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7196-1 Addressing Mental Health and SUD among Yout ...
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I'm going to stop share just because I wanted to kind of get your feedback, if you wouldn't mind introducing yourself, and I stopped sharing because I couldn't see, I can only see the video when I'm sharing the screen, but introduce yourself and just kind of give me, if there's a word or two that resonates with you as you saw the presentation, the news report. Laura Beth, I'm going to just go across my screen, that's who I see first. Hi, Laura Beth, she, her, pronouns, program director at Our Minds Matter. Anything that struck you as new information, anything strike you as concerning as you watched the news report? Not anything that was kind of new to me. Okay. Okay. Thank you. Thank you. And I'm going to go across the screen. Dr. Jeewee, anything? Yeah. Hi. I mean, I can reintroduce myself again, Jeewee, she, her pronouns, director of impact at Our Minds Matter. Nothing surprising, I guess, just feeling concerned with like how young people was doing today. Yeah. Yeah. Wonderful. Okay. Laura, Lauren, I'm sorry, Lauren, I see your name. Yeah, I agree. Nothing new, but yeah, just concerned about the continued trends that we're seeing right now. Okay. Okay. Rachel. Hi. Good morning. My name is Rachel. I use she, her pronouns. Yeah. I would say no new information, but it's always good to hear directly from a teen, like exactly what they're feeling. So I did appreciate that for sure. Okay. Wonderful. Morgan. Hey. I'm just getting home from a site visit, so I'll jump off in a second and drag from my computer. But my name is Mo. I use she, they pronouns. I got into the room a little bit late, so I only really caught the tail end of the video and didn't really get any context. So no new thoughts for me. Okay. Okay. I'm hoping I say the name correctly. Is it Michael or Mikal? Mikal. Mikal. Yeah. She, her pronouns. No new information for me as well. Okay. Thank you. Thank you. And then Nia. Nia, if I'm saying it wrong, it looks like Nia, but I could be putting the pronunciation in the wrong place. Yeah. It's Nija. Nija. Nija. Thank you. Yeah. Yeah. My name is Nija. I use she, they pronouns. I'm a program fellow at OMM. And I think the sentiment is kind of the same, that the information isn't super new, but it is still concerning. And one piece of information that stuck out to me was the, I think it was a 51% increase in admissions to the ER for girls from 12 to 17 for suicide attempts. Yeah. And then there's the OMM administrator. That's what I see. Hi. That's me. My name's Shawd. He, him. I'm a people ops manager at Our Minds Matter. And not to beat a dead horse, but I would agree that this is information that we hear often and we're aware of. But I agree with Rachel in the sense that it is sobering to hear it from the voice of a teen. And sometimes that has been more impact when teens can say for themselves kind of some of the challenges that they're navigating. So it was helpful to see that. Yeah. Yeah. And the data that they report is often backdated, right? We heard the report is, you know, 2019 before COVID and then after COVID, they worked in some semblance of a little bit of information, but quite frankly, we're in 2024 and the information that we got was probably 2021. So we still don't have a couple of years of information, which I'm going to guess is going to be higher, but we're working based on information that really is old now. And so what's alarming for me is that you have that number of young people that are feeling anxious, that are experiencing anxiety. And I agree with the psychiatrist that we don't talk about and we haven't worked with young people to even, they're still coming out of COVID, right? Some are still trying to experience how to navigate life now that they're back together with socialization. And so I don't know about you, but sometimes when I see on the news, those reports about youth and what I come to is that they're acting out, they're reacting because they don't, haven't been given permission to really talk about, I mean, we as adults talk about COVID because we're, how do we navigate work? How do we navigate the kids? But then we expect that young people to just automatically transition into a virtual world where for many, it was very, very new. And then how to do assignments absent of a teacher's assistant in the classroom. And then they're having to not only navigate these things, but their brains are still trying to fixate in terms of development. And so we've placed upon them a lot of responsibility to say, deal with it, right? And we have some parenting, we have some supports, but I think about collectively when you're talking about youth who are homeless, who are dealing with homes that are dysfunctional, when you're dealing with communities that are in, for lack of a better word, a little bit chaotic and disruptive due to violence, young people are dealing with a lot. And so I'm going to share my screen again with you all. And I'm hoping that we can just kind of have a little bit of discussion about how do we move in a way that we can help young people realize their best selves, right? And in doing so, be of promise versus what some people will see as at risk. I'm going to try to, David, shift alt and okay, great. So this is our time in terms of just kind of gaining greater insight. And while they talked about mental health, I mean, we have to talk about the combination of mental health and youth substance misuses, because sometimes they're using it as a means of coping, but we'll talk a little bit more about that. And then we're going to talk about those risk factors. We talked about some like homelessness and maybe peer pressure, but let's talk a little bit more. Let's unpack this according to the Center for Disease Control in terms of identifying risk factors that can contribute to use and misuse of substances, but also can also, what's the word I want to say, increase the likelihood of mental illness among young people and exacerbate it. And then we have to look at what those protective factors can be within the community so that we can help youth in terms of building their resiliency. And then looking at how do we work together as a community from a focal point of view. And so what I'm showing on my screen, I don't have the capacity to see other folks, but I do invite you to please unmute yourself and just kind of ask questions or if you want to contribute additional information, I think for all of us, that would be great in terms of just this expanding our learned environment. And I oftentimes, go ahead. If you don't mind, there's still a toolbar on the top. It was kind of blocking the, yeah, if you can just close that, if you don't mind. Okay. How's that? Or move it somewhere to the writers. Okay. Is that better? Thank you. Okay, perfect. So, you know, and I share all that folks to say, we're not, this isn't anything that's new for you in terms of just Gen Z, Gen Z years and today's teams are just, you know, with the benefit of social media, I think we're learning more and more about what youth are engaged in. And then from a perspective of youth trying to find their own way, it can really be advantageous on some levels with social media, because it did