Major local and statewide efforts are underway to improve the integration of mental health care for women around the time of pregnancy in the areas of education/ training; research; clinical and service delivery, as well as health policy. The Leon County Maternal Mental Health Coalition, led by the Maternal Mental Health Community Advisory Board has achieved a number of goals in this arena over the past year including the formation of a Tallahassee chapter of Postpartum Support International (PSI), as well as a mental health referral and resource list for the community. See the full list of updates from the Maternal Mental Health Community Advisory Board. We have also established a Statewide Maternal Mental Health Coalition that aims to improve coordination and synergy across the state to better address perinatal mental health.

For a look at our latest Maternal Mental Health Newsletter, click here: med.fsu.edu/sites/default/files/userFiles/file/Maternal Mental Health Updates_Spring_2016.pdf 

The new statewide Suicide Surveillence Task Force aims to improve suicide surveillance in Florida towards improved behavioral interventions in multiple settings. Dr. Flynn and Mike Hansen from the Florida Council for Community Mental Health are members of the Task Force.

©2016 The News Service of Florida. All rights reserved.
Used with permission from The News Service of Florida.

STATE POLICYMAKERS LOOK TO CURB YOUTH SUICIDES
By MARGIE MENZEL
THE NEWS SERVICE OF FLORIDA

THE CAPITAL, TALLAHASSEE, May 5, 2016..........Suicide rates are rising for children and young adults, both nationally and statewide --- and Florida policymakers are trying to reverse the trend.

While suicide is increasing for nearly every age group, it's now the second-leading cause of death for Floridians aged 25 to 34, according to the state Department of Health Vital Statistics, and the third-leading cause of death among youths aged 10 to 24.

But experts say suicide is preventable with education and community action.

"Under-treated or untreated mental health is the major risk factor for suicide," clinical psychologist Heather Flynn told the Florida Children and Youth Cabinet meeting Wednesday. "Of those who die from suicide, more than 90 percent have a diagnosable mental disorder."

That disorder is usually depression or anxiety, said Flynn, a professor at the Florida State University College of Medicine who works with families that have lost members to suicide.

Experts say the key to curbing suicides is treating them as the public health threat they are --- and reducing the stigma for those who seek help.

"We need to catch individuals during their time of distress," University of Central Florida professor Kim Gryglewicz, who specializes in suicide prevention, wrote in an email. "And we can do this by working with hospitals and behavioral-health organizations to improve screening and assessment. ... We also need to help get people into treatment once they are identified as being at risk."

Florida's suicide rate is 13.8 per 1,000, higher than the national average of 12.9 per 1,000, according to the Department of Health and the U.S. Centers for Disease Control and Prevention.

And while the rates for children and youths have risen, so have those for many other groups, including military veterans and members of minority groups.

But while the upward trend is clear, the data varies from study to study. Jay Reeve, president and CEO of the Apalachee Center, a multi-county provider based in Tallahassee, said that's due to inconsistent reporting.

"It comes back to prejudice," he said. "Suicide is perceived as being a shameful thing. There are a lot of deaths that are probably suicides but are reported as accidents."

Earlier in his career, Reeve worked at a Rhode Island hospital where, he said, he found it "astounding and horrifying" to grasp the frequency with which "little kids tried to commit suicide."

So he consulted a more experienced colleague, who told him: "It's always described as an accident. But if you've got a kid who is consistently running out in front of cars, and you bring the kid into treatment and the kid says something like, 'Yeah, I was just trying to get away. I don't want to be here anymore' --- well, if that were a 16-year-old saying it, you would define it as suicidal act. But with a 6-year-old saying it, it's too troubling for everybody (to admit), but it's truly a suicidal act."

Getting the correct data is the first step, said Mike Hansen, president and chief executive officer of the Florida Council for Community Mental Health.

On Wednesday, the Children and Youth Cabinet tapped Tanya Wilkins, a nurse and new member of the panel, to chair its new Suicide Surveillance Task Force. The group, which will study the possibility of pooling data on suicide across state agencies to guide their prevention and intervention efforts, will include state leaders, researchers and suicide-prevention advocates.

"We really don't know why" suicide rates are rising, Hansen said. "And one of the reasons why we want to do these studies is to find out what's really going on with these rates, why these rates are increasing --- and as I said, it's true nationally, and it's true in Florida."

Hansen also pointed to Florida LINC, which stands for Linking Individuals Needing Care. A joint project of the University of South Florida and the University of Central Florida, with funding from the U.S. Substance Abuse and Mental Health Services Administration, it's aimed at identifying youth at risk for suicide and linking them to services.

