Adolescence: The Forgotten Age

"Are you lying to me?" "Don't EVER let me catch you doing that again." "And don't ask me WHY, the answer is NO." These are a few of the things that adolescents hear from their parents on a regular basis. Teens are often perceived as troubled kids or trouble makers and their problems are largely ignored.

Research shows that even good students from wealthy backgrounds go off track when they reach junior high. "They desperately want the approval of their friends, to be perceived as 'cool,' and they will do dangerous and just plain dumb things to gain that status" says Phyllis Ellickson, a senior RAND analyst. In high school, dangerous temptations arise from peers to use drugs, alcohol, and to engage in unsafe sex practices. These behaviors contribute to violence and emotional problems. Children between 12 and 18 are extremely vulnerable and have not developed the skills to cope with temptations that arise by this age.

Some of these temptations result in serious consequences, including death. Seventy-five percent of adolescent deaths are primarily caused by three things: automobile accidents, homicide and suicide. These are directly linked with risky behaviors, such as drug use (alcohol and other drugs). Twenty percent of high school seniors smoke and about 30% are binge drinkers. Such things often go together: drug usage increases the risk of unsafe behavior; teens with mental health problems often use drugs.

The problem is compounded by the limited ability to get help. About one-third of poor and near-poor teens have no medical coverage, and a surprisingly large portion of middle-income teens also lack coverage.

So, how do we prevent adolescents from potentially life threatening behaviors? Studys by Ellickson and others discovered that school-based prevention programs can curb drug use. These programs work best at delaying or reducing cigarette and marijuana use. These programs are most effective when continued throughout high school.

We can do better. Treatment plans need to be developed for adolescence that involve families, schools, and health professionals. "We need to promote community-based or school-linked systems of care that recognize the interrelatedness of many adolescent problems" says Ellickson. Better training in adolescent medicine would go a long way to helping health professionals identify with mental disorders and drug abuse in teens.

"Adolescence: Forgotten Age, Forgotten Problems." RAND Corporation Provides Objective Research Services and Public Policy Analysis. RAND, n.d. Web. 25 Jan. 2010. . www.dicts.info/img/ud/alcohol.jpg

Kentuckians and Increased Health Access

Thirty-eight percent of adults from 18-65 went without health insurance at some time during this past year, said a study done by the Foundation for a Healthy Kentucky. This year the foundation joined with the Health Foundation of Greater Cincinnati to conduct an extensive Kentucky Health Issues Poll.

There were over 1600 interviewed and the study had a margin of error less than 2.5 percent, according to Eric Rademacher of the Institute for Policy Research. Despite the economy, 81% of Kentuckians still favor “providing access to affordable, quality healthcare for all Americans,” noted Foundation Executive Director Susan Zepeda. This percentage is down 10 percentage points from the prior year. Of those favoring, 64% supported increased access “even if it means raising taxes.”


The support for access to healthcare may be a reflection of another finding from their study. Thirty-seven percent of white and 55% of African American Kentuckians 18-65 reported going without coverage now or some time in the past year. And, 47% of younger adults (18-29) and 49% of those with family incomes below the federal poverty level are currently uninsured. This contributed to the support of affordable quality healthcare for all Americans.

There were some insured Kentuckians who reported going without needed healthcare in 2009 “because of the cost.” For more information go to www.health-ky.org

Foundation for a Health Kentucky. Despite Economy, Kentuckians Still Favor Increased health Access. Jan 13, 2010.

Vision

I believe that there is one characteristic that differentiates homo sapiens from all other life species and that attribute is the capacity for vision. All other living creature's behaviors are dominated by their conditioning, their history, their past. Human beings have the additional option of visualizing a future that is yet to be and they can utilize it to determine how they will act.

A rat consistently reinforced for turning left at a choice point in a maze becomes conditioned to always turn left at that choice. A human being confronted with the same choice point can chose to turn right regardless of prior conditioning. We have the choice of repeating the past or innovating change in ourselves based upon where we wish to go rather than where we have been.

Vision provides us with direction. It allows us to gauge our progress and examine the effectiveness of our behaviors. If you know where you want to go you can begin to develop strategies to get there. When I counsel others invariably my first question is "What is your vision of how you would like your life to be?" Beginning with the end in mind allows us to evaluate the effectiveness of our choices in getting us there.

