May is Mental health awareness month. Mental health is one of those things we tell ourselves it happens to other people, not us. It is not okay to not talk about becuase more people than we realize struggle with it and here is why.

Psalm 34:18. The LORD is close to the brokenhearted and saves those who are crushed in spirit.

 Since 2020, suicides have skyrocketed off the charts.  So has accidental deaths caused by opioid overdoses.  But, we're not talking about it so wouldn't know about those statistics. But one look at the Sunday obituaries with pictures of seemingly healthy younger people who have died tells a different picture.  Unlike acknowledging our physical health problems, mental health has always brought shame.  Like the biblical reference to those with leprosy, we send those afflicted with mental health problems to some cavern where we wouldn't have to be bothered. Hence, we saw the construction of mental health institutions located out in the country where we could put 'Crazy Aunt Betsy or crazy old Jim. These were far enough places where we didn't have to be bothered by their problems.  

I would like to surmise that addiction, depression, and anxiety all have one common denominator. What is it you say? That common denominator is traumatic grief.  All of us experienced a little about what this felt like as we read the grim report coming out of Uvalde, Texas when a lone gunman walked into a 4th-grade classroom and began killing every single student, including their beloved teachers, using an AR-57 he had just purchased a day before.  It was said the lone gunman used so much firepower that the EMTs had to use DNA to identify the victims.  One day after the shooting, the husband of one of the teachers was so overcome by these losses that he died of a heart attack.

Grief is one of those things we actually set a timeline for when you must be recovered by it.  We wouldn't do this for the treatment of cancer, or treatment for paralysis, but we do it for mental health. In Griefshare, we teach our participant that there is no timeline for when one will be fully recovered from grief. We teach them that the pain which we feel is a reflection of the love we had for those who died.  The sudden death of a child is one example of this point.  One can expect that it will take many years for these families to recover from losing their children in this Robb elementary school classroom.

Even when we do not talk about it, this pain can affect us in ways we least expect it. When we feel this pain, we turn to chemicals to try with all of our might to make the pain go away. It rarely does. We do everything but talk about it. Our insurance companies pay lip service to grief recovery by setting a limit on what they will cover, or simply not offering that service. This is shaming and sends a strong message to those trying to make some sense out of their pain that they better be fully recovered by 'x' amount of time or one's job may be in jeopardy. 

It is time to bring mental health out of the dark ages into a more enlightened age where one doesn't have to feel shamed when they hurt after sudden losses.  

As a facilitator of griefshare, I believe this is one group that can help those experiencing traumatic grief. For 13-weeks, we take participants through the process of helping them understand what grief is while giving them each the opportunity to share in a safe affirming environment how this loss has personally impacted their lives.

I tell people that every single one of us is just one traumatic event away from a major mental health crisis. 

It is time we understand so when the next traumatic loss of a loved one occurs we are able to take the appropriate steps and seek the mental health treatment we need to help us instead of sweeping it under the rug and turning to alcohol and drugs to sedate that pain.

Over the past two weeks our country has experienced mass shootings in Buffalo, New York and again at the Robb Elementary school in Uvalde, Texas. Today, I want to pay tribute with this Star tribune article on the victims who were killed in the one single 4th grade classroom by a very angry 18 year old man with no history of mental health problems, and certainly no red flags that we know. To the families who lost a 10 year old child in this tragedy, my heart goes out to you. I wish I had a magic wand that I could wave to bring them back, but I can't. I believe that this tragedy happened because there is evil in this world.

 

The names: 19 children, 2 teachers killed in Uvalde school

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Associated Press

 

MAY 28, 2022 — 4:35PM

CHANDAN KHANNA, AFP VIA GETTY IMAGES/TNS

A woman mourns at a makeshift memorial for the Robb Elementary School shooting victims outside the Uvalde County Courthouse in Texas on May 27, 2022.

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UVALDE, Texas — Nineteen children were looking forward to a summer filled with Girl Scouts and soccer and video games. Two teachers were closing out a school year that they started with joy and that had held such promise. They're the 21 people who were killed Tuesday when an 18-year-old gunman barricaded himself in a fourth-grade classroom at Robb Elementary School in the southwestern Texas town of Uvalde. Some families have been willing to share their stories with The Associated Press and other media. Others asked for privacy. Here are their names.

