While living in Greene County, Illinois, in the 1980s and 1990s, Lea Anne Varble took a gut punch each time she heard about a suicide in her community. Eight to 10 in total in 15 years, she says.

“It just took me aback,” she says.

What the tragedies had in common: the person faced mental health challenges common to a rural setting.

Varble, a clinical psychotherapist at OSF HealthCare, knew she had to do something about it. So not only did she devote higher education time to studying the problem, but she’s also now getting the word out about the resources available.

The issues

Varble says stress and isolation are often experienced by people living in a rural setting, such as a farmer. There’s also a desire to be self-sufficient – a trope associated with farmers and other rural residents for decades.

“People living rurally often are independent. So, when stress comes, they want to handle it on their own,” Varble says.

Varble also knows the issues – stress, anxiety and even depression – of planting and harvest season.

“Hours and hours,” in the field, she says. “You’re expected to keep working even if you don’t feel well. Even if the stress is getting to you. You have to get up and do it again. Or at least that’s what your father before you did and his father before him.”

The work ethic can be admirable, but it can lead to medical issues if left unchecked.

And, the heads of some rural households are caring for two generations: their kids and their parents. School, chronic illnesses and advanced care planning are just more things to add to the to-do list. Varble adds that older adults in a rural setting are more likely to see themselves as a burden and choose to end their life.

Treatment

Varble says getting better starts simply with noticing the problem and talking about it with a trusted adult, like a friend, family member, faith leader or a medical professional.

The good news is that mental health professionals have made strides in this area, such as telemedicine and mobile health services. And society is more willing to talk about mental health. Farming magazines have articles on mental health, for example.

Other ways to help that Varble has picked up over the years:

• Get to know your neighbors and local organizations, like churches and businesses. Then, lean on them for help when the stress gets to be too much.
   
• Look into resources offered by state or federal agencies. In Illinois, where Varble works, the Family Farm Resource Initiative operates a 24/7 hotline and email.
  
  “Individuals can receive support from trained professionals who understand the unique challenges faced by those in the agricultural sector,” the initiative website states. “The helpline offers specialized assistance, including mental health resources and agriculture-related support, ensuring that farm families have access to the help they need.”
   
• Health care professionals should encourage people with rural backgrounds to become therapists.

               “It’s someone from their community who understands what’s going on,” Varble says.

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When talking about the good and bad of pregnancy, you might have heard terms like postpartum depression or, more casually, baby blues.

It’s critical new mothers get help in this area, says Tiffany Waters, a birthing center charge nurse at OSF HealthCare. She says up to 80% of moms experience the so-called baby blues. But when talking about maternal mental health, experts prefer the umbrella term: perinatal mood, anxiety and depression (PMAD). Perinatal refers to the time between conception and one year after delivery.

PMAD basics

Waters says for two to three weeks after delivery, most women experience hormone changes, a lack of sleep and general stress related to the “new normal.” Having a traumatic birth, like an emergency caesarean section, can compound mental health impacts. Waters says around one-third of women fall into this category.

All these factors can lead to a variety of longer-lasting PMAD symptoms, including brain fog, weeping, sleep changes, anxiety, depression, obsessive or compulsive behavior and even suicidal thoughts.

“There’s no one single cause that leads to a person experiencing these issues. It’s a combination of psychological, societal and biological factors,” Waters says. “There’s nothing a mom has done to get or deserve this experience. The best we can do is help her work through it.”

Screening and treatment

Waters says health care providers should screen a woman for depression and other mental health issues during and after pregnancy.

“There are commonly used tools,” Waters says. “The woman answers 10 questions. It gives us a rating on how their emotional and mental well-being is.”

She’s referring to the Edinburgh Postnatal Depression Scale (EPDS). Each question is scored 0 to 3, with 3 being the response that most signals a possible mental health issue. That’s 30 total points, and a final tally of 10 or higher would warrant further evaluation.

Waters also says research is ongoing into whether certain biological markers in a woman are a sign of mental health issues to come.

“It can be difficult to admit or even recognize that a person is having depression or anxiety symptoms,” Waters says. “There are lots of reasons for that. There’s societal pressure to be a great mom. Moms might feel like if they admit how they’re feeling, their children might be taken away.”

Waters says journaling or talking to a trusted adult can help a mom document the issues she’s facing, opening the door for her to get help.