allow them to stay connected when we think about COVID-19 and they're still staying connected. But we also know from a social media standpoint, that it actually can be sometimes concerning for our young people because of the immediate access to harmful things that can impact young people, such as bullying, you know, and such as maybe even self-identity, that social media can be a help for our young people, but they also can be a challenge for our young people as well. And so what we know, and this is even in terms of our, we think about our own time period in our young teen years, we know that the transition into adolescent is a period that can be very, can be very fun, but it also can be very scary. And so, you know, when we talk about that transition into adolescence, we're defining it, right? In terms of the biologic and social psychological entrance into puberty. But we also have to understand along with that comes a lot of changes, not only physically, but neurologically as well. And if there is not that connection for young people with a caring adult, right, in terms of how to develop good relationships, young people only replicate what they see. And so oftentimes if the friends that they have, or if the family members that they have are not necessarily engaging with them in a healthy way, then what they're exposed to can be episodes of violence, hostility, frustration. And so it's a really indelible time for young people to really try to identify who they are, what are their values, but oftentimes what we know is, and we know this from our own experience, is we get them from the people that surround us most, which is why it's important that we help young people and support them in their time of emergence of finding self. And so we talk about the problems that teenagers are facing today, and it's an awkward stage, and we all know that, and they go through an insurmountable of changes, right? Not only is the brain changing, but from a physical standpoint, there are hormonal changes. And so sometimes the pressures that they're dealing with within themselves as well as outside of themselves can really have a trajectory for themselves that can be problematic if they're not given the supports, the positive supports that they deserve. So what are teens facing with, and I'm certain in your work you're seeing this often, depression, anxiety, peer pressure, bullying, body shaming, the pressure of being part of social media or not, and sometimes young people are utilizing social media in terms of that connection, that positive connection, but sometimes they're not always receiving that. And in turn, then, there might be some things that are happening from an educational point of view, and we mentioned in the news report talked about young people during times of COVID and that academic challenge then, and that academic challenge can even transition into now whereby they're having a difficult time transitioning, even today, from the times whereby they were asked to be part of a Zoom educational process, and if they weren't being able to be evaluated during that time of academic challenges during COVID, they've taken that and advanced that, even in terms of their high school years, right? And so they still could be experiencing those academic challenges, which is putting them further and further behind. And we also know that from an educational point of view, that sometimes schools are having to face about how do we help bring youth along, and if young people aren't in school, because sometimes they might be faced with suspension or not going to school on a regular basis, those things can compound their academic challenges. And then we also know that there are some students that might face low self-esteem. There's the onset of risky sexual behaviors, young people trying to find themselves during those teen years, and the self-identification now process for them. We're seeing more and more young people having to identify themselves in the way of being either straight or gay or lesbian, and what are some of those challenges that come about because of that? And so all of these things can really set the tone for youth trying to find that escape, and oftentimes finding that escape through other risky behaviors such as substance use and misuse, as well as gambling. And so here's a report, and we talked about this, that this is something that may not be new to you, but I think it collectively, when we take all of this information in, it really does give us a state of affairs of identifying what youth are being faced with today. And so when we talk about adolescents in 2021, two out of every five students experienced emotional distress. And when we talk about the LGBTQ community, they were five times more likely to even attempt suicide during the pandemic, and that's according to the CDC. And then what we also know about suicide is suicide is now the second leading cause of death for young people between the ages of 10 to 34. It's overall increase of over 31%, and now we're seeing suicide as the 10th leading cause of death in the United States overall. And so when we think about suicide and suicide ideations for young people, are we forming supports for young people who might feel like they want to hurt themselves? Are we giving information as it relates to the suicide hotline? Are we providing support groups for young people who may not feel that they're part of a connected group, that they're feeling helpless? And what are we doing in the way of reducing the likelihood of young people actually attempting suicide? And so again, taking a look at our communities, are our communities positioning itself to provide resources and supports that are viable for young people to connect with? We, there's a recent survey out, adolescent substance use in 2003, talked about information as it relates to youth using substances. And so as you can see, it says about 31% of 12th graders and 20% of 10th graders and 11% of eighth graders reported illicit substance use in their past. And the most common that they're using is alcohol, vaping and cannabis. And so in terms of the substances that they're using, those are pretty common. I think it's important to recognize that tobacco products, youth have had a decrease in smoking cigarettes, but there is an increase in vaping. And sometimes youth aren't aware that there's actually nicotine and vaping because of how the industry has really promoted vaping. They promote it as a smokeless episode, but the reality is, is that in the vape products, nicotine is evident. And we try to share that with young people in the way of helping them understand that the marketing is really trying to sway young people to engage in using nicotine through vaping. And then the NIDA, which is the National Institute of Drug Abuse, says that despite adolescent use declining over the years, we still have to talk about the rising influence of using prescription drugs, which is leading to overdose deaths amongst teenagers ages 15 to 19. And that's really largely due to the availability of fentanyl. This is a national vital statistics information that just kind of demonstrates that over the years, the unintentional drug overdose deaths among youth has peaked, really peaked during the COVID. And while there is showing some decrease, it's still higher than what it was in 