Tag Archives: mental health

Coping through COVID: Reminding stressed-out youth they aren’t alone

When COVID-19 struck the United States early this year, the world as we knew it changed. Countries began tallying up their dead, borders closed, cities and businesses shut down, and more than 120,000 schools swiftly ceased in-person learning for more than 72 million K-12 and college students.

The lockdowns ended time with precious friends and family, travel, graduation ceremonies, proms, birthday parties and entertainment outings. They resulted in millions of job losses and a collectively high level of stress that hadn’t been seen in decades.

African American female with short hair wearing pearl earrings, opera length necklace with white collar showing from beneath celery green, burnt orange with black diamond shapes

Kamilah Davis-Wilson

In particular, the pandemic’s subsequent effects—uncertainty, isolation, unrest and disappearance of opportunities—are putting young people at risk for higher rates of depression, anxiety and suicide.

“How do we expect youth to process it all?” asked Kamilah Davis-Wilson, community outreach and education manager for The Corner Health Center in Ypsilanti, Mich., which provides health and mental health services to 12- to 25-year-olds and their children.

Adenike Griffin, behavioral health manager at the center, said society isn’t equipped for the after-effects of COVID and likely won’t be even after vaccines and treatment are developed.

“I don’t think we’re prepared for people’s inability to cope,” Griffin said. “There will likely be higher rates of depression, anxiety, PTSD (post-traumatic stress disorder) and more profound mental illnesses, like psychosis. The effects are going to be huge. We’re going to need to pull together as many resources as we can to create a new normal.”

African American female with short hair wearing black top and unlined jersey knit jacket

Adenike Griffin

The Ford Motor Company Fund, the auto company’s philanthropic arm, is responding by increasing its support of mental health awareness and treatment. Among its initiatives, the nonprofit is partnering with the Corner Health Center on a series of virtual discussions for 12- to 19-year-olds. Topics include social isolation; anxiety, depression and social unrest, suicidality; and grief and the holidays.

“We know mental illnesses in youth have been on the rise over the past several years, and the pandemic has given us even more reason to bring resources to this space,” said Lisa Gonzalez, a manager at the Ford Motor Company Fund. “Our team continues to look at new ways we can partner with specialists and bring forth resources free of charge to teens in this new virtual world. It is important to give our youth the tools necessary to improve their mental health in a safe setting which can hopefully translate to an open dialog between family and friends.”

In this story, we explore how COVID-19 is affecting young people in this country and provide information to help parents and guardians alleviate their distress.

Stress preceded pandemic

Even before the pandemic, the number of young people ages 10-24 who were suffering from serious mental stress, including depression and anxiety, was rapidly growing. These high rates of depression and anxiety caused suicides to climb 56% from 2007 to 2017, making it the second-leading cause of death in that age group.3 Other findings:

• About 2.3 million or 9.4% of adolescents ages 12-17 had at least one major depressive episode.1
• 11 million or 13.1% of 18- to 25-year-olds reported at least one major depressive episode.1
• More than 60% of college students said they felt overwhelming anxiety.2
• 56% of college students felt hopeless, and 13 percent considered suicide.2
• Among black adolescents, the rate of suicide attempts surged 73% from 1991 to 2017.3

To gauge the effects COVID-19 was having, the U.S. Centers for Disease Control and Prevention conducted a survey from March through June and found that 1 in 4 adults ages 18-24 said they had seriously considered suicide in the past 30 days.

Uncertain and unsettled

When schools first shut down in March, many administrators said it would be for two to four weeks. That’s because no one knew how long the pandemic would last. Six months in, however, and there’s still a big question mark over the direction it’s going and how it will affect our future.

Male with salt and pepper short hair wearing glasses, dark suit with mauve shirt, striped tie and holding a microphone

David Rosenberg, MD

That question mark is adding to the latest mental health crisis, said David Rosenberg, MD, a practicing child and adolescent psychiatrist and professor and chair of the Department of Psychiatry and Behavioral Neurosciences at Wayne State University.

“Do we wear a mask? What’s going to happen with flu season? Will we be shut down again? Will the vaccine be effective? The uncertainty around these kinds of prolonged, pronounced societal pressures fuels depression and anxiety, especially in the most vulnerable—our teenagers,” Rosenberg said.

Extremely/very negative impact on personal financial security due to COVID-19
Click on image to enlarge

“And the more depression and anxiety there is, the more uncertainty we feel.”