If a mom is diagnosed with PMAD, a provider will talk with her about resources like support groups, counseling, spiritual care and medication. Daily things like improved diet and exercise and exploring new hobbies can also help. And Waters says mothers should not be afraid to prioritize themselves. It’s OK to ask for a break from daily housework, for example.

Why it’s important

Waters says untreated PMAD can have consequences for the whole family and the people around the family. Substance abuse and domestic violence can increase. But if treated, it means a better life for everyone.

“It will improve the whole family dynamic,” Waters says. “It will lessen stress for everybody and lead to a happier unit.”

Learn more

Read more about pregnancy and birth and behavioral and mental health on the OSF HealthCare website. If you are in crisis, the Suicide and Crisis Lifeline is 9-8-8.

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Mental health challenges in young people

Brittany Algee, APRN, a board-certified psychiatric nurse practitioner at OSF HealthCare, says people Jamie’s age – late teens to mid-20s – have unique mental health challenges.

“It’s the transition phase into adulthood. They’re transitioning into college or a career. They’re starting a family. They have the pressure of being successful. There are financial constraints. They’re figuring out their lives,” Algee says. “They have this unrealistic expectation at 18 to have everything together. It’s very overwhelming.”

That can lead to anxiety and depression, and Algee says social media can make it all worse. Daily, symptoms can look like a lack of motivation, intrusive thoughts, worrying, eating too little or too much, irritability and poor hygiene. Parents should be on the lookout for all these.

“Maybe the child doesn’t want to talk as much. The child is self-isolating. You ask what they did over the weekend, and they say they stayed in bed. Or, they’re not going to class. Maybe the parent is getting a letter saying the child is on academic probation,” Algee says. “Those are red flags to ask ‘What’s going on? Why are we feeling that way?’

“Ask about sleeping habits, too,” she says. “Are they sleeping too much or not enough? Is there substance abuse going on? They could be doing that to self-medicate.”

If parents identify a problem, Algee suggests getting the child in to see their primary care provider, who could provide short-term help like medication while referring them to a mental health provider.

Some other tips from Algee and the Boones:

• Get outdoors to clear your head.
  
  “Exercise. Do some hiking or biking. Find hobbies and things you like,” Algee suggests. “I tell my patients not to wait until you have a buddy to do something you like. Nine times out of 10, you’re going to find some like-minded person you’re going to get along with. So if you want to go hear live music, go do it. There will be people there who like live music, too. That will help you meet new people.”
   
• When talking to a loved one about suicide, Johnny Boone says don’t be afraid to get specific. Ask if they have weapons at home. If so, ask to take them or change the combination to the gun safe, for example.
   
• Be mindful of how you talk about mental health and suicide, too. For example, Anita Boone suggests steering clear of phrases like “committed suicide” or “afflicted with mental health” because the person might feel judged.

Grieving a loss

Since Jamie’s death, Anita and Johnny have been in counseling, and Anita hasn’t returned to her accounting job at the University of Illinois. It’s proof that everyone grieves differently, and there’s no schedule for it, Algee says.

“There are numerous stages of grief,” Algee points out. “It’s imperative that you work through all of those stages. Seeing a mental health professional is going to be very beneficial in helping you get through those stages effectively and process the grief.

“Losing a child is absolutely horrific,” she adds. “It’s not something you can put a timeline on. You’re not going to get through it in a few weeks or years. It’s a void that’s difficult to fill. So just make sure you have resources like a therapist, medication and an overall support system.”

For the Boones, grieving involved changing their routine. Driving through the University of Illinois campus where Jamie once thrived is tough, so they steer clear when they can. A hobby of theirs – camping – is out in favor of a simpler outdoor activity – kayaking. Sometimes the couple talks while on the water. Sometimes they just float and cry.

There are even unconventional ways to grieve, as long as you do them safely. When Anita and Johnny need to get emotions out, they’ll take a baseball bat to a plastic pail in their backyard. Neighbors will peek over the fence, and Johnny will flash a thumbs up to show that no one is in danger.

