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“Be Kind to Your Mind: The difference between mental health and mental illness”
On Monday, Oct. 26, Monique Evans, Miss Florida USA; Armando Llechu, chief officer of hospital operations and women and children’s services at Lee Health, and Dr. Sandra Mills, pediatric psychologist at Lee Physician Group Pediatric Neurology/Developmental & Behavioral Health discussed what is mental health, ways to stay mentally and physically well, how the pandemic is affecting families in the community and how you can be an advocate for enhanced children’s mental health care in Southwest Florida.

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Differences between Mental Health and Mental Illness
Dr. Sandra Mills: It’s important to realize we all have mental health. It’s like physical health. The World Health Organization defines it as our emotional, psychological and social well-being. Just like with physical health, there are times when you feel poorly, which is where we get into the areas of mental illness at times. Mental illness affects how we think, how we feel and how we behave. Mental health is more than the absence of mental disorders or disabilities. It’s a factor in how we handle our stress, relate to others and make choices.

What parents can do is look at how your child is handling stress, how they are behaving and making choices. Sometimes these are the first indicators that something is going wrong. As parents, you are the biggest advocate for your child. It’s not that mental health experts are the experts on your child, but we can help you problem solve. Oftentimes there is a barrier to seeking help with a stigma or parents thinking they “should” be able to handle things. We have the tools and tool kit to help.

Warning signs, changes in behavior you may notice:

  • Sadness lasting two weeks or more
  • Withdrawing or avoiding social interaction
  • Hurting themselves or talking about wanting to hurt themselves
  • Talking about death or suicide
  • Outburst of extreme anger, irritability, lashing out
  • Out of control behavior that can be harmful to themselves or others
  • Drastic changes in mood, behavior and personality

Sometimes, when children don’t have the language abilities to talk about emotions, you may see:

  • Changes in eating habits
  • Weight loss
  • Difficulty sleeping
  • Physical complaints like headaches, stomach aches
  • Difficulty concentrating or focus
  • Changes in academic performance,
  • Avoiding or missing school

When someone comes to see us, we start out with a thorough intake. What we are looking for is when did this behavior change? How did it change? We are seeing a lot of that with COVID-19. Kids are highly resilient, which is good. Seeing friends and socializing and having those things taken away is impacting them like it is impacting their parents. Loss of structure and routine can be frightening and lead to increases in depression. The need to isolate is driving some to suicidality and substance use.

 

What can we do?
Dr. Sandra Mills: Mental health issues are on a continuum. I don’t like to talk about mental illness, I like to talk about struggles with mental health. Just like you can come in with symptoms of a cold. It doesn’t mean that you have a serious illness, but you have some symptoms. If we can intervene early, we can help prevent it from becoming something serious.

Advice for parents if there is an issue:

  • Learn about the diagnosis
  • Family therapy can treat the whole family working as partners together
  • Ask for advice from the mental health professional on how to respond to the child
  • There are parent training programs available for dealing with specific mental health struggles.
  • Seek stress management for yourself
  • Find ways to relax and have fun with your child
  • Praise your child’s strengths and abilities
  • Work with the school to secure necessary support

 

Be Kind to Your Mind
Monique: There are daily steps you can take to help strengthen your Mental Health.

  • Nutrition. 80/20 rule. 80% of your food should be low processed, plant based and healthy. 20% is “fun foods.” Also, eat the rainbow. Different colored foods bring nutritional content. For example, orange foods are generally high Vitamin C. Also, meal prep. Think about what you are going to eat during the week and plan for it. If you have healthy food ready to go, kids will go for what’s easy.
  • Exercise. Ensure you have proper movement during the day. With kids, get them outside. For adults, park father away, take the stairs instead of the elevator. If you add activity during the day, it’s a healthy habit. Activity is a mental break for you. It’s good for the body and the mind.
  • Mindfulness. I enjoy journaling to reduce stress. Even kids can do this. Write down your thoughts, feelings and emotions. Emotions are healthy until you bottle them up. Putting down on paper how you are feeling is important, particularly if you are not comfortable talking about them outright.
    • Breathing. Breathing exercises are healthy. For example, take a deep breath through the nose. Pause and exhale longer than you inhale. This helps slow the heart rate down and calm the mind and body. It allows you to be prepared for what’s happening. It’s a way to reset.
    • Positivity. We need to deal with negative emotions. But try to look at the world and find gratitude. Everyone has something to be grateful for. You can’t be stressed when you are blessed. Allow gratitude to fuel you. Instead of thinking “I have to go to work,” think: “I get to go to work because I have a job.” Instead of thinking “I have to go to school,” think: “I get to go to school because I live in a country that allows me to get an education.” Instead of thinking “I have to go to the gym,” think: “I get to go to the gym because I have a body that’s healthy enough to move.”
    • Ask how people are doing. Don’t do it causally. Make it genuine. Being connected with people is more important now than ever. You can make connections with people by talking to them, even when we can’t hug or get together.