2015 and 16. And so what we know is the availability of substances for youth promotes the opportunity for youth to engage in experimenting and even habitually using these substances. And when we're talking about things like fentanyl, we are actually seeing an increase in overdose deaths among our young people. And so when it comes to prescription misuse, you know, I think it's important in terms of just kind of providing information that's in the news report spoke about the athletes that are using that might get hurt and might suffer an injury during their time of sports. And then they're given a prescription pain pill, and how sometimes if young people once they get better, they still have the prescription drugs available, then they might even just kind of share it with their friends or sell it to their friends. And then there are episodes which are called farm parties, where young people are gathering together and bringing all types of prescriptions out of their medicine cabinet for to share among each other. And it's really leading to an increase in prescription misuse. And so regardless of the intentions, the drug misuse is defined as taking a prescribed medication that's not necessarily prescribed for the reason that you're taking it for. And this is where young people are sharing their medications, whether it's in the home or in the schools. What we know is that oftentimes young people are sharing their prescription drugs with their friends. And you're taking somebody else's prescription drug, or you're taking it at a higher dose than the doctor might have prescribed it for you. Or you might be taking that medication when you actually don't need it. And then here's just a quiz question that we often ask when doing these presentations, is that how many Americans 12 years and older do you think have misused prescription drugs in the past? And I'm just wondering if you can unmute yourself and just give me what you're best, what you think the number of Americans 12 years and older misusing prescription drugs in the past year. And this, let me date this correctly. This is actually a 2022 question. Okay. Well, let me just tell you that in the past year, in 2022, it was reported that 18 million people were misusing prescription drugs over the past year. And why we talk about this is because oftentimes when we're talking about misuse of substances for our young people, we are talking about usually those things that we talked about earlier, such as vaping or alcohol or nicotine. And so we need to bring into the conversation the fact that youth are misusing prescription drugs as well. And what can be some of the consequences that evolve as a result of misusing substances? We know that there can be conflicts with family and friends. We know through information, data information, that not being able to manage schoolwork appropriately or even your home life because of substance misuse, there can be a reduction or discontinuation in social activities, which once youth found very, you know, they were very excited for because now the misuse of substances, they're now less likely to engage in social and occupational activities. And then what we also know is that ultimately young people who engage in misuse of substances by the age of 15 or before the age of 15 have a five times higher likely of developing a substance use disorder. And then also what we know is because it's reported is the number of overdose deaths because of misuse of substances, as well as, you know, talking about opioids. And so we have to recognize that young people, if they're not turning appropriately to positive supports is that they, what they will do is find ways of dealing with internal struggles on their own. And sometimes when they're in the comfort confines of their friends who might be using, they could be introduced to those substances. So we talked a little bit about reasons why youth are using substances. And so these are some of the reasons that are reported by young people through surveys, and they talk about wanting to relax. We know, we talked about the pressures of our adolescents that youth are trying to find outlets. And if they're not provided with positive role models and positive outlets, they're going to find their own means. And so sometimes they'll say, and I've heard you say this to me, you know, I smoke weed every day and I use it to relax, right? Not understanding what the harmful effects can be from a physical development as well as a neurological development, but youth are using substances to relax. And then they indicate a report that maybe they find a better focus. Again, I've worked with young people who have been diagnosed with substance use disorder and I've worked with young people who said, well, when I use marijuana, I feel like I focus better. And that's actually not true. And so we provide them with the appropriate information as it relates to what research is indicating about science regarding using substances. And many report to feel good along with peer pressure. And they also indicate that they want to relieve stress. Some report that substances allows them to do better in school and even do better in sports. And then those are those perhaps enhancing substances that young people are doing. And then they're feeling like they feel they're getting a positive outcome because of those enhancing supplements that they're engaged in using. But what we know is that there are risk factors according to the CDC of what are the likelihood that engages youth into using substances, such as our family history of using substance use, peer pressure, when there's a lack of family involvement, the early onset of use. And I just kind of talked about that. The earlier that young people are introduced and engaged in using substances, the greater likelihood that perhaps substance use disorder will evolve. When parents are engaged in substance use and misuse, oftentimes young people, if that's what they see about how adults in their lives are coping with that behavior, they're going to do the same. And then there's favorable parental attitudes. There are reports sometimes that young people are actually using substances with their parents. Parents are allowing young people to engage in drinking alcohol or engage in using marijuana. And so there's favorable parental attitudes. There's also reports of a lack of school connectedness, as well as childhood sexual abuse problems. And then there might be low academic achievement and also mental health. So what we know is that the combination, when you have undiagnosed mental illness and youth are finding ways in which to try to help themselves feel a little bit better, that sometimes they will result and resort to using substances. And then we have to talk about the teen's development. And what we know that from a the brain development that youth are primed to seek taking risks. They're primed to think that they are infallible, that they're not going to get hurt. And so what happens is, and I apologize if you hear that, we actually have the lawnmower running outside, that youth are going to seek sensation and they're going to seek the quickest, best way that they can feel good. And what we know is that their brain is not fully developed until their mid-twenties. And, but during the meantime, they're trying to prune, their brain is