The Jamie Boone Project

Johnny and Anita are still grieving, but they have turned pain into purpose by founding a nonprofit, the Jamie Boone Project. The pair spends hours toiling in their living room, assembling J.A.M.I.E. bags. It stands for Just A Mental Inventory Everyday. The bags contain things to take your mind off the world (stress balls, fidget spinners, journals and coloring books) and also steps to get long-term help, like information about the 988 Suicide and Crisis Lifeline and the 741741 Crisis Text Line. Johnny and Anita take the bags to schools, hospitals and anywhere else that could use them.

“We know it’s not curative. It’s just one way to get them through the moment,” Anita says. “For example, some people in a mental health slide might struggle to journal about positives in their life. Instead, the J.A.M.I.E. bags ask you to write down three things that didn’t stink today. It could be something as simple as ‘the car started this morning.’”

The couple has also visited schools and had students write what they call S.A.G.E. words. That stands for Student Affirmations of Grace and Encouragement and is a nod to the Monticello High School mascot, a sage owl. Through S.A.G.E. words, students write things they like about their classmates. Johnny compiles the comments and gives them to each child, sometimes at a milestone event like graduation. It emphasizes a simple message, one that’s on a sign outside the Boone home: you matter.

“We always hear the negative things about us,” Johnny says, speaking generally about how words can hurt. “We need to be more intentional. We need to hear positive things. You don’t realize how much you mean to people.”

“I’ve not had anybody not give us positive feedback on all our work,” he adds. “Monticello and the area have embraced us.”

“I think what the Boones are doing is absolutely phenomenal,” Algee says.

Learn more

If you are experiencing mental or behavioral health issues, such as depression, anxiety or addiction to alcohol or drugs, there are resources available.

• The OSF HealthCare website lists resources such as support groups and SilverCloud, an anonymous online platform available to people 18 and up living in an area served by OSF, even if you’re not an OSF patient.
   
• The 988 Suicide & Crisis Lifeline. The lifeline encourages veterans to press one to be linked with resources unique to that group.
   
• The 741741 Crisis Text Line, similar to 988. This hotline’s website encourages you to reach if you simply “need to vent.”
   
• The Substance Abuse and Mental Health Services Administration, or SAMHSA.
   
• The Jamie Boone Project website lists other resources and hotlines.

“Talk to somebody. A professional, a friend,” Johnny urges. “Make a mental health safety sheet. Write down what things calm your spirit and who you can talk to. Anything that will help you get through a stressful situation. When you’re in the middle of the stressful situation, you’re not going to remember that you like to listen to a certain music to calm you down. You need to write it down. And make sure you give a copy to a friend or family member you talk to a lot. That way, they can spot the warning signs.”

“It’s OK to not be OK. You’re not alone. Don’t be afraid to have the hard conversation because suicide does not discriminate,” Anita says.

Interview clips - Johnny and Anita Boone

Interview clips - Brittany Algee

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Johnny Boone explains the Jamie Boone Project

Johnny Boone explains the J.A.M.I.E. bags

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It’s like “Mean Girls,” but everyone is 80.

So reads a 2018 Associated Press headline about a problem you may be surprised exists: bullying among older people living in assisted living facilities.

Shunning people from cafeteria tables, gossip, vandalism, physical scuffles and residents checking their mail at night to avoid running into an unkind cohabitant are just some examples.

While the issue may not be widespread, experts are telling the 65+ population, their loved ones and their caregivers why the problem exists and how to confront it.

Causes

Ari Lakritz, PsyD, is a clinical psychologist at OSF HealthCare who has taken a keen interest in mental health care for older folks. He points to a few reasons why senior home bullying might happen.

One, the seniors arrive with untreated (or sometimes even unknown to their caregivers) mental health issues.

Dr. Lakritz sums up the second reason: old habits are hard to break.

“The same types of personality dynamics, the same types of biases these individuals hold maybe as a product of the particular generation they grew up in. Any types of biases or beliefs about individuals different than them. Why would those go away just magically as they grow older?” Dr. Lakritz says.

Another simpler explanation: older people are cranky due to issues that come with age like chronic pain or feelings of helplessness.

Solutions

There’s not a one-size-fits-all solution to the problem of senior bullying. But Dr. Lakritz says it must start with the caregivers.

“A clinician not just reacting to different problems in the facility but proactively speaking with residents at least for a few minutes each day,” Lakritz suggests. “As well as having a really good referral system set up to psychiatrists, psychologists or another type of clinician if mental health concerns really do become a problem with individuals in that facility.”