 

About Kids’ Minds Matter
Armando: Kids’ Minds Matter’s goal is to improve access to pediatric mental health services. Here’s some of what we have done so far:

  • Improving access to mental health providers by 1,000% in the past few years
  • Seeing significant reductions in the number of involuntary mental and behavioral health admissions at Golisano Children’s Hospital
  • Teaching Mental Health First Aid classes, an opportunity for parents, grandparents, people who work with children to help identify signs and symptoms of mental health issues
  • Teaching Mental Health First Aid to college students to help them identify their own stressors and stressors on classmates
  • Providing parenting classes and groups to help parents to be successful
  • Hiring Mental Health Navigators in Lee and Collier county schools to help high risk families work through treatment and therapy
  • Creating a team of advocates everywhere. We are spreading awareness and changing lives.

 

RESOURCES / RECURSOS

 

QUESTIONS FROM VIEWERS

Q: Miss Florida, what motivated you to choose “Be Kind to Your Mind” as your platform?
Monique: It started out when my older brother was diagnosed with schizoaffective disorder, and I noticed how it affected not only him but our family and our community. When he was starting to show symptoms, none of us knew what was going on. We thought he was acting out, trying to get attention, which was not the right thing to do when he actually needed help in those moments. I felt there was more education that needed to happen. I also work in the mental health sphere, so I was able to see daily how mental health affected people beyond my family. Yes, we have people with these diagnoses, but I wanted everyone to get involved and realize that we, too, need to take care of our minds. I think if we understand that we are taking care of our minds and bodies, when someone has a diagnosis for a mental illness, we realize they are not that different from us. I want to reduce that stigma and bridge it to realize we all can do something daily.

Q: What are some activities parents can do at home to support your kids’ mental health?
Dr. Mills: Mental health is a component of physical health. Make sure your child is active. Just spending time with your child is supportive. Provide an open space for them to come talk to you. Read together. Play board games, anything that helps you feel connected as a family will benefit their mental health. Gratitude. I have used this with adults and children. Keep a gratitude journal. Before you go to bed jot down three things you are grateful for. There’s science behind this. It’s really easy to get bogged down with the scary stuff that’s going on in the world. Changing that focus from negative to positive and knowing you have to look for the positive at the end of the day has a significant impact on kids. I think in my career, I’ve taught breathing exercises to everyone I’ve ever seen in clinic. With kids it can actually be really fun. The easy way to do with children is with bubbles with the wand. To blow a good bubble, you need to take a deep breath and exhale slowly.

Q: Where can families turn if their child is in need of mental health services locally?
Dr. Mills: You can come see us. We have an outpatient clinic in Fort Myers. We have multiple providers and are adding providers all the time to keep up with the need. We are located at 15901 Bass Road, Suite 108 in Fort Myers. Call 239-343-6050 to make an appointment. Also, don’t discount the schools. Sometimes there are services available there.

Q: What is the best way to possibly get a child to open up who is typically more reserved? What’s the best way to approach a conversation about mental health?
Dr. Mills: That’s not uncommon for us to deal with when they come to the clinic. Part of it is establishing trust and rapport. Sharing your own experiences can go a long way to helping a child feel they aren’t alone. Talk about what your experiences felt like. The truth is, we were all young and can relate to those experiences. If you have a concern about mental health specifically, talk about the behaviors that are concerning you. Come at it with an attitude of love and caring. “How can I help?” And then try to open the door that way.
Monique: Everything you just said are things my parents did. My parents always built a great rapport with us. We talked about it on a daily basis. Another thing that’s important is family mealtimes. We always had to come to the table with a thought. I think that was important. When I did have a tougher, time, I was able to have that dialog because it seemed normal.

Q: What are activities to do in the wintertime for a child with extra energy who is unable to go outside due to cold and COVID?
Monique: My Dad always made my brother do pushups and pull ups.
Dr. Mills: I have a child with ADHD and lived in the Midwest. We would tell him to run around the house. That extra energy can be displaced in a lot of different ways, such as those mini trampolines. Activity doesn’t always need to be large muscle groups but can focus on fine motor skills with Playdough or Legos. Give them tasks within a timer, children love timers, and it helps activate their minds. COVID has restricted a lot of activities that kids are used to doing. It is taking some creativity. You can still go to the parks and socially distance. Go to the beach and letting them swim when the weather is warm enough. Go on bike rides and walks as a family when the weather is good.

Q: How does a parent get started with an assessment if they think they see some changes in their child?
Dr. Mills: You can call and make an appointment with us. Our first appointment is an intake where we take a thorough history from you and the child. The child is part of the interview process. We develop a plan of care from there.

Q: You hear folks say, “they will grow out of it” or “it’s a phase.” Can you speak to the power of early intervention?
Dr. Mills: As far as child development, we look for certain things. There are ages and stages as far as emotional maturity, cognitive ability and behaviors. We don’t want to pathologize things that are within range. There’s a large range of normal and no correct way to be a kid. However, I look for certain red flags. How is their behavior impacting their life at home? Is it impacting school and learning? Is it impacting their social interactions with other people? If we see red flags, it may warrant coming to see someone like me. The earlier the intervention the better. Children are amazingly resilient. We’ve all heard stories of people who had really rough starts as children who are now CEOS of companies. The brain is really malleable, so you can really build up some of those resilience factors and give children language to talk about what’s going on.

