How Do Communities Welcome People Managing Mental Illnesses and the Disease of Addiction?

How Do Communities Welcome People Managing Mental Illnesses and the Disease of Addiction?


>>>Hello, everyone, and welcome
to our session for the national network of libraries and
medicine middle Atlantic regions monthly boost box series. I am very pleased today that our speaker is Marie Verna and she
will be speaking about how do communities welcome people
managing mental illnesses and the disease of addiction. I’m the executive director of the national network of
libraries of medicine middle Atlantic region, and I thought
it would be fun just to see who is here and who registered for
this topic, who among our membership are particularly
interested in this session. Out of 90 registrants, the
majority of library staff of one kind or another, mostly from
number libraries followed by health sciences libraries and we
also have some academic libraries including staff from
community colleges. We also have a few health
professionals and public health workers with us and them a
couple others, and most of you others are from community-based
organizations. I’m really thrilled that this
topic seems to be of interest to others. I met Marie at a meeting last December and she was speaking on
a similar topic and I knew very quickly that I wanted to bring
her message to the wider audience of the national network
of libraries and medicine. Marie is president of dominion
behavioral health policy and a leader of behavioral health
policy, public affairs and communication with an emphasis
on public and private insurance reform, integration of the
medical and behavioral health systems and outcomes in line
with meaningful consumer satisfaction measures. She has over 25 years of building collisions of many
relevant departments, payers and consumers resulting in realistic
and cost effective solutions. Marie is able to articulate root
causes of the unmet needs of vulnerable citizens and the
public policy needed to successfully, swiftly
compassionately respond to those needs. Marie will be giving a brief presentation and then we will
open it up for questions. If at any time you have a
question, you can write it in the chat box and I will serve as
moderator and ask Marie all of your questions after her
presentation. I also want to thank those who
sent me questions in advance, and I will ask for those as
well. Marie, thank you so much for
coming. I will hand the ball over to
you. Thank you, Kate. Thank you very much for welcome and the opportunity it talk to
people all over the country with some of the issues that kind of
come down to the saying all politics is local, well, so is
all welcoming in communities. Again, thank you very much. Just to tell you a little bit about myself besides what was in
my bio, my job usually for the last 25 years has been to ensure
that the voice of people who manage mental illness and the
disease of addiction is actually heard wherever it’s not being
heard, and I guess my credential for that is that I myself manage
bipolar disorder and clinical anxiety disorder and have done
that since 1983. I was diagnosed when I was 26
years old and I’m older than that now. My whole job has been very much consumer advocacy and at this
point in my career having worked in government affairs and
getting to know treatment settings, I can say that I speak
for most of the stakeholders and the people in our communities I
would say are the most important stakeholders. So with that the concept here is how can a community welcome
people managing mental illnesses and disease of addiction. I’m really happy to see who is on the line. As I’m not getting my — you must have to give me permission
to move my slides? Okay. I got it. Okay. So this issue has become higher and higher and higher on our
lists of what is a meaningful outcome for a American managing
those particular disorders, meaningful meaning not just
measuring whether you go back in the hospital a lot and not just
whether or not you go back to rehab a lot, back and forth and
back and forth, what we’re really trying to do is cure a
collateral damage of a person’s life when all this starts to
happen. Usually their relationships
break down. They lose jobs. They are not able to make it through school. If there are still people by law supposed to be in school, they
can’t make it to school. I call all that collateral
damage of mental illness, and all of that has to be rebuilt in
order for true recovery to happen and for people to get off
of public entitlements. So with that we are paying a lot
of attention now to measuring, do people actually get
reintegrated into their community. Does that really happen. One of the things that I can see
the interest is gaining on the part of librarians to try to
welcome you in to that effort because most of the librarians I
know operate under the ideas that they are public servants
and this they serve the whole public and that their patrons,
you know, can’t be discriminated against. So the way we’re seeing it right now is that we really want to
focus on libraries. Every township, community has
one. Many of you work near areas
where there’s an academic library. For us here at Rutgers University behavioral health
care we’re connected with the Robert Johnson medical school. These libraries have become a very, very important nexus for
all of what we want to happen, and them coincidentally but with
lots of work on your part, all of those others places that make
up a community like churches, schools, landlords, corporate
stipulations and by that I mean business partners who are
willing to donate to local initiatives, gyms,
