♪ ♪ ♪ >> Renee: AS OPTIMISM GROWS THAT WE'RE TURNING A CORNER IN THE COVID PANDEMIC, THERE ARE LIVES THAT WON'T EVER RETURN TO NORMAL.

THOSE REALING FROM THE LOSS OF LOVED ONES, FACE CHALLENGES WITH GRIEF, THE EFFECTS OF WHICH CAN BE AS PHYSICAL AS THE DISEASE SYMPTOMS.

I TALKED WITH UNIVERSITY OF KENTUCKY PSYCHOLOGIST AND PROFESSOR JULIE CEREL ABOUT MANAGING BEREAVEMENT AND TENDING TO OUR MENTAL HEALTH.

THAT'S NOW ON "CONNECTIONS."

♪ ♪ THANK YOU FOR JOINING US FOR "CONNECTIONS" TODAY.

I'M RENEE SHAW.

TODAY WE'RE FOCUSING ON THE GRIEF AND MENTAL HEALTH CHALLENGES LEFT IN ITS PATH.

RESEARCHES SAY THAT FOR EVERY PERSON WHO DIES OF COVID-19, NINE LOVED ONES ARE LEFT BEHIND.

BUT IS THERE ALSO A WAVE OF COLLECTIVE GRIEF THAT WE HAVE IGNORED WHETHER WE HAVE LOST LOVED ONES OR NOT?

AND HOW DO YOU MEASURE THE TRAUMA OF THIS GLOBAL HEALTH CRISIS AND WHAT CAN BE DONE TO HELP THE BEREAVED HEAL?

HO HELP US TO UNDERSTAND THIS SELDOM DISCUSSED ISSUE IS OUR FRIEND FROM THE UNIVERSITY OF KENTUCKY WHO WE OFTEN TURN TO FOR ANSWERS ABOUT MENTAL HEALTH, LICENSED CLINICAL PSYCHOLOGIST, AND PROFESSOR IN THE COLLEGE OF SOCIAL WORK AT THE UNIVERSITY OF KENTUCKY, Dr. JULIE CEREL.

THANK YOU SO MUCH FOR BEING WITH US.

YOU HAVE BECOME KIND OF OUR TRUSTED -- I DON'T WANT TO CALL YOU IN RESIDENT-PSYCHOLOGIST BUT WE OFTEN APPRECIATE YOU HAVE BEEN A PART OF OUR MENTAL HEALTH EFFORTS TO FOR YOUTH AND TEENS AND WE APPRECIATE IN TIMES WE NEED TO HAVE THESE CANDID CONVERSATIONS, THAT WE OFTEN DON'T HAVE, THAT YOU ARE AT THE READY TO HELP US THROUGH.

GOOD TO SEE YOU.

>> GOOD TO SEE YOU.

>> THIS HAS BEEN SOME 15, 17 MONTHS, HASN'T IT.

AND WE HAVE OFTEN TALKED ABOUT THE HEALTH AND THE ECONOMIC IMPACTS AND CONSEQUENCES FROM COVID, BUT, THE MENTAL HEALTH PIECE, JULIE AND I'LL GET PERSONAL, WE SEEM TO HAVE JUST IGNORED.

DO YOU FEEL THAT WAY?

>> I THINK THE MENTAL HEALTH PIECE WAS USED FOR ALARMIST, A POLITICAL PAWN IN?

CASES OF WHY WE NEEDED TO OPEN UP THE ECONOMY.

FROM THE FORMER PRESIDENT ON TO SCHOOL DISTRICTS AND OTHER STATES, THAT SUICIDE BECAME KIND OF A TOUCH POINT OF, IF WE DON'T DO SOMETHING, WE'RE GOING TO LOSE THOUSANDS AND THOUSANDS OF PEOPLE AT ONE POINT, SOMEONE SAID, IN EXCESS 75,000 DEATHS OF DESPAIR WOULD HAPPEN DUE TO THE PANDEMIC.

>> IN CHILDREN.

>> OVERALL.

>> OVERALL.

OKAY.

SO, THAT WAS PART OF THE NARRATIVE BUT THE REALITY DOESN'T MATCH UP, THE STATISTICS DON'T BEAR THAT OUT.

>> THE REALITY IS FORTUNATELY TO DATE, WE HAVEN'T SEEN INCREASES IN SUICIDE, AND IN FACT, WE HAVE SEEN DECREASES IN SUICIDE ACROSS THE BOARD.

SOME GROUPS, SOME RACIAL AND ETHNIC GROUPS HAVE SHOWN SOME INCREASES BUT FOR NOW, PEOPLE HAVE REALLY DRAWN TOGETHER AND LOOKED OUT FOR EACH OTHER AND WE HAVEN'T SEEN EXCESS SUICIDES.

>> AND WE ARE GOING TO OCCASIONALLY PUT UP THE NATIONAL HOTLINE NUMBER FOR SUICIDE, BECAUSE, WE FEEL IT IS IMPORTANT TO GIVE PEOPLE THE TOOLS IF THEY KNOW SOMEONE OR IN A SITUATION THEMSELVES WHEN THEY WOULD NEED TO SPEAK WITH SOMEONE, WE'RE GOING TO SUPPLY THAT RESOURCE FOR YOU THROUGHOUT THE PROGRAM.

I MENTIONED ABOUT BEREAVEMENT AND YOU'RE ALSO AN EXPERT IN THIS AND HOW WE DEAL WITH INDIVIDUAL GRIEF AND COLLECTIVE GRIEF AND I DON'T KNOW, MAYBE I'M OVERSTATING THE COLLECTIVE PART OF IT BUT LET'S START WITH INDIVIDUALS FIRST WHO ARE DEALING WITH MAYBE THEY HAD LOVED ONES THEY LOST BUT THEY ALSO LOST MAYBE THEIR LIVELIHOODS.

