Quality of Life Team
The term “quality of life” has meaning for nearly everyone and every academic discipline, individuals and groups may define it differently. Although health is one of the important domains of overall quality of life, there are other many other aspects — jobs, housing, schools, and built environments. As well as intangibles such as culture, values, and spirituality which are key domains of overall quality of life that add to the complexity of its measurement.
The Quality of Life Team is comprised of representatives from across Polk County including non-profits, government, healthcare, education, and faith-based organizations. This diversity affords the opportunity to obtain different perspectives as the Team strategizes on ways to conduct inter-active education forums on various topics impacting the quality of life of Polk County citizens.
Addressing behavioral health is a huge and complex undertaking. It can be daunting to try to dispel the myths, reduce stigma, and solve the myriad of problems associated with treating mental health disorders. However, by starting the conversation, the Team ‘s goal was to demystify the complexities that are often associated with mental health, enhance understanding, and provide information on accessing resources in Polk County.
Mental health plays a major role in people’s ability to maintain good physical health. Mental illnesses, such as depression and anxiety, affect people’s ability to participate in health-promoting behaviors. In turn, problems with physical health, such as chronic diseases, can have a serious impact on mental health and decrease a person’s ability to participate in treatment and recovery (Healthy People 2020.)
The Department of Children and Families is seeing an increasing number of children entering the foster care system not because of abuse or neglect, but because the child needs intensive mental health services. Polk County Public Schools Student Services has observed an increase in the number and severity of behavioral difficulties. During the last school year, 1,238 Crisis Interventions were completed with 110 students Baker Acted directly by Polk County School Resource Officers.
The number of Involuntary Examinations of Children under the age of 18 in Polk County rose from 727 in 2010/2011 to 1,723 in 2015/2016. Reflecting a 131.18% increase and ranked 3rd highest in the state. (Baker Act Data Report, University of South Florida, Released March 2017.)
What's Normal? What's Not? Do you Know a Child in Crisis: Community Forum
On May 11th The Polk Vision Quality of Life Team held an interactive forum focused on how to identify, understand, and help youth who may be experiencing a mental health challenge or crisis.Questions asked during the forum are posted here.
Are the risk factors the same for young adults and adults?
Dr. Haight - Family history of a behavioral health or mental health problem is a common risk factor for both young and old. Differences in risk factors might be “traumatic experiences” since those who are younger may interpret and respond to an awful experience differently than an adult. An adult may not appreciate that an experience that they feel was mild could be seen as very traumatic to a younger person.
Why do they only keep you 2 days after a Baker Act?
Dr. Haight - This time period gives care givers a chance to ensure the person’s safety and complete an evaluation to assess future risk of harm to oneself and others. With the addition of a second qualified opinion, the time frame can be extended if there is concern that more observation is needed.
How do we distinguish between sadness and depression?
Dr. Winny - Sadness is a normal human emotion. Sadness is usually triggered by a difficult, hurtful, challenging, or disappointing event, experience, or situation. In other words, we tend to feel sad about something. This also means that when that something changes, when our emotional hurt fades, our sadness remits. In other words there is always an external reason or a trigger to explain our sadness.
Depression is an abnormal emotional state, a mental illness that affects our thinking, emotions, perceptions, and behaviors in pervasive and chronic ways. When we’re depressed we feel sad about everything. Depression does not necessarily require a difficult event or situation, a loss, or a change of circumstance as a trigger. In fact, it often occurs in the absence of any such triggers.
Are there any physical warning signs that someone may be more inclined to commit suicide? Are people depressed or lethargic?
Dr. Winny - There is no “1” physical warning signs for someone who may be inclined to commit suicide. Feeling of fatigued, sluggish, and physically drained maybe be some characteristics but parents should be aware of the following signs:
- Change in eating and sleeping habits
- Withdrawal from friends, family, and regular activities,
- Violent actions, rebellious behavior, or running away
- Drug and alcohol use,*unusual neglect of personal appearance,
- Personality change
- Persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork,
- Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc...
- Loss of interest in pleasurable activities
- Not tolerating praise or rewards, complains of being a bad person or feeling rotten inside
- Give verbal hints with statements such as: I won’t be a problem for you much longer, nothing matters, It’s no use, and I won’t see you again
- Puts his or her affairs in order, for example, gives away favorite possessions, clean his or her room, throws away important belongings, etc.
- Becomes suddenly cheerful after a period of depression
- Has signs of psychosis (hallucinations or bizarre thoughts)
If a child or adolescent says, I want to kill myself, or I’m going to commit suicide, always take the statement seriously and immediately seek assistance from a qualified mental health professional.
Do psychiatrists only treat by prescribing medicine?
Dr. Winny - No, Psychiatrist do detailed Psychiatric evaluations, make diagnosis, and they are trained to do different therapies, however, the case load is so high practically they stick with only treating by prescribing medication while recommending different therapies and treatment if needed from others for their clients.