entertainment, restaurants, parks, merchants and health care
providers, and anything I’m missing I would like you to put
in the chat box so Kate can let me know during the Q&A. We know that in our world many many church leaders have had to
learn how do we welcome people with those particular illnesses,
like what do we do when there’s someone in the back of our
church whose hearing voices and the other people in the church
don’t want them there, they are afraid of them. Well, churches also feel like they don’t turn anyone away. So we needed to create some really good relationships with
them and educational materials just for them, just for the
leaders and then we can go in and teach the actual
congregation by itself. In terms of schools, we are
trying desperately, desperately, desperately to get into as young
as grade school and kindergarten we’re keeping little kids about
how you, with compassion, manage someone who quote looks
different, to get into a curriculum for a teacher that
you can’t get your license unless you take a specific
number of credit in what it means to have kids in your
classrooms who aren’t quote normal. And so all of these things are happening all at the same time,
with landlords, as I said, most of your life falls apart and you
lose assets, you lose all of your private assets and them
you’re homeless and near homeless and living in shelters. We know that in each community that there’s a group of
non-profits and treatment providers that are trying to be
a network, they are trying to be a network of landlords who
understand no, we’re not all going to be drug dealing, we’re
not all going to be — we don’t all want to live in horrible
neighborhoods that aren’t near any kind of food so that we have
to basically eat something from a Wawaall day long, not to
mention we don’t have money. Corporate citizens are doing a
great job in focusing or their locale, their grant fund it go
departments has a group that just focuses on that. Coalitions of all these communities need to tap into
them for very vulnerable populations. Gyms I think is interesting because a lot of consumers will
say that’s like a normal place where people go, and some of our
non-profits around the country have taken the time to talk to
gyms and fending on the clientele dedicate certain times
of the day to when they are Britain their clients and
conversely try to get the regular clientele to accept
people with mental illness or addiction and get there without
being stigma advertised or ridiculed that would happen in a
place where people aren’t educated enough about the
realities of these disorders. I know that every Friday
afternoon I run a group of — we have consumers and we’re
specifically not just trying to talk about what are you going to
do this weekend. We’re trying to talk to them
what are you going to do so you can stay healthy until you can
come back here on Monday. For people who are trying
desperately not to pick up a substance, we talk about the
fact that you can distract yourself in a park. If you’re trying to isolate and you know that’s part of your
illness, you can go to a park as a gentle place to just get out
of the house. These are all of the parts of a
community including merchants and restaurant openers. I want to let you know, some someone comes into a psychiatric
screening center in a geographic locale. And here in jersey there’s at least one in every county. We have 11 counties. They need to know what they call
collateral and what they are talking about is all of the
information we can possibly glean about this human being
because that person is part of a community, and often times they
want to know, so the guy that sees — the merchant who sells
this guy a number every day, is he seeing something different
today that wasn’t happening yesterday. Is this a person that generally speaking is not at all agitated. It’s just not his personality. So that when we see the
agitation and he has to be brought to the psychiatric
screening center, we have some more information about the porn
and we can maybe figure out that triggered it it. Maybe that person saw a robbery and that triggered some kind of
anxiety. So that’s what we mean by a
community. The whole thing that’s trying to
talk a lot, come together a lot, libraries usually are focused
for gatherings and offering their space and all their
knowledge and their staff for the purpose of bringing together
everybody that represent a community. So that’s really what this is all about. So then the next question is are we prepared as communities to
welcome them the way we would want to be welcomed if we moved
to a new environment. And I want to stress that, first
of all, that means defining behavioral health clinically and
what we really need? So there’s a manual that
psychiatrists use. It’s called the diagnostic and
statistical manual. It’s in its fifth edition, and
it’s very specific criteria. Very specific screening tools
for a number of true clinical diagnosis so sometimes people
don’t understand it’s not like that phrase, well, everybody
gets depresses. It’s, no seriously, these are
people who by virtue of being assessed clinically with
assessment instruments that have been studied by major academic
institutions that we are honing in on what does it mean to be
clinically depressed, clinically anxious, clinically suffering
from insomnia and clinically what does it mean to be manic
and what does it mean to be psychotic. So when we say behavioral health, although behavior has
sort of a disciplinary connotation. What we really mean is what does a person say or do or not say or
not do that one of us — someone in society would say, yes,
