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Reaching youth for mental health

The News-Herald - 3/28/2018

One of the most important groups of people mental health experts try to reach are younger.

Cherokee Health Systems and the Mental Health Association of East Tennessee both put an emphasis on schools.

Cherokee partners with Lenoir City Schools to provide in-school services, while MHAET tries to provide training to schools across the region.

"Fifty percent of everybody with a mental health condition will have their symptoms start by age 14," Ben Harrington, MHAET executive director, said. "Then, what happens for most of those people is the symptoms start at some point by age 14 and nothing happens for a decade or more. That is the problem that we have.

"If folks go untreated they are going to have recurring episodes of mental illness that are going to get more profound, longer lasting, more symptoms, bigger symptoms," Harrington said. "Then, that person gets to a point where they might snap, might get more angry or irritable, contemplating suicide or that sort of thing. It's imperative to us to intervene early, train students, train youth what to recognize. What symptoms can they recognize in their fellow youth?"

MHAET provides programs in 107 schools in 27 counties in East Tennessee, including Loudon County.

"We are on a path to teach about 30,000 kids this school year what to recognize, when to recognize it and what to do about what they've recognized," Harrington said.

According to the Tennessee Suicide Prevention Network, suicide was the No. 2 cause of death among youth age 10-14 in 2015. It was the No. 3 cause for ages 15-24 and No. 2 for ages 25-34.

That 25-34 age range is the group Harrington said was at highest risk for suicide because of potential undiagnosed problems from their youth that may worsen over time.

Because of the higher risk among young people for suicide, schools put a focus on making sure they are training to recognize warning signs.

"Every year all school systems are required to provide, by law, are required to provide training for suicide prevention," Mary Harding, Coordinated School Health coordinator for Lenoir City Schools, said. "A lot of mental health problems are talked about during that training.

"... It's like anything else, the more you're exposed to it the more likely you are to remember it," she added. "Each year there is a little bit of a different twist on the training, so it's still getting in the basic training, but it's working in a different component."

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"Whenever you get training, the purpose of any training is to try to keep teachers and staff current on the different mental health issues as they come to light," Harding said. "That's part of why a little bit of the training changes every year is to make sure we're staying current."

Teachers are also trained to identify the standard warning signs for mental health, which includes physical, emotional and social changes.

From there, teachers can reach out to guidance offices in schools to get help. There is a pyramid of need set up in Lenoir City Schools with guidance at the base, then from there if the problem is at a higher level schools can tap into resources available, including social workers and services from Cherokee.

Cherokee Health Services can send a professional to work with students with parent approval.

"As a community health center, outreach is a core part of our mission," Parinda Khatri, chief clinical cfficer for Cherokee Health Systems, said. "We recognize that children are most vulnerable and valued population, yet it's very difficult for them to get into the clinic for care, for mental health care. We have a group of school-based specialists that we send out to the schools. ?. Going where the need is has really been our model."

At the top level of the needs pyramid could be help outside schools or even a stay in a mental health facility, which is uncommon.

Schools hope to avoid those steps if possible and try to teach healthy ways to cope with stress, sadness and anger beginning in elementary school.

"The earlier they recognize that there are appropriate ways of dealing with anger and sadness and there are inappropriate ways, the better," Harding said. "We want kids to know there are support systems for them and it's OK to feel sad or angry - everybody feels sad or angry, but there are appropriate ways to handle them.

"We try and teach kids that exercise is a really good way to deal with stress, not yelling and screaming," she added. "Trying to help them find an appropriate way to express themselves. It's important that kids know it's OK to have those feelings, it's just the way they react to them that we want to be on a positive note. Those are skills that move into adulthood. How do you cope with stress at work? How do you deal with anger as an adult? ? That's why we really want to start these skills and knowledge at an early age, so they don't get into the habit of dealing with them in a negative way."

According to Mental Health America, 9.91 percent of youth in Tennessee reported a major depressive episode in 2017. The state ranks 49th out of all states and the District of Columbia in terms of youth with major depressive episodes receiving some consistent treatment.

"If we can train those young folks what to recognize and how to act and where to reach out for help then we can help younger people who need help get that identified and get treatments," Harrington said.


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