“True Integration: Can Genuinely Holistic Healthcare Exist in a Siloed World?”

“No one would ever say that someone with a broken arm or a broken leg is less than a whole person, but people say that or imply that all the time about people with mental illness.”  

--Elyn R. Saks

“The mentally ill frighten and embarrass us. And so, we marginalize the people who most need our acceptance. What mental health needs is more sunlight, more candor, more unashamed conversation.”

--Glenn Close

This or that. Yes or no. Up or down. Mental or physical. As I have discussed in this column before, we here in this country like (and expect) our issues to be purely binary, falling into neat little piles of solutions. Unfortunately, most issues don’t get solved quite so neatly and the lingering bifurcation (despite a long-promised integration) of our physical and mental health systems (and attitudes about aspects of health) is no exception.

What sustains this problem? To be sure, we have made some progress as a society around this issue. The reaction to Senator Fetterman’s recent decision to enter inpatient treatment for clinical depression further complicated by post-stroke struggles (which is generally-while not universally seen as a positive and role-modeling step) is considerably more evolved and nuanced than the reaction in 1972 to the revelation of then vice-presidential candidate Tom Eagleton’s treatment history for depression. That treatment history included electro-convulsive therapy (ECT- at the time poorly understood and less well designed than it is now) which scared the Democratic party sufficiently that Eagleton was forced to withdraw from the race. We’ve been afraid of our mental health illnesses in ways that other biologically based illnesses seem not to scare us so much. What’s behind this fear?

Bob Dylan once wrote “don’t criticize what you can’t understand.” Dylan meant that as a warning about uninformed pontification. As related to the issue at hand here one might have written “I can criticize it all I want to because it has nothing to do with me.” Many of us are anxious about getting what we think of as a “strictly physical” illness (cancer, for example) but much less so than years ago when we heard “cancer” as “death sentence.” For most cancers this hasn’t been factually and statistically true for a very long time, but our societal “shared assumptions” take years to shift. Our fears persisted despite the facts and, for some, still do.

I would argue that there is a whole other dimension to the way we think about mental illness, one that makes true integration difficult for us and continues to drive the notion that folks who struggle with mental illness are somehow “not us.”

What is “the mind?” How does it differ from “the brain?” I won’t pretend that I can fully articulate that in a brief column, but here’s a pretty good description of the difference (credited to communication pathologist and neuroscientist Caroline Leaf, Ph.D.):

“The mind uses the brain, and the brain responds to the mind. The mind also changes the brain. People choose their actions—their brains do not force them to do anything. Yes, there would be no conscious experience without the brain, but experience cannot be reduced to the brain's actions. 

The mind is energy, and it generates energy through thinking, feeling, and choosing. It is our aliveness, without which, the physical brain and body would be useless. That means we are our mind, and mind-in-action is how we generate energy in the brain.”

While I think this is as good a description as one could offer, what happens to this paradigm when the brain betrays the mind? With a healthy brain, people do indeed “choose their actions.”  Can we still refer to it as “choice” when brain illness is significant enough to send the mind faulty information? One might argue this question, but, without a doubt, it makes “mind/brain” juxtaposition a bit more complicated than one would think.

Why does this matter?  Unlike diseases of all other body parts and organs, mental illness, at its most severe, robs the person of the solid belief that their full being can mobilize to fight the illness itself.  This, for most of us, is something we are, understandably, afraid of.  To lose one’s sense of self-direction and trust in our ability to negotiate a common reality is, indeed, terrifying. In truth, we have improved our treatment methods for many mental health conditions and, like cancer, the idea that someone with mental illness “cannot be helped” is a tremendously antiquated notion. Through this lens, Mr. Dylan might have said “you’re just afraid of that which you can’t understand.”  Knowledge is power and, as Ms. Close notes in our opening, we need “more sunlight, more candor, more unashamed conversations.”

Illness and treatment are not absolutes; they are part of a continuum. This is also true for mental illness and substance abuse issues. We have known for years that this, too, is a continuum of relative illness (or, conversely relative health). We here in New Jersey theoretically merged our government oversight bodies into one contextual whole (Division of Mental Health and Addiction Services-DMHAS) quite some time ago and yet our larger systems continue to struggle with this, as do practitioners, self-help groups and, frankly much of the public. Real integration is possible, however.  Some organizations have concretized these integration efforts better than others (Substance Abuse and Mental Health Services Administration-SAMHSA) which functions on a federal level.

It isn’t this or that. It’s this and that. It isn’t us and them. Us is them, whether it scares us or not. Act, accordingly, friends.