that’s healthy behavior. So when it might seem logical
and common sense that a person whose trying to, you know,
trying to stay clean from alcohol, the normal person would
say why would they do that, and why would they pick up that
drink, what behavior is compelling them to do that? And that’s what we call the disease of addiction. We all know the consequences. We just can’t seem to — our
brain literally is anatomically altered so it can’t do the thing
like I see a beer there but I’m not going to pick it up. So that’s what we mean when we say behavioral health. What does it look like? I look like a professional
person who works in a professional place. I’ve heard many, many people say to me, well, you don’t look like
a person with a mental illness. My response was you weren’t
there 30 years ago. I didn’t expect look healthy,
and so we need to think about the fact that, you know, upward
of 70%, 90% of the population of lawyers have serious addiction
issues. Many many pastoral has some
mental illness or addiction. It has no class bounds, no
salary bound. Our ability to behave is what
takes us into the disability range. So most of the people that you see that you might say they look
like they have a mental illness, like people in a train station
were talking to themselves, that behavior is what looks like
mental illness and we can say at this point we do suspect that
that person need treatment and we’re very fortunate that on the
national level the federal government has come up with a
curriculum this we’re calling mental health first fade and
we’re working on making it be the equivalent of say CPR,
cardiopulmonary resuscitation. So that when you see a person
you know how to approach them, you know how to do it
compassionately and with skill and you know exactly who to call
to get in. When you see somebody who it
does look like, yeah, their life is falling apart and it appears
they are suffering from those illnesses, and so the next
question is what would make a person feel welcome? And that’s really again what I do for a living is find out by
talking to people. The thing with regard to
definition of behavioral health, our diagnoses are, again, they
are real. We don’t make them up. I think sometimes we over the years, I guess our industry it,
hasn’t been really able to educate well. We’re not getting our points across that this isn’t mystical. This is actually science. And them the treatments,
unfortunately, we aren’t at the point where we have diagnostics. We can’t do a pet scan and say this person need precisely this
or blood tests. Unfortunately, at this stage of
the game when someone describes their symptoms, the prescribing
physician tries a medication that typically will relieve
those symptoms and that’s how we figure it out. For example, when I was first diagnosed, doctors thought it
was only depression so they put me on an anti-depress enter. Six months later it looked like no, it’s not just depression,
she’s swinging all the way over to the other side of the
spectrum and it was very obvious my moods were moving too fast,
we call it rapid cycling where I was laughing, crying, laugh,
crying. So clearly they could say there
was not only depression it was bipolar disorder. It balanced you in the middle of mood so there’s no disorder. In terms of prognosis, we know that the prognosis has
everything to do with whether or not the person is integrated
back into the community add safe housing, access to good food,
places where they are not going to be in gang neighborhood and
they are not going to be where every dealer is there because
they know they are an easy mark. So treatment is far more than
med. We’re trying to treat far more
than the an at media of the brain. So then what does it look like when you’re seeing it in
churches, when you’re seeing it in your doctor’s offices, in
your train stations, in your libraries, there is nobody who
can talk about mental illness and addiction without having to
mention stigma. It would seem that that wouldn’t
be such a big deal during the cure. To be honest with you, sometimes I can’t get my head around the
fact that stigma itself is such a boundary. It compared to the fact that we don’t have really good
treatments for the illness itself. It just strikes me as oh, my God, stigma is just — stigma is
just respect. How can that be so hard. Stigma is the myth — a set of myths somebody has about another
group of people, discrimination is the absolute illegal decision
having to do with somebody with a disability. At first stigma is a problem because you can’t really make
law that says be nice. Discrimination we work very hard
to make laws, and I think some of those laws need to be
explained in libraries. Libraries need to do a good job
of teaching all of the laws that actually protect a person from
discrimination. So libraries might be a good
place to brung in a disability lawyer to do an education event. So there’s a lot of common misperceptions about us and then
there’s a set of truths, and I personally don’t like to say
that people who don’t know these truths, I don’t like to say they
are ignorant of them. That’s a very negative term to
use for people who have simply not been through this, and so we
think about it as innocence. A lot of us good through life
not even knowing how bad this gets and how much damage it does
to someone’s life. You don’t even know it so you
can’t possibly be faulted for not knowing that. So I kind of think — I start with the idea that it’s
innocence, and then when I find somebody is interested in
learning, that’s the best thing that can possibly happen is
someone is opening their mind, and I do meet people, I decide I
