>> Renee: THE ISOLATION CAUSED BY THE COVID-19 PANDEMIC WEIGHS HEAVY ON MOST OF US, BUT FOR THOSE ALREADY DEALING WITH MENTAL WELLNESS ISSUES, THIS TIME CAN BE ESPECIALLY CHALLENGING.

TODAY WE'LL EXPLORE HOW THE CORONAVIRUS IS IMPACTING MENTAL WELLNESS AND HOW WE CAN HELP THOSE, ESPECIALLY OUR YOUTH COPE.

THAT'S NOW ON CONNECTIONS.

THANK YOU FOR JOINING US FOR CONNECTIONS TODAY.

I'M RENEE SHAW.

AN IMPORTANT TOPIC TODAY, RESEARCH SUGGESTS THAT DURING THE GLOBAL CORONAVIRUS PANDEMIC, DEPRESSION, ANXIETY, AND SUICIDE HAVE INCREASED, ESPECIALLY AMONG YOUNG PEOPLE.

WHAT DO WE ALL NEED TO KNOW ABOUT HOW TO TEND TO OUR MENTAL HEALTH AND HOW TO HELP THOSE WHO STRUGGLE?

JOINING ME TODAY TO GIVE SOME PROFESSIONAL ADVICE AND INSIGHT ABOUT THIS ARE Dr. RUCHITA AGRAWAL, ASSOCIATE CHIEF MEDICAL OFFICER FOR SEVEN COUNTY SERVICES IN LOUISVILLE AND Dr. JOE BARGIONE, A SCHOOL PSYCHOLOGIST.

HE WAS THE LEAD PSYCHOLOGIST FOR 25 YEARS WITH JEFFERSON COUNTY PUBLIC SCHOOLS AND A LEADER IN THE BOUNCE COALITION THAT HELPS BUILD RESILIENT CHILDREN AND FAMILIES.

THANK YOU BOTH FOR BEING WITH US TODAY.

WE HAVE HAD YOU ALL TOGETHER AND ASSEMBLED IN OTHER PLATFORMS, ONLINE AND ON OUR AIR AND I'M GLAD TO HAVE THIS CONVERSATION HERE ON THIS PROGRAM TODAY.

AND I WANT TO START WITH YOU, DO YOU THINK WE ARE HAVING THE RIGHT CONVERSATIONS WHEN IT COMES TO MENTAL HEALTH AND THIS OVERLAY OF COVID-19?

WHERE DO YOU SEE THAT STANDING AND IS IT HELPING TO MAYBE ERASE SOME OF THAT STIGMA THAT HAS PREVENTED US FROM TALKING ABOUT THIS FOR MANY, MANY, MANY YEARS?

>> THANK YOU, RENEE FOR HAVING ME AND ABSOLUTELY THIS IS SUCH AN IMPORTANT CONVERSATION THAT WE NEED TO HAVE BECAUSE YOUTH IS OUR FUTURE.

AND RESEARCH HAS SHOWN THAT THIS COVID-19 PANDEMIC HAS MADE IT WORSE.

OUR YOUTH, THEIR BRAINS ARE NOT DEVELOPED, THE PREFRONTAL CORTEX IS NOT DEVELOPED UNTIL LATE TEEN AGE SO THIS IS A VERY TENDER AGE AND WE NEED TO TALK ABOUT MENTAL HEALTH AT THIS AGE ESPECIALLY.

>> Renee: I'M CURIOUS, IS IT TOO EARLY TO TALK ABOUT MENTAL HEALTH WITH YOUR CHILD?

WE'VE DONE PROGRAMS IN THE PAST THAT SUGGEST THAT EVEN AS EARLY AS THEIR KINDERGARTEN YEARS, PRIMARY AGE, THAT THAT IS A GOOD TIME TO KIND OF LAY A FOUNDATION OF COMFORTABILITY WITH THOSE CONVERSATIONS?

IS THAT TOO YOUNG OR IS THAT THE RIGHT TIME?

>> I THINK IT'S THE PERFECT TIME, ELEMENTARY SCHOOL AGE.

I CAN TALK IN A PROFESSIONAL OPINION AND BEING A MOM.

I KNOW I TALK TO MY KINDERGARTENER WHEN HE STARTED SCHOOL AND YOU KNOW KIDS STRUGGLE WITH THEIR OWN INSECURITIES.

SO HE UNDERSTOOD.

KIDS UNDERSTAND.

MY PATIENTS UNDERSTAND.

SO I THINK THAT'S PERFECT AGE TO START.

>> SO HOW IS YOUR KINDERGARTENER DOING?

>> HE IS NOT KINDERGARTENER ANY ANYMORE.

HE IS IN SECOND GRADE.

BUT WHEN HE WAS KINDERGARTENER, YOU KNOW, THERE WAS SOME ANXIETY STARTING SCHOOL AND, YOU KNOW, SO I HAD TO NORMALIZE THAT.

HEY, BUDDY, IT'S OKAY TO BE ANXIOUS A LITTLE BIT HERE AND THERE, JUST GET YOURSELF PREPARED, LET THEM KNOW WHAT THEY ARE EXPECTING IN SCHOOL AND IT'S OKAY TO EXPRESS YOURSELF.

AND YOU SHOULD EXPRESS YOURSELF.

>> Renee: THAT'S RIGHT.

IT'S OKAY TO HAVE THOSE FEELINGS BECAUSE HE IS NOT THE ONLY ONE THAT HAS THEM AND I DON'T KNOW IF YOU EVER OUTGROW THAT, THOSE FEELINGS OF ANXIETY.