pruning for connections in the best way that they can. The limbic region, which we know manages the emotions, memory, and behavior. And actually the limbic region is one of the last things to fully develop, right? In terms of the brain. The free prefrontal cortex is managing those decisions and logical thinking. And so when you have the prefrontal cortex in conflict with that, that memory that says this feels great, it can cause a dysregulation for our young people and even our adults. And the limbic region, it talks about developing faster than prefrontal cortex. And so there's an increase in risk-taking and impulsivity and adolescence behavior. And so due to the variety of risk factors, adolescents are at a higher risk of developing substance use disorder and at higher rates than adults, particularly when it comes to alcohol and cannabis, because those seem to be the two likelihood substances that young people will use. And of course, as I mentioned earlier, the onset, the higher the likelihood of developing dependence. And of course, as I mentioned earlier, the onset, the higher the likelihood of developing dependence. And I think it's important that we also mentioned ACEs, which is adult childhood experiences. What we know is that ACEs came about in the mid-90s, and it was a study that was looking at the impact of youth exposure to certain experiences during childhood and the likelihood that that would lead to adults engaging in unhealthy behaviors once they're in their adulthood. And so during the first 18 years of an individual's life, what we know is that the exposure to emotionally disturbing incidences can create a likelihood that as an adult, youth would be experiencing things such as homelessness or violence in their communities. And so ACEs has been charted in our society today to say the likelihood of young people experiencing things like abuse and neglect at an early childhood has the propensity to result in certain things happening like violence, substance use disorder, and even mental illness as an adult. And so there's some common information here that talks about when, if there are, and there are four, there are different questions that are asked for that ACEs study. And it says individuals with four or more ACEs are 12 times more likely to attempt suicide. Individuals with five or more ACEs are seven to 10 times more likely to use illicit drugs. And individuals with six or more ACEs are 46 times to inject drugs. And what ACEs really does help to do is, I know in some efforts, particularly when individuals are in substance abuse treatment, ACEs has become part of the biopsych social that have asked adults when they're in treatment, have you experienced these as a child? And it's been helpful in terms of helping to develop a treatment plan so that individuals can address certain traumas that they've experienced in their childhood and even in their later teens and adulthood, as well as other social issues that they've addressed that could be physical. So if there's someone that has experienced perhaps HIV, exposure to HIV, exposure to tuberculosis or something of that nature, they're able to actually track that back to childhood experiences. And we also have to talk about stress, which we know stress is a well-known risk factor for addiction and also serves as an addiction relapse vulnerability or return to use. And so the early stress lives can be harmful to the brain. The brain can actually dysregulate as a result of ongoing traumatic stress. And the changes in those pathways can really are associated with the risk, higher risk of using substances. And the impact can be dysregulation as well as impulse control and compulsive drug seeking because of the stress. Talking about additional statistics from the CDC, one in four children experienced trauma or maltreatment. One in four women experienced domestic violence, right? And then, so these are some of the things as a result of trauma that is a huge risk factor for substance use and misuse. One in five women and one in seven men experienced rape at some point in their lives. 12% of women and 30% of men when they were younger will have a high risk factor for substance use and misuse because they were experiencing sexual trauma. And over 80% of children who live in dangerous neighborhoods experience trauma, have a high propensity for misusing substances. Along with adverse childhood experiences is the social determinants of health conditions. And what we know is some of our most vulnerable populations because of conditions in their communities or lack of education or poor healthcare systems, those things can contribute to high mortality rates, right? As well as other healthcare outcomes. And so what we know for our young people today who are experiencing things such as homelessness, maybe they have poor healthcare or don't have any healthcare at all because they're living in with families that don't have access to that healthcare, or they may lack education or even not have access to the appropriate health education or even not have access to the appropriate education. And so social determinants of health in combination with trauma can really be a high propensity for youth experiencing mental illness as well as substance misuse and even substance use disorders. And so having a perspective of social dynamics that are happening for our young people. Now more than ever, prevention is a really important element to reducing young people's impact of what's some of those things that are happening in their lives and in those communities. Prevention is essential, right, throughout the lifespan. And what we know is that when we can reduce the elements of those things happening for young people allows for the opportunity for resiliency to occur as well as the infusion of protective factors. The Institute of Medicine in the early 2000s developed the continuum of care and it talked about in order to have healthy communities, in order to start having the conversation about healthy communities, we have to understand that there is a continuum that an individual can experience or that communities can experience to evolve in a system whereby individuals can receive appropriate services. And so when we go from the promotion of prevention, which can be universal for our communities, we talk about appropriate health care, when we can talk about access to nutrition, nutritional foods that can help for the development of our well-being, all the way to talking about how prevention, prevention against unhealthy behaviors, prevention against exposure to certain conditions in our communities. And then if there is that exposure, how do we treat it so that people can maintain their well-being? We know that the continuum of care has been an opportunity to engage individuals in the environment that they're in as well as communities to promote wellness. And I like this. This was actually an opportunity to say that oftentimes when we do our work, we kind of operate in silos. And so we work in communities where you might see promotion happening in and of itself, but there's no connection to that or prevention is happening in and of itself and there's not connection to referring to treatment or there's just treatment in and of itself. But I promote that when we use the continuum of care as it is a continuum and we work