THERE IS DIFFERENT LEVELS OF GRIEF.

IT IS NOT ALWAYS ABOUT THE PHYSICAL LOSS OF SOMEONE BUT THERE ARE OTHER WAYS TO MANIFEST.

>> GRIEF ISN'T JUST THE LOSS OF SOMEONE HE WOULD CARE ABOUT.

IT IS ALSO GRIEF FOR WHAT WOULD HAVE BEEN IN OUR LIVES.

AND SO, THOSE TWO DIFFERENT KINDS OF GRIEF EXPERIENCES PLAYED OUT IN SOME CAPACITY VIRTUALLY FOR EVERYONE.

IT IS NOT THE YEAR THAT EVERYONE ANTICIPATED.

>> AND THERE HAS BEEN CALLS FOR THEIR THERE TO BE LIKE A WHITE HOUSE OFFICE OF BEREAVEMENT OR TO HAVE SOME TYPE OF CLEARINGHOUSE OF INFORMATION FROM THE WHITE HOUSE, FROM THE ADMINISTRATION TO ADDRESS THAT.

DO YOU THINK THAT THAT'S NECESSARY?

>> I THINK THAT PEOPLE DON'T GIVE ENOUGH ATTENTION TO THE ISSUES THAT GRIEF BRINGS TO PEOPLE.

PEOPLE -- AND EVEN IN MY CAREER STUDYING GRIEF, PEOPLE SAID GRIEF IS GRIEF.

IT IS A NORMAL HUMAN EXPERIENCE.

EVERYONE HAS GRIEF BUT I THINK THAT, FOR SOME PEOPLE, GRIEF CHANGES THE COURSE OF THEIR LIFE FOR THE WORSE, BUT VERY FEW PEOPLE, THERE ARE THINGS LIKE POST TRAUMATIC GROWTH THAT YOU AND I HAVE TALKED ABOUT.

BUT GRIEF CAN REALLY CHANGE PEOPLE AND THERE'S TREATMENTS THAT WORK FOR PEOPLE WHO HAVE PROLONGED GRIEF.

AND SO IT IS NOT SOMETHING THAT WE NEED TO SAY, OH, IT IS JUST GRIEF.

IT WILL GO AWAY.

THEY'LL GET OVER IT.

OR, THE STAGE THEORY OF GRIEF THAT WE HAVE -- WE KNOW DOESN'T REALLY WORK LIKE THAT.

>> RIGHT.

AND, TO GET TO THAT POST TRAUMATIC GROWTH, JUST TO REMIND PEOPLE BECAUSE WE TALKED A LOT ABOUT THIS FOR OUR YOUTH MENTAL SERIES.

THERE CAN BE SOME POSITIVE GROWTH FROM GRIEF BUT YOU MAY NOT ALWAYS KNOW THAT OR EXPECT THAT AT THE OUTSET, RIGHT.

>> AND POST TRAUMATIC GROWTH IS REALLY WHEN SOMEONE'S WHOLE VIEW IS SHATTERED AND THEY COME OUT WITH A DIFFERENT PLACE THAN THEY WOULD HAVE BEEN OTHERWISE.

AND SO IN MY EXPERIENCE, FOR EXAMPLE, SUICIDE LOSS SURVIVORS WHO HAVE LOST A CHILD OR A LOVED ONE END UP FINISHING COLLEGE AND BECOMING A THERAPIST.

THEY NEVER WOULD HAVE DONE THAT BUT THEY GROW IN A WAY THAT NO ONE WOULD HAVE ANTICIPATED.

>> THEY PRESS ON THROUGH THE CHALLENGE AND FIND A NEW WAY TO BLOSSOM.

>> RIGHT.

>> BUT FOR THOSE WHO THAT TRAJECTORY DOESN'T SEEM TO BE AS OBVIOUS, OR ATTAINABLE, WHAT DO THEY DO?

>> PROLONGED GRIEF IS WHEN SOMEONE GETS STUCK IN THEIR GRIEF IN A WAY THAT, THEY CANNOT SHAKE THE SADNESS, THE YEARNING FOR THE PERSON LEFT BEHIND AND FACT THEY FEEL THAT THEY CAN'T GO ON WITH THEIR OWN LIFE.

AND IT LASTS USUALLY SIX MONTHS OR LONGER.

AND, THAT KIND OF GRIEF REALLY DOES RESPOND TO SPECIFIC TREATMENTS.

>> RIGHT.

AND WE THINK ABOUT, THE UNFORTUNATE LOSS OF A CHILD.

THIS TRACK TICK, HARD TO EVEN IMAGINE THAT AND PARTICULARLY, DURING THE TIME OF COVID WHEN PEOPLE WERE IN ISOLATION, NOT JUST IN THEIR HOMES BUT IN HOSPITALS WHERE YOU COULDN'T BE WITH LOVED ONES WHO WERE DYING AND YOU HAD HEALTHCARE WORKERS, WHO WERE HOLDING THE PATIENT'S HAND OR I HAD EVEN SEEN, SOCIAL MEDIA, WHERE THERE WAS A WARM BALLOON OF A HAND IN HOT WATER THAT THEY WOULD PUT ON TOP OF A PATIENT TO KIND OF MIMIC THE HAND OF A HUMAN TOUCH.

>> SO PEOPLE DIDN'T GET THEIR NORMAL RITUALS THAT WE ASSOCIATE WITH DYING.