Q: I recently gave birth and since then, my 5-year-old started being very defiant, not wanting to follow rules. How should I handle this without losing my temper?
Dr. Mills. That’s not unusual either. With the birth of a sibling, you may start to see an uptick in that kind of behavior. Negative attention is still attention, and that’s what the child is looking for. Try to catch them being good and praise them for good behaviors you notice. I understand that no one can push your buttons like a kid can. I would refer you back to the breathing. It’s helpful in calming your fight or flight response, which is what’s kicking into gear.

Q: What can I tell my 16-year-old niece to share/say to her friends that are struggling?
Monique: I think one of the biggest things is being able to talk to them. Ask how they are. What can I do to help? I’m here for you. We should be able to talk about what we are feeling. Ask the person you are talking about why they are feeling that way. Be empathetic. It’s not necessary to jump in and try to solve the problem. Let them vocalize their emotions and be there as a friend.
Dr. Mills: Be present. If your niece is ever afraid about what her friends are talking about, absolutely talk to an adult who can help intervene. I used to work in high schools. Kids came in who wanted to keep secrets for fear of losing a friend. Sometimes it’s better to have an angry friend than one who dies from suicide.
Armando: I had a friend when I was young named Dennis. Dennis had parents who went through a pretty traumatic divorce. Each parent left town and left Dennis with his grandmother. We all thought that Dennis was fine. He seemed completely unaffected. One day he hung himself. I still think of him often. So many times, I wonder if there was something I should have seen, something I missed. I feel a great deal of guilt and trepidation. I can’t reiterate enough: if you see something, say something. It may be that conversation that saves someone’s life. If you knew Dennis, believe me you would know the world was a better place with him in it.

Q: Since COVID-19, the therapist my daughter was seeing was Zoom only. She really doesn’t like this format. Any suggestions?
Dr. Mills: It is a big change from what we are used to even as providers. On our side it takes adjustment as well. I believe there are providers who are starting to see children face to face with precautions. We have PPE. It depends on the provider. I think we are opening up more and more face to face visits now.

Q: What is a great way to get started with schools as a Kids Mental Health Coach?
Dr. Mills: If we are talking about becoming a provider within a school setting, that would be a 4-year degree plus graduate education with training. Nonprofessional, you can go to PTO meetings and advocate for mental health education.
Monique: Every school district seems to be different. You can do your own thing within your kid’s friends. The state of Florida has started having mental health training mandated in the schools.
Armando: Folks can volunteer with us as part of Kids’ Minds Matter. I would encourage you to find organizations doing advocacy work in your area. There are many ways to serve. I can’t think of very many issues in this country that need more attention and more able-bodied people supporting it than mental health, especially during COVID.

 

About Kids’ Minds Matter

The goal of Kids’ Minds Matter is to raise awareness about the need for pediatric mental and behavioral health care services and to raise the funds required to make these services available in the region through Golisano Children’s Hospital of Southwest Florida and Lee Health. An estimated 46,000 Southwest Florida children are impacted by mental and behavioral health disorders like anxiety, depression, eating disorders, psychosis, substance abuse, autism and attention deficit hyperactivity disorder. As part of the region’s strategic solution to the children’s mental and behavioral health epidemic in Southwest Florida, Kids’ Minds Matter is dedicated to fostering partnerships that support existing services, identifying and filling gaps in the continuum of care, and innovating new treatments.

Philanthropic support for Kids’ Minds Matter has allowed Lee Health and Golisano Children’s Hospital of Southwest Florida to: implement a tiered model of care that clinically aligns community, inpatient and outpatient care; hire additional psychiatrists, child advocates and other mental health professionals; offer Mental Health First Aid training to local pediatricians, emergency service providers and others who work directly with children; renovate an outpatient center in Fort Myers where a child’s needs can be addressed in a therapeutic setting; and launch a first-of-its-kind Pediatric Digital Cognitive Behavioral Health diagnostic and treatment protocols interlaced with Tele-Psychology support to treat anxiety, depression and trauma. Most recently, Kids’ Minds Matter introduced mental health care navigators into Lee and Collier County schools who will help families find resources and care to address their child’s mental healthcare needs.

The “Mental Health Mondays” segments are a public forum, designed for open discussions that benefit a large audience, and to provide real-time resources and advice from pediatric mental health professionals and advocates. The information shared on this platform is intended for general public consumption and not intended for individual treatment. The views, advice, and resources shared by each guest speaker are solely their own and are not endorsed by Lee Health, Golisano Children’s Hospital of Southwest Florida and Kids’ Minds Matter. Kids’ Minds Matter is dedicated to raising awareness and essential funding to enhance pediatric mental & behavioral health programs, services and access to care in Southwest Florida. To learn more about Kids’ Minds Matter, visit KidsMindsMatter.com.

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