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Children and youth who experience trauma display increases in stress hormones comparable to those displayed in combat veterans. Click here to learn more about the behavioral health impact of traumatic events on children and youth.

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USA Today Your LIFE|Health                            By Steven Reinberg, HealthDay posted Sept 5, 2001 

About half of Americans will experience some form of mental health problem at some point in their life, a new government report warns, and more must be done to help them.

 
Getty Images/BananaStock 

One survey done in 2009 by the Substance Abuse and Mental Health Services Administration found that 11 million people — nearly five percent of the population — experienced serious mental illness during the past year. Mental health issues run the gamut from depression to post-traumatic stress disorder to suicide, and many of those suffering presently do not get help, experts say. The new report, from the U.S. Centers for Disease Control and Prevention, tallied the national burden of mental illness based on country-wide surveys.  

There are “unacceptably high levels of mental illness in the United States,” said Ileana Arias, principal deputy director of the CDC. “Essentially, about 25 percent of adult Americans reported having a mental illness in the previous year. In addition to the high level, we were surprised by the cost associated with that — we estimated about $300 billion in 2002.”  

The high cost includes care for the illness and lost productivity, Arias said.It isn’t clear why so many Americans suffer from mental illness, Arias added. “This is an issue that needs to be addressed,” she said, not only because of the illness itself, but because mental disorders are associated with other chronic illnesses such as heart disease and cancer.

And while having a psychiatric illness is tough enough, the stigma surrounding these diagnoses adds to the burden, experts said.  ”Mental illness is frequently seen as a moral issue or an issue of weakness,” Arias explained. “It is a condition no different from cancer or other chronic diseases. People need to accept the difficulties they are having and avail themselves of the resources that are available.”  The report was published Sept. 2 as a supplement to the CDC’s Morbidity and Mortality Weekly Report.

One survey done in 2009 by the Substance Abuse and Mental Health Services Administration found that 11 million people — nearly five percent of the population — experienced serious mental illness during the past year, defined as conditions that affected the ability to function.

In addition, some 8.4 million Americans had suicidal thoughts in the past year and 2.2 million made plans to kill themselves. One million attempted suicide, the report found.

Information from other sources confirmed these numbers, with slight variations, the report said.

Dr. John Newcomer, professor of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, believes the problem may be even bigger than the CDC report indicates. For example, state Medicaid programs spend a great deal on drugs to treat mental illness, which the CDC didn’t take into account, Newcomer said. “For several years the top three drugs were antipsychotic drugs,” he noted.

Also, many people with mental illness hide the problem from others, Newcomer said. The CDC report looked at people already in the health-care system, “but there is a big problem with underdiagnosis and undertreatment,” he said. 

Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, said healthy living — getting enough sleep, eating right, exercising — can help people avoid some mental illness. 

“Understanding how to deal with psychological stresses is also important,” he said. “How to deal with emotional reactivity and stress tolerances are also important skills to develop early in life.” 

Manevitz said people should always seek help for mental health troubles whenever “you are not functioning well in your life and isolating yourself.” 

More information: The U.S. National Institute of Mental Health has more about mental health, http://www.nimh.nih.gov/index.shtml

 Staffing the Youth MOVE Maine table at the national conference in Chicago are (from left): Jacinta Storer, Ashalie Wark, Chesari Tempesta and Ryun Anderson.               (Photo by Lisa Preney) 

State Chapter Active in Four Regions, Ready to Launch in Bangor 

CHICAGO – After three years of mobilizing support, Youth Motivating Others through Voices of Experience (M.O.V.E.) National, now has 29 chapters in 25 states, including Maine. For the first time, Youth MOVE Maine joined colleagues and 1600 federally funded System of Care partners from across the United States at an annual Community Training conference July 19-21 to celebrate efforts to improve services for youth in mental health, juvenile justice and child welfare systems.

“It is great to connect with the national movement and with other states because we learn from each other and can effect change on a larger scale,” says Ryun Anderson, Youth MOVE Maine Coordinator.

Anderson and four staff shared that over the past year Youth` MOVE Maine has expanded from its core of young people in Lewiston to start groups and trainings for youth ages 14-25 in the midcoast, Kennebec Valley and southern Maine with a northern region just funded to start in October.

In the midcoast, a half dozen youth are engaged in peer support and trainings, including meditation, musical self-expression and leadership.

“We have ten youth from greater Portland advocating for better housing, and being trained in leadership and creative expression,” says Chesari Tempesta, Youth Resource Specialist.