inclusively versus exclusively, we have an opportunity to promote a system that works for youth and families so that we can coordinate that continuum of care for the healthy development of our society. And so this just really talks about how we can feed into each element of that continuum of care so that we can up the ante of improving the system entirely so that we're all working together. And to do that, we have to talk about prevention. Prevention are strategies that address both the individual and the shared environment and they're an important part of a comprehensive approach to prevention. And so as you can see, when you're talking about your community, when you're talking about the individual and getting the individual to be able to have the exposure to people, places, and things so that they can get the appropriate services that they need, it helps to increase the well-being of the individual as well as the families. And there is a reciprocal that connectedness to the community allows the individual to not only receive services, but also embrace the community and its well-being overall. And this is just a quote by Janet Reno that I really like. She talked about the problem in America is that everybody focuses on their own narrow lane. And when we can work together, there's an opportunity that you have a greater impact for the community overall. The communities that care, I'm not certain how many of you are familiar with the communities that care, but it is a approach to healthy communities and they have different approaches to how we can help develop youth through bonding, through all the elements of our communities. There are different domains, including the schools, the families, and the community in and of itself, along with peers, helping youth achieve a state of healthy behaviors as well as healthy well-being. And so in that social development project, they talk about different interventions from the classroom to a youth-owned social development. And so it talks about establishing clear classroom management and instructive teaching that allows young people to give information, to ask information, where it's a learned environment that folks can really be able to evolve their own thinking, their own independent thinking, and then using cooperative learning by including small teams to work together. But it also talks about how this can contribute to a child's emotional development through communication, decision-making, conflict resolution. It can really help young people develop their own social well-being for themselves and helps them also to recognize how they can generate refusal skills that can promote their own well-being. When we talk about individual-focused strategies, we're talking about how to reduce the likelihood of young people coming in contact with problem behaviors. And this individual-focused strategy is really talking about misuse of substances. And so when you're talking about the host, the host is the individual, and how the agent, which is the substance, might impact the host's ability to make healthy decisions. And what we're trying to do when we're talking about prevention is minimizing the onset of the substance interfering with or coming in contact with the youth to begin with. And helping young people, and I think this is something when we go back to COVID, we've kind of are now in the throes of helping young people to be self-regulators, helping them to identify how they're feeling and how those emotions can be regulated so that they're not acting out. And so self-regulation really talks about the ability to manage their own well-being, their own state of affairs in a positive, proactive way, and in ways that are socially acceptable and that they can achieve positive outcome goals. I mentioned mindfulness during this presentation because there has been a movement about mindfulness. Some of you may even use this in your practice, but mindfulness really encourages young people to promote well-being within themselves. It allows for pathways that they can be centered and that they can appreciate who they are and where they are in their state of well-being, and allows them to just kind of open up about how they're feeling about themselves. And so I know that mindfulness has really been a practice that sometimes has been instituted in community settings as well as in the school settings. And so we want to be able to also encourage pro-social behavior with our young people. And what we know through research is that when there is a healthy dose of exercise, it stimulates the youth's well-being physically and mentally, encouraging pro-social behaviors of studying with friends, allowing them to discover who they are and do hobbies, proactive time spent with families, and then giving them a space and place of somebody that they can just speak with. We oftentimes talk about adults as parents, but oftentimes, too, there is research around how mentoring can really be a positive development pro-socially for young people to bond with a positive adult in their life that might be beyond the family member. And here I just kind of identified some individual focus strategies that young people can do to build their skills. And these are just some that are in the schools and even in the community that really focus on young people well-being. After-school programs, there is an after-school program that's really focused in the schools. It's called AVIDM. AVIDM is a national school program that helps young people encourage to focus on mental wellness, and they do that through different events and different media messages about well-being. There's also evidence, school-based curriculum like Say No to Drugs that can help young people, again, find information out about substance misuse and the dangers associated with that, but more importantly, about refusal skills and the importance of refusal skills for young people. There's life skills training that might be available, maybe allowing young people to get engaged early on, thinking about something that they would like to develop as an adult. We in our community have a young youth academy working with police officers and even fire people, so maybe that's a track that, you know, getting youth engaged in something early on can be a proactive experience for them. And then there's social school assemblies oftentimes bring in, you know, guest speakers to talk about building up youth and their attitudes and positive behaviors and enriching their lives through just kind of promoting positive messages. We also know tutoring programs are available, and then I like parenting classes because oftentimes there's an opportunity to keep young parents engaged in young people's positive development outside of the home, letting parents know that there's opportunities for them to connect with the school and with the community through parenting classes. And then when it's needed, assessment and referral programs for young people as well as teaching them about media literacy. There can be awareness days in our communities. We do Red Ribbon Week. We also do Prevention Week whereby we honor young people for the work that they're doing that is positive. Also youth council and mentoring programs, and then letting youth-led media campaigns can be very, very positive for young people, as well as SBIRT, which is Screening, Brief