>> WHEN YOU START SOMETHING NEW... >> Renee: YEAH, EVERYONE FEELS ANXIOUS WHEN YOU ARE EMBARKING ON SOMETHING NEW AND DIFFERENT.

THAT'S NORMAL, RIGHT?

>> EXACTLY.

WE NEED TO NORMALIZE THAT ANXIETY IS NOT ALWAYS BAD.

SOME ANXIETY, WE ALL GET.

IT'S OKAY.

IT'S HOW WE COPE WITH IT.

>> Renee: AND IT CAN HELP US IN OUR PERFORMANCE, IF WE HAVE A HEALTHY AMOUNT OF ANXIETY THAT PUSHES US AND ENCOURAGES US TO DO OUR BEST.

THAT'S HEALTHY.

>> ABSOLUTELY.

I TELL ALL MY PATIENTS, YOU KNOW, A LITTLE BIT ANXIETY IS OKAY.

ACTUALLY HELPS YOU FOCUS AND BE MORE PRODUCTIVE.

YOU KNOW, YOU GET THAT CORTISOL RUSH AND A LITTLE ABOUT IT OF IT IS OKAY.

IT'S A PROTECTIVE MECHANISM.

>> Renee: BUT Dr. BARGIONE, WHEN IS IT THE THRESHOLD OF TOO MUCH?

WHEN IS ANXIETY A DEBILITATING STATE WHERE IT IMPEDES YOUR PROCESSING YOUR FUNCTION AND QUALITY OF LIFE AND WHAT DO YOU TELL PARENTS WHAT THEY SHOULD LOOK FOR IN THOSE BEHAVIORS?

>> RENEE, FIRST OF ALL, LET ME THANK YOU FOR ALLOWING ME TO BE PART OF THIS DISCUSSION TODAY.

IT'S SO IMPORTANT FOR US TO HAVE.

THIS IT'S REALLY, AT ANY TIME, WHEN YOU TALK ABOUT STRESS OR ANXIETY FOR CHILDREN, THERE ARE THREE LEVELS OF THAT.

THERE IS POSITIVE STRESS, OKAY, LIKE THE FIRST DAY OF SCHOOL AS PLY COLLEAGUE JUST MENTIONED.

THE FIRST DAY OF SCHOOL IS ALWAYS A BIT ANXIOUS FOR OUR CHILDREN, ESPECIALLY CREARPD GOING INTO SCHOOL.

BUT WHAT THE PANDEMIC WHAT IT HAS DONE TO US AND THIS CAME FROM MY FAMILY RESOURCE COORDINATOR I WORK WITH.

HE SHARED WITH ME, BECAUSE OF THE PANDEMIC, SHE HAVE HAD THREE FIRST DAY OF SCHOOLS FOR THE KINDERGARTEN CHILD SO THE CHILD IS NOT ONLY ANXIOUS THE FIRST TIME, BUT THEN HE IS ANXIOUS A SECOND TIME AND THIRD TIME.

SO THE STRESS IS THERE AND OTHER ISSUES SUCH AS DEPRESSION ARE THERE.

SO YOU HAVE THE POSITIVE STRESS AND THEN TOLERABLE STRESS WHICH IS WITH SOME SUPPORTS YOU GET THROUGH IT AND THE LAST STRESS IS TOXIC STRESS WHERE YOU ARE JUST OVERWHELMED.

FOR THE PARENTS IN YOUR AUDIENCE TODAY, WHAT I WOULD SUGGEST THEY WOULD DO, HAVE THEY SEEN CHANGES IN THE PERSONALITY OF THE CHILD OR THEY'RE ISOLATING THEMSELVES OR THEY'VE CHANGED LIKE THEIR SPEECH PATTERNS OR THEY'RE USING LESS LANGUAGE, ESPECIALLY FOR THE YOUNG CHILDREN.

I WOULD JUST LOOK TO SEE, THE BEST INDICATOR IS WOULD IT BE, FOR EXAMPLE, THEY JUST SEEM DIFFERENT.

AND IF THE CHILD SEEMS DIFFERENT TO YOU, WHAT I WOULD SUGGEST IS HAVE THAT CONVERSATION WITH THE CHILD AND MAKE IT WHERE THEY CAN EXPRESS THEIR FEELINGS AND YOU ARE NOT GOING TO PASS JUDGMENT.

WE ALMOST IN THE BEGINNING ARE A SOUNDING BOARD FOR THE CHILD AND ALLOW THEM TO EXPRESS THEIR FEARS BECAUSE THEY MAY BE FEARFUL ABOUT GOING TO SCHOOL OR THE CHANGES IN THE WORLD THAT ARE GOING AROUND THEM PLUS IT'S A DIFFICULT TIME FOR ALL THE CHILDREN AND THEY HAVE DIFFICULTY PROCESSING.

AND AS MY COLLEAGUE SAID, YOU KNOW, THAT PREFRONTAL CORTEX IS NOT FULLY DEVELOPED.

WHEN THE CHILDREN ARE YOUNG, THE REASONING SKILLS AND BEING ABLE TO PROBLEM SOLVE AROUND THE FACT, WITH WHAT IS GOING ON AND WHERE DO I FIT IN THE WORLD.

>> Renee: GO AHEAD Dr. AGRAWAL.

>> THE SAME THING MY COLLEAGUE IS MENTIONING.

I TOTALLY AGREE WITH THAT.

YOU KNOW, A LITTLE BIT ANXIETY IS OKAY.