And the facilities can take short-term steps, such as holding anti-bullying or anger management classes for staff and residents. Don’t allow residents to “claim” things in common areas like chairs or televisions to prevent others from being excluded. Include language on bullying in admission agreements that could allow staff to remove someone if they are a menace.

Families of the residents should check in with them frequently, too. Watch for changes in how they talk and act. A sudden desire to move out of a facility may be a sign of a bigger problem. Drop in for lunch and see if you witness any bullying yourself. If so, report it to staff.

The National Center for Assisted Living also has a document with tips to spot and stop bullying.

Visit the OSF HealthCare website for behavioral and mental health resources. If you or a loved one – of any age – are experiencing a mental health crisis, call 9-8-8, the digits for the Suicide and Crisis Lifeline.

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Burnout.

It means different things to different people. But one thing’s for sure: you should know the skills to cope with burnout to avoid a mental health crisis.

“Things are really expensive right now. People are looking for jobs. There’s a political climate with a lot of changes. It’s all created a lot of upset,” says Sara Bennett, an OSF HealthCare psychotherapist, commenting on the prevalence of burnout today. “And social media has a big role in how we feel. We see everybody’s problems. Or the opposite: Everybody’s life is so great and rosy. It leaves us wondering what we’re doing wrong.”

Causes and symptoms

Bennett says burnout doesn’t have a written-in-stone clinical diagnosis like, for example, the flu does. But generally, she describes it as physical, mental or emotional exhaustion that makes it difficult to navigate life. Issues with your job, school, finances, health and relationships can all lead to burnout.

“You’re probably going to feel a lack of concern. We call that apathy. You might not care if something’s going on. You might have a lack of interest in things you usually enjoy,” Bennett explains. “You might not be sleeping well. You might get stomachaches or headaches. You may be irritable.”

A sense of hopelessness can also occur. You might feel like things will never get better, or you can never get ahead of your problems, Bennett says.

Treatment

From your home to the doctor’s office, there are ways to navigate burnout.

• First, Bennett says you should take stock of the situation you’re in. Is it one that will resolve itself soon? Or do you need a bigger plan? For example, Bennett says accountants can be stressed during tax season. But after all the filings are done and the chaos dies down, their mental health will likely get a boost.
   
• Take care of the basics. Get good sleep. Eat a healthy diet. Exercise regularly.
   
• Ask someone for help. For example, if caring for an elderly family member causes stress, ask a neighbor to man the house for an hour so you can get some fresh air or take a nap.
   
• Learn to say no. You can’t be all things to all people. So, recognize when you don’t have the bandwidth to take on a task.
  
  “Learn to prioritize,” Bennett suggests. “Figure out the things you can’t say no to. The things that are really important. Or maybe there’s some suffering involved, and you’re the person that can help.”
   
• See a health care provider.
  
  “Doctors can prescribe something that might help you through a short-term experience,” Bennett says. “Therapists can engage you unlike others in your life. They can process stressors with you. They can give you good coping skills and relaxation techniques.”

For example, Bennett says she may work with someone to identify what they can and can’t control in their life and encourage them not to get hung up on the latter. Journaling can also help avoid bottled up emotions. And, Bennett implores people to be grateful for the good things in life.

Learn more

Read more about healthy thoughts and behaviors on the OSF HealthCare website. If your burnout has reached a crisis where you are thinking about harming yourself or others, talk to a trusted adult or mental health professional or go the emergency department right away. The 9-8-8 Suicide & Crisis Lifeline is also available.

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We’re talking about sniffing products like paint, markers or nail polish for a temporary high. You might hear it called huffing, chroming or, in the medical community, inhalant abuse.

Health care providers like Justin Rapoff, DO, an emergency medicine physician who sees patients at OSF HealthCare, are again reminding parents about the serious health impacts of this activity and what to do if your child shows symptoms. It’s especially important for kids to steer clear, he says, because their organs are still developing. An interruption to that development could mean trouble. Young people can also be more susceptible to peer pressure, giving in when other kids tell them to try something.

“Inhalant abuse is common because these are things that are easily found in your house," Dr. Rapoff adds. “They’re underneath your kitchen sink and in your garage and bathroom. These are cheap and easy to find for kids.”