BEING WITH THEIR LOVED ONCE, GETTING TO HEAR THEIR FINAL WORDS.

AND THEN, HAVING VISITATIONS AND FUNERALS, AND THE KINDS OF COMMUNITY EVENTS THAT SHOW SOMEONE THEY ARE NOT ALONE.

SO EVEN ZOOM SERVICES, AT THE END OF THAT, YOU'RE ALONE.

>> RIGHT.

>> SO, GRIEF, PEOPLE WHO ARE GRIEVING NEED THEIR COMMUNITY FOR THE MOST PART.

NEED TO KNOW THAT, THE OTHER PEOPLE CARE ABOUT THEM, AND ARE THERE TO SUPPORT THEM.

>> DOES THAT, DO YOU THINK, PROLONG GRIEF WHEN YOU DON'T GET TO EXERCISE THE RITUALS THAT ARE MOST ASSOCIATED WITH YOUR CULTURE AND YOUR TRADITIONS?

>> IT DOES SEEM TO, YES.

>> WHEN DO YOU KNOW THAT IT IS TIME TO SPEAK WITH SOMEONE PROFESSIONALLY ABOUT WHERE YOU ARE IN YOUR MENTAL STATE, WHETHER YOU'RE BEREAVE OR IT IS ANOTHER MENTAL HEALTH CHALLENGE?

>> FOR THE DIAGNOSIS OF PROLONGED GRIEF, YOU NEED SIX MONTHS OR LONGER.

BUT, DEPRESSION IS TWO OR MORE WEEKS OF SADNESS MORE OFTEN THAN NOT, CRYING MORE OFTEN THAN NOT.

NOT WANTING TO DO YOUR USUAL ACTIVITIES.

AND SO, IF IT HAS BEEN A FEW WEEKS EVEN IF YOU HAD A LOSS, IT MIGHT BE TIME AT LEAST TO JUST TOUCH BASE, TALK WITH A MENTAL HEALTH PROFESSIONAL.

>> IT DOES SEEM THAT WE'RE SEEING A LOT MORE POSITIVE IMAGERY AND MESSAGING ABOUT GOOD MENTAL HEALTH OR MENTAL WELLNESS FROM PROFESSIONAL ATHLETES, THAT WE HAVE HAD THAT EXAMPLE IN THE TENNIS PLAYER AND OTHERS WHO WERE SAYING, I'M GOING TO STEP BACK FROM FOR A MOMENT AND TEND TO MY MENTAL HEALTH.

HOW DO YOU THINK THAT WILL RESONATE WITH THE GENERAL PUBLIC AND WHAT DO YOU HOPE IT WILL DO?

>> THE OPTIMISTIC PART OF ME REALLY FEELS LIKE, ALL OF THIS WORK THAT HAS BEEN DONE IN MENTAL HEALTH ABOUT MESSAGING AND ABOUT IT IS OKAY TO TALK TO PEOPLE AND IT IS OKAY TO SAY THAT YOU'RE STRUGGLING, MAYBE THIS YEAR, WE FINALLY COLLECTIVELY WERE ABLE TO USE THAT MESSAGE.

BECAUSE, THERE HAS BEEN A LOT OF CHECK IN ON YOUR FRIENDS, IT IS OKAY IF YOU'RE NOT OKAY, BUT REACH OUT TO PEOPLE.

SO, MAYBE WHAT WE HAVE SEEN IS IT IS FINALLY WORKING.

>> THE STIGMA LESSENED.

>> AND IN CERTAIN COMMUNITIES OR CULTURES, IS THERE STILL A STIGMA ISSUE THAT HAS TO BE OVERCOME.

>> I THINK IN A LOT OF COMMUNITIES AND CULTURES, THERE IS A STIGMA.

>> THAT ROOTED IN A RELIGIOUS PHILOSOPHY OR JUST SUCK IT UP, EVERYBODY GETS DOWN IN THE DUMPS?

PULL YOURSELF UP AND GET OVER IT CULTURE, BUT, I THINK A LOT OF IT IS FEAR OF THE MEDICAL ESTABLISHMENT AND HARM THAT'S BEEN DONE IN THE PAST.

A LACK OF CONFIDENCE THAT SOMEONE ELSE CAN ACTUALLY UNDERSTAND ME WELL ENOUGH TO HELP ME.

BUT, ALSO, SOME OF THOSE VALUES OF OTHER PEOPLE DON'T NEED TO BE IN OUR BUSINESS OR KNOW OUR PROBLEMS THAT WE CAN HANDLE IT OUR SELFS.

>> AND TWO THINGS COME TO MIND, Dr. CEREL, BECAUSE I THINK ABOUT RURAL COMMUNITIES WHERE, YOU KNOW, IT IS A SMALLER COMMUNITY AND EVERYBODY KNOWS YOUR BUSINESS OR THE AVAILABILITY OF MENTAL HEALTH PROFESSIONALS IS LACKING AND I THINK ABOUT, YOU KNOW, THE OTHER SIDE OF THAT TOO, PEOPLE WHO BECAUSE OF THEIR CULTURE THIS THAT I'LL TURN TO MY FAITH AND THAT WILL PULL ME FROM THE DOLDRUMS.

HOW DO YOU FEEL ABOUT THAT?

>> I THINK THAT ONE OF THE BEST THINGS THAT HAS COME OUT OF THE PANDEMIC, THE LACK OF STIGMA, PEOPLE WITH DO THERAPY THROUGH TELEMEDICINE OR THERAPY.