IT'S WHEN YOU START NOTICING BEHAVIORAL CHANGES IN YOUR CHILD, YOU KNOW, PARENTS, YOU KNOW YOUR CHILD.

SO IF YOU SEE THAT YOUR CHILD IS BEING MORE CLINGY OR YOUR CHILD IS ACTING OUT MORE OR ISOLATING, YOU KNOW, MAYBE HAVE SOME PHYSICAL PROBLEMS LIKE MAYBE THEY'RE TALKING ABOUT HEADACHES OR SOMETHING, IT CAN PRESENT IN SO MANY DIFFERENT WAYS.

SO PLEASE TALK TO YOUR CHILD AND TELL THEM THAT, YOU KNOW, YOU ARE HERE TO SUPPORT AND HELP THEM, TALK AND DISCUSS AND NORMALIZE AND IF THEY NEED HELP, REACH OUT FOR HELP.

>> Renee: YOU KNOW, I REMEMBER Dr. A AND Dr. B, I'LL CALL YOU THAT FOR SHORT.

SOUNDS LIKE A GOOD TEAM, Dr. A AND Dr. B.

SOMETIMES CHILDREN WILL COMPLAIN OF HAVING A TUMMY ACHE AND THAT THAT IS A POSSIBLE MANIFESTATION OF ANXIETY OR OTHER MENTAL HEALTH CHALLENGE WHEN THEY SAY MY TUMMY IS HURTING, MY STOMACH IS UPSET.

IS THAT TRUE?

IS THAT WHAT YOU BOTH HAVE SEEN AND CAN VALIDATE?

Dr. A FIRST.

>> YEAH, ABSOLUTELY.

THIS IS SO COMMON, NOT JUST IN KIDS I MEAN I SEE IN MY ADULT PATIENTS AS WELL, BECAUSE IF THEY DON'T KNOW HOW TO EXPRESS AND THERE IS STIGMA, YOU KNOW, SO KIDS MIGHT JUST SAY THAT, YOU KNOW, MY TUMMY IS HURTING OR I'M HAVING NAUSEA.

I'VE SEEP SEVERAL OF MY-- I'VE SEEN SEVERAL OF MY PATIENTS AND MY FRIENDS KIDS TYPICAL COMPLAINT AND OVER THE COURSE OF TIME, WITH SUPPORT AND ENCOURAGEMENT, IT GOES AWAY.

SO YES, ABSOLUTELY.

>> Renee: AND Dr. B, DO THEY REALLY HAVE A TUMMY ACHE OR IS IT JUST A REDIRECTION OF THAT STRESS THAT THEY'RE FEELING?

HOW DOES THAT WORK?

>> YEAH, AND THEY COULD ACTUALLY HAVE A STOMACH ACHE.

IT COULD BE A PHYSICAL ISSUE WITH THEM.

SO WHAT I WOULD DO AS A PARENT, IF A CHILD IS COMPLAINING OF A STOMACH ACHE OR BUTTERFLIES OR HEADACHE, THE FIRST QUESTION I WOULD ASK IS HOW LONG HAVE YOU HAD THE STOMACH ACHE, WHERE WERE YOU WHEN YOU FIRST STARTED TO HAVE IT, THE STOMACH ACHE.

IT'S ALMOST LIKE YOU BECOME A DETECTIVE A LITTLE BIT AS A PARENT AND YOU MIGHT LEARN BY THE QUESTIONS AND RESPONSES TO THE QUESTIONS YOU ARE ASKING, YOU MIGHT BE ABLE TO ZERO IN IS IT REALLY A PHYSICAL ISSUE OR IS IT MAYBE RELATED TO SOMETHING IN THEIR ENVIRONMENT?

THAT THEY'RE REALLY ANXIOUS ABOUT GOING BACK TO SCHOOL.

SO, FOR EXAMPLE, MANY OF OUR SCHOOL DISTRICTS HAVE BEEN ON N.T.I.

OR THE VIRTUAL LEARNING FOR NINE MONTHS AND A LOT OF YOUNG PEOPLE NOW ARE KIND OF GETTING ANXIOUS.

A LOT OF THEM ARE ANXIOUS GOING BACK INTO THE SCHOOL ENVIRONMENT.

SO ASK THE QUESTIONS AND BE THAT DETECTIVE TO SEE MAYBE IT'S AN ENVIRONMENTAL ISSUE OR IT'S MORE OF A PSYCHOLOGICAL ISSUE RATHER THAN A PHYSICAL ISSUE WHEN THEY'RE TALKING ABOUT A STOMACH ACHE OR HEADACHE.

>> AND TO YOUR POINT, Dr. B, YOU KNOW, THERE ARE SOME KIDS WHO AREN'T COMFORTABLE IN THE SCHOOL ENVIRONMENT; THAT THEY HAVE THOSE STRESSES AND THOSE TRIGGERS BEING AT SCHOOL, AND THAT THEY WOULD PREFER TO CONTINUE PERHAPS INTO THE REMOTE LEARNING ENVIRONMENT.

WHAT WOULD YOU SAY ABOUT COACHING YOUR KIDS ALONG WHO HAVE THOSE TYPES OF CONCERNS ABOUT GOING BACK TO SCHOOL BECAUSE THEY PERHAPS DON'T FEEL SAFE OR HAVE THE PEER SUPPORT THAT OTHERS DO?

Dr. B?

>> SURE.

TWO THINGS TO THAT QUESTION.

