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    Making Your Mental Health a Priority in 2020

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    As we begin a new decade, 2020 is testing the mental health of humanity. After the world mourned the loss of Kobe Bryant to start the new year,  we are now in the midst of a global corona virus pandemic with looming public health and economic consequences so severe experts are unable to quantify its impact. With social distancing, stay at home orders, and a host of economic challenges, humanity’s resolve is being stretched past our normal limits. Maybe you made a list of resolutions or life changes you wanted to make in 2020. But, one the is for sure, collectively we must be more diligent in protecting our mental health and develop coping mechanisms to help us endure these turbulent times. 

    Based on surveying individuals, it was estimated that, in 2018, 19.1 percent of Americans 18 years old and up had a mental illness in the last year. Maybe you have a mental illness, maybe you don’t. Either way, your mental health is important. So what are some practical things you can work on?

    Get sufficient sleep.

    The Centers for Disease Control and Prevention (CDC) conveys that a person might have an elevated likelihood of poor mental health, some physical health problems, and dying prematurely if the person regularly doesn’t sleep for sufficient time. They indicate that it is advised for individuals ages 18 to 60 to sleep at least 7 hours a night.

    If you’re not making enough time for sleep, now is the time to start. As hard as it may be, tell yourself you’ll finish that television show or those household chores tomorrow.

    If you’re having trouble sleeping, there are things you can try. Commit yourself to a regular sleep schedule, going to bed and waking up at the same time every day (yes, even on the weekends). Don’t drink too much caffeine, especially later in the day. Stop using devices that produce blue light (like your smartphone, laptop, and television) at least an hour before bed. Practice relaxation techniques, such as deep breathing exercises.

    Exercise.

    One of the many reasons to exercise is that it might improve your mental health. Try to find something that you’ll enjoy, so you’ll actually stick with exercising. You might decide to start regularly playing a sport with friends, going to a fitness class, or enthusiastically dancing to some of your favorite music. 

    If you have any health conditions that might be made worse by exercising, make sure to talk with your healthcare provider first. Together you can develop a plan that is right for you.

    Plan ways to reduce stress.

    The National Institute of Mental Health (NIMH) conveys that being stressed long-term could be detrimental: it might play a part in mental and physical illnesses, for instance anxiety, heart disease, and depression. Some things that stress us out are beyond our control. A family member might fall ill or a car might suddenly break down. However, some stressful situations can be avoided with better planning. 

    If you find it stressful to do all of your household cleaning on Saturday, make time to do a little bit at a time during the week. If you are stressed as soon as you start reading those class syllabi, sit down with a planner and figure out when you will allot time to work on each thing you need to do (maybe you can start working on that final paper a little earlier so you then have time to focus on studying for exams). Yes, it takes some upfront time investment to plan, and it takes commitment to stick to the plan. However, it might help you feel less stressed (and maybe you’ll do better on those exams too!).

    Another important thing to plan? Time to do things that you enjoy. Maybe its hiking or crafting or reading. Determine when you are going to do these things, whether it’s planning to do a specific activity or simply planning to do something enjoyable. Make sure it’s a plan that’s reasonable for your life, and then stick to it.

    What about those things that are out of your control, or times when you’re working on what is in your control but still stressed? Relaxation techniques, such as deep breathing exercises, progressive muscle relaxation, or mindfulness, might be helpful for you. Research how to do these things, and practice them when you are not feeling stressed.

    Take care of your physical health.

    Mental health and physical health are connected. Physical health conditions can affect a person’s mental health. For instance, hypothyroidism might make a person feel depressed, and hyperthyroidism might make a person feel anxious. Low vitamin D levels could contribute to feeling depressed.

    If it’s been a while since you’ve seen a healthcare provider for a physical, schedule one now. Even if you feel good physically and mentally, a healthcare provider might detect a health concern before it starts causing issues, and some conditions are easily treatable.

    Assess your substance use.

    For persons who don’t consume alcohol, beginning is not advised by the Dietary Guidelines for Americans 2015-2020. If a person is going to drink and is old enough to do so legally, for men they advise two drinks or less a day and for women they advise one drink or less a day.