Do you ever see very many pre-school aged children?
Dr. Winny – We do have an infant mental health program. They complete a detailed psycho/social developmental evaluation and recommend appropriate treatment which include infant mental health group. Sometimes the therapist may rarely consult with the Psychiatrist, but clients under the age of 6, is not prescribed psychotropic medications.
What is the affect of “Thirteen Reasons Why” on our mental health community in our county?
Dr. Winny – When working with new clients with significant depression, we would not recommend them to see this series. If the client has watched the series we highly recommend that the parents watch the series and have an open discussion about the issues involved. It would also be beneficial to inform the therapist/psychiatrist of the issues.
Candace Barnes -
What is the best way for a caregiver to become involved in supporting their child’s treatment?
Candace Barnes - Talk to the treatment provider and express your desire to become an active participant. Ask questions about how you can practice or reinforce those skills being worked on in session, in the outside world. Provide feedback to your treatment provider about how things are going.
If a parent is not on board or does not see an issue or need, what can I do to help the child?
Candace Barnes - Be as supportive as you can to the child while exploring options that may be least intrusive to the family, for example, some school programs can be useful in helping with emotional issues and do not require extensive involvement from a parent. Some parents have resistance to even this, and a parent’s wishes must be respected. However, you can have a conversation to see where that resistance comes from and see if it can be overcome. In the context in which you interface with the child, provide what support you reasonably can. Providing support to a child who seems to be in need can make a big difference, even if the parent is not on board with formal treatment.
Has Peace River Center looked into Accelerated Resolution therapy (ART)? Similar to EMDR
Candace Barnes - This is something that the community providers are aware of. Interested persons can find a Certified Accelerated Resolution Therapist at http://acceleratedresolutiontherapy.com/web/therapists/#fl.
Becky Razzaire – Tri County Human Services offers Accelerated Resolution Therapy. We have several therapists in our agency that are trained in this.
What are the basic requirements and approach to reporting when I become suspicious or aware of abuse or suspect that a child may harm themselves? What if I learn this in a confidential context?
Candace Barnes - Every adult in the state of Florida is a mandatory reporter. It is best to never promise a child that absolutely anything they say to you is confidential. It is best to be up front and explain that if a child tells you something that would affect their safety or the immediate safety of someone else, then you would have to act on such information. If you are suspicious or aware of abuse or neglect to a child, you can call the Florida Abuse hotline at 1-800-96-ABUSE. You do not need proof or to be able to verify that something has happened, the Department of Children and Families employs Child Protective Investigators whose job it is to investigate these reports. Simply, if you see something off, please say something.
Where can someone get certified in infant mental health?
Candace Barnes - Many different universities offer specific programs for training in Infant Mental Health, some which provide the therapist with a trained status and others that are certificate courses. Some require face to face commitment, others are entirely online. They vary in time commitment and financial commitment. I am not going to endorse one over another, but a simple internet search would yield plenty of options to explore.
What should I do if I suspect a child is being neglected?
Candace Barnes - Contact the Florid Abuse Hotline at 1-800-96-ABUSE.
Becky Razzaire – If you suspect that a child is being neglected or abused, you can contact the abuse hotline anonymously at1-800-96-ABUSE. You can also report abuse or neglect anonymously on the DCF website.
Should you ask a child if they are considering suicide? Won’t that plant the idea in their mind and perhaps encourage them to act on it?
Becky Razzaire – If a child is considering suicide or self-harm asking a child if that is what they are planning to do does not plant a seed in their mind. Asking a child if they are wanting to hurt themselves is an act of intervention to talk about what is going on and get the child appropriate help.
Mind: What Matters? Community Engagement Forum
Question 1. What is the difference between substance abuse & substance use? Which term is used now? Is it based on DSM?
See SubstanceUseAbuse.pdf Click Here.
Question 2. How does a parent recognize warning signs that differentiate between a young child acting out versus exhibiting more serious trouble?
Youth Mental Health First Aid addresses just this question. I should add that Mental Health First Aid teaches us that something becomes a disorder if it affects the person’s ability to learn/work, have satisfying relationships, and to do activities of daily living like care for our hygiene, keep our house or room, prepare our meals, and so on.
Question 3. Mrs. Fleisher noted someone close encouraging someone else to seek mental health treatment. What about a stranger? Would the potential to sound accusatory be more harm than good?
It’s possible that we could help a stranger. We could approach a stranger in a way similar to the way we ask someone close to us if they need help. We could begin by asking, “Are you ok? It looks like something might be bothering you. Can I do something to help?”
Question 4. What does CIT mean?
CIT stands for Crisis Intervention Team. The standard for CIT training is known as the Memphis Model. It is an innovative law enforcement based first responder program that has become nationally known as pre-arrest jail diversion for those in a mental illness crisis. This program provides law enforcement based crisis intervention training for helping those individuals with mental illness.