Conditioned behavior takes place at a level that generally is outside of our consciousness. I often recall the story of a friend of mine who found himself driving into his office parking lot to discover that his child was in the back seat because he was to have dropped him off at day care.
He mindlessly drove his usual route since he was conditioned by many repetitions to drive to work each morning. On this day he had a new destination but he did not keep his end in mind and so he repeated his old behaviors. Being mindful is the key.

How often have you experienced people coming from virtually identical backgrounds behaving in very different ways from one another. Consider a family of origin in which there is alcoholism and abuse. Too often such dysfunction appears to perpetuate itself but there are certainly instances of offspring who have created lives of sober living and family nurturance.

Breaking the tyranny of our past involves three components : 1) Developing a vision, 2) Evaluating the effectiveness of our behaviors in terms of moving us closer or further away from that vision and 3) Mindfulness of both our vision and behaviors.
It is these elements that make recovery, achievement and the shaping of our future, possible.

Howard F. Bracco, Ph.D.

Suicide Behavior in America

A National study was done on suicidal thoughts and behaviors in the United States of America. It found that 8.3 million adults(1) had serious thoughts of suicide in the past year. Of 8.3 million only 2.3 million of these adults had made a suicide plan and only 1.1 million of these adults actually attempted suicide.

This study also found this risk of thoughts and attempts is significantly different among age groups. Young adults(2) were far more likely to have considered suicide in the past year than those ages 26-49. These young adults were nearly three times more likely than those people 50 or older.

Another factor comes into play when considering risk of suicide and adults is substance disorders. People experiencing substance disorders were more than three times(3) more likely to have seriously considered suicide than those non-users. These people were also a shocking 7 times more likely to have attempted suicide.


1. Adults are 18 and older and residents of the United States. 8.3 million or 3.7 percent.
2. Young adults- 18-26. This age comparison is a ratio of 6.7% to 3.9%. 50 or older: 2.3%
3. Three times: 11% to 3%. Seven times: 2% to .3%.


"National Study Reveals Statistics on Suicidal Thoughts and Behaviors SAMHSA NEWS." Substance Abuse and Mental Health Services Administration (SAMHSA) Website. Version 17. SAMHSA , 1 Nov. 2009. Web. 10 Dec. 2009.

Bridgehaven

From 1955-56 The Louisville Section of the National Council of Jewish Women studied mental health needs in Kentucky. They identified a need for programs to assist people in the transition from hospital back to community. Bridgehaven was founded in 1958 as a direct result of this study, and was the first community program in Jefferson County. It started with three clients and now has over 500 members annually.

Their mission: “Bridgehaven provides the highest quality community-based psychiatric rehabilitation and recovery services for adults with severe and persistent mental illness. We enhance the lives of Bridgehaven members by encouraging them to achieve the skills to live, learn, work and socialize in their chosen environment. Through individual, person-centered rehab planning, we assist members in setting and achieving recovery and community integration goals.”

Some of the group therapies that are offered to the members of Bridgehaven are:
o Independent Living Skills
o Communication Skills
o Self-determination
o Recovery Awareness
o Stress Management
o Relationship Skills
o Health and Fitness
o Pet Therapy

The two programs providing activities designed to improve the ability to interact and function in the community are Bridge To Recovery and Opportunity House. They believe recovery is “a process in which individuals with severe mental illness are encouraged to take control of their lives, set goals, take advantage of opportunities and return to living, learning, working and socializing activities of their choosing.”

Along with these available programs they have Adult Day Training. This program is designed to combine person centered interventions for adults with an intellectual disability with a high quality community based psychiatric rehabilitation and recovery program. The goal is not only to allow these people to socialize in their environment, but to thrive as well.

Bridgehaven has achieved their goal of reducing the amount of hospitalizations. They have found of 137 members, 53 were hospitalized during the prior year. But, during treatment at Bridgehaven only 2 members were hospitalized during their first 6 months to a year. This is a 96% reduction in hospitalizations. This reduction represents a cost savings of at least $1.4 million.