    The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides limits for “low-risk” drinking. Low-risk drinking is drinking 7 or fewer drinks in a week as well as drinking 3 or fewer in a day for women. For men, it’s drinking 14 or fewer drinks in a week as well as 4 or fewer in a day. It is recommended that men older than 65 do not exceed 7 drinks a week and 3 a day. For some individuals, it is recommended to not drink at all.

    If you are drinking more than these limits, it’s time to reduce how much you drink or quit drinking entirely. However, NIAAA conveys that you shouldn’t try to quit drinking on your own if you might have a dependence on alcohol, as withdrawal could be deadly. Talk with a healthcare provider if you think you might be dependent.

    If you are using any illegal substances or misusing any medications, talk with a healthcare provider. It’s important to stop using/misusing these, but stopping without supervision may be dangerous, depending on the substance and other factors.

    Seek help.

    If you think you might have a mental illness, reach out for help. You can talk with your primary care provider or schedule an appointment with a mental healthcare provider, such as a therapist, psychologist, psychiatrist, or psychiatric nurse practitioner.

    A healthcare provider can talk to you about your symptoms and work with you to develop a plan. Therapy and/or medication might be beneficial for you. 

    If you are having thoughts of suicide, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.

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    Sophie Stein received her master’s of science in nursing from Vanderbilt University School of Nursing. She previously worked as an advanced practice registered nurse at an outpatient psychiatric practice providing mental health care for children, adolescents, and adults. She performed patient evaluations and medication management, including using pharmacogenetic testing to guide her treatment plans.

    Global

    Trigger Warning: A Chinese Father Saved More Than 300 People at Nanjing Yangtze River Bridge

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    “I understand these people. I know they are tired of living here. They have had difficulties. They have no one to help them.” – Chen Si

    Since the Nanjing Yangtze River Bridge was first built in 1968, an estimated 2,000 people have died from suicide involving the bridge. According to data from 1995-99, in China’s first national survey in 2002, death from suicide accounted for 3.6 percent of the country’s total deaths. During that period of time, 287,000 Chinese people died from suicide every year, putting the average suicide rate at 23 per 100,000 people.

    Chen Si, also known as The Angel of Nanjing, has been patrolling this bridge every Saturday for more than 20 years and has managed to save more than 300 people from death by suicide. He is a 52-year-old father from Nanjing, the capital of Jiangsu province of the People’s Republic of China. Following the loss of a close relative to suicide, Chen Si has taken up this cause because someone needs to.

    A Long History

    The relationship between mental illness and suicide is controversial in China. Those who follow traditional Chinese philosophy are not encouraged to express their feelings, nor are they encouraged to expect their environment to change to suit their needs. Therefore, intense misery and feelings of despair may go unrecognized, and suicidal symptoms are not easily detected by Chinese medical professionals. In fact, many doctors working in rural areas do not understand the symptoms of depression and often receive low salaries, which discourages more doctors from entering the mental-health field.

    Gender Differences

    According to the World Health Organization (WHO) statistics, China’s suicide rate in the 1990s was 20 per 100,000 people. In the 1990s, female suicides were higher than male suicides by a factor of three. While China remains one of the few countries with a higher suicide rate among women than men, recent data shows that these disparities have evened out. In 2016, suicide rates among Chinese men and women came up almost even at 9.1 per 100,000 men and 10.3 per 100,000 women. Overall, China’s suicide rate in 2016 was 9.7 per 100,000 people, which was among the lowest globally.

    A 2002 survey also revealed that 88 percent of females who died from suicide used agricultural pesticides or rat poison. Although China initially eliminated highly toxic pesticides to improve the safety of its farm produce, the elimination also had a substantial impact on the reduction of deaths from suicide among women. Research shows that men tend to attempt suicide through violent means such as hanging, whereas women tend to attempt suicide with medication. Overall, most studies indicate a decline in suicide rates among all gender and regional categories in China. The studies also recommended targeted suicide prevention programs, particularly for people in rural areas.

    Shifting Tide

    Women’s freedom, urbanization, and decreased access to toxic pesticides are key reasons behind the decline in suicide rates. According to Jing Jun, a professor at Tsinghua University in Beijing, “female independence has saved a lot of women.” The founding of New China in 1949 in combination with the opening-up policy in the late 1970s and the continuous growth of China’s economy has led to more equitable opportunities for women. Additionally, urbanization removed certain social constraints leading to more freedom for women. For instance, escaping an abusive partner or household may be easier in a city than in a small village.