THE FACT THAT IF YOU'RE IN A RURAL COMMUNITY AND YOU KNOW EVERYBODY THERE, YOU CAN SEE A THERAPIST IN A DIFFERENT COUNTY, BY THE INTERNET.

YOU DON'T HAVE TO BE IN A WAITING ROOM OR HAVE YOUR CHILD LEAVE SCHOOL.

SO THAT IS A WAY TO DECREASE THAT STIGMA AND HOPEFULLY, THAT'S AROUND TO STAY.

>> AND I THINK THE ENVIRONMENTAL LINING, ONE OF THE SILVER LININGS FROM THE PANDEMIC HAS BEEN THE USE AND RELIANCE ON TELEHEALTH WHICH HAS BEEN AROUND FOR A VERY LONG TIME BUT WE WERE NOT OPTIMIZING THAT BECAUSE WE HAD THE IN-PERSON AVAILABILITYS BUT WHEN THAT IS TAKEN AWAY, TELEHEALTH HAS STEPPED IN AND BECOME A SUPPORTIVE AND USEABLE TOOL.

THERE IS ANOTHER ISSUE ABOUT MAYBE THE DIRT -- OF PEOPLE OF COLOR IN OUR-HE-DIRTH, ABOUT WHEN I'M TRYING TO FIND A THERAPIST OF O'CLOCK IT IS VERY HARD.

SO, YOU KNOW, WHAT'S BEING DONE TO DIVERSIFY -- I HATE TO USE THE WORD INDUSTRY, BUT THIS INDUSTRY SO THAT IT REPRESENTS PEOPLE WHO NEED TO REALLY LATCH ON TO THESE SERVICES WHEN THEY NEED TO.

>> THAT'S ONE OF THE THINGS THAT I HAVE BEEN REALLY HAPPY TO SEE IN MY COLLEGE, THE COLLEGE OF SOCIAL WORK AT UNIVERSITY OF KENTUCKY.

THAT DEAN MILL HEAR REALLY CREATED AN -- MILL HEAR CREATE AN INITIATIVE TO HAVE THERAPISTS OF COLOR AVAILABLE FOR THE EAP UNIVERSITY OF KENTUCKY AND ALSO TO REALLY INCREASE THE NUMBER OF SOCIAL WORKERS THAT WE'RE TRAINING WHO ARE PEOPLE OF COLOR WHO CAN THEN GO BACK TO THEIR COMMUNITIES AND HELP PEOPLE AND MAYBE, BREAK DOWN SOME OF THOSE BARRIERS OF WHY PEOPLE AREN'T SEEKING TREATMENT.

>> AND WE'RE SEEING PEOPLE OF NON-TRADITIONAL AGE WHO ARE ACTUALLY GOING BACK TO SCHOOL BECAUSE THEY THINK MAYBE I CAN MAKE A DIFFERENCE.

>> RIGHT.

>> IN THIS FIELD.

AND SO THAT'S ANOTHER POSITIVE STEP AND ENVIRONMENTAL LINING.

I DON'T WANT TO, YOU KNOW, TURN A BIT OF ATTENTION TO THE YOUTH.

WE OFTEN DO, AND YOU KIND OF ALLUDED TO IT EARLIER THAT PREDICTIONS ABOUT SUICIDE RATES, AND, BUT WHAT ARE THE MENTAL HEALTH CHALLENGES OF KIDS?

ARE THEY DIFFERENT OR WORSE DURING THE PANDEMIC OR IS IT ABOUT THE SAME?

>> WELL I THINK WE DON'T QUITE KNOW YET.

WE KNOW THAT SUICIDE RATES DID NOT GO UP.

WE KNOW THAT, THERE MIGHT HAVE BEEN MORE EMERGENCY DEPARTMENT OR CRISIS VISITS FROM YOUTH, BUT, THAT'S ALSO BECAUSE OUTPATIENT CLINICS WERE CLOSED, SCHOOLS WERE CLOSED.

BUT CRISIS SERVICES LIKE LIFE LINE AND NATIONAL CRISIS TEXT LINE, THOSE USE OF SERVICES REALLY SKYROCKETED.

>> DID THEY REALLY.

>> AGAIN, HOPEFULLY THIS MESSAGE, THERE IS HELP AVAILABLE THERE IS A LIFE LINE THAT YOU CAN CALL.

PEOPLE ACTUALLY STARTED USING IT.

>> AND SO, FOR KIDS, SOME OF THEM WERE OUT OF SCHOOL, AND FELT VERY SUPPORTED BY THEIR FAMILIES IN COMMUNITIES AND TEACHERS AND SCHOOL PSYCHOLOGISTS I KNOW WERE WORKING THE HARDEST THAT THEY COULD TO KEEP ALL KIDS SAFE.

BUT OTHERS I THINK MANY PEOPLE HAVE COME TO' LIE ON SCHOOLS AS THE MENTAL HEALTH CLINIC FOR OUR KIDS AS WELL AS FEEDING THEM AND ALL SORTS OF OTHER THINGS THAT SCHOOLS NOW DO THAT THE PANDEMIC REALLY POINTED OUT THAT KIDS WERE MISSING OUT ON.

>> RIGHT.

>> AND, AS WE, YOU KNOW, REALLY TALK ABOUT KIDS NEEDING TO BE BACK IN SCHOOL, AND THERE ARE A LOT OF EXPERTS, THE AMERICAN ACAD MIGHT HAVE OF PEDIATRICIANS I THINK, HAD SAID THAT, THAT'S THE BEST THING BUT WE HEARD THAT FROM Dr. FAUCI AND THE FORMER CDC DIRECTOR AND CURRENT CDC DIRECTOR ABOUT THE IMPORTANCE OF IN-PERSON LEARNING BUT FOR KIDS, THAT'S ALSO STRESS INDUCING THAT IT WAS NOT A HEALTHY ENVIRONMENT BEFORE.

