TALK ABOUT MENTAL HEALTH — IT'S OKAY
By VIVIAN LaMOORE, INAAJIMOWIN EDITOR
When you have fallen and twisted your arm trying to break the fall, you often experience pain. Is it broken? Is it sprained? Will the pain just go away on its own? You just don’t know for sure what is wrong, but you know it hurts and you want to feel better. So you don’t think twice about seeking medical attention to find the answers. But the same is not always true when someone is experiencing a mental health issue. Mille Lacs Band Health and Human Services Mental Health Department recognizes the need to normalize mental health and they are here to help. It’s okay to talk about it.
Aaron S. Bucci, MSW, LICSW is the Mille Lacs Band of Ojibwe Associate Director of Behavioral Health. Thinking along the lines of mental health awareness, but outside of the box, he pictures a T-shirt with the graphics appearing as a road intersection. At the intersection would be two roads. One direction the road is bumpy, a little jagged, and zig-zagging; and the sign is a little crooked, with tarnished letters that say “Mental Illness.” The other road is smooth, nicely paved with gradual curves, maybe leading to a mountain; the sign is nice and straight, freshly painted with bright letters that say “Mental Wellness.” When you don’t know which way to go, it’s okay to ask for help.
Sometimes, we all need a little help navigating the zig-zagging bumpy roads in order to get back to a smoother surface and on the right track to wellness. But there are many reasons people often do not seek attention when the road they are on becomes more bumpy than usual. “Often, people suffer in silence fighting that battle, and they do so for a wide range of reasons,” Bucci said. “They feel shamed, they feel guilty. They feel indifferent. And historically to show indifference, or weakness, or vulnerability would make you a target for exploitation, for violence, a wide range of difficult and/or dangerous encounters. Those reasons have historically kept mental health out of the limelight. People did not want to be recognized for that. So, in order to maintain their baseline of function, self-medicating would happen, illegal substances were acquired to stay off the radar. That is kind of an overview of where a lot of dysfunction from substance use and addiction comes onto the scene.”
Mental illness is common, as nearly one in five Americans live with a mental health condition in some form, according to MakeItOK.org. The good news is, most mental illnesses can be treated effectively with the proper care. HHS approaches mental wellness from a medical model with a complete wraparound approach to find the root of the challenges, whether medial, physical, or emotional. Anything that disrupts a person’s thinking, feeling, mood, ability to relate to others, and daily functioning.
“When you find yourself inundated with an inability to recover from grief, from loss, from mental duress, from job stress, from compassion fatigue, all of these things can compound our normal range of emotions,” Bucci said. “As professionals, we came together and came up with effective ways to displace, reduce, and/or remove those barriers and challenges. To get community and society by-in, the direction had to come forward from the medical model with evidence-based practice.”
Therapy only goes so far when wounds are very deep. You can’t put a band-aid on a broken bone and expect it to heal. “When you have a very deep mental wound, sometimes just talking about it doesn’t help,” Bucci said. “So, we bridge the gap with psychiatry and begin to utilize medical assisted therapies in that healing journey.”
Difference between therapy and psychiatry
Bucci provided a simple analogy to explain the difference between therapy and psychiatry. A therapist is much like a coach. They help to move you through goals that you set for yourself. Also, a therapist can be thought of like a general practioner who is well rounded in many areas of health.
A psychiatrist, on the other hand, would be classified more as an orchestra conductor, because they are helping to direct healing in certain parts of the brain through medicine when there is a chemical imbalance. Another way to look at it is a psychiatrist is more like a surgeon who specializes in certain areas of health.
Youth are the future
Although Bucci is new to the Mille Lacs community, he has worked in Indian Country for roughly 10 years, most recently from the Fond du Lac community. His practice as a therapist has been well rounded, working with children, youth, adults, Elders, addictions, and with a strong focus on trauma-based needs. He has been connecting with the youth in the Mille Lacs Community. HHS is currently working with youth staff through Aanjibimaadizing, Family Services, Nay Ah Shing school, social workers, and other staff. Their feedback directly fed the need for more services.
“The number of Mille Lacs community youth being screened are disproportionately higher than most communities for suicidal idealization and/or attempt,” Bucci said.
The statistics are startling. Mille Lacs youth were screened through a process initiated by the Band internally over concerns brought forward from the community.
L. Read Sulik, MD, Child, Adolescent, and Adult Psychiatrist at Ne-Ia-Shing Clinic reported their findings "indicate that many youths in our community are suffering. Of 56 adolescents ages 11 to 17 who have completed a mental health and wellbeing screen over the past two months, 76% were identified as being at risk due to signs of serious depression, anxiety, or other identified concerns; 56% were identified as being at high risk; 40% reported having current suicidal thoughts; and 25% have made a previous suicide attempt. Of these 56 adolescents screened, only four had been in care with a community therapist already.
Sulik reported that 36 of these youth identified at risk have now been referred to and are engaging in care with a team at HHS. Mental Health Care at HHS for children, adolescents, and adults now includes having a team available that includes a mental health and a wellbeing coach, a therapist, and when needed, a psychiatry provider.
Changing the conversation
“As we strive to normalize mental illness, our effort is to gain increased mental wellness,” Bucci said.
The more you can connect with youth at a younger age, the healthier they will become as adults. “Think of it like growing a garden. What you feed your garden is directly proportionate to the yield. With the youth being the future of the Band, to bring about a sense of awareness and destigmatize mental health can transcend generations in breaking down those barriers to accessing services and facilitating mental wellness at a much earlier age, therefore reducing the need for self-medicating, reducing the levels of addiction in the community, and bringing about a collective wellness.”
Bucci brings the discussions of the seven teachings into his practice. “When you have that presence of those teachings bringing forward those values daily that are steeped in ancestral tradition and showing the value of walking that life, it gives buy-in for the next generation to carry those values forward.”
In order to break a cycle, it takes about three generations, Bucci said. The first is to recognize that there is a problem. The second is to see the problem as a need for change and to make those changes. “By the time you get to the third generation, they don’t see those challenges anymore and they go on to a different trajectory.”
It is time to begin the transition to make it normal to talk about mental health for the future generations.