As Arizona continues to react and respond to the January 8 mass shooting in Tucson, communities across the state have focused their attention on mental health. Much speculation has focused on the portrayed mental state of the gunman and what interventions could have potentially prevented this tragedy.

In response to this public discussion and request for education, Community Partnership of Southern Arizona (CPSA) has partnered with the Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS) and the National Council for Community Behavioral Healthcare (National Council) to launch a statewide, extensive training campaign in Mental Health First Aid.

“People in our community want to take positive action after this tragedy,” said Neal Cash, President and CEO of CPSA. “Learning more about mental health and how to recognize and respond to possible problems is one way of doing that, one that could be of long term benefit to everyone in our community.”

Mental Health First Aid is a novel, evidence-based public education program. The program teaches average people a five-step process to assess a situation, select and implement appropriate interventions, and help a person in crisis or who may be developing the signs and symptoms of mental illness. The groundbreaking training equips people to provide initial help until appropriate professional, peer or family support can be engaged. Participants also learn about risk factors and warning signs of specific illnesses such as anxiety, depression, psychosis and addiction.

“None of us should underestimate the importance of early identification and intervention with an emerging mental health or substance abuse problem,” said Laura Nelson, M.D., Deputy Director at ADHS/DBHS. “Just as with diabetes or high blood pressure, the earlier the problem is recognized and addressed, the better the outcomes can be. It is also true that people who know the individual best can recognize the early signs and symptoms and can help that person get the treatment and support they may need.”

CPSA has been involved with Mental Health First Aid since 2009 and is now working to expand program offerings in the state.

CPSA will host an Instructor Training, conducted by the National Council, to increase the number of certified instructors who can offer the program throughout Arizona. The Instructor Training takes place the week of February 28-March 4, 2011. CPSA and the other Tribal and Regional Behavioral Health Authorities from around the state will identify thirty (30) future instructors to participate in this event.

The National Council has worked closely with CPSA and ADHS/DBHS to quickly mobilize its nationwide resources to support the Arizona trainings.

”People in the family or community often don’t connect a person with mental illness to care because they don’t know how,” said Linda Rosenberg, President and CEO of the National

Council. “Mental Health First Aid teaches people how to offer concrete help. This early intervention can prevent tragic consequences and save lives.”

CPSA will offer a Mental Health First Aid training in early March for organizations and individuals most affected by the events of January 8. CPSA and the National Council will provide instructors for these sessions.

CPSA also will schedule trainings that will be open to the general public. For information, see the CPSA Web site at www.cpsa-rbha.org, call (520) 618-8860 or e-mail Prevention@cpsa-rbha.org.

CPSA, founded and based in Tucson, has overseen publicly funded behavioral health services in Pima County since 1995 and currently serves close to 30,000 members. CPSA receives funding from ADHS/DBHS, the Arizona Health Care Cost Containment System (AHCCCS), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

Resources for mental health and trauma issues
following the January 8 shootings

• Tucson Tragedy Support Line: (520) 284-3517, available at no cost to anyone in Pima County who is struggling to deal with these events, or who wants information on how to help themselves or others cope. Staff at this number also will provide referrals to community behavioral healthcare providers and other services such as help coping with trauma and help talking with children and teens about tragedy.
• CPSA Web site (www.cpsa-rbha.org), including links to information from trusted sources on how to talk with children and teens about a tragedy, self-care in the wake of trauma and related topics.
• Community-Wide Crisis Line: (520) 520-622-6000 or 1-800-796-6762. Available 24/7 for anyone having a behavioral health crisis. Hearing impaired individuals may call the Crisis TTY Line at 520-284-3500 or 1-888-248-5998.
• Walk-in behavioral health crisis services: SAMHC, 2502 N. Dodge Blvd. (enter from Flower Street, which is parallel with and just north of Grant Road). If possible, please call the Community-Wide Crisis Line before going to SAMHC.