COVID-19 has also taken a toll on the financial security of young adults. About 31% of 18- to 23-year-olds surveyed reported that the virus has had an extremely negative financial impact on their lives, and 26% said they had to move back home.4

“This is one of the first generations that doesn’t feel as if they will accomplish as much or earn as much as their parents because of how the job market is right now,” Rosenberg said. “So, there’s almost the sense of ‘What’s the point?’ ”

Amanda Beck, a home-based therapist at the Inkster, Mich.-based nonprofit Starfish Family Services, said the teens she works with are usually excited about getting new clothes for school.

Female with dark hair pulled back wearing a denim collared shirt

Amanda Beck

This year was different.

“They didn’t know if they were even going to be able to go school or if their recently unemployed parents could afford to buy clothes,” Beck said.

Before the pandemic, a 12-year-old that Davis-Wilson worked with was preparing for track season, a 17-year-old was looking forward to driver’s education, and a college student was getting ready for his first internship. Then COVID-19 canceled their plans.

“Choirs, dance recitals, SATs, overnight retreats, proms—they all went away,” said Angela Burgess, a Starfish therapist. “Kids say: ‘I did what everybody told me to do. I worked hard, and now I can’t have those things.’ ”

As a result, young people are grieving and unmotivated.

African American female with dark shoulder length dreadlocks wearing black V-neck shirt and cream denim jacket

Angela Burgess

“Graduating from high school signifies the end of childhood, while going to college or getting a job signifies the beginning of adulthood,” Beck said. “If we’re not going to celebrate these things now, then when? Nobody knows. That’s stressful.”

Living in the great unknown is also leaving some teens unmotivated to learn and adding anxieties to those who already struggle with school.

Sofia, a high school freshman who asked that her last name be withheld, lives with depression, anxiety, obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD).

“School is already one of the biggest pressures for me, especially if I don’t have enough time to complete my work or get enough explanation,” said Sofia, 14.

Moving to distance learning made things more difficult. “Online school was a hard transition because we didn’t really get taught,” she said. “So, we didn’t really understand anything.”

Teachers are doing better this school year, Sofia said. But she misses her friends and doesn’t know when they will return to the classroom.

“The best thing about school is the social aspect,” she said. “But there is no school in Miami because it’s still the epicenter [of the pandemic].”

Nineteen-year-old Kayla Williams was a college freshman still adjusting to living in a dorm, going to her classes at Wayne State University in Detroit and trying to pin down her undergrad major when the pandemic struck. Suddenly, the public health major had to move back home and adjust to learning remotely.

In September, Williams returned to campus for her job. But because most students haven’t moved back, she said it doesn’t feel like the same school. She knows the number of young people getting COVID-19 has increased and worries about catching the virus.

“As an employee, they enforce a lot of extra rules, like hand-washing every half-hour,” Williams said. “But the virus is still really anxiety-producing. It makes every task stressful because there’s so much uncertainty with this disease and what’s going to happen.”

Alone and anxious

Experts say isolation before the pandemic increased the susceptibility to illness, depression, anxiety and substance use disorder. Pandemic-related quarantines and shutdowns will have a bigger global mental health impact.

School doesn’t just provide teens and young adults a basic education, said Griffin of The Corner Health Center. It also keeps them connected to the teachers, coaches, peers, communities and safe spaces that have, for a long time, played important roles in their lives.

Without that connection, said Beck of Starfish Family Services, teens often feel as if no one wants them, loves them or cares for them.

Psychologists say distance learning can make it more difficult for youths who have suffered—or continue to suffer—emotional, physical or sexual abuse at home and also for those living in food-insecure households.

“There’s no escape at home,” Beck said. “School was somewhere they could go.”

At the same time, working parents are overwhelming many lonely, bored adolescents with adult responsibilities.

“They’re having them step up and help with siblings by babysitting and checking homework,” said Burgess, the Starfish therapist. “They’re also expecting teens to use self-discipline to manage their time and get their work done. But teens don’t have those skills yet.”

See the signs, seek solutions

Sofia knows suicide is avoidable. After a classmate shared graphic details of trying to kill himself, she sought out a counselor, who got him help. Still, Sofia worries about the classmates, teachers and administrators who don’t always take mental health issues seriously.

11 suicide warning signs

Suicide warning signs
Click on image to enlarge

“Kids would say: ‘Why would you try to help them? They are just doing it for attention,’ ” she said. “But if they are self-harming, they need help and attention. Not giving them help is the worst thing.”

