Weaving Mental Health First Aid Into Workplace Wellness

Every month Anne LaFleur sends employees in her office a quiz about various wellness topics. When the topic was depression, she received twice as many responses as usual from co-workers.

When LaFleur, vice president of human resources at a credit union in Pawtucket, RI, took a Mental Health First Aid course in February, she quickly understood the reason for the high level of interest in these types of issues. The training also helped her identify people in her office who may be suffering a mental health problem and taught her how to provide help and refer people to self-help and professional resources.

“The training made me realize that mental health issues are very common, yet one of the least talked about problems,” LaFleur says.

More than one in four people suffer from a diagnosable mental health problem in any given year. Mental illness likely costs businesses more than $79 billion a year, $63 billion of it in lost productivity. The statistics point to the significant need to incorporate mental health into burgeoning employee wellness programs, which have received a shot in the arm with the passage of federal healthcare reform legislation.

Mental Health First Aid has proved to be an ideal program to promote improved mental health in workplaces across the country.

LaFleur is one of more than 6,000 people certified in Mental Health First Aid since the training was introduced in the United States two years ago by the National Council for Community Behavioral Healthcare along with the Maryland Department of Health and Mental Hygiene and the Missouri Department of Mental Health.

Those who participate in the 12-hour Mental Health First Aid course learn a five-step process to assess a situation, select and implement appropriate interventions and help a person developing signs and symptoms of mental illness or in crisis receive appropriate care. Participants also learn about the risk factors and warning signs of specific illnesses such as anxiety, depression, psychosis, and addiction.

Evaluations show that the evidence-based Mental Health First Aid program saves lives, expands people’s knowledge of mental illnesses and their treatments, and reduces the stigma associated with mental illness by helping people understand and accept mental illness as a medical condition. One trial of 301 randomized participants found that those who took the training had greater confidence in providing help to others, greater likelihood of advising people to seek professional help, and decreased stigmatizing attitudes.

Unexpectedly, the study also found that Mental Health First Aid improved the mental well-being of the participants themselves.

“By understanding the signs and symptoms of depression, I learned to recognize this in myself,” says Kellie-Ann Heenan, director of human resources at a company in Lincoln, RI.

Heenan, who had the training in February, has an adopted son from Russia who suffers from a number of emotional issues.

“The tools I learned made it easier to connect with him and better understand where he’s coming from,” she says. “In the end, the training improved my own mental health.”

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Mental Health Care Coverage in Minnesota – Supplementing Federal Healthcare Reform

In 2007, the governor of Minnesota proposed a mental health initiative and the legislature passed it. One of the more important components of the initiative was legislation amending Minnesota’s two programs for the uninsured – General Assistance Medical Care and Minnesota Care – to add to the comprehensive mental health and addictions benefit.

Who Is Covered?

General Assistance Medical Care covers those with income at or below 75% of the federal poverty level who meet one or more of additional criteria known as General Assistance Medical Care qualifiers. Qualifiers include waiting or appealing disability determination by Social Security Administration or state medical review team; or being in a homeless or live in shelter, hotel, or other place of public accommodation.

Minnesota Care covers children and pregnant women, parents, and caretakers up to 275% of the federal poverty level, except that parents and caretakers gross income cannot exceed $50,000. Single adults without children increased to 200% of federal poverty level by January 1, 2008 and will rise to 215% of federal poverty level by January 1, 2009.

What Services Are Covered?

For Minnesota Care, there are limits of $10,000 on inpatient care for any condition (physical, mental health, or addictions) for parents over 175% of federal poverty level and childless adults. For General Assistance Medical Care, inpatient benefits are fully covered. Both programs cover chemical dependency outpatient services. An intensive array of outpatient and residential mental health services are available.

What Is The Cost?

In Minnesota, the Medicaid Temporary Assistance for Needy Families population, General Assistance Medical Care and Minnesota Care are enrolled in comprehensive nonprofit health plans that are responsible to deliver and are at risk for the entire health benefit, including behavioral health. Adding mental health rehabilitative services (including adult rehabilitative mental health services individual and group rehabilitation services, assertive community treatment, intensive residential treatment and mobile and residential crisis services) to Minnesota Care was projected to cost $3.40 per person per month. For General Assistance Medical Care, which includes a homeless population, the cost was $7.01 per person per month. The additional targeted case management service was projected to cost $2.22 per person per month for Minnesota Care and $7.66 for General Assistance Medical Care.