Intervention, and Referral to Treatment. Again, looking at young people and helping them to identify issues and problems in their life they may need to get additional help and assistance for. Acknowledging that youth have the opportunity and the capability of making positive decisions in their lives and honoring them for making those positive decisions can go a long way. And we also know that within the environmental context, there are risk factors that happen for young people. And what are some of those positive messages or positive programs or activities can we introduce in the community for an environmental approach that can reduce the likelihood of young people engaging in problem behaviors? And so from an environmental standpoint, hours and days of sale, so limiting access to problem behaviors such as alcohol and marijuana by limiting the time that sales can happen. Promoting clean air laws such as smoke-free park places. And in that, that discourages the vaping from happening in those areas. Social hosting ordinances, which allows parents to know that it is not okay to provide alcohol for our young people, even during prom time. Those social ordinance laws allows parents to say, we promote and we pledge to have a drug-free post-prom or post-graduation party. And then it gets published perhaps in a local newspaper or even on social media. And it's just a great way to promote an environmental community safe way for young people to have a safe celebrations. There are youth aid panels, which are opportunities for young people to engage in looking at problems that they might have had in their lives. Maybe they have something like they skipped school. And so there is an opportunity through the youth aid panel to learn about other things that they can do that are proactive and more positive to decrease the likelihood of them continue to engage in problem behaviors. There are health fairs that again, promote health environment, health attitudes, health activities for young people that they can actually help either support or participate in or create. Compliance checks are usually in communities that again, we're looking at reducing youth's access to certain substances like alcohol and tobacco products. And those compliance checks allow for law enforcement to go into these establishments to ensure that they're in compliance with not serving young people under the age of 18 or 21, certain products. Prescription drug monitoring systems have been in place that basically promotes the coordination and compliance of prescription drugs not being over prescribed for young people, as well as it reduces the opportunity for pill shopping, quite frankly. You can't go to another dispensary, not dispensary, but you can't go to another pharmacy to get a prescription drug and have another doctor prescribe you that same drug. There's party patrol that includes law enforcement, as well as control party dispersal, and then restriction on marijuana dispensaries in their locations, as well as drug courts. Drug courts allow young people to, if once they are participating in drug court, it can allow them to be monitored by probation. And if they're in compliance with those requirements and their families, they actually get their charge expunged. And so drug court is a way to support young people while helping them address some concerns and conditions that might be happening in their life. And then ultimately find resiliency and making good choices. The other element that I just kind of want to mention is harm reduction. Harm reduction is a approach that really talks about empowering people who use drugs. While we talk about prevention and the importance of prevention, what we know through history and through student data is that you're going to have the onset of young people engaging in substances. But how do we work with these young people to empower them and become more aware of their own use of substances and working with their families to make healthy choices? And harm reduction is really a practice that reduces other consequences, other health-related consequences, such as HIV and AIDS or Hep C or TB. And it works to provide an arena where young people can get the support and information to promote their health and well-being while reducing the likelihood of continuing to use substances. This is part of our training is through the opioid response network. And so I think it's really important that we talk about fentanyl and other synthetic opioids that leads to overdose. And so through harm reduction, we talk about improving access to treatment and recovery services while promoting use of reversing overdoses through Narcan, strengthening understanding that the epidemic is being monitored nationally, and that there are certain approaches that the National Institute of Drug Abuse as well as CDC is taking to raise awareness about drug overdose deaths in our communities. We're doing so through providing cutting-edge research on pain and addiction and looking to advance best practices for pain management. What we know is that when we can increase protective factors through caregiver involvement, and I'm going to include again positive role model involvement, increasing healthy self-esteem and coping skills, as well as providing positive norms and peer relationships in youth lives, then we do have the opportunity to reduce those risk factors such as trauma, such as mental health conditions and poverty and academic problems. And the CDC advances the promotion of positive peer role models, protective factors that can really influence young people to make positive decisions. And while they're making those positive decisions, reducing their risk factors of engaging in the problem behavior, and ultimately increasing their health and well-being while reducing the chances of engaging in substance use disorder and mental health problems. And I like this, this is out of the Texas Network for Youth Services, and it really talks about the importance of providing support to youth, but oftentimes understanding and recognizing that without youth input, we will miss the mark and how to best support them. But when we can involve youth, then we have the power to help them advocate for themselves while we're advocating for them as well. Youth raise terrific and important questions, which can help us be good stewards of providing them the best chance for empowering them, and then utilizing programs that they're going to take advantage of, right? And then thinking about how do we do this at a time whereby we know that there are financial and regulatory requirements that might challenge us to be able to promote the best services to young people, and how do we manage that? And we may have to do so through our own efforts of advocacy and just saying, wait a minute, we know that these things can help young people, and how can we do that in the best way so that we can raise the resilient youth of today, and get empowering them to be able to speak on their own behalf? And so that kind of is my talk with you for the day, and I'm just wondering, I want to open it up, I want to stop share and see if there are any questions that you might have. Any questions? I see there's some things in the chat box. Okay, those are just, can I ask, what are you seeing? Go ahead. Oh, sorry. Ms. Yvonne, thanks for this