While the increasing rates of depression, anxiety and suicide are troubling, mental health experts say there is hope—and also help.

Recognize the signs: Young children with anxiety or depression may have more tantrums or become clingier. Older children may exhibit changes in appetite, mood, energy levels or activity.

“Listen to what they are saying and how they are feeling,” said Davis-Wilson of The Corner Health Center. “They have a lot of feelings about everything happening. Ask why they feel this way. Remember, they are children and try to work with them in a way that works for them.”

If you or someone you care about is exhibiting suicidal behavior, seek help immediately from a mental health professional, or call the National Suicide Prevention Lifeline at (800) 273-8255.

“When a teen is having thoughts of suicide, we can’t discount it,” Beck said. “We have got to take them seriously. Connecting them to appropriate treatment can be lifesaving.”


Sources: Substance Abuse and Mental Health Services,1 American College Health Association-National College Health Assessment, Fall 2015 and Spring 2019,2 Centers for Disease Control and Prevention,3 Edward Jones and Age Wave study4

 

Music and Our Brains

Christina Rodriguez

By Leslie D. Green

Changing minds and bodies through musical experience

The Ford Motor Company Fund recognizes that creativity and artistic expression enrich lives and inspire innovation and that communities which support and provide access to the arts are stronger for it. In this collection of stories, we share how and why music affects us at all ages and stages of our lives.

Cristina Rodriguez, on the right, holding a ukelele, and Lauren Koff, third from left, holding a green microphone with Mind&Melody music enrichment specialists. Photo by Amanda Smith Photography

As a young student, Cristina Rodriguez adored music. But when a teacher announced a donation of instruments would allow her school to start an orchestra, she was unsure what to expect.

Then Rodriguez picked up the cello. And soon, she was smitten.

In high school, Rodriguez discovered the string instrument wasn’t the only thing that charmed her. She was fascinated by the way music touched people’s brains: How all the members of the orchestra had high grade-point averages; how most of the students in her honors and AP courses participated in the arts; and how time seemed to stop when she created music and played her cello.

“You are present the whole time you are playing and can’t really worry about anything,” Rodriguez said. In her teens, she volunteered at hospitals and conceived of various ways to share with others the comfort music gave her.

Years later, while working on her thesis for degrees in biochemistry and pre-med at Florida Atlantic University, Rodriguez found a way to combine her loves of music and medical science to help those in need.

In 2014, she and classmate Lauren Koff founded Mind&Melody to bring interactive music programs to individuals experiencing neurological impairment, such as Alzheimer’s disease, dementia, autism and Down syndrome. Based in Miami, Fla., the nonprofit engages musicians who perform music that represents patients’ favorite eras and personal cultures to help reengage their static minds and improve their cognitive and motor skills.

Mind and Melody music specialist demonstrates didgeridoo to elder adults

Ashlie, a Mind&Melody music enrichment specialist, demonstrates the didgeridoo an indigenous Australian instrument to older adults. Participants are fascinated by the sound and shape of the instrument.  Photo by Amanda Smith Photography

“They play a song that brings back memories for the patient,” Rodriguez explained, adding that the brain stores emotional memories in a different way from how it stores regular memories.

While listening to or playing music hasn’t been shown to prevent dementia or cognitive impairments, Rodriguez explained that music can reach hidden areas spared by diseases like Alzheimer’s and help patients reunite with the world around them.

Rodriguez recalled a formerly active married couple whose age-related cognitive difficulties made it difficult for them to connect with people. When the pair started therapy with Mind&Melody, they were able to socialize again.

“It helps them connect better with friends and family,” Rodriguez said. “They talk through music. It keeps their brains active and keeps them socially active.”

Violinist Diane McElfish Helle launched a similar program for the Grand Rapids Symphony. Her Music for Health Initiative at Spectrum Health in Grand Rapids, Mich., partners musicians with medical professionals to provide music therapy for people with myriad health issues. McElfish Helle has called the nonprofit agency her most important endeavor as a professional musician. In 2017, she received the Ford Musician Award for Excellence in Community Service from the League of American Orchestras for her work.

Musical chemistry

In addition to creating chemical reactions in the brain, researchers have also found that music produces a sense of comradery, or unity.

Ever notice that it only takes two or three claps to get thousands of people at a concert to synchronize their claps or foot taps on beat?