Nevaeh Alyssa Bravo, 10

Her aunt noted that Nevaeh's first name is heaven spelled backward. In a Facebook posting, Yvonne White described Nevaeh and her friend Jailah Silguero as "Our Angels."

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Jacklyn Cazares, 9

Javier Cazares said his daughter was someone who would give the "shirt off her back" to help someone. "She had a voice," he said. "She didn't like bullies, she didn't like kids being picked on. All in all, full of love. She had a big heart." Annabell Rodriguez, also a victim, was Jacklyn's second cousin.

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Makenna Lee Elrod, 10

Makenna's father asked on Tuesday if he could go to the local funeral home to search for his daughter because he feared "she may not be alive," TV station KTRK reported. Her family later asked for privacy.

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Jose Manuel Flores Jr., 10

Jose's parents told CNN that the 10-year-old was helpful around the house and loved his younger siblings. "He was just very good with babies," his mother said. His father told CNN that Jose loved baseball and video games and "was always full of energy." A photo taken at school Tuesday shows him smiling and proudly holding a certificate to show he made the honor roll.

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Eliahna Garcia, 10

Eliahna's relatives recalled her love of family. "She was very happy and very outgoing," said her aunt, Siria Arizmendi, a fifth-grade teacher at Flores Elementary School in the same district. "She loved to dance and play sports. She was big into family, enjoyed being with the family."

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Irma Garcia, 48

Irma Garcia was finishing up her 23rd year as a teacher at Robb Elementary School. In a letter posted on the school's website at the beginning of the school year, Garcia told her students that she had been married for nearly a quarter of a century and that she and her husband, Joe, had four children — a Marine, a college student, a high school student and a seventh grader. She told the students that she loved barbeque, listening to music and taking country cruises with her husband. On Thursday, Joe Garcia died of a heart attack, according to a nephew.

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Uziyah Garcia, 10

Uziyah's grandfather called him "the sweetest little boy that I've ever known." Manny Renfro said he last saw Uziyah when the boy came to his home over spring break. "We started throwing the football together and I was teaching him pass patterns. Such a fast little boy and he could catch a ball so good," Renfro said. "There were certain plays that I would call that he would remember and he would do it exactly like we practiced."

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Amerie Jo Garza, 10

Amerie loved to paint, draw and work in clay. "She was very creative," said her grandmother Dora Mendoza. "She was my baby. Whenever she saw flowers she would draw them." For her 10th birthday, Amerie was given her first cellphone. Her father, Angel Garza, recalled that her face "just lit up with the happiest expression." Garza said that Amerie's friend told him that Amerie had tried to call the police on her phone before she was shot.

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Xavier Lopez, 10

Xavier had been eagerly awaiting a summer of swimming. "He was just a loving ... little boy, just enjoying life, not knowing that this tragedy was going to happen," said his cousin, Liza Garza. "He was very bubbly, loved to dance with his brothers, his mom. This has just taken a toll on all of us."

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Jayce Carmelo Luevanos, 10

Carmelo Quiroz's grandson had begged to be allowed to join his grandmother on Tuesday as she accompanied her great-granddaughter's kindergarten class to the San Antonio Zoo. But, he said, the family told Jayce it didn't make sense to skip school so close to the end of the year. Besides, Jayce liked school. "That's why my wife is hurting so much, because he wanted to go to San Antonio," Quiroz told USA Today. "He was so sad he couldn't go. Maybe if he would have gone, he'd be here." He died with his cousin, Jailah Nicole Silguero.

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Tess Mata, 10

Faith Mata told The Washington Post that her sister loved TikTok dance videos, Ariana Grande, the Houston Astros, and having her hair curled.

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Maranda Mathis, 11

The mother of a close friend described Maranda as "very loving and very talkative." She told the Austin American-Statesman that her daughter and Maranda had been in the same classes and that Maranda would ask to have her hair done like her daughter's.

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Eva Mireles, 44

In a post on the school's website at the start of the year, the fourth-grade teacher said she had been teaching for 17 years. Mireles loved running and hiking. She said she and her husband, a school district police officer, had an adult daughter and three pets.

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Alithia Ramirez, 10.

Alithia Ramirez loved soccer and she really loved to draw. Her father Ryan Ramirez's Facebook page includes a photo, now shown around the world, of the little girl wearing the multi-colored T-shirt that announced she was out of "single digits" after turning 10 years old. The same photo was posted again Wednesday with no words, but with Alithia wearing angel wings.