presentation. I was wondering if you could speak more to what you have found as being most effective when it comes to talking to teens who are currently experimenting and using, and there's a reason why they go back to using substances. How do you talk to them and help them when it comes to harm reduction, right? Either reduce the use or, yeah, what's been helpful? Because we know teens, when you tell them no, they're still going to do it. Right, and so that's a really great question, and because here's been my experience, is that we know when you tell young people in their effort of being, we know that they are finding their own way. They want to have their own independence. They want to make decisions on their own, and what happens is empowering them to say, you know, you're using marijuana. Let's talk about that. Because they have to come from a place of when did you start, right? Sometimes we get them, 13, 14, 15, and they've been, you know, I've had young people say, well, I've been smoking weed since I was nine years old. So what started you, right? And then finding out, taking the time to find out what started, because it might have been witnessing violence in their homes. It might have been experiencing being bullied. It might have been curiosity, but taking hold of those reasons why when you started, so how did that make you feel, right? And sometimes they may not be able to tell you, but really trying to massage for me those questions that develop into relationships. And then saying, you know, well, how do you feel now? Because sometimes what I have young people saying is, I'm trying to stop it because I don't even like it anymore. I don't like the way it makes me feel. I don't like the way it makes me smell. I found that the folks that I was using with, some things happened. And so then say, well, are you interested in learning about different ways? And what we know is our own experience. You know, I use myself as an example. If I'm trying to lose weight, right? I'm not going to get down on myself if I don't, versus saying it's a little bit at a time. And so that harm reduction allows us to say, because to quit might, you're going to experience some withdrawal that's going to say, I want to feel better. So I'm not going to go back to what I did. But what about if we just say, we cut down, we cut back a little bit. What do you think you can do? And finding from their perspective, what are they willing to do? Because oftentimes as adults, we say, well, you know, they're expected for you. Well, you know, this is going to happen. Well, you know, probably they already do because they've heard it from somebody else. But let's say, but what can we manage with? What can we work with? What are you willing to try? And then applauding the other, the small, the, I shouldn't say small because every, every opportunity to reduce is huge. And we should make a big deal of that. That is great. That is wonderful. Even if they say, well, I was able to cut down for two days, but then something happened because then we can say, well, then what happened? So you were able to reduce for a couple of days, but then you said you shared with me and thank you for sharing that with me. What happened? What happened that you went back to? Because there might've been an incident. And we don't, we don't give enough observation to trauma. And I think, I think when young people are experiencing situations in their life, you know, they're asked to be the breadwinner sometimes today, they're asked to work and go to school and watch their younger brothers and sisters. And oh, by the way, I'm 15 years old. So they're, they're put in positions of adulthood before they're ready to even be adults. And so looking at the fullness, the wholeness of who youth are and helping them find some space in place that to know that I'm a good person, I'm a good person who is capable of making good decisions. Because there are some youth that I worked with, I don't even, I can't even imagine what they hear about when they get home. And we don't realize, or we don't ask them, well, you know, how's everything at home? Even just offering some time support in the way of, and you may not need this, but you know, here's a list of supports. Like there's the food bank, there's the clothing bank, you know, just offering them what systems are available to them in the community. And sometimes they may not need it, but sometimes they might. And I just kind of think about being proactive in their life and being supportive in their life so that they want to know that there's somebody else that's kind of cheering for them besides themselves. Yeah. Yeah. Thank you. That was helpful. What else are you, what else are you thinking? And when I asked, so are you, what age group are you working with? Yeah, sure. I'm happy to answer and feel free to chime in. So we work with middle schoolers and high schoolers. Okay. Okay. Yeah. So 11-ish to 18. And, and, and sometimes in my experience anyway, I've found working with young people and I've worked with young people who were in juvenile detention facilities and group homes, worked with young people who were participating in a program called Grandparents Raising Resilient Youth. And so when I'm talking about, that's the framework I'm talking, I mean, they, I think for them and they've shared that sometimes they've been able, they felt that they needed to be an adult before they were able to be an adult. And if they're being put in that position, then they feel like they have to make adult decisions. And sometimes in those adult decisions, but that's what they see, adults are right. Drinking alcohol, vaping, using marijuana. And so they're feeling, well, then that's, that's a me too, along with the stressors, right. And the other risk factors that are going on, it's just a combination for, for a quiet storm for them. And they're not talking about it, right. They're not talking about those pressures. So they're going to show you. Yeah. I was going to ask if you could go over the continuum of care again. I found that interesting. Yeah. And so let me go back to it. I'm going to go back to the continuum of care. Let me just go down and scroll down here. Yeah. And so let me, I'm Dave. I'm going to try and shift, try and do it with one. Oh, I'm sorry. Let me go back. It's a ways back. Sorry guys. Yeah. And so again, it's by the Institute of Medicine. And when we talk about the continuum of care, it's really a stage process, which can really help to promote healthy communities. And like I said, when you talk about the promotion, it's kind of a universal thing. You know, when we talk about access to adequate healthcare or access to food, right. And not only food, but you know how some communities have like those community gardens where they're growing fresh vegetables and fruits and stuff like that. And so when we promote those things, right, those are things that can contribute to the wellbeing overall of individuals as well as people. But what the community, the continuum of care also recognizes that there are some things that you have to do along the way though, along with that. So the prevention piece of that, when you're talking about prevention, you're talking about prevention as it relates to substance use and misuse in this fashion. And what we talk about in terms of prevention is