    Despite a decline in death by suicide rates in China, this is an area that we should pay more attention to. Chen Si acts as an angel, but he cannot do this work alone. He hopes that officials consider building a net across the Nanjing Yangtze River Bridge to prevent deaths by suicide. 

    Resources Available

    The Crisis Intervention Centre, the first of its kind in China, was established by Nanjing Brain Hospital to provide psychological advice and support to Chinese people. The Centre also has a hotline, which can be reached at 862583712977.

    The Lifeline Shanghai at (400) 821 1215 is a free, confidential, and anonymous support service that is open 365 days a year from 10am-10pm GMT+8. 

    Facebook and other social media platforms also offer many virtual support groups for individuals experiencing hardship. The National Suicide Prevention Lifeline at 1-800-273-8255 is a 27/4, free and confidential resource to support people in distress, prevention, or in an active crisis. Users should utilize the translate function on these web pages to adjust for language barriers, if necessary.

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    Global

    A 10-Year-Old Girl in Kenya Learns Coding in Milwaukee–Virtually.

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    The pandemic and a year of virtual schooling had an unexpected benefit for a little girl in Kenya who connected with Girls Who Code at the University of Wisconsin-Milwaukee.

    “I use the computer for school, and I wanted to understand more about how they work,” said Elsie Maingi, who is 10 years old and lives in Nairobi.

    However, computer classes in Kenya were geared to high school students and business people and were usually quite expensive, said her mother, Lilian Wangechi.

    So in the fall of 2020, they turned to Google and found the free Girls Who Code program at UWM. Because of the time difference, Elsie got up at 2 a.m. for every class during that semester and the spring 2021 semester.

    Encouraging young women

    The national Girls Who Code program encourages young women of middle and high school age to get involved with computer sciences, according to Christine Cheng, an associate professor of computer science who launched UWM’s program in 2016.

    “When we knew we were going to be online in the fall of 2020, it was a blessing in disguise because it allowed many people who were not living near UWM to attend classes,” she said, “but Elsie was the only one from a different country.”

    Sammie Omranian, a graduate student and teaching assistant who manages UWM’s program, said she was amazed at Elsie’s persistence. “It was so surprising for me. I knew that she was from Kenya, but never thought about the time difference until her teacher, Anahita, told me.”

    Anahita Qashqai, a graduate student who is one of the program’s teachers, also encouraged Elsie to overcome her shyness about using her English. Qashqai told her that English was also her second language since she grew up speaking Farsi. Another student piped up that her first language was Spanish. By the next class, Elsie had turned on the camera, unmuted, and was chatting away with her new friends and classmates from across the world.

    “After that she felt more involved and engaged,” Omranian said. After falling a little behind for the first session because of the language concerns, Elsie quickly caught up. “Elsie was the only student who completed everything 100%,” Omranian said.

    ‘Awe for the amazing opportunity’

    When the second class finished in the spring of 2021, Omranian sent Elsie the certificate and tote bag that all the students received. It took a few months to get to Kenya, but Elsie and her mom were so excited to get it that they sent a photo and a thank-you note.

    “Today Elsie received her certificate from GWC and I can tell that it’s one of her best days,” Wangechi wrote in an email to Omranian. “I look back at the year 2020 and am at awe for the amazing opportunity my daughter got at your program. She had always wanted to understand how computers work and her dream came true.”

    The UWM program was the perfect answer to their needs, she added, with the only requirements being an internet connection and the ability to go to class early in the morning.

    “The program has opened a new frontier for Elsie that is boundless and she knows that her wildest dreams can come true. This is an experience as a parent that I could never have replicated,” Wangechi wrote. “We say AHSANTE (THANK YOU) to everyone who made this possible – the tutors, program coordinators and the donors.”

    What is Girls Who Code?

    Girls Who Code is a national program designed to encourage young women to enter computer sciences and other STEM fields.

    In 1995, 37% of computer scientists were women. Today, it’s only 24%, according to Christine Cheng, an associate professor of computer science who launched UWM’s Girls Who Code program in 2016. The percentage will continue to decline if we do nothing, she told NPR station WUWM in an interview. “We know that the biggest drop-off of girls in computer science is between the ages of 13 and 17.”