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Annabell Rodriguez, 10

Polly Flores told the New York Times that her great-niece Annabell Rodriguez was an honor roll student and close to her second cousin Jacklyn Cazares.

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Maite Rodriguez, 10

After a rough time with Zoom classes during the pandemic, Maite Rodriguez made the honor roll for straight As and Bs this year and was recognized at an assembly on Tuesday, said her mother, Ana Rodriguez. Maite especially liked physical education, and after she died, her teacher texted Ana Rodriguez to say she was highly competitive at kickball and ran faster than all the boys. Her mother described Maite as "focused, competitive, smart, bright, beautiful, happy." Maite wanted to be a marine biologist and after researching a program at Texas A&M University in Corpus Christi she told her mother she wanted to study there.

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Alexandria "Lexi" Rubio, 10

Lexi's mother, Kimberly Rubio, posted on Facebook that her daughter was honored for earning all A grades and received a good citizen award in ceremonies at the school shortly before the shooting. The fourth-grader was a softball and basketball player who wanted to be a lawyer. Lexi's father, Felix Rubio, is a deputy with the Uvalde County Sheriff's Office. The couple told CNN that he was among the law enforcement officers who responded to the shooting.

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Layla Salazar, 11

Layla's father said she loved to run and swim, dance to TikTok videos and play games including Minecraft and Roblox with friends. He said she won all six of her dashes and hurdles races at the school's past three annual field days. He said each morning as he drove her to school in his pickup, he would play "Sweet Child O' Mine" by Guns N' Roses and they would sing along.

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Jailah Nicole Silguero, 10

Jailah's mother tearfully told Univision that her daughter did not want to go to school the day of the shooting, and thought that maybe she sensed something was going to happen. Jailah and her cousin, Jayce Luevanos, died in the classroom.

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Eliahana Cruz Torres, 10

Adolfo Torres told the Associated Press that his granddaughter, Eliahana, died in the shooting. Television station KIII reported that Eliahana was set to play the last softball game of her season that day. The team members kneeled for a moment of silence to remember Eliahana and the other victims.

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Rojelio Torres, 10

Rojelio Torres' mother, Evadulia Orta, told ABC News her son was a very smart and loving child. "I lost a piece of my heart," she said.

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This story has been corrected to show Uziyah Garcia was 10, not 8. It also corrects the spelling of the first name of another victim. Her name was Maranda Mathis, not Miranda Mathis.

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Find more of the AP's coverage of the Uvalde school shooting at https://apnews.com/hub/school-shootings

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Our nations children are perhaps the greatest victims of this pandemic with rising mental health cases along with a shortage of services and programs to meet their needs. Time will tell how these kids fare in the decades to come.

 

Hospitals overwhelmed with kids in crisis being dropped off at ER doors

Masonic Children's created a makeshift holding unit in an ambulance bay to try and meet the demand. 

By Jeremy Olson Star Tribune

 

MAY 11, 2022 — 8:55PM

JEREMY OLSON

The ambulance bay at M Health Fairview’s Masonic Children’s Hospital has been converted into a temporary shelter for children dropped at the ER because of mental or behavioral issues.

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Children who lash out in homes and protective placements are increasingly being dropped off at the M Health Fairview Masonic Children's Hospital, prompting the creation of a makeshift shelter in an ambulance garage.

While hospitals have always been a place of last resort for children in emotional or behavioral crises, Fairview leaders said counties and social service providers are using their pediatric emergency room at an unprecedented rate. Normally expecting one or two such cases a month, the Minneapolis pediatric hospital has taken in 145 children since September — with most staying about 15 days and one staying 97 days.

Hospitals already are strained by children suffering from heightened anxiety, depression and other mental health issues and needing inpatient care amid the pandemic. A few of the children being sheltered in the ambulance bay are in that category — needing mental health evaluations and awaiting open inpatient psychiatric beds. The rest have behavioral disorders or long-standing developmental disabilities, such as autism, but no acute medical issues for the hospital to treat.

"They are not appropriate for admission. They have no medical concerns … but yet we can't safely discharge them because there is no place to discharge them to," said Lew Zeidner, director of clinical triage and transition services for M Health Fairview, which operates the pediatric hospital on the University of Minnesota's West Bank. "They are too vulnerable to just put on the street."

