One thing the pandemic has really highlighted is the importance of mental health. We now know that mental health issues are much more common than previously perceived. Seventeen percent of youth and 20% of adults will deal with a mental health issue this year, says the National Alliance on Mental Illness. It is a complicated issue that comes with a lot of stigma, presenting real barriers to treatment.

Mental health issues do not discriminate, affecting individuals of all economic classes, races, cultures, ages and genders. While it is an equal opportunist in prevalence, there are a great many disparities when it comes to treatment and barriers. Those from marginalized populations and those who are financially stretched, underinsured or uninsured, or low income are affected at an equal rate. But they experience barriers to treatment at a much higher level.

This is especially true of the workplace, which is where many of us spend a great deal of time. Few are comfortable talking about their mental health struggles with employers and colleagues. The result can be a failure to receive early care, leading to loss of productivity or a need for more intensive treatment later. According to the World Health Organization, mental health issues may be responsible for millions of lost workdays each year. This means lost productivity to the tune of $1 trillion globally each year. This trend is increasing, and the burden of mental health issues continues to significantly grow.

Early, appropriate and effective treatment can decrease costs significantly while diverting individuals from hospitals or jails, before the issue becomes a crisis. It is important to know where to go as well as to ensure that services are accessible and affordable. Funding is a large part of what drives the availability of mental health services, especially for marginalized populations and those dealing with financial barriers.

Many states are seeing a crisis in the lack of acute inpatient or crisis stabilization services for those experiencing a psychiatric emergency. Wyoming is experiencing this crisis along with geographic complications (transportation) and economy of scale resources with a frontier population. This contributes to individuals ending up in emergency rooms for care.

In addition to overburdening the hospitals, many individuals that fail to receive treatment end up in the criminal justice system. Serious mental illness is found to be much higher in jails and prisons than can be found in the general population (NAMI). The disparity of individuals with mental illness involved in the criminal justice system has a significant affect on both health care costs and public resources. Appropriate and effective intervention and community-based services can improve outcomes and result in cost savings and reduce recidivism.

NAMI estimates that one-third to one-half of those dealing with mental illness will not seek treatment. Barriers include people thinking they can handle problems themselves, not knowing where to go for help, stigma attached to mental illness and accessibility and affordability of appropriate levels of service. In addition to the financial barrier there is also a time investment needed for treatment that many who are living paycheck to paycheck find difficult to prioritize.

What does this mean for Teton County? The state has an open access system that provides subsidized services for all residents in each county. The funding does not cover the entire cost of service and has decreased substantially over the last 10 years while the demand for services has steadily increased. The town of Jackson, Teton County and local donors have been extremely supportive of mental health. Funding cuts that were put on hold due to ARPA funds are set to hit this next fiscal year. In addition the state is looking at moving from the open access system to one where only prioritized populations have access to the subsidies for care.

The price of not investing in mental health is a burden that we all share. The consequences will fall on the individuals affected, family and caregivers, employers, service providers, government entities and, most importantly, quality of care. The responsibility rests on us all to invest in mental health, both our own as well as our most vulnerable community members.

This time of year we are all busy with summer activities, work, fitting everything possible into the short summer season we tend to have here. Outdoor events to plan and attend, family to visit and memories to create.

While summer feels like it should be about getting outdoors or relaxing, this time of year also brings stress and anxiety for many as well. Commuting, traffic, busy and stressful work — it all takes a toll. Anxiety disorders affect 40 million individuals each year. In fact, it is the most common reported mental illness. Panic disorders fall under this category and are experienced by a roughly 3% of the population.

Panic attacks can be a terrifying experience, not only for the person having the attack, but also for those around them. Knowing a bit of mental health first aid to recognize and respond can be helpful. The group Mental Health First Aid describes a panic attack as “a sudden onset of intense anxiety, fear or terror that often occurs for no obvious reason.”

Symptoms (according to Mental Health First Aid):

• Rapid heart rate

• Sweating

• Trembling

• Shortness of breath

• Sense of impending danger

• Hyperventilation

• Faintness or dizziness

• Nausea

• Hot flashes or chills

• Chest pain

• Headaches

• Tightness in your throat, difficulty in swallowing

Panic attacks can come on suddenly and without warning at any time. If you have ever experienced one, you know why many end up in the emergency room. The Mayo Clinic reports the disorder can manifest in late teens or early adulthood and tends to affect women more often than men. The cause is not known but research does support a combination of biological and environmental factors including family history, trauma or life events, substance abuse and cognitive distortions that exaggerate physiological response. Attacks may vary but will usually peak within 10 minutes or so and may cause the individual to feel fatigued afterward.