SO, NOW THAT YOU HAVE BEEN AWAY FROM MAYBE THAT RICK FOR FOR 15, 16 MONTH, IS -- RIGOR FOR 15 OR 16 MONTHS, ARE YOU CONCERNED ABOUT THE MENTAL HEALTH CHALLENGES THOSE KIDS MAY FACE?

>> I REALLY AM.

THE MESSAGING WAS UNFORTUNATELY ONE SIZE FITS AWFUL KIDS NEED TO BE IN SCHOOLS AND SCHOOLS NEED TO BE OPEN IT AND IT DID NOT CONSIDER THE KIDS THAT WERE BULLIED AT SCHOOL AND NOW HAVE TO GO BACK INTO THAT.

OR THE KIDS WITH ANXIETY, THAT WERE OUT OF SCHOOL, AND, REALLY DOING WELL, BECAUSE THEY COULD STRUCTURE THEIR DAYS.

AND SO I THINK THAT THERE REALLY NEEDS BE A MUCH MORE NUANCED LOOK AT WHAT IS IT THAT KIDS NEED AS THEY ARE COMING BACK, AND, MORE PLANNING THAT LOOKS AT THAT -- ALL OF THE DIFFERENT LEVELS OF NEEDS INSTEAD OF JUST ALL KIDS NEED TO BE IN SCHOOL.

>> AND NOT THAT YOU -- YOU SHOULDN'T ASK YOU THIS BECAUSE MAYBE YOU CAN'T JUDGE OR SHOULDN'T BUT DO YOU THINK THAT WHEN KIDS DO .>> IT IS A LOT.

AND WHEN YOU THINK ABOUT, YOU KNOW, THERE ARE KIDS WHO DID LOSE PARENT, AND WHO DID LOSE OR GUARDIANS OR LOVED ONES.

AND THAT YOU WANT TO CREATE RESILIENT YOUTH WHO BECOME RESILIENT ADULTS, BUT, DO WE PUT PRESSURE ON KIDS TO BOUNCE BACK IN A WAY, THAT IS UNHEALTHY IN YOUR VIEW?

>> I THINK THE ADULTS AROUND KIDS NEED TO BE SUPPORTIVE BECAUSE THERE IS NO ONE-SIZE-FITS ALL.

SOME KIDS FLOURISH IF YOU PUT THEM BACK AND STRESS ON THEM IN TERMS OF THE -- NOT STRESS BUT PRESSURE TO SUCCEED AND DO WELL AND GET BACK TO THEIR PRIOR LEVELS OF FUNCTIONING.

WHEREAS, OTHER KIDS NEED A LOT MORE SUPPORT.

AND I THINK AS PERSONALIZED ASSESSMENT, UNDERSTANDING WHAT KIND OF LOSSES KIDS HAVE HAD, AND, REALLY, WHAT THEY NEED IN ORDER TO BE BACK DOING THEIR BEST.

>> RIGHT.

>> AND, YOU KNOW, WHAT'S THE ROLE OF MAYBE BUSINESSES AND ORGANIZATIONS TOO.

WE ALWAYS THINK IN TERMS OF WHAT SCHOOLS DOING, BUT, YOU KNOW, KID GROW UP, AND BECOME FUNCTIONING ADULTS HOPEFULLY AND, SO, IF THE NATION IS DEALING WITH THE KIND OF THE UNADDRESSED COLLECTIVE GRIEF, BUT YET WE'RE ALL GOING BACK TO OUR WORKPLACES AND MAYBE REMOTE WORKING, IS GOING TO BE BY THE WAYSIDE OR NOT AS ROBUST AS IT USED TO BE.

THERE IS A LOT FOR PEOPLE TO PROCESS IN GENERAL.

I'M JUST CURIOUS ABOUT WHAT TOOLS ARE BEST FOR, YOU KNOW, REORIENTING YOURSELF TO A NEW NORMAL.

>> I THINK THAT SOME OF THE SAME MESSAGES THAT PEOPLE WERE USING, FOR THEIR OWN MENTAL HEALTH DURING THE PANDEMIC, DURING QUARANTINE, SOCIAL DISTANCING, WE NEED TO CONTINUE TO DO, CHECKING UP ON OUR FRIENDS.

REACHING OUT IF YOU'RE STRUGGLING.

AND NOT BEING AFRAID TO SAY THAT TO PEOPLE BECAUSE, OFTEN TIMES, IF YOU'RE HAVING A BAD DAY, OR YOU'RE STRUGGLING WITH GOING BACK TO THE OFFICE, PUTTING ON REAL CLOTHES, YOUR LEGS ARE TOO.

AND, I THINK THAT KIND OF HONESTY AND SUPPORT IS MUCH BETTER THAN KIND OF JUST BRUSHING IT UNDER THE RUG AND SAYING IT IS BUSINESS AS UNDER.

>> WHEN IT COMES TO SUICIDE, WE'RE TALKING MORE ABOUT THAT.

I REMEMBER A TIME WHEN I GREW UP THAT, NEWS MEDIA DID NOT REPORT SUICIDE.

THOSE WERE THE GUIDELINES.

>> THOSE WERE THE GUIDELINES.

>> ONLY A FEW YEARS AGO GENTLEMAN SO THE CHANGE TO DO THAT, DO YOU THINK THAT THAT IS POSITIVE?