don’t think I can change your mind right now, but I’ll meet
you up the road. But right now I have people who
want to learn. So according to most of my
conversations with consumers over the years, I think that we
live with this world, we live with this idea that the common
misperceptions are that we’re dangerous, we’re violent, we’re
difficult, we’re demanding, weak and unmotivated. Those are all very very very negative terms, and they are
also not true. So when you’re trying to recover
from something where you’ve already disappointed yourself so
badly, even if you’re a child, you know you’re the one who
can’t get to school, everybody else in your class knows
something’s wrong. I wasn’t able to get to work. I am not weak. I’m sick. And it’s not that I’m unmotivated. It’s that I’m trying so hard but I’m working against something
that’s way stronger than me. And then the truths are — they
are just true by virtue of lots of research and lots of policy
now. The fact is that most people
with mental illness or an addiction are vulnerable to
violence and actually are not the perpetrators. Now in the news recently you’ve heard a lot of shootings and
usually the term mental illness comes up within hours, someone
will say those terms. Those people generally speaking
have either tried to get treatment and failed or when
they went to get treatment, they were unable to engage them in
coming to treatment because it’s not easy to treat. It takes some time. And people can’t get — they
don’t have enough like internal resources to put that much work
into it. Basically they feel hopeless
anyway. So the poverty I think I’ve
already talked about and the stigma, the trauma, we’re at the
point where we’re doing a lot more work in understanding so
what has happened to these people, you know, the mother
with the children who are screaming in the library or
screaming in the church or screaming in the restaurant? What happened to that family as a whole? Usually it’s something we would say was fulfilled the clinical
definition of trauma and there’s a very easy assessment that was
studied very rigorously. It’s called the adverse
childhood experience assessment, and you can look that up on the
internet really easily and find when we’re looking at people
whose behavior is so different, we start to seek information
about trauma and trauma is something that’s very, very hard
for people to talk about, and I think a lot of us are coming to
understand that because of veterans who are coming home. I talked about diagnostics and how community, employment
opportunities, very, very difficult for somebody to find a
job, and the thing that I’m most interested in is the cutoff from
friend, spouses and intimate partners and confidantes. That’s really what has fallen apart and they don’t know how to
rebuilded it, somebody hose had friend who do nothing but party
literally have to find a whole new group of friends, and these
people have to be friend who respect all of the work that
person’s trying to do. They don’t do that stuff at a
party where they are like you sure you don’t want a beer, are
you absolutely certain. They have to be with people who
continue to treat them. We know with mental illness they
go back to families that say no, you don’t have a mental illness,
you don’t have to take those drugs. A whole community has to be on board. So those are the misperceptions and them the truths and those
are important for anybody in the community whose trying to
welcome them. So I again I have this
incredible opportunity to listen to consumers and these are the
things they tell me when I ask them a straight-up question,
what would make a person feel welcome in a community, in a
library, so the way they feel is a library is a safe place. Sometimes it is a quiet place, and I use that to manage
anxiety. I literally say to myself I’m
going there because it’s quiet and there’s not that many people
around, there’s not that much stimulus. Nobody knows me. So in other words, they don’t
know that, you know, my house has been in shambles. My house looks horrible from the outside. They just don’t know me so they have non-of the repercussions on
me. Very complicated stuff and don’t
have enough time to do the level and research and education that
people need to do. They want — in order to feel
welcome, what they really want is for you to not assume that
they are dangerous or that they will quote go off. That is something that they hear a lot, they see a lot, and it is
destructive. Again, a lot of times you have
small rooms of you don’t want to be with other people. Let’s remind everybody in our society that just because a
mental illness is diagnosed, we still have all of our faculties
and we don’t have IQs, you don’t have to think that. When you see somebody and they seem very anxious, what you
might not know is that’s their base line, that’s good, that’s
them managing. So they may have a little bit of
trouble forming a question for you, but they are not worried
about becoming — they don’t feel like they have to go into a
psychiatric screening center. If possible don’t call the
police automatically. We have plenty of training
programs on how to prevent not just deescalate but to prevent a
situation that you don’t feel you could control, and them
don’t walk back and forth watching me, and, if I smell,
offer to let me use the bathroom to wash up. Please be kind. When I was researching for this
work, I found there are many many libraries who basically
have a place where they know somebody would wash up. That’s the whole point. That’s the whole point, you can
go there and wash up. So what do you do to prepare? This is what I refer to as the under grouped, and I cannot tell