The consequences

There are short and long-term effects of inhalant abuse, Dr. Rapoff says. Among the short-term issues is the general haze the activity will put you in. If you have to, for example, drive a vehicle while under the influence, you could crash or face legal consequences. If you’re intoxicated at work or school, your performance will decline.

“You can have cognitive difficulties and even dementia [later in life],” Dr. Rapoff adds of the long-term impacts. “You can have bone marrow suppression and anemia. You can have abnormal coordination.”

Cardiac arrest, when the heart stops beating suddenly, is also possible.

What parents can do

If your child shows signs of intoxication – slurred speech, nausea, confusion and a lack of balance are big ones – call 
9-1-1 and get them to the emergency department.

“Inhalants hit similar receptors to those hit by alcohol. It causes a similar intoxication, which lasts around two to 30 minutes,” Dr. Rapoff says.

That means you should get the child checked out even if they say they feel better. Dr. Rapoff says providers will likely test the person’s blood, urine and heart. There’s no bonafide treatment for inhalant abuse, Dr. Rapoff says. Rather, providers will treat the symptoms. For example, if the child feels nauseous or is vomiting, providers may give an anti-nausea medication.

What about avoiding an unpleasant trip to the hospital in the first place? Dr. Rapoff encourages parents to talk with their kids about the risks of huffing and, generally, any emotional issues they are dealing with. The young ones may be turning to inhalants to cope. In fact, Dr. Rapoff says studies have shown that when young people abuse inhalants, they are more likely to use heroin or even commit suicide later in life.

Parents should also pay attention to kids’ behavior, especially if they make unexplained purchases of things like hairspray or whipped cream canisters. Keep items that could be misused out of reach. Put things like markers and cosmetics out only when it’s time to use them. Keep things like spray paint and gasoline canisters locked up in the garage.

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Lavender Zarraga, APRN, a behavioral health provider at OSF HealthCare, says it’s not uncommon for her patients to ask for a medication that isn’t the right fit.

The culprit? She says symptoms of common mental health issues like depression, attention deficit hyperactivity disorder (ADHD) and bipolar disorder can overlap. So, it’s important to stay in contact with your provider to make sure you’re on the best treatment plan.

On depression mimicking ADHD: “You have changed executive functioning. You can’t decide. You feel dull. You can’t concentrate,” Zarraga says. “You have a hard time learning new things. You can’t remember things or forget things easily. Attention and concentration are low. You think ‘Why am I processing everything so slow?.’”

Zarraga adds that she’s seen people with depression take prescribed medicine and feel better, but then residual symptoms that mimic ADHD creep in. And, she says, ADHD can seem like bipolar disorder.

“If you start somebody on an antidepressant and they have an underlying bipolar disorder that they have not been diagnosed with, that can trigger mood symptoms. It could potentially trigger mania [a high energy period where high-risk behaviors can occur],” Zarraga says.

It’s a lot to sort out, and it may make the person feel like they have a whole new set of problems.

“Talk to a provider. See what’s going on,” Zarraga says to people in that situation, noting that kids should not have to carry these issues into adulthood.

“There’s a lot of talking involved,” she adds. “Let’s start from the beginning. Let’s go back to your childhood. How were you doing then? And we relate that to how you are now.”

From there, Zarraga says treatment could include more counseling or different medication. She says medicine for children is more straightforward. But for adults, a provider will make sure the pill isn’t impacting the rest of the person’s body.

There are also science-backed written tests that can help diagnose someone with ADHD. Questions along the lines of: Can you sit still in class? Does your mind wander all the time?

And a word for caregivers, friends and family members: watch for symptoms of these disorders in your loved ones and have a conversation, if needed. Don’t ignore things, Zarraga says.

“There’s nothing wrong with just talking about it. It’s not going to hurt anybody to discuss it,” she says, noting that society is now more accepting of mental health issues.

Signs to watch for in your close companion: irritability, aggression, anxiety and trouble sleeping. If you or someone you know needs to talk to a professional quickly, the national suicide and crisis lifeline is 9-8-8. And the OSF HealthCare website lists other resources.

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When talking about the opioid crisis in America, you don’t have to explain much to Howard Marsh.

A first responder for nearly a half century, Marsh has gone on numerous ambulance calls for a suspected overdose.

