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Melanie Brown-Woofter: Reducing stigma of mental health is key to reducing suicide deaths

We should make mental health prevention programming available in every school, for every student, every year.

The recent suicide deaths of two students who survived the shooting at Marjory Stoneman Douglas and a father who lost his daughter at Sandy Hook are heartbreaking reminders of the trauma that school or workplace violence can inflict on survivors. They also underscore the need for treatment and support, long after an incident occurs.

In Florida, death by suicide is the second leading cause of death in the 15-24 age group. More teenagers and young adults die by suicide than from motor vehicle accidents or homicides. While more girls attempt suicide and more boys die by suicide, the rates of death by suicide have increased over the last decade for the young, the old, and our veterans.

But there are actions we can take to reduce suicide deaths. Prevention, post-event intervention and providing community mental health treatment resources are key to reduce the number of suicide deaths.

Gov. Ron DeSantis and First Lady Casey DeSantis deserve praise for hosting a mental health listening session in the wake of these recent tragedies. Florida needs a multi-track strategy for addressing its mental health challenges, and these are positive steps forward.

I am an inaugural advisory panel member of the Institute for a Safer Florida, a new organization created by the Florida Chamber of Commerce to help make our schools and workplaces safer through sharing best practices and supporting common-sense public policies. One of the institute’s key areas of focus is mental health.

As a state, what can we do? Let’s start with prevention. This includes training and education aimed at reducing the stigma of mental health treatment, particularly for people having suicidal thoughts. Studies show that Gen X and Boomer generations are less likely to make a negative association about seeking mental health treatment. However, those in the Gen Z and Millennial generations are more likely to feel ashamed when actively seeking help.

Programs like Mental Health First Aid teach people how to recognize the signs of a mental health or addiction crisis, initiate a conversation, and ultimately connect people to professional help and community resources. Everyone can #BeTheDifference for someone who is struggling with a mental health or substance use problem if they know what to say and what to do.

Somehow in our society, we talk openly about cancer, diabetes and heart disease yet we whisper about diseases of the brain like mental illness, depression and bipolar disorder. Together each one of us can raise the public awareness of suicide deaths and the role we can play in saving lives, simply by talking about it and messaging that is safe to seek treatment.

Post-event intervention activities are those which reduce risk and promote healing after a suicide death. We know that a key indicator for a future suicide death is a past attempt. When someone experiences a loss by a suicide death, they need their own intervention — a postvention — to prevent another suicide death. These interventions include offering mental health treatment using trauma-informed care, peer-to-peer support, and spiritual support.

There is also a need to improve mental health prevention programming in our schools; We should make mental health prevention programming available in every grade, in every school, for every student, every year. Better yet, make it part of the curriculum.

Additional mental health expansion should include services for students year-round, not just during the school year. Plus, the Mental Health First Aid Training should be offered to both parents and students along with school personnel. The training can help students feel safe in reporting suicide thoughts and other mental health concerns.

These are the types of programs and activities that the Institute for a Safer Florida endorses.

Just as there is no single cause that leads to death by suicide, there is no single prevention effort that will reduce suicide death rates. But a combined effort, over time, may begin to make a difference. The mental health of our young people, our veterans, our neighbors, our families, and our children is too precious to waste. Start a conversation today.

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Melanie Brown-Woofter is president and CEO of Florida’s One Behavioral Health Association — the newly merged Florida Council for Community Mental Health and Florida Alcohol and Drug Abuse Association. She also serves as an advisory panel member of the newly formed Institute for a Safer Florida.

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2 Comments

2 Comments

  1. Harold A Maio

    April 13, 2019 at 2:07 pm

    —-This includes training and education aimed at “reducing” “the stigma” of mental health treatment

    Your statement begs two questions:

    1. Why accommodate people who direct this stigma? Doing so only empowers them more.
    2. Suggesting keeping some is wholly without merit.

    Harold A Maio

  2. Linda Montalbano

    April 14, 2019 at 2:02 am

    Questions needed to ask:

    1. After the shooting were referrals made for all the students effected to ESE for evaluation to see if they may need special education?

    §300.111 Child find (a) General. (1) The State must have in effect policies and procedures to ensure that—(i) All children with disabilities residing in the State, including children with disabilities who are homeless children or are wards of the State, and children with disabilities attending private schools, regardless of the severity of their disability, and who are in need of special education and related services, are identified, located, and evaluated;

    2. The professionals in the school did they recognize the students were at risk of Post-Traumatic Stress Disorder and do a referral to ESE so that the students would have access to counseling and accommodations in school?

    §300.34 Related services (c) Individual related services terms defined. The terms used in this definition are defined as follows:(3) Early identification and assessment of disabilities in children means the implementation of a formal plan for identifying a disability as early as possible in a child’s life.