you how many times I tell people about this, how many times I
hear we just don’t know anything about this. And when you have a crisis in your family or in your church or
in your restaurant or in your park, that’s not the time to be
learning it, that’s what you want to do more than call the
police. So there’s this whole entire set
of organizations and institutes that frankly when I got involved
in advocacy I was stunned that there were so many organizations
working on my behalf. I thought I was all alone with
this. So some of them are non-profits,
some of them are government. The ones that I trust, I never
generally try to learn anything from pharmaceuticals website
because obvious it’s biased and many many people do their
research on unvetted sources and that causes a lot of confusion
for them, their families and their providers, so I trust the
national library of medicine, the institute of mental health,
mental health America and national alliance on mental
illness, children and adults with attention
deficit/hyperactivity disorder, national council on behavioral
health, facing addiction, and them the last four, everything
from mental health America are non-profits and the government
entities are the ones that are most — they haven’t already
stated a cause. They don’t already have a
position. They are research organizations
that are trying to find answers. Whereas I work for several
chapters of mental health America. We know where we’re going to stand and we’re going to fight
nor that. We’re going it take that
research and use that research to fight for — let’s get
communities welcome for the people we care about. All Hamilton these have website. And more of the things you can
do to prepare, so mental health first day I talked to you about
how you can just Google that and you’ll find it. It’s a full curriculum. Some said why don’t we have
movie night? We don’t really have places to
go at night. Psychiatric advance directives
are something many states have, 35 to 40 of them now have. They are specific medical advanced directives that deal
with psychiatric preferences and they are different from end of
life because usually a person is diagnosed at the early part of
your life. Like I was 23 years old. I had to start making decisions. A lot of people have a very
innocent thought about psychiatric advanced directives
that we’re going to ask you to do things that are not possible
and were not because a medical doctor and psychiatrist has to
do what is the best thundering for that person. So let’s think then about preferences. So, for example, there’s a lot of people who don’t like
heavy-duty med. They don’t want them. Every time I’ve had a psychotic preying and had to go in the
hospital, a set of chemicals that brung me down into a
peaceful state, I sleep for three days, I come back and I’m
ready to move into the next level of care. But I can put those preferences and here in jersey it’s a crime
of the fourth degree not to listen to them. Have sections for bags for homeless. Offer temporary library cards if someone is living in a shelter. Bring in experts to teach health literacy. It’s amazing, amazing how people with behavioral health issues
have not normally had a primary care doc and we know that it’s
whole health. If your body is — if you’re
taking a second generation anti-psychotic and we know that
causes serious weight gain in six months, then we want you to
learn more about cardio metabolic syndrome. We need you to know that. We also know insurance is one of
the most complicated things in the world and in the United
States it’s the most horrible thing to learn about. Libraryes have been excellent at sign pep up for Medicaid but
once you have it, how do you use it? Those are funded by governments and non-profits. They are phone lines where you can call if it’s an emergency or
if you just need someone to talk to. And you don’t necessarily think you’re going to — you don’t
have a plan for doing anything dangerous but you need to talk
through with someone and your psychiatrist and therapist
aren’t available. Consumers recommend that you go
around and you visit that you host support groups in your
libraries that it would be really good if you went around
and visited all of the community behavioral health centers in
your area, and in just the same way we would do for any other
people that came in in distress, water, coffee, tea, phones,
computers and gym memberships which is the thing I was talking
about before. So these are just ideas that
communities all over the country are doing, and I know that
there’s a really really strong interest in libraries and
figuring out how do we do that? Toward that I would recommend
that the state of California has done a tremendous amount of
training for libraries and all you have to do is Google
California library and mental health, and that’s all you have
to do and you’ll come up with this really great curriculum
on-line including what is now referred to. It was called a almost line Bay Area where a person like me
would go into a library and just talk with people about what my
situation, what my life is like. I’m not a book. I’m not a CD but I certainly had some information to offer. So those are just the idea that consumers have and primarily
they feel like we need you to be kind and we do need you to
become more integrated in society, and it’s okay to ask us
what we need. So my job is all easy. I get to ask them what to tell you, but you also get to ask
them, and that’s really really where we want to — that’s
really where we’re trying to get to, and I hope this really short