FIRST ONE IS, WE ARE GOING TO HAVE TO KIND OF THINK IN TERMS OF WE ARE GOING TO HAVE TO ACCLIMATE THEM GOING BACK TO SCHOOL.

SO DEPENDING ON WHEN SCHOOL STARTS IN THE DISTRICT WHERE THE CHILD IS ENROLLED AT, I WOULD PROBABLY REACH OUT TO THE SCHOOL STAFF, EITHER THE PRINCIPAL, THE ASSISTANT PRINCIPAL OR COUNSELOR AND SAY JOE IS REALLY CONCERNED ABOUT COMING BACK TO SCHOOL, AND SO WHAT KIND OF PLAN CAN WE CALL TRANSITION PLAN CAN WE PUT IN PLACE SO JOE CAN GET BACK IN SCHOOL.

ONE THING MIGHT BE YOU KNOW, WE ALLOW HIM TO COME TO SCHOOL EARLY WHEN ALL THE OTHER STUDENTS, IF WE ARE GOING TO START SAY NEXT TUESDAY, THE FIRST DAY, CAN HE COME IN ON UPON DAY, SEE WHERE HIS CLASSROOM IS?

SEE WHERE HIS LOCKER ROOM IS.

SEE WHO IN THE BUILDING CAN BE SUPPORTS FOR HIM, WHETHER IT'S THE TEACHER OR THE ASSISTANT PRINCIPAL OR THE SCHOOL COUNSELOR, SO COMING UP WITH THAT TRANSITION PLAN SHOULD HELP MANY OF THE STUDENTS MAKE A SMOOTHER TRANSITION BACK TO SCHOOL EVEN THOUGH THEY'RE ANXIOUS.

>> THE OTHER POINT I WANTED TO MAKE IS ONE OF THE THINGS I LEARNED WITH THE PANDEMIC, AS YOU MENTIONED IN THE QUESTION IS SOME STUDENTS DON'T DO GOOD AT SCHOOL.

THEY'RE VERY FEARFUL ABOUT SCHOOL AND THE ANXIETY.

SO SOME STUDENTS ARE ACTUALLY BENEFITING LEARNING AND BEING IN SCHOOL VIRTUALLY.

SO THE QUESTION I WOULD HAVE FOR LEADERS IN OUR STATE IS THIS MAY BE A PATHWAY THAT WE WERE FORCED INTO, DUE TO THE PANDEMIC, BUT FOR SOME OF OUR YOUNG PEOPLE, WILL PATHWAY CONTINUE WHEN WE GO BACK TO IN-PERSON SCHOOL FOR EVERYONE ELSE?

THERE ARE SOME STUDENTS THAT A VIRTUAL FORMAT IS BETTER BECAUSE SCHOOL IS SO ANXIETY PROVOKING.

SO THE IMPORTANT THING IN THESE KINDS OF SITUATIONS, WE WANT TO MAKE SURE OUR CHILD HAS A PATHWAY TO SUCCESS, WHETHER IT'S IN PERSON, WHICH WILL HAPPEN FOR THE VAST MAJORITY OF THE YOUNG PEOPLE BUT THERE ARE PROBABLY A SMALL GROUP OF STUDENTS WHERE VIRTUAL LEARNING MAY BE THE BEST PATHWAY FOR THEM TO BE SUCCESSFUL.

>> Renee: Dr. A, ANYTHING ELSE YOU CAN ADD TO THAT?

THE ANXIETY AND FOR THE PARENTS?

I MEAN I WANT YOU ALSO TO COMMENT ON HOW PARENTS CAN MODEL BEHAVIOR FOR THEIR CHILDREN TO HELP THEM DEAL WITH THESE ANXIETY-RELATED ISSUES?

>> RIGHT, RIGHT.

KIDS LEARN FROM US.

SO IF THEY'RE COMPLAINING ABOUT MAYBE TUMMY ACHE OR HEADACHE, FIRST OF ALL, WE WANT TO BE SYMPATHETIC AND EMPATHETIC AND NOT JUST SAY THAT IT'S NOT PHYSICAL.

YOU ARE JUST, YOU KNOW, MAKING IT UP OR FAKING IT UP.

WE DON'T WANT TO DO THAT BECAUSE YOU KNOW, PSYCHOLOGICALLY THEY'RE GETTING AFFECTED BY THAT.

SO IF I HAVE HEADACHE, I I AM HAVING HEADACHE.

I NEED SOME REST AND MAYBE DESTRESS MYSELF.

SO SOMETIMES I JUST, YOUY KNOW, WATCH A MOVIE WITH MY KIDS OR DO SOME MEDITATION OR GO FOR A WALK, YOU KNOW, THESE STRESS MANAGEMENT TECHNIQUES WE HAVE TO TEACH OUR KIDS HOW TO MANAGE THEIR STRESS AND NORMALIZE THESE FEELINGS.

>> Renee: HOW HAS-- >> THIS IS VERY IMPORTANT.

>> Renee: HOW HAVE THE SERVICES THAT ARE PROVIDED BY SEVEN COUNTIES, HOW HAVE CHE CHANGED AND HOW HAVE YOU HAD TO ADAPT DURING THIS PANDEMIC TO MAKE SURE THAT CLIENTS AND PATIENTS ARE DOING WELL AND TAKING CARE OF THEIR MENTAL HEALTH?

>> ABSOLUTELY.

YEAH, SO SINCE MARCH, YOU KNOW, 2020, WE HAVE BEEN DOING MOSTLY TELEMEDICINE.