The legislature appropriated a total of $1 million in additional state dollars in fiscal year 2008 and $ 3.5 million in fiscal year 2009 to add the adult rehabilitative services and case management in Minnesota Care. State funds previously targeted for case management were moved from the counties to the state in an amount of $4.4 million in fiscal year 2009.

What Led To Comprehensive Coverage?

The state collected data on the residents served by Minnesota Care, General Assistance Medical Care, and Medicaid managed care plans serving non-disabled populations, and discovered that an increasing number of individuals with serious mental illnesses were in these plans. Several insurance reforms – similar to those included in the national healthcare reform bill – modified the private market, including guaranteed issue in small and large group plans, broader rate bands, parity for mental health and chemical dependency services, medical loss ratios, high risk insurance pool, and others. A lawsuit by the attorney general called attention to health plan denials of payment for court-ordered treatment, for example for civil commitment or out of home placement for adolescents.

Health plans settled with an agreement that behavioral and mental health benefits would be covered by a health plan if the court based its decision on a diagnostic evaluation and plan of care developed by a qualified professional. In addition to the court-ordered services provision, the state contracts and capitation with prepaid health programs (Minnesota Care and General Assistance Medical Care) were amended to align risk and responsibility for services in institutions for mental illnesses, 180 days of nursing home or home health, and court-ordered treatment. There were also highly successful experiments reducing costs and improving outcomes for commercial and non-disabled Medicaid clients who were offered a more intensive community based mental health service that improved coordination with and linkages to behavioral healthcare, primary care, and other needed services.

These demonstrations produced a positive return on investment – $0.38/person/month – and gave the health plans tools to manage the increased risk that resulted from several insurance reforms, including parity, a statutory definition of medical necessity, and the court-ordered treatment provision.

Mental Health Maintenance Is Made Simple

Your mental health is often drastically improved when you use the techniques Dr. Kuhn teaches in this article. When you are able to experience this improvement, your relationships blossom, career paths open, and people find you attractive and accessible. You deserve to have fun and joy in your life – and Cliff Kuhn, M.D. will help you do that.

In the classic Frank Capra film, It’s a Wonderful Life, George Bailey’s mental health is overwhelmed by the difficulties of his life and he wishes he’d never been born. George’s guardian angel grants his wish and takes him to a grim reality as it would’ve been without him. George feels nothing when he reaches into his coat pocket to retrieve the flower his daughter, Zuzu, placed there – and that’s when George knows that his wish has come true…he’s never been born.

Wishing she had never been born, Roberta became my patient, seeking desperately to improve her mental health. Like the fictional George Bailey character, Roberta’s depression and anxiety had grown so strong as to threaten her ability to lead any semblance of a normal life. Fortunately for Roberta, she soon discovered exactly why the natural medicine of humor is one of the most powerful adjunctive treatments for improving mental health, because humor literally pours water on the fire of depression and anxiety.

Roberta is not alone. As many as 35% of all Americans suffer from depression and anxiety, the twins that make mental health elusive for millions. Your depression and anxiety is exacerbated by your seriousness – taking yourself too seriously. As we move into adulthood, we unfortunately buy into the notion that responsible and productive people must be “serious.” As we make the biggest mistake of our lives and relegate our humor nature and fun to recreational activities (if we experience fun at all), we doom ourselves to all the symptoms of the corresponding seriousness that fills the void – declining health, rising stress, increased pain, lessened energy, impaired creativity, and more.

The good news for your mental health, however, is that we know how to shrink your deadly seriousness to practically nothing and reduce almost completely the sway it holds over your health, vitality, wellness, and zest. The natural medicine of humor is an incredibly powerful resource that you already possess; you’ve only forgotten how to use it to maximum effectiveness. You will soon discover that, while not a panacea, the natural medicine of humor is a tremendous tonic for depression or anxiety and will also supercharge other treatments because it is an amazing adjunctive medicine too!