Once you have a panic attack the fear of having another can become so great that individuals may begin to avoid situations where they may occur. If not treated the condition can affect every area of one’s life. Psychotherapy, biofeedback and medications can all be helpful, as can making lifestyle changes in sleep, diet and exercise. Panic attacks can also resemble serious health problems such as a heart attack, so it is important to seek medical help if you experience symptoms.

Now that you know the symptoms, how can you help someone having a suspected panic attack? Mental Health First Aid classes give some direction in responding. First, you should remain calm and speak in a reassuring but confident manner. Speak using short and clear sentences with clear and slow speech and avoid negative reactions.

• Let the person know that you are concerned and willing to help.

• Ask the person if they know what has happened or if they have a history of panic attacks.

• If you are unsure whether it is a panic attack or a serious health condition, check for a medical alert bracelet and follow any instructions and seek medical assistance.

• If the person knows they are experiencing a panic attack, reassure them and ask the person if they would like assistance.

• Reassure the person that you understand the fear and anxiety they are experiencing feels very real.

• Calmly remind them that he/she is safe and that the symptoms will pass.

• Ask the individual how you might be able to best assist them. Grounding exercises are often remarkably effective.

• Stay with the person until help arrives or the panic attack has ended.

• Once the attack has ended, offer resources for learning more about panic attacks such as the Anxiety and Depression Association and HelpGuide.org.

• Encourage the person to speak with a health professional if the attack persists.

To learn about Mental Health First Aid and to find classes near you, visit MentalHealthFirstAid.org or call Jackson Hole Community Counseling Center. We offer free classes throughout the year.

My favorite go-to grounding exercise is the 5, 4, 3, 2, 1. This exercise takes your mind off uncomfortable thoughts and feelings and into the present by using your senses. Notice:

• 5 things you can see around you

• 4 things you can touch/feel

• 3 things you can hear

• 2 things you can smell

• 1 thing you can taste

Additional activities:

• Name things in categories. Pick a category and name things that fall into that category. For example, name five types of dogs, name three types of trees, etc.

• Describe a normal activity in detail. Laundry, for example. Describe what you are doing in detail: “First, I separate colors from darks, then I let the machine fill, then I pour in the detergent …”

• Visualize a calm and safe place. While this may seem vague, try focusing on a pleasant mental image. Imagine yourself on a beach or a mountain, or anywhere you consider to be restful or joyful.

• Turn to humor. Use humor to jolt yourself out of the moment. If you have a smartphone and happen to come across funny videos occasionally, save those videos so you can watch them in moments of panic or anxiety.

• Count. You can also count to 10 followed by counting backward or saying the alphabet very slowly. You can even try to say the alphabet backward.

As always, you can call JHCCC 24/7/365 to speak with a therapist or ask questions about dealing with this issue or any other concern. We also now have an additional resource available to us all — you can call 988 and be routed to a professional trained in handling a variety of crisis.

Mental Health Awareness Month is upon us. The month of May has been recognized to bring awareness to this important topic since 1949. While the focus should not end with the month, it does provide opportunities. Talking about the issue, in fact, does make it easier to talk about, to personalize the issue rather than seeing just an illness or perceived weakness. This is the importance of awareness, a start to the conversation.

Mental health issues are common; an estimated two out of five of people are dealing with some sort of mental illness. Expand the conversation to include substance use and the numbers are even higher, especially after the strain of the pandemic. There tends to be a barrier to discuss behavioral health issues. It is called stigma, defined as “a mark of disgrace associated with a particular circumstance, quality or person.” In contrast, when there is awareness about mental illness it encourages more open communication, identification and early intervention.

Keep in mind these individuals are not only statistics but make up our community. This is our family, neighbors, friends; or it could be ourselves. This can be especially important for marginalized community members. Early intervention is essential in receiving appropriate care. By raising awareness we can normalize treatment and prevention like we would any other illness.

Behavioral health (includes mental health and substance use) should be seen as part of overall health and wellness rather than the many misconceptions that are out there. These issues can be managed by treatment and prevention efforts. Why should mental illness be any different from physical health conditions, such as diabetes, blood pressure or cancer? In fact, focus on your mental health can positively impact your physical health.