SO MOST OF THE STAFF IS EITHER, YOU KNOW, LIKE MYSELF AS A PSYCHIATRIST, I'M EITHER CALLING MY PATIENTS AND DOING PHONE VISITS OR DOING VIDEO CALLS FOR PATIENTS WHO HAVE VIDEO ACCESS.

AND MY NURSES ARE DOING THE SAME, THERAPISTS ARE DOING THE SAME.

PATIENTS ARE EVEN GETTING GROUP THERAPY.

WE ARE TELEMEDICINE.

SOME LIMITED SERVICES LIKE, YOU KNOW, PATIENTS WHO NEED INJECTABLES OR LABS, THEY COME TO THE CLINIC STILL.

SO IT'S A HUGE CHANGE FOR US AND FOR OUR PATIENTS.

BUT I'M SO GLAD WE GOT THIS OPPORTUNITY TO CHANGE AND GROW BECAUSE OTHERWISE WE WOULD NOT HAVE BEEN ABLE TO HELP OUR PATIENTS.

AND RENEE, LET ME TELL YOU, SOME PATIENTS REALLY LOVE THIS, THAT THIS OPPORTUNITY BECAUSE THEY DON'T HAVE TO WORRY ABOUT TRANSPORTATION AND SOME PATIENTS GET REALLY ANXIOUS ON THE BUS OR IN THE WAITING ROOM.

AND THEY REALLY LOVE WHEN I CALL THEM AND DO THE ZOOM VIDEO CALL.

I'M SO BLESSED AND THANKFUL FOR EVERYBODY FOR LETTING US HAVE THIS OPPORTUNITY.

IT'S TOTALLY CHANGED.

>> Renee: I WAS JUST GOING TO SAY, I WAS THINKING THE OPPOSITE OF THAT, THAT USING A VIRTUAL PLATFORM MAY CREATE MORE OF A DISTANCE THAT WOULD BE INHIBITING IN SOME WAY.

BUT TO YOUR POINT ABOUT HOW YOU DON'T HAVE TO WORRY ABOUT ALL OF THOSE WAYS OF TRANSPORTATION, THAT THOSE ARE, YOU KNOW, DESTRESSING KIND OF THINGS AS WELL.

SO I AM CURIOUS ABOUT FOR THOSE WHO HAVE LOW TECH OR NO TECH, HOW WERE YOU ABLE TO REACH THOSE POPULATIONS WHERE THERE WASN'T THE INTERNET ACCESS TO BE ABLE TO CONNECT WITH YOU?

>> YEAH, YEAH, SO ALMOST EVERYBODY HAS A PHONE, YOU KNOW, PATIENTS WHO DON'T HAVE INTERNET ACCESS, VIDEO CALLS, WE DO PHONE CALLS.

I WOULD SAY THE MARKET OF MY GERIATRIC PATIENTS ARE PHONE CALLS BECAUSE THEY DON'T HAVE INTERNET OR TECHNOLOGY TO DO THE VIDEO CALLS.

>> Renee: LET ME ASK YOU QUICKLY BEFORE I GO BACK TO Dr. B, ABOUT OLDER POPULATIONS.

THERE HAS BEEN A LOT OF CONVERSATION ABOUT OUR YOUTH AND RIGHTFULLY SO AND WE SHOULD GIVE AMPLE ATTENTION TO HOW THEY'RE PROCESSING THIS.

BUT I'M CONCERNED ABOUT THE OLDER GENERATIONS, EVEN BEFORE THE PANDEMIC WE HEARD ABOUT INCREASED SUICIDE RATES AMONG WHITE-- ALL CALL THEM MIDDLE AGED MEN, 55 AND UP.

I'M CURIOUS ABOUT HOW THE PANDEMIC IS AFFECTING ADULTS.

>> IT IS REALLY AFFECTING IN A BAD WAY AND AS YOU HAVE SEEN ALL THE RESEARCH AND ALL THE SURVEYS THAT HAVE BEEN DONE, YOU KNOW, AMERICAN PEDIATRIC ACADEMY SHOWED THAT 25 TO 50% INCREASED IN DEPRESSION AND ANXIETY.

THE CDC CAME UP WITH THE DATA THAT E.R.

WAS INCREASING ABOUT 31% FOR OUR TEENAGE KIDS IT HAS INCREASED.

AND IN MY PRACTICE, I'M SEEING THE PATIENTS ARE STRUGGLING BECAUSE OF THE PANDEMIC.

THEIR SOCIAL NETWORK, THEIR SUPPORT SYSTEM HAS BEEN DIMINISHED BECAUSE OF SO MANY CLOSINGS.

PEOPLE ARE INSTRUMENTING LUNG PEOPLE ARE STRUGGLING.

>> Renee: Dr. B, I WANT YOU TO TALK TO US ABOUT THE BOUNCE COALITION.

ON KET WE HAVE TALKED ABOUT THIS GREAT ORGANIZATION THAT BUILDS RESILIENCY AND CHILDREN AND IT'S REALLY WHAT YOU DO AND THAT WORD RESILIENCY OFTEN GETS THROWN AROUND A LOT AND I'M NOT SURE OUR VIEWERS HAVE A GREAT SENSE OF MEANING OF THAT WORD WHAT DOES IT MEAN TO BE RESILIENT DURING TIMES LIKE THIS WHERE THERE ARE LOTS OF ANXIETIES ABOUT OUR FUTURE AND NOT EVEN FROM THE PANDEMIC FRONT BUT EVEN OUR POLITICAL ONGOINGS, HOW THAT IMPACTS OUR MENTAL WELLNESS.

TALK TO US ABOUT THE BOUNCE COALITION.