“It breaks my heart,” says the Advanced Medical Transport paramedic. “I just can’t believe people do this to their bodies.”

New federal data show nearly 108,000 people died of an overdose in 2022. That's up slightly from 2021. It’s a time to know the facts and misconceptions about overdoses, their causes and ways to reverse the deadly effects. One such way is naloxone, known under the brand name Narcan, a medication that has become more available in recent years to both first responders and everyday citizens.

“It’s really a good drug to have around,” Marsh says.

Narcan basics

Les Mennenga is lead educator for East Central Illinois Emergency Medical Services (EMS), an OSF HealthCare organization that trains ambulance workers. He describes Narcan as an opioid antagonist that helps reverse the effects of dangerous drugs like fentanyl, morphine, heroin and Tramadol.

“If we get too much of those medications in our system, they’ll bind with receptor sites in our brain. They’ll slow our breathing and pulse rate down,” Mennenga says. “They can actually stop the signal to our diaphragm and make us stop breathing.”

Conversely, he says, “Narcan gets to those receptor sites, competes with the opioid and will knock it off. It will help the person restore their breathing.”

Mennenga says Narcan does not work with methamphetamine, cocaine and other non-opioids.

At the scene of a suspected overdose, typically the first bits of information come from friends or family of the ailing person. Those people likely know if the person has a history with a certain drug, for example. First responders will also look for drug paraphernalia like needles. Mennenga says if the person is still alert and breathing, they would not qualify for Narcan.

“The only time we should be administering Narcan is if they’re having difficulty breathing,” Mennenga says. “They’ll be unresponsive, snoring-like respirations or not breathing at all.”

Blue lips are another sign, Marsh says.

There are three ways to give Narcan: through a shot into the muscle; intravenous therapy, commonly known as an IV; and the most common and simple way, Mennenga says, is a nasal spray. Mennenga adds that Narcan may be combined with cardiopulmonary resuscitation (CPR) or a bag valve mask to help restore breathing.

Mennenga says once the person comes to, they might experience withdrawal symptoms like nausea, vomiting or, in rare cases, a seizure or heart issues. First responders will provide more care as needed.

“Go to the hospital and get checked out,” Marsh advises. “We prefer we take you in case something happens in route.”

What you should know

East Central Illinois EMS has rolled out a Narcan leave behind program. The agency provides kits for first responders to leave with friends, family and others after responding to an overdose. The program serves as a reminder that this is an important issue. Experts say survivors are at high risk for repeated overdoses, and Narcan may be the only chance to save their life.

“Overdoses are quite common, unfortunately,” Mennenga says. “Nobody’s immune to the opioid crisis.”

He says if you want a supply of Narcan at home, contact your local health department for options.

Mennenga also says Narcan, shockingly, has some detractors. He says some people think opioid users need to learn the consequences the hard way. But Mennenga, a veteran of the EMS world, says many people who suffer overdoses aren’t your stereotypical drug user. Their use might have started with an injury, leading to pain medication. Or older adults often mix up pills and take too many.

“If they really want to get some help, we can give them resources like their public health department or the state public health department,” Mennenga says.

Learn more

Websites for the U.S. Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Illinois Department of Public Health and the Michigan Department of Health and Human Services all have information on opioid addiction, treatment and recovery. If you are in crisis, the national Suicide and Crisis Lifeline is 9-8-8.

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My own car or an ambulance?

Sure, for minor cuts and bruises that require a trip to urgent care, the former may be appropriate.

But for things like heart attack symptoms, stroke symptoms or serious wounds, Kurt Bloomstrand, MD, says the choice is clear: call the ambulance.

Dr. Bloomstrand is an Emergency Department physician at OSF HealthCare and medical director for East Central Illinois EMS (emergency medical services). He and his colleagues have seen an alarming trend lately of people with suspected heart attack coming to the Emergency Department on their own.

“Ambulances and pre-hospital providers are equipped and trained to deal with these emergencies. We can deal with these emergencies at your home or wherever you called 9-1-1 at,” Dr. Bloomstrand says. “We’re bringing the equipment from the ED to you so we can get that treatment started even sooner and bring you life-saving treatment and medication immediately.”

