of the 11th graders reported that they don't have an adult that they felt comfortable that they could talk to when they have problems.

"That's hard to hear."

That was very difficult to hear.

Those of us that were looking at the data and saying "what could we do, what can we do?"

is we need to be having conversations with ourselves, as well as with our youth, and making sure that we are identifying and it doesn't have to be maybe the parent, but whether it's a teacher in the school, me as a community member, as a neighbor, at church, your place of worship, schools, wherever we're coming in contact with youth and each other, being kind creating a safe space to have conversations and being real about problems and issues that we're facing.

"Well, I have so much more to learn and unfortunately we only have a couple minutes left so I want to ask a couple rapid fire questions again with regard to youth.

Do you think that social media is making it worse or better?"

"Both."

"Interesting, say more briefly."

It does provide an opportunity for kids that maybe experience isolation, so it can, if it's positive social media, it's definitely positive .

If it's negative and that's negative whether it's social media, whether what we are watching on tv, what we're hearing from our parents, what we're hearing from people at school, so it's every interaction we have , whether it's technology or in person and anything in between, can be positive, negative , or neutral, and I want to make sure that either it's positive or neutral as much as possible, and I want to also, as a parent, make sure for my kids that I'm providing that same experience.

"Tami, what's the relationship between homelessness and mental health issues here in our region and more broadly?"

"yeah, so definitely, I mean, we know that people that experience homelessness are also struggling with mental health, anxiety, depression, those kinds of things; and sometimes it's untreated as well, because they're not stable, so things are going on in their lives that are impacting them and maybe it's past trauma, so I think there's definitely a correlation and as well as we work on that in our community, we hope that we'll be able to help people with those things as we're helping them with their housing.

"You know, in the 1950s it's my understanding that there were nearly 600,000 beds for folks that had mental health issues or mental illness.

Today, it's a 97% reduction!

Why is that and how does that affect your work?"

Well, it's kind of back to the "Is that good or bad?"

and I would say "Both."

We made a dramatic shift.

The system made a dramatic shift from institutionalization and hospitalization to more community based, and that was needed.

However, we maybe cut too far and so there has there's been times in the adult or the children's world that we have struggled to find an inpatient, more of that crisis bed for somebody that really needs it, that all community-based services had been exhausted, and I think the system has recognized that and is trying to shift, but we don't want to go back to what you described in 1950, we don't want to go all the way back so we need to find that in-between, that balance, "So kind of along the same lines, to what extent is the prison system kind of backfilling that need?

are there folks with mental illness that are in prison because they have mental illness?

very briefly, Tami?"

Yes, there are, and I also think that there's a lot of efforts going on to try to help and address that as well , but we do know that, of course, people that are in our jails and in our prison systems are experiencing mental health related issues and concerns and illnesses and you know some of the efforts that we're trying to do with that is locally we have two embedded social workers now over at the Crow Wing County jail that work to help people get connected to mental health services so that when they are discharged that we address those kinds of things "Well, Tami and Kara, I really appreciate the work you do on behalf of our communities and thank you so much for joining me today."

Thanks.

Thank you and thank all of you for joining me.

Once again, I'm Jason Edens, your host of Lakeland Currents.

You can tweet me @currentspbs.

Be kind and be well.

See you next week.