talk has given you some idea how to do that. So, Kate, you can tell me whether or not you’ve got any
questions that people would like answered.>>Thank you, Marie. That was great and it’s so
powerful to hear from your own perspective and I really
appreciate your openness and willingness to talk about it,
not only on behalf of the people that you serve but also from
your own perspective. That’s have valuable for us to
hear.>>Thank you. My pleasure.>>I will ask if anybody has
questions to please put them in the chat box. In the mean time I have a few questions that have come in via
e-mail. Somebody who works in a public
library regularly sees people with mental illness
self-medicate with drugs or alcohol. As they get to know those folks, they do get to understand their
difficulties better but with new-comers it can be difficult
to tell what’s up. Do you have any tip for
distinguishing whether or not someone is dealing with a mental
health crisis or is under the influence of drugs or alcohol?>>For you guys, I think one of the things we like to get across
to people is it’s not your job to know all this. That’s not fair, and it doesn’t make any sense. I can’t know what your job is. So we have around the country
most of the time we have mobile screening centers meaning
there’s no need to call a family member or the police telling
them you’ve got to take this person physically over to our
screening center at this hospital. You can call a mobile unit that actually will speak to you on
the phone asking for specific types of symptoms or things that
you’re observing, and they can go out to the library. So from your perspective when you’re saying to yourself, man,
oh man, should I be concerned? I think you can — if these are
people you really know, icon you’ve seep them all day, trust
your judgment about whether or not they need more of the peace
and quiet and things you’re offering them at the library,
but once you see something that troubles you, I would say trust
your instincts on that and get the number of the screaming
center. Here in jersey we call them
screening centers but basically every state has a place where
people who are — we believe they are in trouble, they may be
a danger to themselves or others, we have laws set up and
they are funded around the state, so, if you don’t know
what they are, I would call your — check your state website. It’s usually mental health or addictions. It might be in your human services department, your local
chapter of mental health America or your local chapter of the
national alliance on mentally ill. All of these would be able to give you that information in a
heart beat.>>Jennifer has a question in
the chat box. How can we find experts to
specifically deal with mental health and substance abuse
health insurance options under the impression that mental
health issues are not covered or are only covered in the most
basic way.>>Right. Access is what he we call that. Even if the treatment exists and
we adopt have that much, we don’t have enough treatment
capacity for all of the people who need it, but even for —
even if you’re in a community where you have it, where you’ve
located your community meant — mental health certainty, you’ve
located your behavioral health clinic, if a person can’t afford
it, then they can’t access it. So what has to happen in your
particular case is that those agencies have to help you figure
out so how do they pay for it? If we bring that person over to
you, do you have a way to pay for it, for mental health
policy, we have private independence, charity care,
sliding scales. There’s all couped of ways to do
it but I think what this person is talking about is health
insurance literacy. That is actually the thrust of
most of my work. I’m trying to prove that this is
not — we can’t just pretend that somebody who sells health
insurance does the little brochure and then everybody
knows what to do, and, face it, it’s money. So we’re trying not to — we’re trying to get services without
breaking the bank. So all of the insurance
companies that sell into your state have to have an education
department, and they would be easy ones to call. But also your — if your state expanded your Medicaid program
without affordable care act, there are what are called
navigators. They were trained to help people
get registered for Medicaid, and they know more about Medicaid in
that state than anybody because each Medicaid program in all of
the states is different. They cover different things. They have discretion to cover different things, and I
personally think this is one of the most important things that
we need to teach people. I was very young and I had to
learn the insurance system such that I could pay my psychiatrist
and my therapist and whoever else I had to go to. So I learned really early, oh, I get it, okay, so you can’t give
me the check but you can give me the check, okay, that’s really
hard to do when you have a mental illness, and a lot of
states also fund none profit organizations that are dedicated
only to providing legal and financial support to people with
mental illness. These are the people that you
could ask them, come on in and do a presentation. Social security comes in a lot to our place and does
presentations to people because most of them fill the
requirement for social security because they are literally
disabled. They are so sick that they can’t
go to work, they can’t, you know, we really have to get them
better before they will suck — succeed at work.>>Marie, another question from e-mail. What are some of the indicators you might be working with
somebody who is suffering from military trauma or Pit. —