>> WHEN YOU ARE TALKING ABOUT RESILIENCY, THE ABILITY TO BOUNCE BACK FROM A SIGNIFICANT OR TRAUMATIC EVENT IN YOUR LIFE ANALOGY IS IN TERMS OF A RUBBER BAND.

WE ARE ALL GOING TO EXPERIENCE NEGATIVE EVENTS IN OUR LIVES.

THE LOSS OF A LOVED ONE, I DIDN'T MAKE THE FOOTBALL TEAM I WANTED TO MAKE OR MY GIRLFRIEND OR BOYFRIEND BROKE UP WITH ME.

THAT CREATES STRESS.

THE RUBBER BAND EXPANDS.

YOU GET ANXIOUSNESS AND ANXIETY.

THE RESILIENCY PIECE COMES BACK IN THAT YOU ARE ABLE TO OVERCOME THAT OR GET THAT RUBBER BAND TO GO BACK TO THE ORIGINAL FORM AND YOU HAVE THE GOING BACK TO THE ORIGINAL FORM.

THAT'S WHAT WE ARE ALL ABOUT WITH BOUNCE.

IT'S HELPING ORGANIZATIONS WHETHER IT'S SCHOOL DISTRICTS OR HOSPITALS OR OUT OF SCHOOL TIME PROVIDERS OR CHILD CARE CENTERS, ANYONE, ANY ORGANIZATION THAT WORKS WITH CHILDREN AND FAMILIES TO TEACH THEM FROM TAWM TRAUMA INFORMED AND HELP BUILD RESILIENCY SKILLS IN THE CHILDREN THEY WORK WITH, THE FAMILIES THEY WORK WITH AND THE COMMUNITIES THEY WORK WITH BECAUSE THE REALITY IS, THE PANDEMIC IS JUST REALLY HIGHLIGHTED THE INEQUITIES WE HAVE IN OUR COMMUNITY AND EVERYONE IS STRUGGLING WITH WHAT IS GOING ON DURING PANDEMIC AND THAT OUR NATURAL SUPPORT SYSTEMS HAVE BEEN STRETCHED TO THE LIMIT OR THEY HAVE BEEN CUT OFF SO RESILIENCY REALLY IS THE KEY FOR US AS BEING ABLE TO BOUNCE BACK FROM THOSE EVENTS.

AND SO WHAT BOUNCE DOES, WE HELP THOSE ORGANIZATIONS TO CREATE THE TRAUMA INFORMED TRAIM WORK OF SUPPORT TO PROVIDE THE DIRECT SERVICES TO THE FAMILIES AND THE CHILDREN THAT THEY SERVE AND SINCE MARCH OF 2020, WE HAVE HAD TO TURN ON A DIME LIKE EVERYONE ELSE AND DO ALL THAT VIRTUALLY.

SO ALL THE TRAININGS THAT WE DO FOR THOSE ORGANIZATIONS, ALL THE CONSULTATION WE DO OR EVALUATION SERVICES WE PROVIDE TO THOSE ORGANIZATIONS, THAT ALL IS DONE VIRTUALLY.

>> YOU KNOW, WE HAVE BEEN TALKING ABOUT HOW THIS PANDEMIC AFFECTS CHILDREN AND THE FRAMEWORK OF THEIR EDUCATIONAL EXPERIENCE.

BUT Dr. B, THERE ARE CHILDREN WHO HAVE LOST PARENTS AND THEY'VE LOST THEIR CAREGIVERS.

THEY'VE LOST FRIENDS AND OTHER LOVED ONES FROM THIS PANDEMIC AND OTHER DISEASES AS WELL DURING THIS TIME AND SO WHEN WE TALK ABOUT TRAUMA, YOU KNOW, IT'S NOT JUST THE SCHOOL INDUCED TRAUMA.

IT'S REAL LIFE TRAUMA THAT THEY EXPERIENCE AT AGES THEY SHOULDN'T, RIGHT?

AND GETTING BACK TO THAT FORM, THAT RUBBER BAND COMING BACK TO ITS BEGINNING, YOU KNOW, THAT CAN BE TOUGH WHEN YOU HAVE HAD A LOT OF LOSS AT A YOUNG AGE.

>> AND WHAT I WOULD SUGGEST IN THOSE KINDS OF SITUATIONS IS THE NUMBER ONE PROTECTIVE FACTOR FOR YOUNG PEOPLE IS HAVING A POSITIVE ADULT, A CARING ADULT, AN ADULT WHO IS IN THEIR CORNER.

SO WHAT WE NEED TO DO IS MANY TIMES THAT IS A FAMILY MEMBER, MOM, DAD, GRAND A, GRANDPA BUT IF WE JUST LOST OUR PARENT DUE TO COVID OR COMMUNITY VIOLENCE, WHO ELSE IN THE CHILD'S LIFE CAN BE THE POSITIVE ADULT?

WE WANT TO CREATE THAT SUPPORT SYSTEM AROUND THAT CHILD AND SO MANY TIMES WE WILL SEE OTHER FAMILY MEMBERS COME TO THE AID OF THE CHILD OR THE TEACHERS AT THE SCHOOL WILL COME TO THE AID OF THE CHILD OR IF YOU ARE A PERSON OF FAITH, THE PEOPLE IN THE CHURCH WILL COME AND WRAP THEIR ARMS AROUND THE CHILD.