In Augusta, 16 youth through partnerships with the Boys and Girls Club and Capital Clubhouse are tackling bullying and improved employment opportunities, in addition to attending leadership training and creative expression workshops,” says Ashalie Wark, Youth Resource Specialist.

The state chapter’s flagship group in Lewiston has 12 youth connected with the federal initiative Moving Forward working to improve housing, behavioral health services and employment opportunities, while taking cooking and other life skills classes.

To get in touch with a Youth MOVE Maine resource specialist, go to www.youthmovemaine.org  

Youth MOVE Maine, a state chapter of Youth Move National, supports youth and adults in building the skills, partnerships, policies and practices essential to making sure all  youth are connected, resilient, growing and included in the decisions that impact their lives.

Video stars and presenters celebrate their “bridge building” on a Canal Street bridge in Lewiston (front left): Norm LeBlanc, Jennifer Collins, Jennifer Herrick, Joy Hodgson, Carol Tiernan, Rebecca Williamson and Lisa Preney; back row: Allen Hodgson and Jonathan Williamson.       (Photo by Carol Karczewski)

 “Together we can build a bridge” Earns Silver for
Excellence in Community Communications and Outreach

CHICAGO – THRIVE, Maine’s trauma-informed System of Care Initiative, and G.E.A.R. Parent Network accepted the silver award in the Professional Outreach category for Together we can build a bridge (“Bridge”) July 21 at the 2011 Excellence in Community Communications and Outreach recognition ceremony sponsored by the Substance and Mental Health Services Administration’s Caring for Every Child’s Mental Health Campaign.

The public service announcement by mothers and their children from Dixfield, Lewiston and East Livermore, Maine, urges child-serving providers to be “trauma informed” and “strength based.” From personal experience, the women also let families of children with significant behavioral health issues know they are not alone, that help is available, and “When you use your voice, you have a choice.”

“Our hometown bridges depict how isolated we felt when we first started out with a provider,” says Rebecca Williamson. “Families want help, but may not know how to get it or how to ask for what they need,” she says.

At the end of the video, the families stand together symbolizing the strength they’ve found in peer support and their readiness to use their own voice with child welfare, mental health and other providers.

“We want to bridge the abyss between us and them,” explains Joy Hodgson, “and meet providers halfway. We want them to listen to us and not judge us, to learn from us instead of trying to fix us. That way, our meetings can support an interchange of experiences and be cultural learning opportunities with the shared goal of getting our child’s needs met.”

Bridge has been viewed 1000 times to date on You Tube, and been broadcast by 40 Community Access TV stations to over 3.5 million homes  in 70 Maine communities; 13 other states, South Africa and New Zealand. It has been presented by members of Family Advisory Councils for Empowerment Statewide to hundreds of providers and service agencies at the state and local level throughout Maine. 

THRIVE trauma-informed trainings and technical assistance help child-serving providers and community organizations transform the way services are delivered to children and youth with serious behavioral health challenges and to their families.

G.E.A.R. Parent Network empowers parents of children with emotional and behavioral health needs to effect life decisions based on their family’s individual strengths and needs by providing safe and supportive avenues for: emotional support, problem solving, sharing common experiences, seeking knowledge about community resources and advocacy, identifying the strengths and needs of their child(ren) and families and accessing information and education related to children’s issues.

New research has shown that children’s risk for learning and behavior problems and obesity rises in correlation to their level of trauma exposure, says the psychiatrist at the Stanford University School of Medicine and Lucile Packard Children’s Hospital who oversaw the study. The findings could encourage physicians to consider diagnosing post-traumatic stress disorder rather than attention deficit/hyperactivity disorder, which has similar symptoms to PTSD but very different treatment.

The study examined children living in a violent, low-income neighborhood and documented an unexpectedly strong link between abuse, trauma and neglect and the children’s mental and physical health: It reported, for instance, that children experiencing four types of trauma were 30 times more likely to have behavior and learning problems than those not exposed to trauma.

“In communities where there is violence, where children are exposed to events such as shootings in their neighborhoods, kids experience a constant environmental threat,” said senior author Victor Carrion, MD, associate professor of psychiatry and behavioral sciences at Stanford. “Contrary to some people’s belief, these children don’t get used to trauma. These events remain stressful and impact children’s physiology.”

The new study is being published online today in Child Abuse & Neglect; The International Journal. Carrion collaborated on the research with scientists at the University of New Orleans and the Bayview Child Health Center, part of San Francisco’s California Pacific Medical Center.