PTSD?>>That’s a great question. All of us know that we are not actually welcoming our vets back
as much as most of us would have wanted. Some of the things that you’ll see with post traumatic stress
from a military point of view is if a person is a police officer,
they see a lot of very gruesome deaths, and there’s so many
triggers that we couldn’t begun to talk about them. Like some of them, if there’s a bang on the door, that may
trigger something. You’ll see a lot of anxiety and
a lot of perhaps misdirected anger or anger, like bursts of
anger, and I think one of the most valuable, honest to God the
most valuable thing I know about, is a program called vet 2
vet, vet the number 2 vet. And it’s veterans on the phone
so we leave their — we leave the phone number everywhere. We go to every, you know, Memorial Day, 4th of July,
veterans day. We try to get the phone number
out there. We get it out in police
stations, libraries where what they will meet with when they
make that phone call is not a mental health professional who
is going to talk to them about all kind of symptoms and
diagnosis. They are going to be the people
that understand that what’s happening up your house now is
your wife is petrified and our kid are petrified and you’re
probably drinking a lot in order to manage those symptom. You’re hang around at the V.A. where everybody is drinking. Earlier in the history of the United States, we knew that,
okay, so people would, they would self medicate and we
thought all this use of alcohol, we just said to yourselves,
well, that’s the way it is. People come home and they are
quote wrong or damaged or something like that. But we are making some progress with trauma care, evidence-based
practices are helping people prepare and get coping skills to
deal with this, and these vet phone lines are really just to
start with acknowledging that you do by your open definition,
have a problem, not just by the people around you. You really don’t want to be screaming at someone you love
and that’s agonizing. So again you don’t have to —
you don’t have to be a psychiatrist or psychologist
with all the assessments. What I think you could call in
is the Via to do some work and do an educational night, and at
first you may not get a lot of people coming because
everybody’s afraid. But if I go and find out I have
a mental illness. Trauma is a classified mental
illness and our treatment, we tried some medications, they
don’t always work. She has a little dog and swears
that dog saved her life. It was after that second tour in
Afghanistan. Do you think the little dog
hangs around with veterans and this little dog does more than
anything. So bringing in those kind of
places that do service dogs, bringing those people in to talk
about emotional service dogs, service dogs, those kind of
things that are just trying to get out there and do some
messaging so that the people who are really affected by these
distressing symptoms understand that someone cares and that we
really do want to do more than tolerate, you know, a situation
where you’re just going to be a person who is addicted to
alcohol for the rest of your life. I hope that answers that question.>>Do you have any general situations for how to approach
people who are clearly having some sort of crisis and maybe
their behavior is becoming more than the library staff feel like
they can manage?>>Yes. Your folks said don’t call the police. So what are the other options in that moment?>>Right, right. So not to be repetitive but that
is precisely the curriculum mental health first aid because
most of society has no idea what to do anyway, but libraries
happen to be a place where people convene and so the staff
swell your patrons, we’re concerned about all of you, and
so the thing in the curriculum in California addresses this
specifically in one of the modules and the first aid
curriculum does the same thing where when a person is
responding to internal system lie which we call you’re hearing
someone, you’re hearing a voice, you’re tasting a taste, you’re
feeling a touch or any of the other senses, your brain is
telling you that that’s what’s happening but it isn’t, and so
if we try to then use healthy logic or we try to say oh, no,
that person’s not really talking to you. That’s just your imagination, then you’re kind of saying that
person’s reality isn’t really happening, but it is real for
them. I think the response should
definitely be call whomever that person — whoever is a trusting
person. If you happen to know a friend
or a mom, definitely call them. If you don’t and you’re really
worried about increasing agitation to the point where you
don’t know how to bring it down, definitely do call the police. Generally speaking, the police in an area also know everybody,
and what we’re always trying to train is we’re trying to train
police officers and how do you go into a situation and not make
it worse. Guns often scare people, they
scare vet because they know what they are. So you don’t want a police officer hose going to reach for
his gun right away. You’re going to want the police
officer who is going to basically keep the person very
calm and there are courses in crisis prevention this literally
teach how to distinguish between imminent violence and just this
is the way the person is. They are not, they are not
dangerous, and if you’re seeing something that you believe is
distressing for that person, then definitely call the
screening center. Call the police if you’re very
worried. One of the things that’s in this
click lump two that I think is very, very necessary for all of
you is that you worked there, but you also know that you have
