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Anaconda-Deer Lodge County survey seeks creative mental health solutions

Montana Standard - 8/5/2018

Aug. 03--This July, Montana Tech professor Megan Rediske teamed up with the Anaconda-Deer Lodge County Health Department to conduct a survey of the county's mental health services.

Through a series of fill-in-the-blank and multiple-choice questions, the survey asks residents to detail their concerns with mental illness and mental health services available in their community. For Rediske, the survey is the start of a mission to provide more creative, cost-efficient treatment options. For the county, the survey is a step closer to understanding the prevalence of mental illness and a way to find funding to address it.

"This survey is a snapshot in time to find out what the community knows about mental health, a pulse of their concerns," said Katherine Basirico, Anaconda-Deer Lodge County public health director. "It will help us see where we are and what the community wants to do moving forward."

Montana has the highest suicide rate in the country. On a county level, Anaconda-Deer Lodge leads with 25.8 suicides per 100,000 people, according to a 2016 study put out by the state's public health department. Researchers calculated the county rates by analyzing state suicide data between 1995 and 2014. They also found that 69 percent of those who committed suicide in Montana suffered from depression and 21 percent had multiple mental health issues.

Basirico says she hopes the survey will give the county the up-to-date, concrete numbers it needs to apply for mental health-related grants. Right now, Basirico says, people can't get access to mental health treatment because it's not available in Anaconda-Deer Lodge County, and they don't have recent data they can use to apply for more funding. Residents have to go elsewhere for help.

For example, AWARE Inc., an Anaconda-based healthcare nonprofit, will terminate 25 to 30 mental health positions in a few weeks. The layoffs, a result of the significant statewide cuts to health services, leave about 450 people without the mental illness treatment options they've utilized before.

Like Basirico, Professor Rediske, who teaches the Tech nursing program's Complex Care Mental Health course, hopes the county can use the survey results to get the funding they need -- that's why she partnered with them. For eight years, Rediske has worked as a staff psychiatric nurse at the Montana State Hospital in Warm Springs. She wants to be sure the services Anaconda-Deer Lodge County needs and wants are available.

Funding isn't why Rediske is leading this study, though. It's not even about more services, really. Rediske wants to use the results to help her implement what she calls more creative treatment options that wouldn't disappear when health budgets are tight. Specifically, she wants to focus on helping survivors of suicide -- as in the people close to someone who has taken their own life -- through support group therapy.

"I think it's important to provide better treatment for those that survive suicide, because there's often no one there to help them. It's a unique type of grief," Rediske said.

Rediske wants to base the support group therapy on the University of Utah's Caring Connections. A small nonprofit run through the university's college of nursing, Caring Connections provides group support and therapy to people with varying types of grief, including suicide survivors. Since 1997, the nonprofit has been offering eight-week, clinician-facilitated support groups that are informal -- like Alcoholics Anonymous -- but are guided by a psychotherapist.

"The groups move through the curriculum, which helps participants move through their grief over time," Caring Connections director Katherine Supiano said.

The risk for what Supiano calls complicated grief is much higher for people who lose someone to suicide. Suicide-loss survivors often feel things like shame and blame that are often hard to cope with. Survivors also have a higher risk for suicide themselves, Supiano said.

According to Supiano, Utah and Montana have similar factors that put people at risk for suicide: rural poverty, greater access to firearms, higher altitude. She says that through survivor group therapy, places like Utah and Montana can contribute to reducing the risk for further self harm and promote healthier communities.

In a few weeks, Rediske will begin the online Ph.D. nursing program at the University of Utah, which Supiano also oversees. Supiano believes the program will give Rediske the research skills and experience she needs to create a Caring Connections-like program in Anaconda.

"I am confident that Megan is the person to do this for Montana, to design an effective program tailored to the needs of her community. She is very committed to Montana," Supiano said.

The biggest challenge, Supiano says, is overcoming discrimination against people with mental health issues that draws suicide survivors away from seeking help. In Utah, Caring Connections gets a lot of its referrals from the church, which helps.

Rediske agrees and understands that breaking social barriers is a big hurdle she'll have to clear. She believes it's time for Montana to step up, and she's started to see it with this survey. Rediske said the survey received lots of promotion and support. The response window closed Friday, and Rediske received well over 200 responses. She'll begin analyzing the results and hopes to have a report out by early September.

However, her vision for survivor support groups is still a few years down the road. Rediske will spend four to six years in the Ph.D. program, which will help her perfect a group therapy program for Anaconda.

"I want this to be good, so I need to spend time on it. There are so many things that are just thrown out there, but this is important treatment that takes lots of promotion and research," Rediske said. "I hope to implement it in three to five years."

Not only is Rediske chasing her own passions, she's inspiring others to chase theirs. One of her former students, Caitlynn Heimark, volunteered to help Rediske carry out the mental health survey. One of the only people from Anaconda in Tech's nursing program, Heimark knows the effects of mental health on the Smelter City firsthand. Her dad and her uncle were both suicide victims.

"If you're from Anaconda, you know at least ten people who have committed suicide," Heimark said.

Heimark feels very strongly about mental health awareness and support, especially in Anaconda. She says she knows lots of mothers who lost their kids to suicide years ago who still struggle and don't know how to cope. It's hard for them to talk with people who don't understand. Her own family has struggled, too.

"There are some mental health services here, but they aren't well known," Heimark said. "If a kid came up to me right now for advice on where to go, I honestly would have no idea what to tell them."

For Heimark, mental health is just as important as physical health, and she wants her community to share that view. She's helped Rediske with this survey because she wants to see how many Anacondans need help and wants them to feel comfortable seeking it without feeling stigmatized. Heimark said she used to go to support groups, kind of like the ones Rediske plans to start, but they ended up getting cut for reasons she doesn't know.

Heimark thinks if Rediske can start her support groups and keep them going, they could help Anaconda and Butte, too. But she's also worried about the social discrimination hurdle. Heimark says people need to put themselves in the shoes of those with mental illness and gain a larger perspective to understand that they are not crazy, they are not faking it, and they are not bad people.

"We all know someone struggling whether they come forward or not. If we want to see change, everybody in the whole community will have to start looking at mental health differently, but will that happen? I don't know," Heimark said. "All we can do is try."

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(c)2018 The Montana Standard (Butte, Mont.)

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