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Not only do we need to know the signs; we must REACT to them, too

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former chief justice of the New Hampshire Supreme Court and co-chair of Change Direction New Hampshire John Broderick speaks to high school students at a recent assembly. (Courtesy photo)

Editor's note: The Rochester Voice today publishes the third of a three-part series looking into the mental health crisis currently overwhelming New Hampshire's health provider system and what can be done to right the ship.

Today: What are the five warning signs of declining mental health and what do we do if we see them.

The numbers from the National Institute of Mental Health are staggering.

  • Approximately 1 in 5 adults in the U.S.-- 43.8 million, or 18.5% --experiences mental illness in a given year.
  • Approximately 1 in 5 youth aged 13-18 (21.4%) experiences a severe mental disorder at some point during their life. For children aged 8-15, the estimate is 13%.
  • 18.1% of adults in the U.S. experienced an anxiety disorder such as posttraumatic stress disorder, obsessive-compulsive disorder and specific phobias.
  • Among the 20.2 million adults in the U.S. who experienced a substance use disorder, 50.5% -- 10.2 million adults -- had a co-occurring mental illness.

No one knows this better than John Broderick, the former chief justice of the New Hampshire Supreme Court and co-chair of Change Direction New Hampshire, a campaign seeking to raise awareness of the five major signs of emotional suffering that could indicate someone needs help.

Broderick finds himself the pointman in a pivotal battle aimed at reconstituting how the public views mental health.

"We don't say, 'Hey, that guy's acting diabetic,'" he said recently in an exclusive interview with The Rochester Voice.

Which gets to the core of the problem, said Broderick, who has been crisscrossing the state and region trying to get people to grapple with the notion that mental illness is a disease, not a stigmatizing anomaly for which one should be scorned, ridiculed, ostracized or laughed at.

Broderick says there's no denying the numbers of those suffering from various forms of mental illness - and there is a vast spectrum - is skyrocketing.

"Some 25-30 percent of the kids in New Hampshire have a diagnosable mental health problem," said Broderick.

Some more numbers from the National Institute of Mental Health.

  • An estimated 26% of homeless adults staying in shelters live with serious mental illness and an estimated 46% live with severe mental illness and/or substance use disorders.
  • Approximately 20% of state prisoners and 21% of local jail prisoners have "a recent history" of a mental health condition.
  • 70% of youth in juvenile justice systems have at least one mental health condition and at least 20% live with a serious mental illness.
  • Only 41% of adults in the U.S. with a mental health condition received mental health services in the past year. Among adults with a serious mental illness, 62.9% received mental health services in the past year.
  • Just over half (50.6%) of children with a mental health condition aged 8-15 received mental health services in the previous year.
  • African Americans and Hispanic Americans each use mental health services at about one-half the rate of Caucasian Americans and Asian Americans at about one-third the rate.
  • Half of all chronic mental illness begins by age 14; three-quarters by age 24. Despite effective treatment, there are long delays--sometimes decades--between the first appearance of symptoms and when people get help.

To combat this mental health crisis, Broderick says there are three things we need to do.

First we need to have a conversation about mental illness that sheds light on its existence as a medical condition, not some bogeyman.

Second, we need to recognize the symptoms so everyone gets the help they need as soon as possible.

And thirdly, we need to follow through, or REACT.

The five symptoms as developed by The American Psychological Association include

  1. A Change in personality.If someone is acting like a very different person, or not acting or feeling like themself, this is a warning sign.
  2. Uncharacteristic Anxiety, Anger or Moodiness.Severe changes in emotion are a cause for alarm, especially if they are persistent.
  3. Social Withdrawal and Isolation.If an individual is "closing off" socially, cancelling social engagements, or spending too much time alone, this is a serious warning sign of emotional or mental health issues.
  4. Lack of Self-Care or Risky Behaviors. Persons with mental health issues often lose concern over their own health and well-being, engaging in risky behaviors like drinking and drug use. In addition, a lack of hygiene, or lack of concern with appearance, may be indicative of a mental health issue.
  5. A Sense of Hopelessness or Feeling Overwhelmed. Mental health difficulties often cause people to give up - to feel like life is just too hard, or that they will never feel "normal" again.

Once people have learned to identify the five warning signs, the next step is acting on them when they see someone who may be struggling.

For John Dixon, a Northern Seacoast man who works as a volunteer facilitator for the National Alliance of Mental Health and has a family member who suffers from mental illness, that could be anyone; neighbor, teacher, clergy member, social worker, primary doctor or just an acquaintance.

Courtesy Dartmouth-Hitchcock Hospital

The R.E.A.C.T campaign codifies the desired response when a victim of mental illness is identified.

The five letters stand for Recognize the signs of emotional suffering, Express concern and offer support, Act now and talk to someone you trust: parent, teacher, coach, relative, friend, doctor; Care enough to follow through and follow up; and Text the "signs".

There has been much discussion as to why there is this explosion of mental health issues among our youth.

Dixon reasons it could be a combination of more measurement and higher stress.

"Why is there this explosion in concern in global warming?" he asks. "It wasn't always done. Today they are measuring more and there is more awareness."

"But it could be those damn phones," he adds. "The interconnectedness, the stress level in children disconnected from their phones, it's unbelievable. You lose your phone, you lose your life."

Broderick puts much of the problems kids are dealing with today with just plain more pressure combined with a breakdown of the nuclear family and a greater expectation for success.

But Broderick also believes that students today can be the solution. "(They) have the ability to change the culture and the way mental health is viewed," he says.

Dixon also thinks teachers have a wonderful opportunity to make an impact, since they spend a lot of time with their students on a daily basis, getting to know their individual personalities, strengths and weaknesses.

Broderick says, however, before we do anything else, "We have to have the conversation," a conversation that reverses the centuries-old contention that mental illness sufferers need to be housed in nuthouses, marginalized and kept behind locked doors.

Only when we do that can we truly begin the healing.

Upcoming events with John Broderick:

Sept. 27, 7;30 a.m. Marshwood High School, Eliot, Maine, teachers, faculty, administrators

Oct. 11, 6:30 p.m. Dover High School, evening presentation

About the series

Part I of our series detailed the crowding of emergency departments like Frisbie's with mental health patients awaiting beds at New Hampshire Hospital in Concord, the state's primary mental health treatment facility. Published Aug. 14.

Part 2 of our series dealt with why we need to destigmatize the plight of mental health sufferers and treat mental illness as a disease, not a condition. Published Aug. 21.

Consult The Rochester Voice archives to read these articles.

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