For example, pre-hospital providers on site or in the back of the ambulance can perform an electrocardiogram (ECG or EKG for short), which takes a snapshot of how your heart is working. If problems are found, these providers can call ahead to the hospital and have the person bypass the ED and go directly to the cardiac catheterization laboratory. That’s a time-saving and life-saving step.

On the alternative: “If you drive yourself, there’s no way to monitor you. There’s no way to treat you if something happens,” Dr. Bloomstrand says.

Other possible pitfalls: you may pass out at the wheel from your initial medical event, causing a crash that endangers you, other drivers and pedestrians. If someone is driving you, they will likely be anxious and not drive carefully. That, too, could mean a wreck.

Private vehicles are legally not allowed to speed and go through stoplights and stop signs. An ambulance can safely, saving time.

And it may seem trivial, but if you are driving to the hospital with a serious wound, you will likely make a bloody mess all over your vehicle.

Dr. Bloomstrand has also heard plenty of misconceptions about taking an ambulance.

People who live in a rural area may think, “By the time the ambulance gets to me, I may be worse off, and I could have already been at the hospital if I took myself.”

Dr. Bloomstrand counters that although it might take time for the ambulance to arrive, this time is often faster than the time it would take to get treatment by driving to the Emergency Department.

Others may believe they can’t afford an ambulance. Dr. Bloomstrand says most major health insurance providers cover the care.

Some may think, “I’m not sick enough for an ambulance.”

“It’s your emergency. We’re there 24/7 to help and assist in your emergency,” Dr. Bloomstrand says. “If you feel like you’re having an emergency, you need to call 9-1-1. We can come and evaluate you. Please don’t feel like you’re burdening the ambulance system.”

Others may just fear an ambulance in general. They’re nervous about having a needle in their arm while in a fast-moving vehicle. Dr. Bloomstrand counters by reminding you that paramedics and emergency medical technicians (EMTs) are highly skilled and trained. They have been around the block – literally.

“We deal with this day in and day out. We’re trained and equipped to handle these emergencies,” Dr. Bloomstrand says.

Interview clips

B-roll

New research from Penn State University suggests simply asking young people about suicide increases the chance they will get connected with mental health services.

The research underscores the need for everyone to watch out for their loved ones' mental health. Health care providers, too, continue to try to chip away at the mental health crisis across the country. And the numbers drive home the point:

• The National Institute of Mental Health says nearly one in five adults suffers from a mental illness.
• The U.S. Centers for Disease Control and Prevention (CDC) says suicide is the second-leading cause of death among young people and, prior to the COVID-19 pandemic, was the 10^th-leading cause of death among all Americans.
• The CDC says in 2020, someone took their own life about once every 11 minutes on average.
• The suicide lifeline says for every one person who dies by suicide each year, 316 people seriously consider it.
•  The lifeline has fielded more than 20 million calls since it launched in 2005, and it’s seen mostly year-to-year growth in calls. In 2005, the lifeline saw around 50,000 inquiries. In 2020, there were nearly 2.4 million calls – a record high.

The numbers line up with what Staci Knox and her staff are seeing in at OSF HealthCare in Alton, Illinois – an increase in people seeking help. Some have suffered in silence for a long time. Knox, the manager of Psychological Services at OSF in Alton, says the average time from onset of symptoms to diagnosis is 11 years.

“You think about our culture, it's very much an admirable trait to be tough and to just buck up and get through it,” Knox says.  “It's not easy to experience symptoms and then be able to identify that they're not fleeting.”

Warning signs

Knox and her staff see a wide range of patients - from kids as young as six to some people well into their 90s. She says warning signs for suicide vary by age.

For adults: “They're struggling to get out of bed. They're struggling to not call off for work. At work, they're struggling not to be written up for irritability or conflicts that happen in the workplace. In their home life, they may be struggling in their relationships. They may be isolating,” Knox says.

Some other signs in adults may be tough to spot. For example, a big shopping trip may seem just like a spending spree. But for a suicidal person, they may be spending all their money because they know they can’t take it with them.

For children, Knox says their world boils down to school, family and friends. So many of the warning signs are similar but on a reduced scale: no interest in school, acting out at school and isolating from friends and family. Kids may also start using drugs or alcohol.

Daily self-care

Whether you’re getting mental health treatment or not, Knox highlights some daily to-dos to keep yourself grounded: eat healthy, get enough sleep, take time for deep breathing and practice your faith.