But Hansen also warned that Florida --- which is ranked 49th of the 50 states for per capita spending on mental health --- needs to spend more of its own money.

"Federal grants are never going to cover it," he said.

A federal bill has been introduced that would help states better address maternal mental health around the time of pregnancy. The bi-partisan bill currently has 76 co-sponsors. Dr. Flynn travelled to Washington, DC in Just to meet with Florida lawmakers and staffers to encourage Florida support of this bill.

 A link to the full text of the bill can be found here. Additionally, you can see a brief overview of the bill and it's imporance on the March of Dimes Fact Sheet below (used with permission).

 Dr. Flynn and Dr. Shamra Boel-Studt from the FSU College of Social Work have received funding from the Institute for Child Welfare to pilot integration of behavioral health detection, referral and improved treatment for parents and caregivers of child welfare-involved families. The project will examine the effect of training in behavioral health integration for child welfare case managers as well as for trauma-informed care among behavioral health providers. Results from the project will be used to refine statewide recommendations for behavioral health integration.

 An expensive and complicated journey: Bringing a new drug to market is one of the most difficult propositions in science — partly because so much of the process takes place outside the lab. Dr. Bhide discusses his experience with commercializing research discoveries.   Read More...

Repeat after me: Mental illness is physical

If you've ever tried to warn teenagers of the consequences of risky behavior — only to have them sigh and roll their eyes — don't blame them.

Blame their brain anatomy.

Sociologists and psychologists have long known that teen brains are predisposed to downplay risk, act impulsively and be undaunted by the threat of punishment. But now scientists are beginning to understand why.

"I think teenage behavior is probably the most misunderstood of any age group — not only by parents but by teenagers themselves," says Pradeep Bhide, a Florida State University College of Medicine neuroscientist and director of the Center for Brain Repair.

"It's a critical time in life, and a very stressful one, when they are going through so many changes at the same time that their brains are changing. The teen years are actually a very busy time for brain development."

During the past year, Bhide brought together some of the world's foremost brain researchers in a quest to explain why teenagers — and male teens in particular — often behave erratically. He and two Cornell University colleagues examined 20 of the leading research projects from brain experts around the world and recently published their findings in a special volume of the scientific journal Developmental Neuroscience.

What they found surprised them — not so much because of the behavior uncovered, but because of how much of it was explained by brain development, or lack thereof.

Unlike children or adults, for instance, teenage boys show enhanced activity in the part of the brain responsible for emotions when confronted with a threat, making the threat more difficult to ignore. In one study, even when the teens were specifically told not to respond to a threat, many could not stop themselves. Magnetic-resonance-scanner readings revealed their brain activity was strikingly different from that in adult men.

In the past decade, Bhide says, technological advances in such imaging have shed new light on what goes on inside our heads. Now researchers essentially can watch an individual's brain in action as it responds to various stimuli.

"This field has exploded," he says. "Psychologists, psychiatrists, educators, neuroscientists, criminal-justice professionals and parents are engaged in a daily struggle to understand and solve the enigma of teenage risky behaviors," Bhide said. "Such behaviors impact not only the teenagers who obviously put themselves at serious and lasting risk, but also families and societies in general."

Soldiers and first responders — as well as terrorists — are often teenage males and young men willing to put themselves in harm's way.

From an evolutionary standpoint, some theorize, such risk-taking may have been necessary to hunt, fend off danger or even compete for a mate.

"If you compare the same person as a teenager and then later as an adult, they will still tend to be more impulsive as a teenager," Bhide says. "And different parts of the brain develop on a different timetable."

All species that humans have studied begin their existence with a period of rapid brain development. For humans, brain growth inside the womb and during the first three years of life occurs at a phenomenal rate in both overall brain size and the number of pathways developed.

But as people get older, some of those pathways sort of fall by the wayside while others become major thoroughfares. The teen years, Bhide says, are an especially busy time for that process.

"The body's hormones have a pretty big effect on the brain as well," Bhide says. "And of course it's different for females and males. But, for instance, schizophrenia and certain other mental disorders appear during this time for that reason."

Teen brains also may be more susceptible to lasting damage from drugs and alcohol ingested during that brain-remodeling process — although Bhide says researchers are still looking at that issue. "What we do know is that the damage is different."

Regardless, few of us will be the same person at 47 that we were at 17, a fact you may find comforting.

"I'm always reminded of a quote from Mark Twain," Bhide says. "'When I was a boy of 14, my father was so ignorant I could hardly stand to have the old man around. But when I got to be 21, I was astonished at how much he had learned.'"