The result was on display Monday afternoon as eight children sat and watched "Zootopia" in the large ambulance bay on concrete floors and the narrow windows of the garage doors for natural light. Other children were too unstable to join the group and kept in separate rooms. Beds lined one wall of the garage along with recliners moved out of hospital rooms.

Outbursts or violent incidents draw staff alerts daily. Half the children 10 and older are homeless. Most have one-on-one supervision all day and are seen by nurses and psychiatric aides.

Many of the children have traumatic histories and attachment issues, which aren't helped when exasperated parents or providers drop them off at the hospital, said Stacy Rivers, an M Health Fairview clinical manager with a supervisory role over the makeshift transitional unit.

The classic case "is a child who is no longer a child and is 12, 14, 16 years old — large, now aggressive, with chronic destructive thoughts or behaviors," she said.

State and county mental health officials described a chain of problems that have ultimately fallen on Masonic and other hospitals. They mostly stem from staffing shortages and financial struggles that have reduced Minnesota's residential treatment programs' capacity and other placements that are more therapeutic for children than hospitals.

The number of licensed children's residential facilities in the state has declined from 122 at the beginning of 2019 to 106 at the beginning of 2022, according to the Minnesota Department of Human Services. That total includes detention facilities and shelters as well as psychiatric residential treatment centers. Capacity has dropped at an even faster rate, meaning existing providers are using fewer of their beds.

The pandemic and related school closures and stay-at-home restrictions triggered new mental health crises in some children and made others with long-standing behavioral problems harder to handle, said Cynthia Slowiak, a Hennepin County human services manager for children with mental and behavioral disorders. The county is responsible for one-fifth of the 145 children dropped at the U hospital since September, according to M Health Fairview.

"Families were often left alone to deal with the challenges that already were there if their youth had mental health needs prior to COVID," she said. "But also a lot of families for the first time were being asked to respond to things that were coming of left field in terms of their child. They weren't prepared for it."

The right solutions?

Expansion of inpatient psychiatric capacity for children could help. Children's Minnesota is set to open a 22-bed inpatient psychiatric unit on its St. Paul campus this fall and has asked the Legislature to grant a moratorium exception for the hospital expansion. PrairieCare received legislative permission last year to add 30 inpatient beds at its pediatric psychiatric hospital in Brooklyn Park.

Bipartisan support has emerged for other child mental health solutions. Gov. Tim Walz visited Edison High School in Minneapolis on Wednesday to advocate the use of some of the state's budget surplus to expand school mental health and crisis prevention services. State Sen. Rich Draheim, R-Madison Lake, has gained support for legislation to expand a variety of child mental health services and ensure providers have enough trained staff.

Fairview leaders said many of the solutions address the minority of kids in the temporary shelter needing mental health care but that counties and the state also need to address the problem of children with behavior issues left at the ER doors despite their lack of medical needs.

The Minnesota Department of Human Services first responded in November to the crisis situation at Masonic, diverting $2.5 million in emergency state funding to psychiatric residential treatment facilities to prevent the loss of any more beds and staff members and to expand capacity. Another $360,000 paid for state staff to work with families and social service providers to fix problems that led to the removal of children from their homes or placements in the first place.

"This is very sad that our children, who really don't need to be hospitalized, have to be there," said Neerja Singh, interim director of DHS's Behavioral Health Division.

The support hasn't eased problems at Masonic, though, which converted the ambulance bay into temporary shelter late last month because of the rising demand.

Rivers defended the use of the garage as a temporary shelter. Confining kids for weeks to isolated and cramped emergency room bays can increase their agitation. In comparison, the ambulance bay is spacious and allows for group programming and more supervision.

The hospital provides psychiatric support to the children and also reaches out to their relatives to see if any family problems can be addressed so they can be discharged. It's a "point of pride" when some of the toughest children are no longer aggressive and even make improvements despite the unusual living conditions, she said.

"Within a few days or maybe weeks, we don't see [emergency] codes or issues any more," she said, "and they're talking about their feelings and making connections to family members who they were refusing to talk to when they first came in."

Correction: An earlier version of this story misstated Children’s Minnesota’s expansion plan.

Jeremy Olson is a Pulitzer Prize-winning reporter covering health care for the Star Tribune. Trained in investigative and computer-assisted reporting, Olson has covered politics, social services, and family issues.

jeremy.olson@startribune.com stribJO