we know that there are three stages of prevention. There's universal, which everybody gets a dose of prevention. And so when you think about in our communities, and you think about prevention, some of those health fairs, those health fairs that have people, you know, giving you blood pressure tests or doing some screenings, everybody's eligible for that, whether you're young or old. And so that's a universal prevention. But then there becomes that selective prevention, whereby you notice that there are certain people, and let's talk about our young people. There are certain young people that might be at risk based on their family history, based on maybe some, you know, early exposure to, you know, substances. And so there's a select group that's going to get another dose, a different dose of prevention, that might be maybe a support group. In my community, I think about we have a support group for teens who have parents who are in jail, right? And so that's a select group of young people that is going to get information about families that are kind of maybe dysfunction due to, you know, my father or my mother's in jail, right? And how do we support them through giving them information and providing them some supports, right? Maybe that group of kids will go to Dorney Park for the day, but they're all together. And again, what I mentioned was when I was manager of Grandparents Raising Resilient Youth, grandparents were raising their grandchildren because of the absent of the birth parent, and the birth parent was either using substances and or in jail. And so what we did with these young people was we provided them information about substances, about the harmful effects that can be associated with using substances. But we also did group planning with them. We took them to Dorney Park for a day. We took them to the movies. So we exposed them to positive events and recreational events. And we did that through, they were a select group. There was about 13 or 14 of them between the ages of nine and 13, right? But then there's an indicated group of those that are now dabbling with vaping, dabbling with marijuana. They don't necessarily meet the criteria yet for treatment, but if they continue to use, they're indicated they need a certain level of care. And that care can be, you know, maybe participating in a three hour program or, and or given a opportunity to do a six week class that would, you know, engage them in learning more and more about the dangers of using marijuana, say. So they're indicated because they begin to show signs where they've had one or two times of initial use, and if continuing to use would lead them to, you know, whereby that they need treatment. And so the treatment aspect of it is they've now been identified as having a either mild, moderate or severe substance use disorder. And they now need some semblance of treatment that could be intensive outpatient, outpatient or inpatient. But treatment is recommended, right? And then the maintenance comes into aftercare and maintaining their recovery. So mutual aid support groups, going to intensive outpatient services, continuing with maybe housing, maybe there's a selective housing for, so that they can get well in an environment that's supportive. And so the continuum of care really just says that in order for us to achieve that idea of a healthy community, there, all of these things need to be part of this healthy community environment so that people have access to the appropriated services that they need. And so why I showed this screen then was just really sharing that all of these should be working together versus being disjointed. So I've worked in areas whereby it's just been primary care, primary prevention, and usually it's a school-based, and that's fine, but to do just this without saying, but what about the youth that come in that, you know, are maybe exposed to it because of the family? Don't they deserve some type of, you know, information and support as well as those that are indicated? Because I think sometimes we go down this road of, well, if someone's tried something three or four times, now they need to be immediately in treatment, and that's not necessarily the case. There can be things that we can intercede with and intervene with that's indicated so that they are no longer continuing that behavior. And so that continuum of care, and you can, out of the Institute of Medicine, you can actually Google it and you can see there's been steadily research behind this and how it can be effective for our communities. Yes, thank you. You're welcome. You're welcome. Looks like we don't have any more questions. I just wanted to put in the chat with the Certificate of Attendance if you guys would like to use it, get it. You do have to create a PECSS account and also complete an evaluation. You will first have to, if you don't have a PECSS account, there is that first link there where you can create one. And also after creating your account, you can access the survey. This is specific for this survey. So you will have to use a second link to open that survey. And then there's an instruction on how to, because we have some issues before with others downloading or finding it, but there's information there. If you guys have any issues, I left my email address there as well. So you guys can send me an email, shoot me an email, and then we'll be more than happy to assist you. We're almost at time before we say thank you to Ms. Yvonne. Thank you. It was a great presentation, Ms. Yvonne. Anyone else? Any comments? No, just thank you, Ms. Yvonne and David, for this presentation. We really appreciate your time and expertise. I just copied the message that you sent out in the chat, and I'll drop that in our Slack too, just because I know several folks had to jump earlier for a different commitment. So I'll make sure that our team members fill out the evaluation if they did attend at least part of the training. Yeah. Sounds good. Thank you so much. Thank you so much. Thank you, everyone. Thank you. I'll be reaching out to you in an email. All right. Have a great day, everybody. Thank you. Thanks. All right. Bye-bye.
Video Summary
The presentation focused on the importance of addressing mental health and substance misuse among young people. The transcript covered various topics, including the impact of trauma, social determinants of health, risk factors for substance use, and the continuum of care model. The speaker emphasized the need for prevention strategies, support services, and harm reduction approaches to help youth make positive choices and reduce substance misuse. The discussion highlighted the importance of involving young people in their own care and providing them with the necessary resources and support to navigate challenges they may face. The presentation also touched on the significance of community involvement, positive role models, and access to treatment and recovery services. Overall, the goal was to promote resilience and well-being among young individuals while addressing the complexities of mental health and substance use issues they may encounter.
Keywords
mental health
substance misuse
young people
trauma
prevention strategies
support services
community involvement
role models
treatment services
resilience
well-being
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