Research going back to naturalist and biologist Charles Darwin suggests that our ancestors were more fit to mate if they were able to not just feed, protect and provide for a family, but also were able to sing or make music in a pleasant way. Musical abilities, scientists contend, stimulate cohesion, which helped groups hunt for large game, outlast predators, and better survive the savage world where survival most often only was for the fittest.

Now, music-generated cohesion plays a role in community building and work productivity, according to four economists from Cornell University. They examined music’s impact on cooperation by having three groups of participants make decisions based on how much they would or would not pool resources with other people in the lab.

Kevin Kniffin, co-author of the 2016 study, reported music in the workplace can cause conflicts if people dislike the selections played. However, Kniffin said his research team found “a rhythm that was a common qualifier of happy music” and streamed that for one group. At the same time, they streamed unhappy music for the second group and did not stream any music for the control group.

Kniffin and the Cornell researchers found that those who received the established happy music had better moods and persistently higher levels of cooperative behavior. Meanwhile, the control group, which heard no music, and those who heard unhappy music, were less inclined to cooperate with colleagues.

Regardless of one’s workplace, medical diagnosis, age or stage of life, Mind&Melody’s Rodriguez said an important “chemical thing” happens when you listen to music, play an instrument or sing.

“If you’re having a terrible day or month, music is comforting,” Rodriguez said. “It can bring you back and ground you.”

 

Music’s Physical Benefits


Music initiates brainstem responses that normalize heart rate, pulse, blood pressure, body temperature, skin conductance, and muscle tension in people of all ages, according to Mona Lisa Chanda and Daniel J. Levitin, authors of a 2013 study conducted at McGill University of Montreal, Quebec, Canada.

Infants and children

• By routinely playing familiar music to premature babies, who are prone to neurodevelopmental disorders that include learning difficulties, doctors can enhance connectivity in the brain, according to researchers at the University of Geneva and University Hospitals of Geneva, Switzerland.

• Music therapy has been shown to help children with cancer cope with the stress of treatment by improving mood and relaxation and reducing exhaustion and anxiety.

• People begin developing affection for music in the womb through exposure to their mother’s heartbeat. And learning rhythms and melodies begins during the third trimester of development.

• A few years of music practice thickens part of the corpus callosum, a band of nerve fibers dividing the brain’s left and right hemispheres and integrates sensory processing between the two. As a result, music and musical training can foster academic and life skills in children.

Aging and neurological disorders

• The Johns Hopkins Center for Music and Medicine in Baltimore, Maryland, recently completed a 12-week study where 24 people with Parkinson’s disease played the guitar. They found the patients’ shaky hands, moods and levels of anxiety improved. Moreover, patients who participated in a study involving drum circle classes and choir singing lessons reported having a better quality of life, including enhanced communication with loved ones because of the classes.

• Group drumming counteracted age-related deterioration of immune functioning, in one study Chanda and Levitin cited.

• Music therapy creates entrainment, a simultaneous activation of neurons in disparate parts of the brain. So, even if we are not tapping, clapping, playing or singing along to music, scientists have found that our brains recognize and keep up with the beat. Knowing this, researchers are looking at how they can individualize the use of music in medicine to help people with motor-system disorders, like Parkinson’s.

Heart health

• Medical trials around the country have found that listening to music can help people to exercise longer during cardiac stress tests, cause heart rate and blood pressure to return more quickly to baseline levels after physical activity and alleviate anxiety in heart attack survivors.

Surgery

• Scientists are exploring whether music played during surgery causes surgical teams to provide better care or whether the music is directly helping patients, even those under anesthesia. Either way, music played during surgery and post-surgery has been found to improve moods by decreasing cortisol levels and reduce sedation, pain and infections.

This story was originally published at fordfund.org. The Ford Motor Company Fund supports a range of music-rich programming, including the Detroit Symphony Orchestra, the Mosaic Youth Theatre of Detroit, the Sphinx Organization, The Ark in Ann Arbor, Michigan, the League of American Orchestras in Washington, D.C., the GRAMMY Museum’s GRAMMY in the Schools program and Latin GRAMMY Cultural Foundation’s Latin GRAMMY in The Schools program.

Read more about why music matters

Business communities can help end the addiction crisis

Crain Content Studio, the marketing-storytelling arm of Crain’s Detroit Business, worked with Children’s Hospital of Michigan Foundation to convene, moderate and report on a roundtable discussion among experts in education, medicine and government about the problem of addiction among young people. The discussion took place on Jan. 16, 2019 and was originally published on crainsdetroit.com on March 11, 2019.