ADHS/DBHS and Magellan Health Services of Arizona have established a hotline for people outside of Pima County who need help in dealing with this tragedy: 1-800-203-CARES (1-800-203-2273).

An additional resource for people who are concerned about their own or someone else’s mental health is the “Mental Health Checklist” on ADHS/DBHS’ Web site, www.azdhs.gov

Talking about mental illness in one’s family has always been difficult.  The issues surrounding mental illness continue to be emotional and sometimes controversial.  Is that why Governor Brewer has abondoned her once passionate advocacy for people with mental illness?

According to recent press releases, Brewer’s involvement in state politics started with her activism pushing better treatment and care for our state’s seriously mentally ill population.  Her son is diagnosed with a serious mental illness and has spent time in-patient at the Arizona State Mental Hospital.  As a Mom with a son who had a serious mental illness, I certainly can understand her motivation to try and make a difference.  Stigma continues to be pervasive and some still believe it’s the Mother’s fault when a mental illness presents itself.  Character flaws, laziness, and violent behavior automatically get labeled as mental illnesses when medical science knows that these illnesses are actual biological brain disorders that are treatable.  With proper medical treatment and support people have and do live in recovery.

Given all the positive news about the potential for recovery, why in the world has Govenor Brewer decided to not only distance herself from the issues, but supported drastic slashes to budgets that assist people with mental illness?  I understand that we need to cut our spending, but why cut spending for our state’s most vulnerable?  In the long run, as Gov. Brewer knows, we will end up spending more for emergency room visits, hospitalizations and incarcerations for ignored people living with a treatable mental illness.  With all the publicity and nation wide visability she has created over the last several months, it seems a shame to me that she hasn’t used the opportunity to advance anti-stigma and the value of  proper treatment to some of our states most vulnerable…….including her son.  Is the illegal immigraton bandwagon the only issue she can focus on now?

I was reminded recently about what can happen to a person’s support system when he/she  is dealing with a mental health crisis.  When a loved one ends up in the hospital due to a heart attack or stroke or some other sort of physical catastrophe, friends and family circle around the affected family offering to pray and often times bringing over food and groceries to help with the daily stresses caused by the trauma.  The patient is often showered with attention, cards and flowers.

But when a person suffers from a psychotic break in the earlier stages of serious mental illness and needs to be hospitalized or even when a person who has been living successfully in mental health recovery and experiences a set back, the support system vanishes and the person can be left to climb out of the hole on their own.  No cards and flowers are sent.  No help with day to day chores  is offered.  Rarely are there concerned phone calls asking how the family is holding up.

Why is that?  Is it because mental illness is so frightening to some people that they don’t want to discuss it?  Is it because they still think mental illness and/or a mental health crisis is not as devastating as a chronic physical illness or physical health crisis?

When my son was diagnosed with schizophrenia, many of my “friends” seem to disappear.  While my daughter and I were dealing with the most intense period of our lives, many seemed to look the other way.  As a parent I experienced unbearable grief and pain.  Gone was the brilliant young man who had plans of attending Harvard.  Left in his place was a person that had delusional thoughts that kept him incapable of caring for himself.  His first hospitalization was a rude awakening for all of us.  Psychiatric care at the hospital was not effective and when he was discharged after a few weeks the only advise I got was to “buy him some earphones so he could listen to music and drown out the voices.”  He was literally drooling from being over-medicated and started experiencing tremors that continually ebbed and flowed over the next years.

Fortunately, after several weeks a medication “cocktail” was created to give him some balance and give us some optimism that he would get better.

He did get better and although he never went to Harvard, he began a new life as a forever changed young man.  His old friends never came back around……perhaps they were too scared, and all of my support system was there again for me.  Unfortunately my son died by suicide five years later.  My friends and family were there for us then and continue to lovingly support us today.

The moral of this blog?  When someone with a psychiatric illness needs to be  hospitalized, they need your care and support the same as they would if they had pneumonia or were injured in an accident.  Trauma is trauma, whether it be mental or physical and loving care and support are essential in the healing process.