I have distilled the natural medicine of humor, through my years of medical practice, into an amazing prescription I call The Fun Factor. Based on what I learned over twenty years ago from a terminally ill fifteen-year-old patient, I created a unique set of principles I call the Fun Commandments, then forged these Commandments into my Fun Factor prescription and have been prescribing The Fun Factor with great success for years. This report will show you how to use just three of my Fun Commandments to turn your mental health around, and gain new joy, pleasure, and appreciation from your life!

Improve Your Mental Health Using My Fun Factor Prescription

Step One: Always Go the Extra Smile

The first Fun Commandment I recommend for improved mental health is: Always Go the Extra Smile. This Commandment is doubly helpfully for depression and anxiety because not only does it provide measurable emotional and physical relief, but it also is completely under your control – regardless of your circumstances. Because smiling remains totally under your control, it can be your greatest resource for using humor’s natural medicine to accelerate your mental health.

Smiling produces measurable physical benefits you can experience immediately: your stress decreases, your immunity improves, your pain and frustration tolerances increase, and your creativity soars. And guess what? You experience all these benefits even if your smile is “fake.” That’s right…forcing a smile onto your face perks up your immune system and lightens your mood just as readily as a genuine smile. Fake a smile and you’ll soon feel well enough to wear a real one!

This is great news for your proactive stance on sustainable mental health. You have an amazing amount of pre-emptive control over your mood – you can, literally, choose more energy and happiness. The key for your use of this Fun Commandment in enhancing your mental health is to start practicing right now, so that smiling becomes an entrenched, habitual method of accessing the natural medicine of humor. If you wait to smile until your mental health has taken a turn for the worse, and depression or anxiety has taken hold of you, it will not be as effective.

Step Two: Act and Interact

Smiling leads us right into the second Fun Commandment you’ll find instrumental in maintaining your mental health: Act and Interact. Humor’s natural medicine works best when we are sharing ourselves and this Commandment will teach you how to capitalize on the control you’ve taken over your physiology and mood by smiling. Acting and interacting is now easier for you to do because you’re smiling more. Not only is your mood improved, but your smile is also a pleasant invitation to other people.

My suggestion is that you solidify the power of this Commandment by setting a reasonable goal regarding the number of people you will interact with each day. These social interactions are great for your mental health, forcing you to exchange information and ideas with another person. Combined with your commitment to smiling, your interactions should be pleasant, because your heightened energy, lessened pain, and lowered stress levels are very attractive to others.

Beyond keeping you out of isolation, there is another reason why acting and interacting with the people you encounter fosters improved mental health. It allows you to avoid spiritual “flat tires.” Spiritual flat tires occur when you sidestep, or avoid, an interaction that is about to happen naturally – you duck into an office to avoid encountering someone in a hallway or you don’t answer the phone because you don’t want to talk to the person calling. This type of avoidance drains and deletes your reservoir of powerful natural energy and siphons your mental health reserves.

Have you ever noticed that it usually takes you twice as much mental and physical energy to avoid doing a job than you would have expended just doing it? It also takes twice the energy to avoid acting and interacting with the people who cross your path because you are, in effect, saying, “I’m going to correct the mistake that nature made by putting this person in my path and I’m going to correct it by being mentally and spiritually negligent.” Mental and spiritual negligence have the same effect as physical negligence (isn’t it strange how you get tired if you don’t exercise?). If your mental health can afford to allow this much energy to be drained, then you have a much bigger reservoir than I!

But spiritual flat tires do more than drain our energy, they are detrimental in at least two additional ways:

We miss out on an interaction with a teacher. If nature didn’t have a lesson for you, that person you just avoided would not have been placed in your path. You say that the person you just avoided was a negative influence or would’ve wasted your time? I know we have legitimate schedules to keep, but if I am avoiding people based on my prejudgment of them, I’m cutting myself off from my greatest teachers – those very same people.
We all learn tolerance from the intolerant, patience from the impatient, temperance from the intemperate, gentleness from the ruffian, etc. I am supremely grateful for those teachers and the lessons they give me.