In 2017, the U.S. Department of Health and Human Services declared a public health emergency when 11.4 million people reported misusing opioids and 47,600 people died from opioid overdoses.

In Michigan, 1,941 people died from opioid overdoses that year, a 13.9 percent increase over the number of opioid deaths in the state in 2016, reports the Michigan Department of Health and Human Services.

Addiction is rampant in our society. According to the Center on Addiction, one in four Americans who began using any addictive substance before age 18 is addicted. Still, substance abuse experts are waging an uphill battle against the stigma surrounding addiction, describing a deep-seated culture of shame and fear that prevents parents, schools, and business leaders from engaging in meaningful dialogue on the subject.

The Children’s Hospital of Michigan Foundation in Detroit is trying to erase this stigma and change the culture and conversation around addiction and recovery.

As part of its efforts, the Foundation partnered with Crain Content Studio, the marketing-storytelling arm of Crain’s Detroit Business, to unite parents and experts from government, academic, and medical fields to discuss prescription drug addiction and how businesses can play a part in ending the crisis.

“Most of our initiatives for adolescents and young adults tend to be in mental health and in opioids and addiction. We strive to be a catalyst for change,” said Lawrence J. Burns, President and CEO of Children’s Hospital of Michigan Foundation. The $120 million independent nonprofit partners with more than 40 organizations to further its efforts to help children and young adults.

Children’s Hospital of Michigan Foundation has partnered with Detroit Red Wings announcer Ken Daniels and Lisa Daniels, who formed The Jamie Daniels Foundation in memory of their son, who died of an opioid overdose in 2016. The Children’s Hospital of Michigan Foundation will help The Jamie Daniels Foundation with fund development, financial management and generating awareness about opioid abuse. The Daniels’ foundation provides resources and support to the increasing numbers of people battling addiction.

Wreaking havoc on families and businesses

Ken Daniels once saw a billboard that rang all too true. It read: “The brain isn’t the only organ impacted by addiction. It also breaks hearts.”

Daniels and his family are well acquainted with the heartbreaking consequences of youth drug addiction, a widespread problem as devastating as it is complex. Jamie Daniels was a smart kid. He did well in school and had a family and friends who loved him.

And yet at age 15, Jamie deliberately faked symptoms of attention-deficit/hyperactivity disorder and failed clinical tests to obtain a prescription for Adderall, the stimulant drug used to treat the condition, said his mother, Lisa.

Though she harbored grave doubts about her son’s diagnosis and need for Adderall, Lisa followed professional recommendations, carefully dispensing the medication to Jamie at the prescribed dosage. “I thought I was in control of it,” she said.Source: National Institutes of Health-funded study by the Institute for Social Research at the University of Michigan

TEEN DRUG MISUSE

Percent of the estimated 3.6 million U.S. high school seniors who misused prescription and over-the-counter drugs in 2018:
5 percent: Sedatives, such as Valium and Xanax
4.6 percent: Adderall
3.4 percent: Opioids, such as Oxycontin and Vicodin
3.4 percent: Cough/cold medicine
0.9 percent: Ritalin, a stimulant used to treat attention-deficit/hyperactivity disorder

Source: National Institutes of Health-funded study by the Institute for Social Research at the University of Michigan

While attending Michigan State University, Jamie began abusing opioids as well as Adderall and other drugs. 

Jamie eventually completed two stints in rehab with his parents’ support. He moved into a sober living home in Florida and was under a physician’s care for depression and anxiety, conditions common in people suffering from addiction.

Until he was convinced by an acquaintance to switch to a less reputable recovery facility and doctor, Jamie was clean and on the road to recovery.

Less than two weeks after making the switch, 23-year-old Jamie died from an overdose of heroin laced with Fentanyl, a synthetic opioid 80 to 100 times stronger than heroin.

“There is a hole in my family’s heart that will never be filled,” said Ken Daniels. “And in the time we’re sitting here, we’ll lose eight more people (to addiction). So, we have to continue to talk about it. We need to talk about this in the home. We need to talk about it in the schools and at work; and hopefully in the long term, we can end this crisis.”

Young adults aged 18 to 25 comprise the largest segment of the population misusing and abusing prescription drugs, such as opioids.