Awareness is also knowledge, and knowledge is power. Power can bring about positive changes in our community. Awareness is essential to understanding issues related to behavioral health and how to access support. Public knowledge is so important in accessing community resources. If you or someone you know needs support, do you know what is available in your community?

Awareness also decreases stigma for those individuals struggling with behavioral health issues. If we are aware of their struggles and strengths, we can begin to develop empathy and see the whole person and not just the illness. Stigma creates an environment of shame and guilt that too often stops those who need help from seeking treatment. Normalizing not only treatment but prioritizing all behavioral health issues and struggles could be a huge step forward.

Awareness can also trigger change on a much larger scale. As awareness from the public increases, more powerful and focused attention is produced. This attention can eventually result in important changes for those with behavioral health struggles and their families. It can lead to changes in policy, research, funding, prevention, innovations in treatment, access to appropriate and affordable services and changes in health care coverage.

Let us choose as a community to make behavioral health a priority. If we continue with more awareness, the pressures may increase and may result in more funding for resources. Let us keep the conversations and awareness on behavioral health issues in our community going. Do not be scared to talk about it. It may be difficult to start, but the power to reach out and educate the community is worth it. The connections we make with others in our community are the most powerful tool to reduce the stigma surrounding mental health and substance use issues.

Resources:

Mental Health First Aid Training — May 26, contact adamwilliamson@jhccc.org

Jackson Hole Community Counseling Center — 733-2046

Curran Seeley Foundation — 733-3908

24-hour crisis line or direct support if you have questions for yourself or loved ones.

National Suicide Hotline 1-800-273-TALK

St. John’s Medical Center Mental Health Resource Line — 203-7880

Call to find help with resources and supports in the community.

“The only one who likes change is a wet baby.”

` — Mark Twain

What does change have to do with mental health? Great question. How we deal with change and view it can have a significant impact on mental health. Adapting to change is related to resilience and directly affects your mental wellbeing.

Change is part of life. Our lives and relationships are constantly changing. Our world today is also changing at an extremely fast pace, and it sometimes feels overwhelming to keep up. Sometimes we find ourselves spending a great deal of time and energy avoiding change, which can create anxiety and prolong the stress. How do you approach change in your life?

I remember, years ago, reading the book “Who Moved My Cheese?” and the buzz that it created with the story of types of reactions to change. The story involves four characters — Sniff, Scurry, Hem and Haw — who face an unexpected change of movement of their cheese. The cheese is a metaphor for what you want in life, i.e., job, relationship, health. The story demonstrates the main examples of how people tend to deal with change. It is a great, quick read that highlights common responses. It can be enlightening to see which character matches your own style.

Your worldview tends to affect how you deal with change. If you are having a negative view of things, change can be much harder to navigate and causes more stress. When stress and worry increase, so do physical issues (headaches, insomnia, digestive issues, muscle aches, blood pressure, etc.) and potential mental health issues such as depression, anxiety or substance use.

Most people tend to cope with change in one of two ways: escape coping or control coping. As the escape coping implies, it is based on avoidance. Control coping is a much more proactive approach. It involves managing emotions and taking an active stance being involved in the changes. Most of us work in both types at various times.

It is interesting to note the similarities of reaction to change and grief. I had a graduate school professor who once mentioned that most of the transitions or changes in our lives involve the grieving process, whether a breakup, loss of a loved one, job or a child leaving home. Noted in a recent article from “Mind Tools” are four common stages of reaction to change — shock and disorientation, anger, coming to terms, acceptance and moving forward.

Much like grief, the progression is different for everyone and rarely linear. Everyone has their own timeframe and own process. That is not to say that there are never skills you can use to navigate in a more productive manner if change is difficult for you. You are building your resilience skills.

When presented with change in your life, focus on the various stages:

• Shock and disorientation

• Emotional response — often anger or fear

• Acceptance

• Moving forward

Notice how you are responding and move to a conscious direction of moving with control coping, which entails regulating your emotions, getting support and being a productive and active part of the change. This type of coping does not mean trying to control the situation; it refers to controlling and managing your response in a mindful manner. Take some tips from the Cognitive Behavior Therapy approach, using positive reframes, radical acceptance and humor.