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Random Acts of Kindness

Submitted by Josephine DiMeo, Richard Hall Community Health and Wellness Center

Random Acts of Kindness. Most of us have heard of the concept, read stories on social media, or watched a video showing random strangers giving or doing something special for someone else.  But why?  Why would I want to do something out of the ordinary for someone, let alone for someone I may not even know?  What does one get out of completing a random act of kindness?  What's in it for me?  You may have thought; I am too busy, or I don't have the extra income to give someone money.  We might have seen someone giving a large tip to a waiter or waitress and think "Well that's great, but I don't have the money to do that, and I would if I could but since I cannot do something that big, why even bother?" So, let's explore the concept of Random Acts of Kindness a little further.

To start at the beginning, one must define what exactly is kindness?  The Oxford English Dictionary simply defines kindness as "the quality of being friendly, generous and considerate." Sounds easy enough, however, many of us struggle with being kind sometimes. Life circumstances sometimes get in the way, maybe we had a rough day, maybe we sometimes forget to be kind as we feel others have not been kind to us.  We may even think, what do I get out of being kind to someone else?  Why would I take the time to do this?  

According to the website www.randomactsofkindessfoundation.org "Research from Emory University has found that when you are kind to another person, your brain's pleasure and reward centers light up, as if you were the recipient of the good deed-not the giver.  This phenomenon is called the helper's high." Performing a Random Act of Kindness not only makes the recipient feel good, but the research has shown that as the giver, you will feel just as positive.  Going out of your way to do something for someone else goes both ways.  And it also helps us pass along the good feeling.  Practicing Random Acts of Kindness can get others to also "pay it forward."  According to Jamil Zaki, Assistant Professor of Psychology at Stanford University for Scientific American, July 26, 2016 "The positive effects of kindness are experienced in the brain of everyone who witnessed the act, improving their mood and making them significantly more likely to pay it forward.  This means that one good deed in a crowded area can create a domino effect and improve the day of dozens of people!" (www.randomactsofkindessfoundation.org) 

So, here are some ideas to begin your journey to performing some Random Acts of Kindness:

Write a letter or send a handwritten note to a family member or old friend.

• Make a little extra dinner and send it over to a housebound neighbor.
  
• Hold the elevator or door for the person following behind you.
  
• Let someone behind you in the checkout line in in the supermarket go ahead of you.
  
• Smile and say hello to someone.
  
• Offer to pick up some groceries for someone at the store when you are planning on going shopping.
  
• Send or make a meal for a new parent.
  
• Pick some flowers from your garden and share them with others.
  
• Tell someone they did a great job.
  
• Remove the snow from a neighbor's car.
  
• Give your seat up in the bus or train to someone in need.
  
• Pick up a couple of extra pantry items and donate them to a local food bank.
  
• Volunteer at a local animal shelter.
  

The list of ideas is endless and can be performed by anyone at any time. Remember, not only do you enhance someone's day, but you will also feel great!!  One little Random Act of Kindness can start a chain of goodness that can help propel us all down a happier and gratified road.  
Resources:  www.randomactsofkindnessfoundation.org

If you or a loved one is struggling with mental health, substance use or gambling challenges, please call our ACCESS Center at 908-253-3165. If this is a psychiatric emergency call Bridgeway PESS at 908-527-4100 OR 
CALL the Suicide and Crisis Lifeline at 988 to talk to a counselor 24/7/365
OR
CALL the Suicide and Crisis Lifeline at 988 to talk to a counselor 24/7/365

The Somerset County Department of Human Services hosted an Open House on Thursday, February 9, 2023. It was an opportunity for the community to learn about the Department of Human Services Boards and Commissions, the work they do, and how individuals can make a difference. This event was well-attended and generated excitement and interest in community members to collaborate and serve our communities.

Boards and Commissions are designed to give citizens a voice in their government and allow them to influence decisions that shape the quality of life for the residents of Somerset County. Volunteers of all backgrounds, beliefs and experience help us better understand the real-world impact of our programs in the community. Service on a board or commission is a great way to contribute to the county and your community. The volunteers who serve with these boards and commissions are a valuable part of the Human Services team. The feedback from the individuals with lived experience, family members, stakeholders, and experts who serve on these boards help the Department refine and build the vital programs and initiatives Human Services provides to the residents of Somerset County. There are several boards and commissions to which the Board of County Commissioners make appointments that deal with various public policy matters. It is important to realize that time commitment will vary depending on the functions of a specific board or commission and the way in which a board or commission operates.

We would like to thank all who attended!

If you have questions, would like more information, or would like to join an email list, please contact HumanServices@co.somerset.nj.us.

Somerset County 4-H Public Presentation Judges Needed!

Every year, Somerset County 4-H’ers are invited to participate in Public Presentations. This opportunity was crafted to give our members a way to express their interests and passions while practicing their public speaking skills. Increasing their confidence, improving their arguments, and organizing their ideas.