>> >> I THINK THAT IT IS POSITIVE, IN THAT IT SHOWS THAT, IN KENTUCKY WE USE TWO TIME MORSE PEOPLE TO SUICIDE THAN HOMICIDE.

ALL OF THE HOMICIDES ARE REPORTED WHEN THE SUICIDE WERE NOT REPORTED AT ALL, PEOPLE THOUGHT THAT IT DID NOT EXIST.

>> RIGHT.

>> AND WHEN WE THINK ABOUT SUICIDE IDEATION AND WE'VE TALKED BEFORE ABOUT WHEN PEOPLE MAKE THAT DECISION, IT IS A QUICK DECISION OR QUICK ACTION THEREAFTER?

>> FOR A LOT OF PEOPLE.

>> I MEAN, SECONDS THAT THEY -- >> IT CAN BE.

>> SO, HOW CAN SOMEONE INTERVENE WHEN SOMEONE IS DETERMINED THAT THEY ARE GOING TO TAKE THAT SUIT?

>> >> I THINK, IT HAS TO HAPPEN A LOT FURTHER UPSTREAM.

>> BEFORE STAGE FOUR AS THEY SAY.

>> EXACTLY.

>> IT HAS TO BE BEFORE SOMEONE IS AT THAT ACUTE SUICIDE RISK AND HAS LETHAL MEANS.

>> RIGHT.

>> AND THAT'S SOMETHING ELSE THE PANDEMIC HAS BROUGHT, FIREARM OWNERSHIP IS WAY UP.

AND, SO THERE'S A LOT MORE OPPORTUNITY WITH LETHAL MEANS AND IN HOUSEHOLDS.

>> AND YOU SAID TO US BEFORE THAT, THE ACCESS TO LETHAL MEANS AND IT COULD BE A FIREARM OR IT COULD BE KNIVES OR PHARMACEUTICALS AND YOU HAVE ALSO TAUGHT US A LESSON ABOUT, IN MEDIA REPORTING, ABOUT NOT FOCUSING ON THE MEANS BY WHICH SOMEONE DIED BY SUICIDE.

WHY IS THAT SO IMPORTANT?

WHAT DOES THE RESEARCH TELL US?

>> ESSENTIALLY, IT IS A COUPLE OF THINGS.

ONE, IT GIVES US MORBID DETAILS ABOUT SOMETHING THAT REALLY ISN'T PART OF THE STORY.

IF SOMEONE DIED IN A CAR ACCIDENT, WOULD IT MATTER WHAT THEY WERE WEARING, FOR EXAMPLE, THAT KIND OF THING.

WHAT COLOR THE IMPLEMENT THEY USED WAS.

AND THEN, ALSO, FOR OTHER PEOPLE, WHO MIGHT BE SUICIDAL THEMSELVES, IT KIND OF GIVES THEM MORE DETAILS ABOUT METHODS THAT ARE LETHAL.

AND THEN, ALSO, FOR PEOPLE THAT HAVE LOST LOVED ONES TO SUICIDE, IT IS JUST A REMINDER OF ESPECIALLY WHEN IT IS THE SAME METHOD OF THOSE HORRIBLE MINUTES THAT THE LOVED ONE WENT THROUGH.

>> DOES IT ENTICE OTHERS TO IMITATE -- >> THERE IS SOME EVIDENCE THAT IT DOES FOR EXAMPLE WHEN ROBIN WILLIAMS DIED BY SUICIDE THAT METHOD OF HIS SUICIDE SEEMED TO INCREASE IN THE FOLLOWING YEAR.

>> I HAVE ALSO LEARNED FROM YOU AND OTHERS ABOUT HOW IMPORTANT LANGUAGE IS, AND I APPLY IT TO EVERY OTHER SPACE BUT I NEVER REALLY THOUGHT ABOUT IT SO I HOPE THAT PEOPLE ARE TAKING NOTE THAT WE'RE SAYING DUER BY SUICIDE, NOT COMMIT SUICIDE.

IF YOU'LL MAKE THAT DISTINCTION FOR US.

>> DEFINITELY.

THE LANGUAGE COMMIT ACTUALLY, THE AP-STYLE GUIDE SUGGESTING THAT WE GET RID OF IT, BECAUSE, IT IMPLIES THAT YOU'RE COMMITTING A SIN OR A CRIME.

AND THAT GOES BACK TO WHEN SUICIDE WAS CRIMINALIZED AND THE CHURCH SAID THAT SUICIDE WAS A SIN.

BOTH OF THOSE THINGS DON'T EXIST ANY MORE.

SUICIDE IS NOT A CRIME.

AND, IN MOST MOST RELIGIOUS TRADITIONS IT IS NOT SEEN AS A SIN, IT IS SEEN AS THE LAST MOMENTS OF SOMEONE'S LIFE AND HOW THEY LIVED THEIR LIFE IN MANY RELIGIOUS TRADITIONS IS FAR MORE IMPORTANT.

FOR THOSE PEOPLE LEFT LE BEHIND, HAVING THAT KIND OF REMINDER THAT THE LOVED ONE COMMITTED A CRIME OR COMMITTED A SIN, CAN THEN JUST BE MORE STIGMATIZING AND HARMFUL.

>> HOW IMPORTANT IS THAT IT THE FAITH COMMUNITY IS ALSO CHANGING THEIR PERCEPTION OF SUICIDE?

>> I THINK IT IS SO IMPORTANT.