    3. Under IDEA classification (NOTE: an IEP) was counseling and accommodations provided to the students who were affected by the shooting?

    §300.34 Related services (c) Individual related services terms defined. The terms used in this definition are defined as follows: (2) Counseling services means services provided by qualified social workers, psychologists, guidance counselors, or other qualified personnel.

    4. If the students were referred, evaluated and classified for special education under IDEA were their parents provided counseling and training to support and have continuity of services between school and home?

    §300.34 Related services (a) General. Related services means transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes speech-language pathology and audiology services, interpreting services, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, early identification and assessment of disabilities in children, counseling services, including rehabilitation counseling, orientation and mobility services, and medical services for diagnostic or evaluation purposes. Related services also include school health services and school nurse services, social work services in schools, and parent counseling and training.

    I expect nothing was done because I have done due process hearings in Broward County and it is rare, they follow the laws and regulations of IDEA. Right now, I have a 2nd open to the public due process hearing, May 13, 2019 in Broward County for a child who is violent and a danger to self and others. The child like the shooter displayed violent behaviors since 3 years old. No school staff referred the child to special education for evaluation and services. Parent made referral on August 23, 2018, August 31, 2018 I made the referral, school staff refused the referrals. September 5, 2018 parent filed for a due process hearing. Administrative Law Judge Diane Cleavinger scheduled hearing on the 82 day (NOTE: should have within 75 day hearing decision) November 26, 2018. November 27th we received a settlement agreement to evaluate the child.

    2nd due process hearing complaint: “4. While taking now 126 days to do the evaluation School attorney Susan Hofstetter and due process coordinator Sarah Samuels made the decision my CHILD who they knew to be a danger to CHILDself and others demanded CHILD be placed in a general education class over my and my advocates protest.

    “November 27, 2018 Resolution Agreement:“…The student will be placed in a general education classroom during the evaluation process in spite of the parent’s desire for CHILD to be placed in a “self contained classroom”. (NOTE: evaluation should be done within 60 days)

    §300.114 LRE requirements (a) General. (2) Each public agency must ensure that— (ii) Special classes, separate schooling, or other removal of children with disabilities from the regular educational environment occurs only if the nature or severity of the disability is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily.

    Testimony from the due process hearing identifies the child is violent and a danger to self and others.
    2nd due process hearing complaint: “15. August 23, 2018 my CHILD stabs another student with a pencil. Mr. Marcelo called me to come in for a meeting. I requested my CHILD be referred to ESE and do a FBA. I am told it is required to do RIT first. No one tells me they don’t have the 1/21/18 letter from the doctor.

    “11/26/18 SB Broward, Fl. ALJ Diane Cleavinger, Parent: P:26 L:10-14: “On August 23rd of 2018 I was called by Mr. Marcelo to come to the school, that CHILD. had stabbed a student in an attempt to get CHILD attention. When I got there they told me what happened, and I immediately requested an FBA to be done.” P:26 L:14-18: “I wasn’t told by the ESE teacher that was later identified as Ms. Fumero that they cannot do that, that they have to go through RTI first, with Ms. Galarza agreeing that an FBA cannot be done, they have to follow RTI.”

    §300.530 Authority of school personnel (d) Services. (1) A child with a disability who is removed from the child’s current placement pursuant to paragraphs (c), or (g) of this section must (ii) Receive, as appropriate, a functional behavioral assessment, and behavioral intervention services and modifications, that are designed to address the behavior violation so that it does not recur.

    11/26/18 SB Broward, Fl. ALJ Diane Cleavinger, Ronald Marcelo principal of Bridge Prep. P:119 L:3-6: “Q. Okay. How many write-ups have–are required before a referral to ESE is done by the school? A. The number of write-ups doesn’t determine that. It’s the RTI and TSS process.”

    11/26/18 SB Broward, Fl. ALJ Diane Cleavinger, Linda Montalbano advocate: P:46L:21-25: “I kept saying she made a verbal referral on August 23rd, I says this starts from August 23rd, and they said no, they’re not allowed to do it until they do Response to Intervention.” P:50 L:8-11: “A. Yes, and it notes on it that they’re doing Response to Intervention, and this is on 9/26 which is a month after the parent made a verbal referral and I made referrals on the 31st of August and on September 7th.”

    2nd due process hearing complaint: “18. Principal Marcelo claims he has poor memory of the stabbing incident on August 23, 2018.”