We create a small, nagging spiritual void of dishonesty, the kind of dishonesty that keeps us from laying our heads down with complete peace of mind each night. Our spiritual flat tire is caused by the pothole our avoidance created; it is a natural consequence, or symptom, of our spiritual dishonesty. These consequences clutter our lives with mental and emotional baggage that further drains us of our energy and vitality.

Step Three: Celebrate Everything

The third Fun Commandment which will help you use the natural medicine of humor to charge up your mental health is: Celebrate Everything. Celebrating everything may sound like a monumental task to someone who’s mental health isn’t up to par, but you will find this part of my doctor’s orders much easier to fulfill once you start practicing my first two Commandments. In fact, celebrating everything is more than a maintenance step providing sustainable mental health. It will also become your lifestyle, the more you practice it, because you will enjoy the results so much.

How do you celebrate everything and how will this keep your mental health on the upswing? The epitome of this Commandment is found in the old joke about the boy who wanted a pony for his birthday. Instead, he found a room full of manure waiting for him. But he dove right into the dung, gleefully exclaiming, “With all this manure, there’s got to be a pony in here somewhere!”

Laugh as we might, we’re quick to remember that, as adults, we would never allow ourselves such “naive” enthusiasm. Why not? Do you realize what is behind such a “grown up,” “mature” decision? Your deadly seriousness (taking yourself too seriously) encourages the attitude that a mature adult should not let herself be so optimistic and thus mental health is jeopardized.

We could do more than chuckle at this birthday boy’s unabashed optimism – we should emulate it! When was the last time you encountered an unexpected pile of manure in your life? You had absolutely no control over the mess, right? But you had absolute control over your reaction to it and this is the key to using celebration to keep your mental health improved!

When you celebrate everything, the natural medicine of humor creates spiritual, emotional, and mental health like nothing you’ve felt before. You will find that your fears become much less controlling when you are celebrating everything because it no longer matters so much how things turn out. In fact, you are literally ready for anything because you are prepared to find the blessing in whatever happens.

My daughter-in-law, for example, broke her back last year. My son, who is often my model for the embodiment of my Fun Commandments, can tick off a laundry list of blessings his family has received as a direct result of his wife’s “tragedy.” Not that his mental health hasn’t been challenged, but faced with the choice of depression and anxiety over an event he couldn’t control versus finding the blessings waiting for him, he has chosen the latter.

The choice to celebrate everything is not a panacea; my son’s choice did not change the reality of his wife’s injury. What did change, however, was his ability to respond to the injury and, thus, keep his mental health on an even keel. Celebrating everything changes our lives because it allows us to positively control the only things we have control over – our actions, ideas, and attitudes.

There you have it. Start by going the extra smile, use your newfound smiling energy and vitality to act and interact with people, and celebrate everything to maintain your positive momentum. Say good-bye to imprisonment from depression and anxiety and welcome to your new world of improved mental health!
Start Using The Fun Factor to Improve Your Mental Health…Right Now

Here are some simple, easy steps you can take right now to turbo-charge your mental health.

Subscribe to my Fun Times newsletter. The Fun Times is all about using your natural power of humor to increase the quality of your life – including your mental health. The Fun Times is 100% free, and is delivered instantly, every week, to your email inbox. If you sign up now, I’ll also throw in a copy of my “Stop Your Seriousness” Ecourse and my book, Ten Ways You Can Be Happier…Right Now! which will show you how you can use my Fun Factor prescription in your life to increase your mental health!

Check out The Fun Factor. This prescription has changed so many lives for the better – it would be a shame if you passed it up. Check it out here if you’re sick of wishing for mental health and want to finally achieve your greatest mental health!
My patient Roberta, by the way, learned to use these three Fun Commandments – and the rest of my Fun Factor prescription. She has enjoyed the same job for three years now and was recently engaged to be married. Roberta occasionally has setbacks, as most people suffering from depression or anxiety do. But, her mental health has never been stronger as she continues to apply The Fun Factor to her life.

Teen Mental Health

Parents worried about teen mental health need not look any further. Factual information can help you to make decisions that will actually help your child be happier in his or her life. Teens are at the vulnerable stage in life and, as a parent, if you search the net or talk to your friends, you will get a lot of advice on how to help improve your teen’s mental health.