The findings provide compelling evidence that pediatricians should routinely screen children for trauma exposures, said Carrion, who is also a child psychiatrist at Packard Children’s.

“As simple as it may seem, physicians do not ask about trauma,” he said. “And kids get the wrong diagnoses.”

The study builds on earlier work that linked worsening health in adults with their dose of exposure to nine types of adverse childhood events, including being subject to various kinds of abuse or neglect; having a household member who abused alcohol or drugs, was incarcerated or was mentally ill; having a mother who was treated violently; and not living in a two-parent household. Middle-class men exposed to more of these events had more chronic diseases in adulthood, the prior research found. The results of the current study highlight the need for early identification of such adversity-associated health problems, and early intervention. Obesity, for example, may act as a mediator to other health problems such as diabetes, cardiac risk and inflammatory illness.

To perform the study, the researchers evaluated medical records from 701 children treated at a primary-care clinic in Bayview-Hunter’s Point, a San Francisco neighborhood with high rates of poverty and violence. About half the children were African-American; the rest came from other ethnic backgrounds. Each child’s exposure to adverse events was scored on a scale from 0 to 9, with one point given for each type of adversity. The researchers also evaluated the medical records for evidence of obesity and learning or behavior problems.

Two-thirds of the children in the study had experienced at least one category of adversity, and 12 percent experienced four or more categories. An adversity score of 4 or higher left kids 30 times as likely to show learning and behavior problems and twice as likely to be obese as those with a score of 0. Children with an adversity score of 1 were 10 times as likely to have learning and behavior problems as those not exposed to trauma.

Prior research has shown that about 30 percent of children in violent communities have symptoms of post-traumatic stress disorder, which can include the learning and behavior problems detected in the current study, Carrion noted. However, a physician unaware of the fact that a child experienced trauma, and noting the child’s physiological hyperarousability and cognitive difficulties, may diagnose ADHD instead of PTSD. That’s a problem because the two disorders have opposite treatments, he said. Kids with PTSD need psychotherapy, not the stimulant medications given for ADHD.

“Children can recover from PTSD with the appropriate treatment, which is one of approach and not avoidance,” Carrion said. “By not asking about trauma, we’re utilizing avoidance. We’re perpetuating PTSD.”

As part of their efforts to address the long-term health problems that stem from childhood trauma, Carrion, his collaborators and several San Francisco community partners are working to launch the Center for Youth Wellness, a one-stop health and wellness center for urban children and families in San Francisco. The Center for Youth Wellness will combine pediatrics with mental health services, educational support, family support, research and best practices in child-abuse response under one roof. With both public and private support, the center will coordinate the services of multiple agencies to give children a safe and accessible place to increase their resilience to adverse life experiences and improve their well-being.

The center, which aims to begin operation by mid-2012, is a partnership between California Pacific Medical Center’s Bayview Child Health Center, San Francisco Child Abuse Prevention Center, San Francisco District Attorney’s Office, Stanford’s Early Life Stress Research Program at Lucile Packard Children’s Hospital and Tipping Point Community. Nadine Burke, MD, director of the Bayview center, is also a co-author of the study.

“We need to create trauma-informed systems,” Carrion concluded, adding that the Center for Youth Wellness hopes to function as a model for such systems across the nation. People working for the welfare of children need to be on the lookout for trauma and know how to intervene, and how to work with the family and with schools, he said. “If trauma goes untreated, it’s very costly for the individuals involved and for society in general.”

The research was funded by the Lennar Urban Corp. and awards to Carrion from the National Institute of Mental Health and the Evans Foundation. For more information, visit www.lpch.org

 Click here for WCHS6-TV report

Stories of Resiliency: Youth & Family Share Powerful Messages of What Works Best

     AUGUSTA — Children’s Mental Health Awareness Week got off to a great trauma-informed start in Maine!

     On May 3, at the Hall of Flags, Augusta, more than 30 service providers heard seven youth and family members share inspiring stories of resiliency and the stabilization of emotional wellness in the face of challenges ranging from abuse and teen pregnancy, juvenile incarceration and autism, to a learning disability and depression.  Adults spoke of the difference a family organization can make and family-strengthening intergenerational resiliency.

     Resiliency from within nurtured by family and other natural supports, as well as youth-guided, family-driven and culturally competent treatment goes a long way towards countering research that children, even as young as 18 months old, who are  exposed to traumatic events, can develop serious problems as they mature, including substance abuse, depression, anxiety and stress management issues. Click here for childhood trauma resources.