BECAUSE, PEOPLE LISTEN TO THE FAITH LEADERS AND TRUST THEIR FAITH LEADERS, AND, WHEN FAITH TRADITIONS CAN HAVE NORMAL RITUALS AROUND GRIEVING SUICIDE, COMPARED TO O FOR EXAMPLE, MY COLLEAGUE MELINDA MOORE WROTE A BOOK ON THE STUDS FUNERAL, HELPING CLERGY TO UNDERSTAND HOW YOU DO THIS FUNERAL.

LIKE EVERY OTHER YOU BUT HERE WAYS TO MAKE IT GO EASIER AND HELP THE FAMILIES.

>> RIGHT.

I THINK THAT, IT IS JUST SO IMPORTANT, IT IS SO INTERESTING THAT WHEN SOMETIMES I HAVE THESE SHOWS AND THEN SOMEONE WILL SAY, MY FATHER DIED BY SUICIDE.

AND, SOMETHING THEY KEPT A SECRET BECAUSE THEY FELT SHAME, THE SURVIVORS FEEL SHAME.

CAN YOU ADDRESS THAT AND WHY THEY FEEL SHAME?

>> WHAT WE FOUND OVER THE WORK IN THE LAST FEW YEARS IN A VARIETY OF DIFFERENT SETTING AND WE LOOKED AT THE POPULATION IN KENTUCKY AND LOOKED AT NATIONAL POPULATIONS, SPECIFIC SUBSETS AND NOW WE'RE DOING A STUDY WITH THE KENTUCKY ARMY NATIONAL GUARD.

AND ESSENTIALLY WHAT WE HAVE FOUND IS HALF OF US KNOW SOMEONE THAT DIED BY SUICIDE.

AND ABOUT A THIRD OF US ARE CLOSE TO SOMEONE THAT HAS DIED BY SUICIDE.

NONE OF US EVER REALLY TALK ABOUT THESE LOSSES, BECAUSE OF THAT STIGMA.

BUT, JUST KNOWING THAT, I THINK, FOR SOME PEOPLE, IS SUCH A RELIEF WHEN THEY EXPERIENCE THAT LOSS AND THEY FEEL SO ALONE, AND SO MUCH LIKE NOBODY ELSE IS EVER HAD THIS HORRIBLE EXPERIENCE.

>> I LIKE WHAT YOU SAID, AND IT HAS BECOME A MANTRA THAT I HAVE HEARD THAT IT IS OKAY NOT TO BE OKAY.

AND THAT WE'RE HEARING THAT PERHAPS MORE AND MORE AND THE TERMS, YOU KNOW, ONCE AGAIN BACK TO LANGUAGE, CRAZY AND ALL THE WAY THAT WE DEMONIZED MENTAL HEALTH AND I HAVE HEARD SOME PROFESSIONALS SAY WE SHOULD CALL IT MENTAL WELLNESS AND WE TALK ABOUT, ACUTE DEPRESSION, OTHER FORMS OF MENTAL CHALLENGE, GET TO IT BEFORE STAGE 4, I MEAN, REALLY TRY TO MANAGE IT AS IF YOU WOULD A CHRONIC DISEASE.

ARE WE THERE YET AS A NATION?

OR AS A STATE, RECOGNIZING THAT, IT IS ALL CONNECTED?

>> I WISH THAT WE WERE.

WE'RE NOT THERE YET.

WHEN I LOOK AT KIND OF INSURANCE, AND, ACCESSIBILITY, FOR MENTAL HEALTH TREATMENT WHEN I SEE PEOPLE SEARCHING FOR A THERAPIST OR A PSYCHIATRIST ESPECIALLY.

IT IS HARD TO GET IN THERE IS LONG WAIT LISTS.

BUT I THINK WE'RE GETTING CLOSER.

>> IS THAT PARTICULARLY TRUE FOR CHILDREN, BECAUSE, I HAD SOMEONE WHO TOLD ME THAT, WHAT WE HAVEN'T TALKED ABOUT ENOUGH, IS THE DIRTH OF MENTAL HEALTH PROVIDERS FOR ADOLESCENTS.

IS THAT THE CASE?

>> OH, DEFINITELY.

>> REALLY.

>> YEAH.

>> AND I GUESS WE THINK OF A PLACE WITH THE UNIVERSITY OF KENTUCKY WHEN YOU HAVE THESE INTELLECTUAL CITADELS THAT'S A REPLETE OFFERING AND IT IS NOT.

IF I CAN IMAGINE IT IS WORSE IN AREAS WHERE THERE IS -- >> PRECISELY.

NOT NEVER CHILD PSYCHIATRISTS ACROSS THE WHOLE COUNTRY.

BUT ESPECIALLY IN RURAL AREAS.

AND, IT IS HARDER TO TREAT KIDS.

YOU HAVE TO DEAL WITH THE PARENTS AND THE SCHOOLS, AND YOU HAVE TO KIND OF FIGURE OUT A WAY TO HAVE THESE CONVERSATIONS WITH KIDS.

AND SO IT IS A HARDER, ESPECIALLY IT DOESN'T PAY AS WELL, FOR EXAMPLE, BECAUSE WE'RE SPENDING ALL OF THOSE UNREIMBURSABLE HOURS WITH THE PARENTS AND TEACHERS.

>> RIGHT.

AND SO WHAT DO KENTUCKY -- OF COURSE YOU SAID IT IS A NATIONWIDE PROBLEM BUT I'M CURIOUS IF PEOPLE GO OUT OF STATE, OR, YOU KNOW, WHERE DO THEY -- >> INSURANCE DOESN'T LET PEOPLE GO OUT OF THE STATE.

>> YOU HAVE TO BE OUT OF YOUR OWN POCK TOTE DO THAT IF YOU WERE GOING TO DO THAT.