Yet, facts are what matter! Facts have no vested interest or bias and may help you, the loving parent, to determine what is best for your child. First, to define mental health symptoms, disorders and diagnoses, there are these facts: No medical tests exist that can detect a mental health disorder (no brain scan, no blood test, no chemical imbalance test). Dr. Allen Frances, Editor of the psychiatric diagnostic manual, edition IV, states in an article titled, Mislabeling Medical Illness as Mental Disorder, ” that the diagnoses “will harm people who are medically ill by mislabeling their medical problems as mental disorder.” Dr. Russell Barkley, clinical professor of psychiatry, and pediatrics, in the same article, states, ” There is no lab test for any mental disorder right now in our science.”

Psychiatric disorders are listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. The disorders are voted on by workgroups comprised of psychiatrists. Dr. Thomas Insel, Director of the National Institute of Mental Health, was reported by the New Yorker as refuting the validity of mental health diagnoses. “Insel announced that the D.S.M.’s diagnostic categories lacked validity, that they were not ‘based on any objective measures,’ and that, ‘unlike our definitions of ischemic heart disease, lymphoma or AIDS,’ which are grounded in biology, they were nothing more than constructs put together by committees of experts. America’s psychiatrist-in-chief seemed to be reiterating what many had been saying all along: that psychiatry was a pseudoscience, unworthy of inclusion in the medical kingdom. According to a 2012 report from the University of Massachusetts, “Three-fourths of the work groups continue to have a majority of their members with financial ties to the pharmaceutical industry”. Per the FDA, some of the side effects of psychiatric drugs include mania, psychosis, depression, suicidal thoughts, homicidal thoughts and death. Non-psychiatric medical professionals can, and do, perform medical tests to detect any potential underlying physical cause of unwanted mental health symptoms.

Per Florida Department of Health Regulation, Florida Patient’s Bill of Rights and Responsibilities, each individual has the right to be fully informed about the proposed medical treatment or procedure. This includes the right to know the risks and alternatives. For those who live outside of Florida, Informed Consent, the right to know the risks and the alternatives to any treatment, is a legally accepted term that is used globally and ensures your right to make decisions for your health and well being.

Second, considering the, above-mentioned, facts, there becomes a vicious circle for any teen, adult or elder, who is experiencing life’s stresses, and therefore the effects of those stresses, such as anxiety, depression, mood swings, aggression, and more. The never-ending circle is that of mental health diagnoses, mental health drugs, (more drugs, whether prescribed or abused) and more mental health diagnoses, with only seeming improvement in symptoms if the drug or drugs have chemically restrained the initial and unwanted mental health symptoms, temporarily. Unfortunately, for most those restraints fail to work after time and the adverse effects take place, which of course produce more mental health symptoms, more diagnoses and more drugs.

Teen mental health is an important topic! It has to do with the welfare of your child, our future adult in society. Those that shape and direct how our culture will develop over time. To improve your teen’s mental health, consider the facts and in doing so, talk to traditional, non mental heath, medical professionals about the possibility of a thorough medical exam that will test for all possible physical causes of the teen’s depression, anxiety, aggression, etcetera.

Time and history are on your side, because over time, and strewn through the last 4 decades are medical research and multitudes of documented real-life cases of individuals who did avail themselves of a thorough physical examination, found the true physical cause of their problems and resolved all through the use of medical science that carried none of the FDA warnings on mental health drugs, which of course, are mental health symptoms in themselves. Such as, mania, delusions, psychosis, worsening depression, anxiety, hallucinations, suicidal and homicidal thoughts and actions.

Will Fudeman, a Licensed Mental Health Counselor, recently published an article about his work as a psychotherapist. He felt he had to do more to help his patients than listen to their woes. He decided, after his own personal experience of having horrific pain after a car accident, that he wanted to study Chinese medicine. He got his license to practice as an Acupuncturist and, after his 20 years as a therapist, he says that he had come to understand that emotional and physical are “intertwined”.

Dr. Fudeman cites Dr. Bessel van der Kolk and his research treating those who have experienced all types of trauma. Even those who have been to war, experienced natural disasters and serious accidents, etcetera. Fudeman says “Van der Kolk has found that survivors of trauma are helped most by treatments that bring them into their bodies in the present time.”