“Stretching and keeping our body moving,” Knox adds. “Depending on your physical limitations, it could be stretching in a chair or getting out in nature and hiking.”

A new tool

Beginning July 16^th, 9-8-8 will be the digits to dial to reach the National Suicide Prevention Lifeline. If you’re dealing with a mental or behavioral health issue, you can call or text 9-8-8 to be connected with a trained counselor who’s part of the existing National Suicide Prevention Lifeline network. The counselors you’ll speak to are stationed at crisis centers across the country, so they are likely aware about specific resources and treatment available in your area. Those could include outpatient counseling, inpatient (live-in) care, medication or a combination.

The 9-8-8 lifeline is confidential, free and staffed 24/7. But like any other hotline, there may be a wait. If you or someone you know is in immediate danger or needs medical attention, call 9-1-1. You can always talk to your primary care provider about mental and behavioral health resources. In fact, Knox says your provider should be able to figure out if your symptoms are indeed related to mental health, if they are a physical problem disguised as a mental problem or if they are a bit of both.

Interview Clips - Staci Knox

Previous Coverage

Depression: Breaking the Silence

A Sad Stat: Teenage Suicides on the Rise

Suicide Stigma: Facts, Myths, and How to Help

Mental health care starts with a first step

OSF SilverCloud offered as powerful resource for employers and employees

Tackling any task – from a child walking to an adult learning a new job – starts with a first step. The same goes for taking care of your mental and behavioral health, but even the experts admit it may be daunting to ask for help. During the holiday season where some people may experience loneliness and depression, experts are reminding you there are resources to bridge the gap between “what do I do?” and “I have the care I need.”

Katie Koeller is a behavioral health navigator (BHN) at OSF HealthCare in Alton, Illinois. BHN is a free, ministry-wide service at OSF HealthCare, but you don’t have to be an OSF HealthCare patient to use it. The program helps people in areas like depression, anxiety, drug or alcohol use, and problems with work, school, or relationships. The BHN talks to the patient – either at a provider’s office or over the phone – about what care they need, and they point the person to that care as close to home and as soon as possible. The BHN also checks the patient’s insurance coverage to see how it lines up with the care needed.

“We would do an intake,” Koeller explains. “So we'd ask questions, making sure that they're not in a crisis situation at the time and see what their symptoms are. And then that way we can better judge what they would be suited for as far as counseling, psychiatry, substance use treatment, whatever it may be.”

Koeller notes the treatment could be out-patient (the typical office visit) or in-patient (live-in treatment). She says a BHN will also check-in with the patient via phone call or message on OSF HealthCare’s secure online portal. Koeller says it’s usually three check-ins over a month, but each case is different.

“Some people just decide maybe it's not what they need, maybe just talking with somebody like me and just getting educated and feeling like they have that opportunity or just the knowledge about the community resources is enough,” Koeller says. “Because then they were like, ‘Well I can decide later on if that's what I need.’  But for the most part, I feel like a lot of patients are appreciative and do really like the service and find it helpful.”

Koeller, a BHN for three years, says even if the patient is on a good path, the BHN tells them they can always call back if they need more help.

The tendency to stay quiet about mental health is still an issue, Koeller says. But she’s seeing another roadblock to care.

“A lot of people just feel like they don't have time for it. I've heard a lot of people say that ‘I can't take off work for it.’” Koeller says. “I feel like a lot of people don't consider it to be [a crisis]. You don't want it to get to that [crisis] point. So they kind of push it back like it's not as important as my physical health.”

But in reality, Koeller says, mental health does impact physical health. In other words, if your mind hurts, your body may hurt, too.

Koeller also notes that some insurance providers can help with transportation – getting a ride to a counselor appointment, for example. Telehealth – a digital appointment with a provider from home – is also an option that’s growing in use. OSF SilverCloud is another resource designed for workplaces. These are some of the many things a BHN can check on and, at a minimum, educate the patient on what’s available.

Patients who are experiencing a mental or behavioral health issue can contact their primary care provider or – if you live within OSF HeathCare’s footprint – use the behavioral health navigator program. If you’re in a crisis situation that needs a first responder, call 9-1-1. If it leans toward a mental health crisis, call the National Suicide Prevention Lifeline at 9-8-8.

Interview Clips