• Find your grounding in the familiar

• Take note of your perspective of the environment or situation

• Avoid becoming rigid

• Find support. Use your support network

Throughout your life there will be a good amount of change. It feels like it is coming at a faster pace in the world right now and it is normal to feel thrown off at times. Proactively and mindfully moving through the change can make all the difference in your overall mental health.

From the Jackson Hole News & Guide Column Sound Mind

It never ceases to amaze me what an amazing and complicated thing a community is — always changing and interconnected. When there are issues, solutions rarely come down to one intervention or agency. Maybe it is because we are in the middle of various needs assessments or dealing with the next COVID-19 round, but as the various human service groups collaborate to address needs, gaps and trends, how systems impact each other becomes more apparent and more and more important.

The needs assessments that have begun to come out for Teton County say that lack of housing, mental health and substance use are the top concerns regarding the mental well-being of our community. Mental health, or wellness, is more than just the absence of a disorder, but more about living a full and productive life. It is the ability to bounce or being able to adapt to life stressors and the ability to form connections to others.

None of us are surprised at this point to hear that housing issues and COVID are causing a great deal of stress on many in our community. It becomes obvious that the solutions will take more than one intervention, or organization and a community wide response; maybe not to entirely solve the issue, but to help the entire community be resilient.

The same approach is needed when looking at mental health. Community issues strain the entire system, reducing the efficacy of interventions and social service organization efforts. The response needs to be communitywide to make an impact.

Mental health issues affect all of us. According to the National Alliance on Mental Illness, before the pandemic 1 in 4 individuals were dealing with a mental illness of some sort. Those numbers have increased, with more than half the population reporting symptoms of anxiety and depression. Roughly half never seek services due to the stigma.

The consequences of not seeking assistance prior to reaching a crisis level are felt by not only the individual and families involved, but entire communities. Added stress in the environment — such as a global pandemic — can exacerbate the issue, and the fallout is felt by employers, law enforcement, hospitals, schools, putting more stress on social service systems. The ultimate consequence, and tragedy, is the loss of life. Suicide is the 10th leading cause of death in the United States (Wyoming tends to rank in the top five with per capita numbers) for adults and the second leading cause of death for ages 10 to 34 (NAMI).

While there are many resources and agencies that deal with specific issues such as youth crisis, substance use, domestic violence or mental health, it also becomes the responsibility of each of us as community members. When people are struggling they often turn to those closest to them first. Many times it is family, someone at school or church or friends who will initially respond and then possibly become an ongoing support system. Thus, it is important to feel comfortable talking openly about mental health. In addition to raising awareness of mental illness issues, it is also important to educate the community, empowering individuals to seek the support they need.

One way to become educated is to take a Mental Health First Aid course. Mental Health First Aid involves an eight-hour course that teaches community members basic mental health first aid. Classes are offered throughout the year, can be broken up through a lunchtime learning format and can be scheduled for groups as well.

The program uses the mnemonic of ALGEE, giving community members the knowledge, skills, and confidence to recognize and respond to mental health crises. The more educated and aware we are as a community, the more impact we will have on early intervention, suicide prevention and stigma reduction.

——

A Assess for risk of suicide or harm

Threats of suicide

Preoccupation with death, dying or suicide

Increased substance (alcohol/drug) use

Perception of being a burden to others

Increased agitation/aggression

Hopelessness, no sense of purpose or meaning

Isolation from friends/family

Rage/uncontrolled anger

Risk taking behavior

L Listen nonjudgmentally

G Give reassurance and information (resources)

E Encourage appropriate professional help

E Encourage self-help and other strategies

——

Reaching out to even just one person can make a difference. That can be done by calling and reconnecting with someone or reaching out for a walk or just a chat. Ask questions and listen to answers. This can help if you are the one feeling isolated or if you notice someone around you who may be struggling. Take notice of the people around you. Get to know them and what is going on in their lives; share stories. This may assist them and at the same time help you keep connected.

If you notice some patterns or are worried about yourself or someone else, reach out for help. It is easy with everything going on to feel isolated and withdrawn. One of the most amazing qualities of this community is how open, helpful and accepting we can all be when someone is struggling.

If you are concerned, contact a mental health professional, or call the Jackson Hole Community Counseling Center crisis line at 733-2046; the national suicide line, 800-273-TALK; or 911. You can also all the St. John’s Health Resource line, 307-203-7880, for assistance in finding a local therapist. Go to MyStrength.com and use access code “jhcommunity” for a free and confidential self-help mobile resource.