WOW, AND THAT GETS TO THE HEART OF WHAT YOU WERE TALKING ABOUT, INSURANCE RULES.

IS THAT A POLICY THAT YOU CAN SEE IN THE FUTURE BEING CHALLENGED?

>> I SURE HOPE SO.

I KNOW THERE WAS LEGISLATION THIS SESSION AND I DIDN'T GET TO FOLLOW WHERE IT WENT BECAUSE THERE WAS SO MUCH FOCUS ON OTHER THINGS.

>> AND I DON'T THINK THAT IT DID GET ACROSS THE FINISH LINE.

>> RIGHT.

>> AND WE OFTEN THINK ABOUT, YOU KNOW, WHERE CAN POLICY MAKE A DIFFERENCE AND IT COMES TO MENTAL HEALTH ISSUES AND WE HEARD A LOT OF LAWMAKERS TALK ABOUT, THE NEED TO ADDRESS MENTAL HEALTH.

WELL, WHAT WOULD YOU TELL THEM IF YOU GOT AN OPPORTUNITY AND PERHAPS YOU WILL WHEN THEY MEET IN 2022 FOR THE LONGER SESSION TO SAY IF YOU WANT TO ADDRESS POSITIVE MENTAL HEALTH FOR A KIDS, DO THESE THINGS.

>> I THINK THAT, UNFUNDED MANDATES, HELP EXACTLY THE AMOUNT OF THE COST, WHICH IS, THE MANDATES, PEOPLE TRY THEIR BEST TO DO THEM, BUT, REALLY, PEOPLE NEED FUNDING IN ORDER TO GET THE VERY BEST MENTAL HEALTH TREATMENT ESPECIALLY FOR KIDS.

>> RIGHT.

>> AND SO, TO TRAIN THE PHYSICIANS AND MENTAL HEALTH CLINICIANS BETTER, WE NEED BETTER TRAINING.

WE NEED MORE END PERICALLY SUPPORTED THERAPYS IN USE, AND, CONVERSATION FOR US TO HAVE ANOTHER DAY IS IS ABOUT THIS WHOLE NEW TRANSFORMATION OF CRISIS SERVICES.

SO, 988 IS GOING TO BE THE NEW NATIONAL SUICIDE PREVENTION LIFE LINE.

>> OKAY.

>> IT WILL COME IN TO PLAY JULY, 2022 SO, ACROSS THE COUNTRY, EVERY SINGLE STATE HAS TO FUND IT THEMSELVES.

AND SO, THAT'S GOING TO BE A WHOLE INTERESTING CONVERSATION IN THINKING ABOUT HOW WE CAN REIT OKAY, WE NEED TO STAY ON TOP OF THAT TRANSFORMATION OF CRISIS SERVICES.

THAT'S AN IMPORTANT ISSUE THAT WE WANT TO FOLLOW UP ON.

JUST A MINUTE REMAINING AND THERE IS ALWAYS SO MUCH THAT WE CAN TALK ABOUT WHEN IT COMES TO THESE ISSUES AND I NEVER KNOW WHERE TO STOP AND I NEVER KNOW WHERE TO START.

BUT, IT SEEMS LIKE YOU ARE OPTIMISTIC THAT PERHAPS AFTER ALL OF THIS, THAT WE HAVE BEEN THROUGH, THERE IS A BRIGHT LIGHT.

>> I THINK THAT THERE IS.

I CAN'T TELL YOU THE NUMBER OF KID THAT I HAVE REFERRED TO THE MENTAL CLINIC AT EASTERN KEN UNIVERSITY, FOR EXAMPLE.

-- AT EASTERN KENTUCKY UNIVERSITY.

THEY'VE BEEN DOING TELEMEDICINE THE ENTIRETY PANDEMIC.

THEY SEE COUNTLESS PEOPLE EVERY WEEK, AND, MOST OF THE PEOPLE THAT I HAVE REFERRED, I HAVE HEARD THAT IT HAS BEEN REALLY HELPFUL AND I THINK THAT WE CAN KEEP UP DESTIGMATIZING MENTAL HEALTH AND TALKING ABOUT THESE ISSUES, AND, LOOKING OUT FOR EACH OTHER.

>> GREAT ADVICE.

THANK YOU.

Dr. JULIE CEREL.

IT IS A PLEASURE TO HAVE YOU WITH US AND TO GIVE US YOUR WISDOM AND WE REALLY APPRECIATE IT AND YOUR ADVICE.

AND ALWAYS CHECK OUT OUR WEBSITE AT KET.ORG.

WE HAVE LOTS OF RESOURCES WHEN IT COMES TO YOUTH MENTAL HEALTH AND OTHER PROGRAMS.

JULIE, THIS IS A PROGRAM THAT WE DID LASTIER OR TWO YEARS AGO PRE-PANDEMIC ABOUT YOUTH MENTAL HEALTH AND ALL OF THESE ISSUES THAT QUESTION DISCUSSED.

AND IT IS A TIMELESS PIECE EVEN THOUGH IT WAS DONE TWO YEARS AGO.

SO, THANK YOU FOR WATCHING THIS EDITION OF "CONNECTIONS."

I'M RENEE SHAW.

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ALSO, LISTEN TO OUR PODCAST, IF YOU DON'T GET A CHANCE TO CHECK US OUT SOMETIMES ON THE TELE AND KEEP IN TOUCH WITH US ON KENTUCKY TONIGHT EVERY MONDAY NIGHT WE TALK ABOUT ISSUES THAT ALSO MATTER TO YOU.