But drug addiction doesn’t just impact families. Opioid addictions, specifically, cost businesses, educational and social institutions, criminal justice systems, and health care organizations billions of dollars yearly.

Altarum, an Ann Arbor-based nonprofit health research institute, estimates the economic burden of opioid addiction:

  • $800,000 per opioid overdose death in lost earnings and productivity
  • $1 trillion in costs to individuals, businesses and governments since 2001
  • $215.7 billion in health care costs for emergency and ongoing care from 2001 to 2017

In addition, employees with substance-use disorders miss an average 14.8 days of work a year — almost 50 percent more days of work than the typical employee average of 10.5 days, according to the National Safety Council. And about 70 percent of U.S. employers in construction, entertainment, recreation, and food service industries employ twice the average number of workers with substance use disorders than employers in other industries.

Equal-opportunity killer

Children’s Hospital of Michigan Foundation and its more than 40 partners are strategizing ways to end the addiction crisis. Solutions include ending the social stigma associated with addiction and recovery.

Despite the availability of accurate information, the perception persists that addiction is the result of an inherent character flaw, moral failing, or conscious decision and affects only a certain segment of society.“Nobody goes into their first use thinking, ‘Someday I’m going to be an alcoholic,’ or ‘Someday I’m going to abuse drugs,’” said Brian Spitsbergen, director of Community Relations for Growth Works Inc., a Plymouth-based facility that provides substance dependency and abuse treatments and solutions for adults and youth.

“There’s no one path to recovery that’s going to work for everybody, because every person is different and every brain is different,” Smith-Butterwick said. “So we are trying to do as many different things as we can to reach as many different parts of the population as we can.”

In 2017, Michigan lawmakers enacted opioid-related legislation that includes requiring the Michigan Department of Education, with direction from the Prescription Drug and Opioid Abuse Commission, to provide school districts with models for how to instruct students on the dangers of prescription opioid abuse.

The American Medical Association classifies addiction as a disease, and its task force reports that people who misuse and abuse opioids suffer from a chronic medical condition, like type-2 diabetes or high blood pressure.

Dennis Martell, director of Health Promotion at Michigan State University, added that addiction is not an epidemic.

“It is endemic,” he said. “It’s part of our culture. It’s always been around.”

Spitsbergen, who has been sober for more than 32 years, agreed. “Ten percent of the population will meet the criteria for a substance use disorder in their lifetime,” he said. “It can happen to anyone. That’s the persuasive power that addiction has. It isn’t about the gutter.”

There could be two middle school-aged children who go to the same church and same school and have the same family life, Spitsbergen said. But their responses to their first experience with alcohol could be completely different.

“Because of things that might happen in their brain state, their lives might never be the same,” he said.

The stigma surrounding addiction is so prevalent that parents often don’t participate in potentially beneficial events, said Robert Shaner, superintendent of Rochester Community Schools. He noted only 125 parents attended a recent information session on vaping, opioids and other dangerous drug trends provided by the parent-teacher association for his district, which has 15,400 students.

“People almost treat addiction like they don’t want to ‘catch it,’” Shaner said, adding that some parents think, “‘If I’m not around the people it happened to, it’s not going to happen to my kid.’ Nobody wants to say they’ve got it, and no one wants to say they’ve been treated for it. This is a non-partisan, equal-opportunity killer that we have to attack as a community.”

The challenge of easy access

“There’s no pain greater than losing a child,” Shaner said, adding that the heaviest burden a school administrator must bear is to help parents bury their children.

“Over the past six years, we’ve done this because of opiates well over a dozen times,” said Shaner. “Recently, we had five graduates from one high school lose their lives to opioid addiction. They didn’t start as street junkies; they didn’t start out looking to be addicts. Some of the addictions were caused by self-medicating because of mental health issues, some started because of athletic injuries, and for some it was having access to the drugs.”

The U.S. Drug Enforcement Agency says most teens find prescription and OTC drugs in their home medicine cabinets or on a kitchen shelf. And among those 12 and older who misused opioid pain relievers:

  • 40.4 percent got the drug from a friend or relative for free
  • 35.4 percent received a prescription from a doctor
  • 8.9 percent bought the drug from a friend or relative
  • 6 percent bought the drug from a dealer or stranger

Students as young as middle-school age hold “bowl parties,” said Carmen McIntyre, a physician who serves as associate chair for community affairs for the Department of Psychiatry and Behavioral Neuroscience at the Wayne State University School of Medicine.