    UWM’s program attracts between 50 to 60 girls each semester, and offers three levels, depending on the students’ previous experience. The program is open to young women in middle and high school, though the majority are middle school age.

    Graduate students in computer science and engineering are the teachers, along with some volunteers. Several young women who have competed the program have returned as volunteers, Cheng said.

    While the program hasn’t had the resources to do a formal assessment of its impact, organizers do hear success stories from former students and their families. Makenzie Johnson completed the program in 2019, taking classes from the middle of her sophomore year to high school graduation.

    Her mother, Tanika Davis, saw the national founder of Girls Who Code on MSNBC several years ago, but there were no chapters in Wisconsin at the time. She kept checking and eventually found UWM and Marquette had started chapters.

    “Makenzie has autism and ADHD, but she was always good with computers and I knew that coding would expose her to see if that was something she was interested in and would do well in. It worked out really well,” Davis said.

    Makenzie is now studying IT and software development at Milwaukee Area Technical College, with an eventual goal of becoming a graphic designer. She is also part of a program called Islands of Brilliance that helps people with developmental disabilities.

    “Her mentors at Girls Who Code were great and really helped her thrive,” Davis said. “She felt like she was one of the gang. It was just a wonderful, wonderful experience with a diverse group of girls.”

    Emma Maertz, a former student who is coming back as a volunteer in the program, said Girls Who Code is where she explored her love for coding and the program gave her the confidence to learn more elsewhere.

    “I learned the basics of HTML, CSS, and JavaScript, and dove in a little deeper into Python. Girls Who Code taught me to not give up and to debug instead – problem-solve before you abandon hope. I will forever remember my GWC experiences and am planning on volunteering this year to help out the next generation of young girls who code,” Maertz said.

    For this coming fall, Cheng and Omranian have decided to offer a combination of online and in-person classes.

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    Education

    Easy Strategies and Accommodations for Behavioral and Mental Health Needs in Learning Enviorments

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    The numerous accommodations and modifications that teachers make for students often amount to a lengthy list. These adjustments can involve altering not only instruction but also lesson materials, which tend to exhaust much of a teacher’s planning time. While circumstances, symptoms, and needs vary from student to student, there are some of the best “universal” practices that teachers can employ when a student is impacted by a medical condition, without causing a disproportional amount of stress to the teacher.

    Symptom: Inattentiveness

    Strategies Considerations
    • Verbal/non-verbal prompting or cueing
    • Checklists or sticky notes for work completion; a checkmark or small sticky on the desk indicating strong/prolonged focus
    • Offer preferential seating
    • Proximity while giving instructions/directions
    • Brain breaks for lengthy texts or multi-step tasks
    • Brisk transitions between tasks/activities to build attentive momentum
    • Prompting and cueing could be as subtle as tapping on the desk to regain focus, and could be as direct as asking which number the student is on and encouraging further progress
    • Checklists or sticky notes would typically be paired with a weekly/monthly incentive to track student’s attention goal (504/IEP)
    • Preferential seating doesn’t necessarily mean in the front of the classroom; this could mean near the teacher’s desk, away from the window or hallway, or in the quieter back corner of the room

    Symptom: Vision issues

    Strategies Considerations
    • Offer preferential seating
    • Provide larger text/font size on handouts
    • Limit screen time or allow frequent breaks during prolonged screen use
    • Provide highlighted and/or condensed teacher notes
    • Suggest colored overlays for students whose vision issues are exacerbated by bright white paper (often seen with PANDAS)
    • Highlighted/condensed teacher notes allow students to follow along with notes/outlines without straining their eyes to copy from the board
    • Notes also ensure that only vital information is visually presented, avoiding extraneous details
    • Colored overlays are inexpensive plastic sheets that students can lay over a textbook, worksheet, or even computer screen to dull the brightness of the white background