"Bridgehaven - Home." Bridgehaven - Home. N.p., n.d. Web. 1 Dec. 2009. .

Words from Dr. Bracco

Collaboration and Common Sense

Virtually all of us in the course of our lives evolve or develop a world view. Our world view may be seen as a set of core beliefs that create a framework for us to understand the environment we find ourselves in. Our world view is shaped by our families, teachers and experiences. While individualism and competition appear to be prevailing values in American society I have learned to view my world from another vantage point.

One of the individuals that shaped my thinking was Alfred Adler, a contemporary of Sigmund Freud. Adler’s basic tenet was that humans experience a deep sense of inferiority given that they are exposed to a world filled with natural and man-made forces that are overwhelming. Consider what we must experience at the moment of birth. If we are to thrive we must overcome the challenges in this world that threaten our survival. Adler believed that the solution lay in “common sense.”

Common sense in Adler’s view consists of people coming together to share their talents and ideas in search of answers. Collaboration is common sense and common sense is collaboration.
A social model that supports Adler’s view involves having individuals solve a problem by themselves such as, ranking a list of items that they may need for survival on a deserted island, then they are to come up with the list as a group. Invariably the group solution proves to be synergistic, that is, it proves to be better than any one of the individual solutions. As the saying goes “The whole proves to be greater than the sum of its parts.”

In seeking to fulfill Seven Counties’ mission of building healthy communities; common sense, and consequently collaboration are necessities. While there are many ways to organize the community in which we live I use a model in which our community is composed of twelve systems ; 1) Health, 2) Social Welfare, 3) Government, 4) Criminal Justice, 5) Business & Industry, 6) Faith, 7) Education, 8) Housing, 9) Transportation, 10) Media, 11) Recreation and 12) General Public. Each of these systems affects the health of a community. To achieve its mission Seven Counties must work collaboratively with and across all of these systems.

In order to build a healthy community Seven Counties must create linkages with each of these systems. If we stand alone we will realize our inferiority and we will fail. We can only achieve our mission by collaborating and using our common sense.

Are Suicide Rates Higher at Christmas?

Contrary to popular belief, suicide rates decline during the holiday season. A study was done on 188,000 recorded suicides in the U.S. and they found on average there were 102 fewer suicides during the holiday season. There was a noted dip in suicide rates leading up to, and following the Christmas holiday. One group of researchers found on average there were about 34 suicides per million people. They also found Holiday rates were lower with Christmas and New Year’s Eve at 30/million, and Thanksgiving at a surprisingly low 26/million. The New Years day rate was very high at 41/million people. This group of researchers believes the large number is due to the end of a holiday season when people get depressed at the thought of returning to work and everyday life.

The researchers have some reasons why suicide rates decline during the holidays.

~ Gathering of friends and relatives gives off a secure vibe and creates a comfortable atmosphere.

~Christmas celebrations evoke positive memories.

~There is an increase in awareness of resources available during this period.

Many assumptions are made about suicide and the holidays, but the holidays have a more relevant connection with depression. Loneliness, depression, feelings of loss, financial burdens, family conflicts, and alcohol abuse has shown to increase during the holidays. Some of these stresses can be dealt with before they hit with several simple steps. Planning ahead by identifying your feelings about Christmas is a good place to start. Second of all, being realistic about what can be afforded to give is a good guideline to your shopping adventures. Lastly, choosing to celebrate with the people who make you feel positive and hopeful as well as letting go of expectations about the holidays and just having fun. These are wonderful ways of dealing with the stresses of the holiday season.

"Are Suicide Rates Higher at Christmas?." Centre for Suicide Prevention. Centre for Suicide Prevention, 16 Dec. 1995. Web. 20 Nov. 2009. . Ballas, Chris. "Depression - Suicide Rates and the Holidays." Healthcentral.com - Trusted, Reliable and Up To Date Health Information. My Depression Connection, 7 Jan. 2009. Web. 20 Nov. 2009. http://www.healthcentral.com/depression/c/49/54818/suicide-holidays.
Snopes. "snopes.com: Christmas Suicides." snopes.com: Urban Legends Reference Pages. Snopes.com, 30 July 2007. Web. 20 Nov. 2009. .