THE OTHER IMPORTANT THINGS WE SHOULD BE DOING FOR CHILDREN WHO ARE IN THESE SITUATIONS ARE TRY AND CREATE SOME STRUCTURE AND ROUTINE TO THAT CHILD BECAUSE MANY TIMES AFTER THE LOSS OF A LOVED ONE, THEIR WORLD HAS BEEN TURNED UPSIDE DOWN AND THIS IS PROBABLY IN ALL LIKELIHOOD THE FIRST TIME THEY'VE EXPERIENCED THE LOSS OF A LOVED ONE.

WE NEED TO HAVE OTHER ADULTS FILL IN FOR THAT PERSON WHO WAS LOST.

THEN ALSO MAKE SURE WE PROVIDE LOVE AND AFFECTION, BUT ROUTINE AND STRUCTURE AND SUPPORT IS REALLY KEY FOR THE CHILD TO BE ABLE TO OVERCOME OR ADAPT TO THE LOSS OF A LOVED ONE.

THEY'LL ALWAYS MISS THAT PERSON OBVIOUSLY BUT THEY'RE GOING TO LEARN WAYS TO MOVE FORWARD.

>> Renee: I DO WANT TO ASK YOU ABOUT CHILDREN WHO WERE IN HOMES WHERE THERE IS SUBSTANCE ABUSE, WHERE THERE IS INTIMATE PARTNER AND DOMESTIC PARTNER VIOLENCE.

DRUG ADDICTION, YOU KNOW, INCARCERATED PARENT PERHAPS.

YOU KNOW, HOW DO YOU HELP THOSE CHILDREN AND THEN ON TOP OF THAT, DEAL WITH HOW THE PANDEMIC CAN ADD AN ADDITIONAL STRAIN?

>> ABSOLUTELY.

AND WE KNOW THESE ARE ALL THE RISK FACTORS FOR ADVERSE CHILDHOOD EXPERIENCES, RIGHT, RENEE.

SO WE KNOW THE MORTALITY AND MORBIDITY IS HIGH IF SOMEONE HAS EXPERIENCED ACE.

SO AGAIN, IF MY PATIENTS ARE STRUGGLING, WE HELP THEM OUT.

SOMETIMES WE EVEN DO LIKE IN-HOME PARENTING, THERAPY, FOR, YOU KNOW, FOR PARENT AND CHILD IF NEEDED.

AND FOR MY PATIENTS FOR ADULT PATIENTS, YOU KNOW, WE PROVIDE THEM THERAPY, MEDICATION MANAGEMENT, INCLUDING SUBSTANCE USE.

THAT'S PART OF MENTAL HEALTH.

IF YOU NEED TREATMENT FOR SUBSTANCE USE, WE DON'T NEED TO BE SHY ABOUT IT.

IT'S PART OF YOUR MENTAL HEALTH AND WE ARE HERE TO HELP.

WE JUST HAVE TO GET RID OF THE STIGMA THAT ADDICTION IS ACTUALLY A BRAIN DISORDER.

IT'S NOT JUST A CHOICE THAT SOMEBODY IS MAKING.

THEY'RE HAVING HARD TIME QUITTING.

>> Renee: I DO WANT TO ASK YOU TWO ABOUT THE RACIAL DISPARITIES.

THE PANDEMIC HAS HAS ALSO HIGHLIGHTED AFRESH, MANY OF US HAVE KNOWN FOR A LONG TIME, ABOUT THE HEALTH INEQUITIES THAT ARE IN OUR HEALTHCARE SYSTEM AND MENTAL HEALTH IS NO DIFFERENT.

SO Dr. A I'LL GO TO YOU FIRST TO TALK ABOUT WHAT HAS BEEN REVEALED TO YOU MOST DURING THIS PANDEMIC ABOUT THOSE DISPARITIES AND MENTAL HEALTH OPPORTUNITIES AND MAYBE EVEN ACCESS TO RESOURCES.

>> YEAH, YOU ARE RIGHT, RENEE.

WE KNOW THAT MOST OF THE WORST CONSEQUENCES OF MENTAL HEALTH OR PHYSICAL HEALTH HAPPENS IN PATIENTS WHO ARE IN MINORITY PATIENT POPULATION.

SO MORE RISK FOR MENTAL HEALTH, MORE RISK FOR DIABETES, CANCER, HYPERTENSION, YOU NAME IT.

MOST OF THE MINORITY POPULATION HAVE WORSE CONSEQUENCES AND MORE ILLNESSES.

SO AGAIN, WE NEED TO NORMALIZE.

WE NEED TO MAKE SURE THAT PEOPLE ARE AWARE THAT, YOU KNOW, THERE IS NOTHING CALLED CRAZY.

WE THEY'D TO GET RID OF THIS WORD.

WE NEED TREATMENT.

THIS IS A BRAIN DISORDER.

YOU REACH OUT FOR HELP AND IF PEOPLE STOP CALLING THIS WORD TO EVERYBODY AND THEN I'M SURE PEOPLE WOULD COME OUT AND REACH OUT FOR HELP.

>> Renee: Dr. B, SAME QUESTION TO YOU, SIR.

>> I THINK I'M GOING TO TAKE IT FROM A YOUTH'S PERSPECTIVE.

WE HAVE TO ENSURE THAT WE GIVE THEM ACCESS,-- OUR YOUNG PEOPLE OF COLOR, WE HAVE TO MAKE SURE THAT THEY HAVE EASY ACCESS TO SERVICES AND WE DESTIGMATIZE COUNSELING SERVICES OR SUPPORTS THEY MAY NEED.

THAT'S ONE IMPORTANT THING.