     May has been  Mental Health Awareness month since Congress established it in the late 1960s. Seven years ago, the National Federation of Families for Children’s Mental Health declared the first week of May Children’s Mental Health Awareness Week.  Last year, nearly 11,000 children participated in awareness events nationwide and the number of national organizations collaborating on this public awareness effort has risen from four in 2005 to 88 in 2011.

     Weeklong awareness events are now part of Substance Abuse and Mental Health Services Administration (SAMHSA) overall strategy to raise awareness that positive mental health is essential to a child’s healthy development from birth. Click here for SAMHSA’s 2011 Short Report on data demonstrating the effectiveness of Systems of Care and National Child Traumatic Stress Network grantees in treating children with trauma. To learn more, visit www.samhsa.gov/children.

       LEWISTON –  To celebrate Children’s Mental Health Awareness Week, THRIVE System of Care Initiative today released its first-round evaluation results for trauma-informed services in Maine.

        In partnership with Maine’s Children’s Behavioral Health Services and Hornby-Zeller Associates, THRIVE developed, administered and validated a Trauma-Informed Agency Assessment (TIAA) of how well mental health agencies are meeting principles of: physical and emotional safety; youth and family empowerment, choice and control, trauma competence, trustworthiness and cultural competence.

         “The results show the positive effects of trauma-informed services on children and why they are needed by their  caretakers, as well as by youth who may be on their own,” says THRIVE director, Arabella Perez.

         Future objectives include Continuous Quality Improvement plans for agencies that have completed TIAAs, and continued development and/or support of youth and family organizations’ peer partner programs. THRIVE plans to expand its trauma-informed training and technical assistance to 150 child-serving mental health agencies and the juvenile justice system in Maine. 

            In 2009, researchers found that nationally more than 60 percent of youth age 17 and younger have been exposed to crime, violence, and abuse either directly or indirectly including witnessing a violent act, assault with a weapon, sexual victimization, child maltreatment, and dating violence. Nearly 10 percent were injured during the exposure to violence, 10 percent were exposed to maltreatment by caretaker, and 6 percent were a victim of sexual assault.¹

             The above are common examples of a traumatic experience, but by no means the full list. The death of a loved one, a natural disaster, living with terminal illness or alcoholism are other examples of situations that can cause children and youth to manifest symptoms of anxiety, depression, anger, post traumatic stress, dissociation and sexual concerns. These and other behaviors related to traumatic stress can manifest in school, community agencies, foster homes, homeless shelters, youth correctional facilities — anywhere and everywhere youth and families are found.

          Five years ago, because of its high rate of reported domestic violence coupled with low income levels, the tri-county area received a federal System of Care grant to provide trauma-informed training and technical assistance aimed at improving services for affected families and their communities.

            THRIVE’s first round of evaluation data shows that many youth reported trauma experiences, such as physical abuse and violence in the home, each affecting nearly 40 percent of them. Those who had experienced trauma, either acute or prolonged, displayed significantly more symptoms of depression, anxiety, anger and post-traumatic stress at the beginning of services. After six months of treatment, symptoms of anger, depression and anxiety were reduced.

            Of note was that the majority of children who had trauma experiences had a family member with a mental illness. Moreover, over 40 percent of caregivers reported that they themselves experienced some form of trauma as a child, including sexual abuse, emotional abuse and being separated from their own families. This brings the aspect of intergenerational trauma to the fore. Almost twice as many caregivers who had numerous trauma experiences as children, also had chronic physical health problems, which can certainly impact the public cost of healthcare. 

¹ http://www.samhsa.gov/children/social_media_lateapr2011.asp

THRIVE (www.thriveinitiative.org) helps child-serving providers and community organizations transform the way services are delivered to children, families of children, and to youth who are affected by serious emotional and behavioral challenges. THRIVE trauma-informed trainings and technical assistance are  family-driven, youth-guided and culturally and linguistically competent. THRIVE is funded by Maine’s Children’s Behavioral Health Services and the Substance Abuse and Mental Health Services Administration.

Preney (left) receives Mover and Shaker Award from Sue Henri-McKenzie, Director, Southern Maine Parent Awareness

   Lisa Preney Honored for Behind the Scenes Work for Family Organizations

SANFORD – Southern Maine Parent Awareness (SMPA) honored Lisa Preney, Social Marketing Coordinator, THRIVE System of Care, Lewiston, with its Behind the Scenes Mover and Shaker of the Year Award. Preney, who lives in Falmouth, received the award at SMPA’s Annual Awards Luncheon October 4.