Question 5. What is the difference between a psychiatrist and a Psychologist? How do you know which professional you need to see?
A Psychiatrist is a medical doctor with specialized training in adult and/or child psychiatry who can prescribe psychotropic medications. A Psychologist is a licensed individual with a doctoral degree who can perform psychological testing to determine a diagnosis, assess levels of psychological abilities, and help to determine course of treatment.
Question 6. My family member sees a psychiatrist but I don’t think he tells the doctor all his symptoms. Is there any way a family member can talk to the psychiatrist or send information to the doctor?
Information can be sent to the Dr. but the Dr. cannot confirm the individual is a patient or engage in conversation about the patient unless the patient signs a release of information agreeing to others being able to discuss the patient’s condition with the Dr. If the patient is a minor then the legal guardian can discuss treatment with the Dr.
Question 7. Will the CIT teams work with all ages?
Yes, CIT training is effectively used with all ages. Crisis Intervention Team trained officers frequently intervene with youth as well as adults. In fact, once a CIT officer from the PCSO was called to the home of a teen who was in crisis. The skills and compassion used by the officer during that crisis response and the resulting Baker Act turned a negative experience into a positive one. The officer became a friend and mentor to that youth in the years that followed.
Question 8. How do we help family members of individuals struggling with behavioral health issues?
The National Alliance on Mental Illness chapter in Polk County is a great resource for family members of people struggling with mental illness. They have evidence-based programs for family members as well as for people living with mental illness. There are NAMI members that also care for family members living with mental illness, and they know a lot of strategies for maintaining their own resiliency. They can be reached at (863) 450-2943. Al-Anon is a source of support for family members of people dealing with substance use problems, and they are at (863) 687-3800. We can all be a source of support for family members of people dealing with behavioral health issues by continuing to listen and encouraging them that their family member can recover.
Question 9. How can we help individuals who are not Baker Act candidates but exhibit behavior out of the norm but are in strong denial they need professional help?
We learned from Dr. Risdon Slate and the other presenters that unfortunately it often does take people time to realize that they need help -- just like it may happen for many of us with other types of illnesses. Change can be a long process for everyone. We can encourage the person to talk to someone they trust, and offer to help. So long as we remain patient and open, the person is more likely to come to us when they are in need, and when they are more ready.
Question 10. What should you do if someone in your home is exhibiting bizarre behavior?
If what you are observing suggests the person is at immediate risk of harm, call 911. Calling 911 gets the first, closest available responder to make sure everyone is safe as quickly as possible. If they or the other family members are not in immediate danger but still do not seem safe, you can call the Polk County Sheriff’s Department and ask for a Crisis Intervention Team (CIT) - trained deputy to come and assess. Law enforcement officers can determine if a person needs emergency admission to a detox unit or psychiatric facility for their safety, and can transport them there. Keep in mind that these admissions are for safety, they are not for treatment, so they are short-term.
Question 11. Who can refer to the specialized community care team? Does the referral come from a Primary Care Physician? Can a social worker refer?
Anyone can refer to the Specialized Community Care Team. The phone number is (863) 291-3611.
Quality of Life Team
Marcia Andresen – Co-Chair, Polk County BoCC
Jeff Bachelder – Warner University
Brad Beatty – Heart for Winter Haven
Penny Borgia – United Way of Central Florida
Marquinia Butts-Fisher – Healthy Start
Steve Chapman – READ Polk
Carol Fox – Lakeland Regional Health
Taylor Freeman - Florida Department of Health - Polk County
Bill Gardam - Peace River Center
Laura Lee Gwinn – Community Volunteer
Daniel Haight – Lakeland Regional Health
Cathy Hatch – Polk County Board of County Commissioners
Linda Hawbaker – Florida Department of Health – Polk County
Susan Hurlburt - Community Volunteer
Corlis Johnson – My Natures Delight
Joy Johnson – Polk County Board of County Commissioners
Rosemarie Lamm – Community Volunteer
Doug Leonardo - Bay care Behavioral Health
Colleen Mangan – Florida Department of Health – Polk County
Meri Mass – Polk Arts Alliance
Carole McKenzie – Polk County Farm Bureau
Tim Mitchell – Parker Street MinistriesAndrea
Andrea Nikolai - University of Florida IFAS
Lauren Parkes - Lakeland Regional Health
Angela Pulido – Lilly, O'Toole, & Brown
Rob Quam – Co-Chair, Lake Wales Care Center
Erica Sirrine – Southeastern University
Genet Stewart – Heartland for Children
Steve Thompson – American Red Cross
Donn Vanstee - Tri County Human Services
Jeff Ware - Winter Haven Hospital
Robert Williams - Polk County Problem Solving Courts