“Everybody’s supposed to bring meds out of their parents’ medicine cabinet,” she explained. “They just take a few pills from each bottle so (parents) don’t notice anything. And then they put them all into this big bowl to share.”

McIntyre said children attending these parties also steal Narcan, a drug used to reverse the effects of an opioid overdose, though in her experience children panic and flee the scene rather than stick around and help the youth who overdosed.

When he was a high school principal, Shaner made a point of talking about drugs with his students. “I would say—and I don’t consider this a scare tactic—‘If you love your parents, don’t do these things. You don’t want them to feel that pain, if you truly love them.’”

One of the programs that Shaner, a former law enforcement officer, has helped implement in his district is a prescription drug drop-off program at parent-teacher conferences.

Prescription take-backs are a proven means of reducing the supply of unused, prescribed narcotics, preventing them from circulating among household and community members. Such programs allow members of the community to safely dispose of unused medications at designated locations staffed by law enforcement.

The prevention efforts of Michigan Opioid Prescribing Network, known as Michigan OPEN, include educating medical professionals, law enforcement and others on how to hold opioid collection drives in a manner that encourages participation and does not make community members feel uneasy or like criminals. So far the organization has helped organize drives in 60 cities, getting about 3,000 pounds of pills and 40,000 to 45,000 opioids off the street, said Chad Brummett, associate professor and director of the Division of Pain Research at the University of Michigan Medical School and co-director of Michigan OPEN.

10 WAYS THE BUSINESS COMMUNITY CAN HELP FIGHT DRUG DEPENDENCY AND ADDICTION

The experts say there’s considerable work to be done to reduce overdose deaths and prevent and treat addiction, but they can’t do it without the help of business leaders.
“If you’re thinking about something that takes away from your (company’s) bottom line, mental health and addiction are exponential problems,” Shaner said.
Roundtable participants shared their expert advice.
1. Advocate for more mental health services and counselors at schools: The largest percentage of prescription drug abusers are young adults aged 18 to 25 who are also beginning their careers with area businesses. “We all know K-12 education is important in solving the (opioid) problem, so we ought tobe funding it and supporting it in the right way,” Shaner said.
 
2. Sponsor youth peer programs: Eric Hipple, a former Detroit Lions quarterback and director of Outreach for the After the Impact program, suggests businesses underwrite programs that take a deeper dive into the problem of drugs and facilitate conversations and peer support among youths.
 
3. Support organizations that help: Provide meaningful support to nonprofits working to prevent and treat addiction. “Politics trump data, but business trumps politics,” said Martell.
 
4. Provide job training: People in recovery can’t return to the workforce without skills, said Smith-Butterwick. Helping recovery organizations incorporate job training would help recovering addicts support their recovery financially.
 
5. Make educating workers a priority:Hold human resources-developed programming on identifying, preventing, and treating opioid abuse.
 
6. Teach coping skills: People who develop a substance use disorder may begin using as a means of easing physical or emotional pain.Teaching alternative coping skills, such as meditation, can help promote healthy living.
 
7. Partner with insurers: Commit to offering employees robust, extended mental health treatment and addiction recovery services and challenge insurers to craft a benefit plan that reflects your commitment.
 
8. Become recovery friendly: Be mindful and welcoming of employees who suffer from addiction and/or are in recovery when planning social events. “They can’t tell anybody in the office, ‘I’m in recovery’ because it’s not comfortable,” said Smith-Butterwick. She recommends planning company events that don’t include alcohol.
 
9. Support employees in recovery:Workers often fear they will lose their jobs if their drug use is discovered. Instead, encourage and facilitate confidential addiction referral and recovery services for employees.
 
10. Engage in a community of businesses approach: Brummett emphasized the advantages of businesses combining resources as a community to financially support nonprofits dedicated to preventing and treating addiction. “Unfortunately, state and federal dollars will dry up, and we will still have issues with opioids, pain and mental health,” he said.

Prevention efforts

The number of medical professionals overprescribing potentially addictive medications drastically increased in the 1990s. The National Institute on Drug Abuse reports the number of opioid prescriptions dispensed at U.S. pharmacies tripled from 76 million prescriptions in 1991 to 219 million prescriptions in 2011.

McIntyre said one of her patients died from an overdose two days after another physician — who was aware the patient suffered from addiction — injected her with the benzodiazepine Valium and gave her a prescription for 120 Valium in pill form.