We wanted to extend the invitation to County Employees to participate as Judges and give feedback to our youth – no previous experience required (you will be paired with a 4-H volunteer). Public Presentations will take place April 25, 26, 27 with different timeslots and formats (virtually and in-person). If you are interested in participating or have any questions, please contact Yhannels Limongi at limongi@co.somerset.nj.us or sign-up at https://www.signupgenius.com/go/10C044DAAA629ABF85-2023

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The Restorative Practices in Schools Act of 2022

By Gayle Allen, MA Senior Program Coordinator, Juvenile Institutional Services

The Restorative Practices in Schools Act of 2022 was introduced in the 117th session of the United States Congress on March 31, 2022. S3973 was sponsored in the Senate by Michael Bennet [D-CO] and referred to the Committee on Health, Education, Labor, and Pensions; and H.R.7320 was sponsored by Steve Cohen (D-TN-9} with co-sponsors Sanford Bishop [D-GA-2], Lloyd Dogget [D-TX-35],  Danny Davis [D-IL-7], Jamaal Bowman [D-NY-16], Rashida Tlaib [D-MI-13] and Betty McCollum [D-MN-4] and was referred to the House Committee on Education and Labor. 

According to the text of the bill, the purpose is to:

help local educational agencies replace zero-tolerance disciplinary policies and punitive discipline in elementary and secondary schools with restorative practices that—

(1) provide an intentional approach to school safety and student well-being that addresses the needs of the whole child;

(2) recognize student behavior as a result of underlying need, and childhood emotional and behavioral development;

(3) build community and repair relationships while developing students’ proactive skills for conflict resolution, communication, problem-solving, and empathy;

(4) reduce undesirable behavior; and

(5) promote relationship-centered schools and safe, inclusive learning environments with positive school climates.

If passed, the bill would enable the US Department of Education to award competitive grants to local educational agencies so that they can implement and sustain restorative practices for elementary and secondary schools and replace existing punitive models. Priority would be given to communities that have been disproportionately impacted by the juvenile and criminal legal systems; have disproportionally high rates of grade retention, suspensions, and expulsions for certain subgroups of students; serve students in an area that has a high concentration of residents in poverty; or serve students in a rural community and need additional staff to support the implementation of restorative practices.

So what are these “restorative practices?” They can be proactive (strategies that teach students conflict resolution skills, effective communication skills, empathy, etc) or reactive interventions that hold students accountable for their poor decisions or unacceptable behavior, without the stigma of labeling them “problem children.”  Many school districts have turned to restorative practices as an alternative to traditional disciplinary interventions because they focus on students’ capabilities, rather than their deficiencies, and “promotes inclusiveness, relationship-building and problem-solving, through such restorative methods as circles for teaching and conflict resolution to conferences that bring victims, offenders and their supporters together to address wrongdoing. Instead of punishment, students are encouraged to reflect on and take responsibility for their actions and come up with plans to repair harm.” (Restorative Practices in Schools: Research Reveals Power of Restorative Approach, Part I, by Abbey Porter, March 21, 2007) 

The benefits are numerous- non-violent youth are no longer channeled into the world of juvenile delinquency (where they are likely to be exposed to more advanced criminogenic behavior and receive an “education” that is significantly more harmful to society); we create safer and more nurturing environments in which our children can focus on education; and we cultivate more functional and productive citizens in the long run.  A simple internet search for “links to information about restorative justice in schools” leads to a wealth of research articles, guides, and informational blogs about developing these strategies in your district.

Nearly a year has passed since the bill was introduced, and it’s time for Congress to act. Funneling students into the Juvenile Justice system for disciplinary issues ostracizes them from the very community that is supposed to usher them into a functional adulthood. Instead, we need to focus on giving our youth opportunities to practice the skills they’ll need to heal the rifts that are growing ever-wider in our society.

The Somerset County Youth Council held its 24th Annual Somerset County Youth Conference on Thursday, January 26, 2023. The theme was ‘Choosing You: Healthy Vibes Only’. Somerset County students from grades 7 to 12 had the opportunity to indulge in some self-care, discuss personal growth and learn techniques to maintain a healthy lifestyle. Participants chose two of six one-hour workshops titled: “What’s in Your Head”, “Being Strong on the Inside: Nurtured Heart Approach for Youth”, “Find Your Why”, “Natural Highs”, “Relationship Rights” and “Is Failure an Option”. The workshops were hosted by The Lindsey Meyer Teen Institute, Tri-County CMO, Community in Crisis, and EmPoWER Somerset. Participants received a Community Service-Learning Certificate for 2 hours.

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