“Lisa hung in there with seven sometimes cantankerous family organizations to help us define the public face of the Maine Alliance of Family Organizations (MAFO),” says Sue Henri-MacKenzie, SMPA Executive Director. “She kept us focused on creating an identity statement and image, which sustained our forward momentum.”

Over a year ago, SMPA, Learning Disabilities Association of Maine, Maine Parent Federation, G.E.A.R. Parent Network, Autism Society of Maine, Adoptive and Foster Families of Maine and the National Alliance on Mental Illness-Maine began forming an alliance to help families of children with disabilities and special health care needs and to strengthen family voice.

“This year, it was about choosing words and an image to define them collectively,” Preney said. “They are such distinct entities, yet share common vital goals for families. The photo they developed to brand themselves depicts seven authentic family members hands joined high looking out across a Maine lake. The camera is behind them, so the focus is on the future, which the alliance has chosen to face together.” 

MAFO promotes the family role in influencing policies and procedures governing care for all children.

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Southern Maine Parent Awareness (www.somepa.org) is dedicated to providing information and referral, support, and education to families who have children with special needs throughout Maine.

Thrive System of Care (www.thriveinitiative.org) helps providers and community organizations in Maine transform the way services are delivered to children, families of children, and to youth who are affected by serious emotional and behavioral challenges. Thrive trauma-informed trainings and technical assistance are family-driven, youth-guided and culturally and linguistically competent. Thrive is a partnership of Maine’s Children’s Behavioral Health Services, Tri-County Mental Health Services, and the Substance Abuse and Mental Health Services Administration in collaboration with local provider agencies.

            Click here for Sun Journal story and photo caption

     AUGUSTA — Maine’s premiere youth aadvocacy group, Youth Motivating Others through Voices of Experience (“Youth MOVE Maine”) launched its 2010 public awareness campaign at the Children’s Mental Health Awareness Day celebration, May 6, State House, Hall of Flags, Augusta.

Youth MOVE joined a line-up of youth and family speakers that also included James VanOver, a Morse High School senior, who credited his biological mother’s hard choice, adoptive family’s love, group home’s perseverance and teachers’ supports with getting him to graduation day and a focused future.  Twelve-year-old Kala Grant, a Girl Scout with her troop mate at her side, spoke of her efforts to educate and build awareness in Scouts and middle school about being the sibling of “My Very Special Brother” who is autistic.

Youth MOVE speakers were: operations lead Ryun Anderson, who explained the history of this youth movement in Maine; Jenn McLaughlin who introduced the public service message “You Decide!“; and, Jenn, Allie Spear, Rodney Keisman and Brendon Venable  who performed “Shift your mind, drive your dreams,” a poem by Stephanie Knaus-Tucker, Brendon and Jenn.

NASCAR Pro Series rookie driver Travis Dunbar described how his life from chaotic home life to teenage track star to a two-time All-American with hopes of an Olympic run overcame the results of an auto accident that ended his running career to become a race car owner/driver and mentor of the Youth MOVE Maine Racing Team.

“Travis is the perfect spokesman for our 2010 awareness campaign,” says Brianne Masselli, Youth MOVE Maine’s co-founder. “His life is literally all about shifting gears. He is a role model for what youth stand for— resiliency, self-determination and hope— key factors in mental health and wellness.”

“I’m so pleased to represent these young people,” says Dunbar. “Their commitment to unite their voices and inspire others mirrors my own desire to mentor and motivate young people who persevere through adversity and keep driving their dream.”

Through youth-adult partnerships Youth MOVE trains providers, collaborates with family members, advocates in the community and works with policy makers and program administrators to enhance governance and evaluation.

“We are always getting new members that come from backgrounds where they don’t have access to resources,” says member Matt Brooks, “and Youth MOVE is a perfect place for them to find the help that they need.”

“Through Youth MOVE I am helping to improve the mental health system where youth are concerned,” says Kyle Prior, “I am able to help make the mental health system more accessible to youth.”

“What means the most to me is knowing that I’m helping people,” says Brooks.

“And sometimes, it’s just about getting together and having fun!” Masselli says.

There is lots of fun in store these parallel rookie seasons starting with the Youth MOVE Racing Team’s 2010 Season Opener scheduled for May 29, 6:30 pm at Beech Ridge Motor Speedway in Scarborough.

Youth MOVE Maine (www.youthmovemaine.org), the state chapter of Youth Move National, works to ensure that youth in Maine’s youth-serving systems are prepared for life. Youth MOVE Maine is dedicated to the redevelopment of systems and services, and advocates for youth to use their power and expertise to make change within their communities and within their own lives.