a group of patrons or congregants. We are a public service and these people are just as welcome
as think else, but we’re going to hold a session if you want to
come to learn more about it. But we can’t segregate them. We can’t put them in one room because they have a mental
illness. And I think that that curriculum
in California does a great job with that part. I think it’s a ten page curriculum. It’s not long. It’s just touching on the normal
questions we get from librarians. Some of the libraries around the country are actually hiring
social workers to be on staff and a lot of the ways that
happens is you make a relationship with one of the
academic centers near you that has a school of social work.>>Somebody had a practical question about do you know of
funding resources for funding a program to make an organization
more welcoming.>>Usually you could go in with
one of those non-profits for a grant. I mean they would jump on an opportunity to partner with you. I think more and more your organization, Kate, I think is
starting to understand that there are partnerships that we
should be building that you know literally help all of those
people in the community, all of those people with a mission to
help the public and bring their community together. It’s the notion of the partnership and the coalition
building that would be interesting to a funder. And them, if you do have those — I keep thinking of this one
because I once tapped them for money. Campbell soup down here is all of southern New Jersey, somebody
works there, it’s their play, it’s their corporation. They usually want to do grants to the people right in there,
the area that they operate in. And so again lots of libraries
don’t have grant writers. They don’t have development
managers but non-profits do, and you would just create some kind
of partnership where that organization would come in and
organize a lot of the — a lot of the educational sessions and
help you get the resources inside the library that are
just, you know, librarians went to school for library science. They didn’t go to school for social work and psychology. So getting those resources in there, a lot of times it’s
easier to do it if you’re with an academic center because awful
of the social workers Sr. to do PRACTICUMSand internships.>>Marie, this is so helpful and I really measure your time. We had a question about can you send your slide to today’s
attendees? Suzanne, we will be doing that
from NNLM, once the recording has been processed, give us a
couple weeks to do that, then we will send a link to the
recording as well as to brief slide. And I appreciate, Marie, your willingness to share your slide.>>I would stay in touch. We have — Kate knows Dr.Lake
very well. He’s a family doc who teaches
all of the family docs. He just gets this. He get that libraries are often the focal . of a community, just
like a church, and I think a lot of parts of a community, they
kind of under estimate their power as being part of a
coalition that’s watching out for the vulnerable people in
their world. So really come together and
don’t think you have to write the grant. They are hard. They very time consuming
especially when you’re trying to take care of little kid at a
reading session in a library. Jump on to the people in your
community who would just welcome you so much to their — you
know, stay in touch with me. I think in the slide you’ll have
my phone number, at least on the ones I’m looking at. You should feel free sending the e-mail.>>Thank you. I also encourage you to talk to
your regional medical library. We have people from around the
country on this talk, and we have some amounts of funding
available to do health information, outreach in your
communities. We also provide training like
this webinar and we love creating partnerships and
facilitating those and providing consultation on developing
projects and partnerships so I encourage you to go to NNLM.GOV
and find your region, if you don’t already know it. I know we have a lot of public libraries on this call so I
wanted to give you a head up on a couple of upcoming training
for next couple of weeks, one from the greater midwest region
about strengthening your programming and you may have
heard that NNLM has a partnership with the all of us
research program. That research programs which
aims to enroll a million part pacts around the country
officially launching may sixth and we in preparation for that
are going to have a webinar on April 30th about how you as a
network member can be involved in that. If you go to NNLM.GOV slash training, you’ll get information
on how to register for that. Thank again to our speaker,
Marie Verna. Thank you to NIH web
collaboration and our cappinger for technical support. As always we’re supported about hyped the seeps from Hannah. Hannah is going to share the evaluation and it will also pop
up when we close the webinar. Please do provide us feedback. This session is eligible for one hour of CEfrom the medical
library’s association and there’s information as we
complete the evaluation on how to claim your CEcredit.>>Thank you all.>>Thank you. Hannah, did I miss anything? Oh, she will send the evaluation
to all attendees so you’ll get it by your e-mail as well as
when you close the live session. I hope you can see all of the
thank yous.>>No, I can’t. Where do you get that?>>In the chat box. Lots of people are saying thank you for the the webinar and that
it was wonderful and very helpful.>>Good, good, that’s great. Okay.>>All right.>>Awesome. This has been great.>>Thanks, everyone, and have a
great afternoon.>>Thanks, bye-bye.>>Bye.

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