IT'S BREAKING DOWN THE BARRIERS BECAUSE THEY'RE THERE.

THE SYSTEM WIDE OR COMMUNITY WIDE, THERE ARE BARRIERS WE HAVE TO OVER COME.

THE SECOND IMPORTANT PIECE AS IT RELATES TO EQUITY ISSUES AND RELATING TO MENTAL HEALTH, DEALS WITH PEOPLE OF COLOR, BUT THE COMMISSIONS, DO THEY LOOK LIKE ME.

WE HAVE THE SAME PROBLEM IN EDUCATION.

IF I'M A YOUTH OF COLOR, ALL THE TEACHERS AND PEOPLE IN MY SCHOOL, ARE THEY ALL WHITE?

AND IT'S THE SAME THING IN MENTAL HEALTH.

ARE THE CLINICIANS OR DOCTORS OR THE PSYCHOLOGISTS DO ANY OF THEM LOOK LIKE ME?

SOMETIMES THAT'S A WAY OF BREAKING DOWN SOME OF THE BARRIERS THAT IF I'M A CHILD OF COLOR, IS THE PSYCHOLOGIST OR PSYCHIATRIST A PERSON OF COLOR ALSO, THAT MIGHT MAKE IT EASIER FOR ME TO FEEL MORE COMFORTABLE AND SHARE SOME OF THE MOST PERSONAL THOUGHTS THAT I HAVE.

>> Renee: AND WE'LL END ON THIS QUESTION AND A RESPONSE FROM BOTH OF YOU AND I'LL START WITH YOU, Dr. B.

IS THERE HEADWAY GETTING MORE PEOPLE OF COLOR TO ENTER MENTAL HEALTH FIELDS AND HAVE MORE OF THOSE PROFESSIONALS AVAILABLE?

I KNOW THAT I'VE BEEN A PART OF SOCIAL MEDIA CIRCLES WHERE PEOPLE ARE ASKING HOW DO I FIND A COUNSELOR OF COLOR WHO CAN HELP WITH MENTAL HEALTH ISSUES FOR MYSELF OR MY CHILD.

AND IT REALLY IS DIFFICULT IN KENTUCKY.

>> I THINK PART OF IT IS WE MAY NOT KNOW PEOPLE IN MENTAL HEALTH.

SO PERSONALLY I THINK WHAT DISTRICTS SHOULD BE DOING WHEN YOUNG PEOPLE ARE EXPLORING OPTIONS AS CAREERS, ARE WE ALSO INCLUDING MENTAL HEALTH AND THEN BRINGING IN MENTAL HEALTH CLINICIANS OF COLOR.

BUT ALSO IN THE COMMUNITY, ARE THE CLINICIANS IN THE COMMUNITY, ARE THEY GOING OUT AND NOT JUST DOING THERAPY BUT ARE THEY DOING SOME TRAINING CLASSES AT THE LOCAL CHURCH OR AFTER SCHOOL SETTING LIKE THE YMCA.

SO JUST GETTING EXPOSURE WILL HELP THAT YOUNG PERSON REALIZE HEY, THAT MIGHT BE AN OPPORTUNITY FOR ME WHEN I GROW UP.

I WILL BE A PSYCHIATRIST OR I MIGHT BECOME A SCHOOL COUNSELOR OR PSYCHOLOGIST BECAUSE I'VE SEEN SOMEONE WHO LOOKS LIKE ME IN THAT ROLE.

EVEN THOUGH I DIDN'T GET THE SERVICES.

>> Renee: THAT'S OKAY.

Dr. A, I'LL GIVE YOU THE LAST WORD AND 20 SECONDS.

YOU CAN RESPOND TO THAT OR MAYBE JUST LEAVE US WITH SOME WORDS OF HOPE.

>> OKAY.

OKAY, SO, YOU KNOW, I JUST WANT TO LET YOU KNOW THAT, YES, WE, AT SEVEN COUNTIES, WE TRY TO HAVE AS MUCH DIVERSITY AS POSSIBLE BUT TRUTH OF THE MATTER IS, IT'S REALLY HARD TO FIND PSYCHIATRISTS AND THERAPISTS OF COLOR, SO YOU KNOW, THAT HAS BEEN A STRUGGLE.

SO I WOULD START FROM THE CHILDHOOD AGE THAT LET'S PREPARE AND LET'S EDUCATE OUR, YOU KNOW, OUR YOUTH POPULATION TO COME INTO HEALTH POPULATION AND YOU KNOW, COME AND HELP BE A PSYCHIATRIST, BE A PSYCHOLOGIST, A THERAPIST.

WE NEED YOU GUYS.

SO LET'S GROW UP AND LET'S GET INTO THE FIELD.

>> Renee: GOOD WORDS TO END ON.

ENTHUSIASM Dr. RUCHITA AGRAWAL AND Dr. JOE BARGIONE.

THANK YOU FOR BEING WITH ME TODAY AND FOR THE WORK THAT YOU DO FOR OUR STATE AND FOR OUR MENTAL HEALTH.

SO MUCH APPRECIATED.

I'M RENEE SHAW.

I HOPE YOU HAVE LEARNED A LOT TODAY AND HOPEFULLY WILL YOU REACH OUT TO RESOURCES IF YOU NEED THEM.

IN THE MEANTIME, PLEASE STAY SAFE, TAKE GOOD CARE OF YOURSELF AND I'LL SEE YOU REAL SOON.

YOU CAN FOLLOW ME ON FACEBOOK, TWITTER, ON OUR PODCASTS, ALL THERE ON THE SCREEN.