    Symptom: Working memory/memory processing difficulties

    Strategies Considerations
    • Allow extended time for assessments and lengthier assignments, including a reduced workload when necessary
    • Provide wordbanks, multiple-choice options, and true/false for exam questions that involve more memory recall or fact-based knowledge
    • Allow use of a calculator for math assessments not hinging on mental math skills
    • Provide sentence starters or transition wordbanks for essays or timed writing tasks
    • Extended time should account for the fact that the student likely required twice as much time to review and memorize info prior to the assessment
    • When possible, reduce the exam questions to account for mastery of the skill, not the number of questions answered
    • Quiz and test modifications, such as word banks, assist students with recall by providing examples
    • True/false questions still assess the student’s knowledge of the concept but reduce unnecessary memorization
    • If a math quiz is not based solely on the student’s knowledge of multiplication/division facts, the use of a calculator removes the mental math and memorization barrier

    Symptom: Executive functioning difficulties

    Strategies Considerations
    • Give checklists for multi-step assignments or complex tasks, making sure to model how to order multiple tasks and check off to-dos as students finish sections
    • Maintain consistent routines
    • Provide approximate, suggested lengths of time for homework and/or classwork
    • Provide brisk transitions between tasks/activities to build attentive momentum
    • Model organizational strategies
    • Check in frequently
    • Simplify written instructions and verbally review instructions for clarity
    • Review daily and/or weekly agenda; highlight due dates
    • Allow students to write directly on assessments; avoid bubble sheets
    • Consistent routines ensure that students know the basic procedural expectations and can execute them independently
    • Students may need to be explicitly shown how to place papers in organized sections of a binder
    • Students may need extra time at the end of class to organize papers, materials, etc. in designated places to maintain organization
    • Allowing students to respond directly on test booklets avoids the confusion of bubble sheets and/or the likelihood of them losing their place or skipping questions.

    Symptom: Fine motor issues

    Strategies Considerations
    • Enable use of a word processor for written assignments
    • Provide teacher notes; modified note-taking
    • Utilize multiple-choice, true/false, matching, or short answer opportunities to allow students to demonstrate mastery
    • Provide the student with a larger or slanted work surface
    • Use larger lines, boxes, or spaces for written responses
    • Allow the student to use bulleted responses when appropriate
    • Encourage the use of a mouse instead of a touchpad
    • Utilize speech to text technology if available, or a human scribe if not
    • Offer pencil grips for writing and wrist supports for typing
    • Allow verbal responses
    • If providing teacher notes, encourage students to participate by highlighting or starring essential material; have them include labels or symbols while following along.
    • For lengthy assignments, consider other methods for demonstrating understanding:
      • Put story events in order using event cards instead of writing a summary
      • Match pictured steps/photo cards of a science lab to written steps, then put them in order
      • Use Scrabble letters or alphabet cards to take a spelling quiz, instead of writing out the list

    Symptom: Behavioral issues

    Strategies Considerations
    • Utilize verbal/non-verbal prompting or cueing
    • Use positive reinforcement when procedures/behavioral expectations are followed
    • Offer preferential seating
    • Give instructions/directions in closer proximity to the student
    • Allow frequent breaks for lengthy texts or multi-step tasks
    • Utilize brisk transitions between tasks/activities to deter off-task behavior
    • Use data tracking sheets and hold a weekly conference with the student, possibly providing incentives
    • Utilize the 2 X 10 strategy to build positive relationships between adults and students. In this technique, teachers engage a student in a meaningful, genuine, 2-minute conversation, unrelated to academics, over a span of 10 days.
    • Prompting and cueing could be as subtle as tapping on the desk to deter off-task behavior.
    • Prompting could also be as direct as reminding a student of behavioral expectations
    • Checklists or sticky notes would typically be paired with a weekly/monthly incentive to track a student’s behavior goal (504/IEP)
    • Preferential seating doesn’t necessarily mean in the front of the classroom; this could mean near the teacher’s desk, away from the window or hallway, or in the quieter back corner of the room.
    • Moving closer (proximity) or sustaining eye contact can often deter misbehavior.
    • The 2 X 10 strategy is proven to build rapport in difficult classrooms. It encourages a positive outlook regarding school and adults in schools.

    The classroom environment is filled with a countless array of personalities, abilities, and levels of motivation. Add to that the various medical considerations or chronic illnesses that students might experience and teachers no doubt feel stressed about making sure every learner receives what he or she needs in order to be academically successful. To ensure that students’ accommodations are met, every student must be provided with differentiated, personalized learning experiences to foster intrinsic motivation and appropriate levels of challenge.

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