    11/26/18 SB Broward, Fl. ALJ Diane Cleavinger, Ronald Marcelo principal of Bridge Prep. P:105 L:3-17: “Q. On the day of the–let me see. No. Do you remember what happened on August 23rd by any chance? A. Twenty-third, I don’t remember. Q. Let me probably rephrase that. Do you remember the incident of CHILD stabbing another student? A. I remember being told of that, yes. Q. Okay. On that particular day when CHILD stabbed a student, do you remember calling me? A. Which–there was two–the second one I think I remember, I’m not sure if I remember calling you. I don’t. I know I called you on several of CHILD behaviors. I think we–did I call you to come in? I’m not—I can’t remember. I honestly can’t remember because I know I called you several times.” P:105 L:20-23: “I guess what I’m trying to say is I don’t remember that exact conversation because I know we’ve spoken over several times over several incidents and I don’t recall that exact conversation.” P:126 L:13-23: “A. I see one for the 22nd, I think that’s the day of the stabbing in the elbow. Q. And what about the 23rd? A. Oh, I think the 22nd is the write-up for the hand, and the 23rd is the elbow one. Q. And on the 24th? A. What’s the question? Was there a write-up? Q. Yes. A. Yeah, there is. Q. And August 31st? A. There was a write-up.”

    2nd due process hearing complaint: “21. It was not always documented every time my CHILD stabbed and/or hurt another person. The referrals don’t identify all of my CHILD’s behaviors that are not considered violent.”

    §300.229 Disciplinary information. (b) The statement may include a description of any behavior engaged in by the child that required disciplinary action, a description of the disciplinary action taken, and any other information that is relevant to the safety of the child and other individuals involved with the child.

    11/26/18 SB Broward, Fl. ALJ Diane Cleavinger, Parent:P:26 L:19-22: “Again, my CHILD is exhibiting bad behavior some of which causes harm to others and CHILDself, but still no urgency to assist my CHILD. I would think that stabbing a student is grounds for an evaluation.” (NOTE: it is not a gun so it is OK)

    11/26/18 SB Broward, Fl. ALJ Diane Cleavinger, Linda Montalbano P:60L:13-20: “How many referrals have you seen that you–that I just gave you that shows that my CHILD, CHILD, stabbed another student? A. Only the first one talks about stabbing. Q. Okay. A. I don’t remember any of the others though they claimed on the 31st that CHILD had stabbed another student and that was verbal, but I didn’t see it in any of these.” P:60L:21-23:“And I’ve seen on later on you gave me 9/7 where CHILD threw pencils and they talked about that where CHILD throws things. CHILD makes shooting noises which is on that too.” P:62L:5-15:“the type of behaviors that it shows that my CHILD exhibits. A. From doing Functional Behavioral Assessments and observations which I’ve done myself, reading these exhibits and having seen the write-ups from this school year, they are a continuation of the same behaviors. CHILD had the same behaviors in 2017 based on these write-ups as CHILD has in the behaviors in 2018, so CHILD behaviors have not changed. Whatever they did in the Kindergarten program did not address the behaviors because they continued in 1st grade.”

    11/26/18 SB Broward, Fl. ALJ Diane Cleavinger, Ronald Marcelo principal of Bridge Prep. P:128 L:5-9: “not everything gets put on a paper. Q. Okay. A. But when–yeah, not everything gets put on a paper.” P:105-106 L:24-25,1-10: “Q. Do you remember the reason behind CHILD stabbing the student? A. The reason CHILD gave me? Q. Yes. A. Okay. CHILD said CHILD was trying to get CHILD attention. Q. Okay. A. But that was the time I called you. The first one was when there was no call because we was–it was under the assumption of we believe what CHILD said. CHILD said that CHILD was handing the child the pencil and CHILD stabbed CHILD in the hand the first time.” P:125-126 L:19-25,1-5: “What I recall is there were no write-ups but there were behavior incidents. But sometimes what we do, we give the kids a benefit of the doubt at the beginning of the school year being that CHILD was new, transition time. You know, I’m a child advocate so I’m not going to write them up every single time, I’m trying to work with CHILD . Just like initially on the first time CHILD stabbed the young man, I took CHILD word that CHILD said CHILD was trying to hand CHILD the pencil and I said okay, no problem. Like it’s not — it wouldn’t be the first time that happened in my school and I understood and there was no reason for alarm on my end.” P:127-128 L:22-25,1: “my CHILD exhibit behaviors, bad behaviors that you didn’t write up or that you knew about but you just maybe–like you said, you believe in giving CHILD a chance? A. Here and there. I would say a few.” P:1 L:19-24: “Q. Do you consider my CHILD’s behavior as being violent? MS. HOFSTETTER: Objection. Form. THE COURT: Overruled. THE WITNESS (Ronald Marcelo): Not necessarily violent. Out of the norm for a typical 1st grader.”

    If it is not about guns it is OK to let a child be violent in school and not do as the law and regulations require the child needs to address the behaviors. I believe just like they did to the shooter. If anyone wants to go to the due process hearing e-mail me and I will give you the time and place on May 13, 2019 urania32@hotmail.com.

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