McIntyre also cited her own experience with a pharmacy dispensing 100 Vicodin to her following a dental procedure. She pointed out to pharmacy staff that her dentist likely prescribed 10 Vicodin, not 100, but said the pharmacy refused to take back the medication after it had crossed the sales counter.

Brummett said regularly prescribing opioids following dental procedures “just doesn’t make sense.” The more doses doctors prescribe, he said, the more patients take, regardless of whether their pain is reduced.

Those aged 13 to 30 who filled an opioid prescription immediately before or after having their wisdom teeth extracted were about three times as likely as their peers to still be filling opioid prescriptions long after they needed them, according to a Michigan OPEN study.

“If you think about surgery (alone), the two factors that determine whether and how many opioids a person is going to get are the surgery they’re having and the surgeon caring for them,” explained Brummett.

Not prescribing opioids to the 80 percent to 90 percent of people who don’t need them could significantly reduce exposure and access to the drugs, both primary and secondary, Brummett said. Consequently, in 2017, Michigan OPEN released the first evidence-based prescribing recommendations in the country.

Health care providers in and outside the U.S. don’t know how much of the prescribed drugs patients actually use, he said. “Unless you ask people, they don’t tell you. The only metric you have is whether or not they refill.”

Brummett said having conversations about prescribing recommendations helps create a culture of opioid stewardship that opens the door to progressively more detailed conversations, such as how to deal with chronic users, including the 6 percent to 10 percent of patients who undergo surgery and begin taking opioids as a result.

McIntyre added, “We don’t need to just talk about prevention, we need to talk about developing as normal human beings. We have to start teaching people that after surgery, (you’re) supposed to have pain. Part of the purpose of pain is to slow you down so your body can heal.”

To learn more about combating addiction and ending the opioid crisis, visit The Children’s Hospital of Michigan Foundation at chmfoundation.org.

 

Why children’s mental health matters to your company’s bottom line

Mental illness affects one in five adults and costs U.S. employers upwards of $193 billion annually. Half of chronic mental illness begins before age 14; however, fewer than 20 percent of children with mental illness get the treatment they need.

Yet cardiovascular disease, cancer, diabetes and respiratory illnesses typically dominate healthcare conversations. And when it comes to corporate wellness campaigns, employers emphasize weight-loss challenges, blood pressure screenings and smoking cessation.

That’s because for most people, mental health is not a watercooler conversation. It’s a stigma company leaders just don’t understand.

Matt Friedman, co-founder of Farmington Hills-based communications firm Tanner Friedman, knows from experience. His daughter was diagnosed with obsessive-compulsive disorder while in elementary school; and then, in middle school, she began to suffer from anxiety and depression.

“I think businesses are in denial that mental health affects every family they employ,” said Friedman, who spoke at a recent roundtable discussion about children’s mental health that Children’s Hospital of Michigan Foundation (CHMF) sponsored; he is chair of the foundation’s board of trustees.

“The business community does not get this at all. The business community is largely silent.”

Friedman is grateful he’s self-employed. While medication has helped his now-teenaged daughter over the years, he said regular therapy has been a necessity.

“I’ve got my cellphone and my laptop, and I’m working in the waiting room,” he said. “I’m looking around thinking, ‘All of these people don’t own their own businesses. How do they do it?’ They probably don’t talk to their bosses very comfortably, saying ‘I need an hour a week to take my kid to therapy.’”

Research shows fewer than 40 percent of employees discuss mental health issues with their employers because of the stigma and an associated fear of employers not taking them seriously, according to the Anxiety and Depression Association of America, a partner of the National Institute of Mental Health.

But statistics from the World Health Organization show why mental health needs to be part of each company’s wellness narrative. Last year, WHO reported that for every $1 a company invests in depression and anxiety alone, it would see a return of $4 in better health and productivity.

“If kids can have their mental health treated, they’ll be better students, they’ll be better educated, they’ll be better equipped to be in the workforce and contribute to our community,” Friedman said.

“It starts when they’re kids.”

ABOUT THIS REPORT
The Children’s Hospital of Michigan Foundation and Crain Content Studio, the custom publishing division of Crain’s Detroit Business, brought together leaders in business, family service, medicine and education to talk candidly about children’s mental health and why employers need to pay attention. The conversation, moderated by Crain’s Editor and Publisher Ron Fournier, took place in October.

Read the full story at Crainsdetroit.com.