It’s Grief To Me – Death, Divorce, Incarceration, Deployment and Foster Care

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Every year, educators in the public education system spend roughly 180 days and approximately around 1,000 hours with our children.  For many children, the time spent with their classroom teacher accumulates to more time then the time they spend with their own parents.  For many grieving children and teens in our communities today, their schools and their teachers remain the one constant in their lives.

Who are our grieving students in our schools today?  They are our students impacted by experiences of not only death, but situations like divorce, parental deployment, parental incarceration and foster care placement.  Many students impacted by grief and loss are not only unaware of their own grief, they find themselves struggling academically.

Grieving children have more academic barriers than their peers who are not experiencing grief.

Like the students themselves who may be unaware of their own grieving, many teachers are left in the dark about who their grieving students are.  Many may not know grief and loss experiences can connect to other life experiences such as parental divorce, incarceration of a loved one, parental deployment and foster care placement. Unfortunately, due to shame and stigma that can surround the specific grief situation of a child or teen, they may not tell their teachers out of fear or embarrassment.  Even when the teacher does know the situation, they might not quite know what to do to support their student.

In my research, I continue to find a scarcity of information on how to serve grieving youth impacted by grief and loss outside of death.  In my opinion, death is only one aspect of a much larger issue.  I realized this 13 years after my own graduation from high school when I found myself walking the halls of someone else’s high school thinking of that period of my own life that was so fraught with darkness.  This time however my role was different.  I was different.

As a mental health practitioner one of my roles was to prepare curriculum for an after school grief group within the high school mental health program where I worked.  When one student was referred to the grief group because of her father’s military deployment, I remember initially not understanding what deployment had to do with grief and loss. That quickly changed as facilitating the after school grief group provided a whole new awareness of how different grief and loss can look for a teen.

After finishing up my role as co-facilitator of the high school grief group and as my years working in the mental health program began to accumulate, I began to realize many of the youth I was surrounded by daily were grieving. Not only were they grieving, they were hungry for acknowledgement of their loss.  They wanted validation of their pain.

In my search for information,  I came to the realization that all key players need to be on the same page when it comes to the many emotions youth experience in connection to grief and loss.  Who are these pivotal players?  Not only are they the parents and caretakers of the grieving children and teens, but also educators and other key adults in the lives of youth.

I’ve come across a series of videos on Military Kids Connect, a great resource geared toward military children, teens, parents, and educators.  Although these videos are geared towards parents and caregivers of youth grieving the loss of a loved one, in my opinion, these videos also express very clearly the grief reactions of children and teens due to the effects of divorce, incarceration, and foster care placement.

In the videos Dr. Mogil, a licensed clinical psychologist and Director of Training and Intervention Development at The Nathanson Family Resilience Center, highlights grief reactions in both children and tween/teens.  Also, the Dougy Center, another great resource nationally known for their work with children and grieving families offers coping strategies for children and teens.

What initially began as one grief group experience has now turned into a lifetime mission for me.  My work is a result of my students, who allowed me into their space.  It is through their gifts I’ve learned to be curious, to ask questions instead of pass judgments.  It is through their actions and from their words I’ve learned to set the bar high, to never take “no” or “I don’t know” for an answer, and to never give up on them.

Why Robin Williams Suspected Suicide Matters

Sadly, actor and comedian Robin Williams has passed away. The Marin County Coroner’s Department lists the death Robin Williams suspected suicide due to “asphyxia”.  As a licensed Registered Nurse with emergency room trauma experience, every suicides listed as “asphyxia” that I have seen has been due to hanging.  Here is the exact wording:

Robin-Williams“The male subject, pronounced deceased at 12:02 pm has been identified as Robin McLaurin Williams, a 63 year old resident of unincorporated Tiburon, CA. An investigation into the cause, manner, and circumstances of the death is currently underway by the Investigations and Coroner Divisions of the Sheriff’s Office.

Preliminary information developed during the investigation indicates Mr. Williams was last seen alive at his residence, where he resides with his wife, at approximately 10:00 pm on August 10, 2014. Mr. Williams was located this morning shortly before the 9-1-1 call was placed to Marin County Communications. At this time, the Sheriff’s Office Coroner Division suspects the death to be a suicide due to asphyxia, but a comprehensive investigation must be completed before a final determination is made.”

Although this is an extreme moment of sadness, let’s be sure to celebrate the memories he helped us create with our friends and families.  His wife, Susan Schneider, released this statement, “This morning, I lost my husband and my best friend, while the world lost one of its most beloved artists and beautiful human beings. I am utterly heartbroken…”

In honor of Mr. Robin Williams, Let’s take this moment to recognize that everyone everywhere is at risk for silently struggling with depression.

The National Institute of Mental Health reports that the Wold Health Organization states that 8.1% of American adults suffer from a Major Depressive Disorder while 5.09% suffer from diagnosable anxiety disorders. (click here for tips on overcoming anxiety)

These numbers seem minuscule to the amount of people who likely struggle with undiagnosed symptoms.  Keep in mind that even when someone doesn’t require a diagnosis, similar symptoms as a result of difficult situations can be just as traumatizing.

If you are one of these people silently struggling, please know that you are not alone.  Seek help and affection from those close to you as well as a counselor or therapist. There is no shame in admitting you need a shoulder to cry on.  I’ve been there myself.

For everyone else, remember to never judge a book by it’s cover.  A mental health diagnosis is not a life sentence, but is a description of symptoms.  Please read more about the detrimental affect of diagnoses being used as life-long labels and how “asking why” can improve outcomes by clicking here.

Speak life instead of hate. Help instead of hurt. Encourage instead of belittle. Live and let live.  Every person has value.

Captain Hook and Mrs. Doubtfire were my two favorite Robin Williams Memories, what were yours? Please share in the comments :)

[youtube]https://www.youtube.com/watch?v=yzb726TP-OM[/youtube]

Don’t Be Afraid to Tackle the Mental Health Issues Associated with Grief

Story's Angel of Grief
Story’s Angel of Grief

Not long ago I was given a book on grief, one of those self-published books that anyone can write and sell on Amazon.  The basic premise being promoted by the author is that grief can “be defeated” if one just has enough faith whatever spiritual religious tradition they embrace.  If one is struggling with grief, the author says, they need to have “increased faith,” and “quit stewing.”  “Too much latitude is encouraged especially in terms of time for grief”, according to the writer.  “One cannot rest in peace if his or her loved ones are stewing in excessive grief.” In other words, the author is saying that if someone is grieving the death of a loved one, he or she simply needs to “get over it.”  That really made me feel angry.

I am a Presbyterian minister, a board certified professional chaplain, and a person with specific expertise in counseling and particularly grief and bereavement.  This particular book’s author, on the other hand, was written by a person who is not educated or credentialed as either a religious leader or a counselor/psychologist.  Yet, the author tells grieving people to choose a faith (or consult a medium – seriously, that’s what is written) in order to “participate” in their grief in a way that “will be shallow and brief.”

I’m also a bereaved parent and even though it has been ten years since the death of our daughter, I still grieve for her.  Grief is a journey and an event that affects our lives forever.  It does not mean we cannot continue to participate in life and find joy, but the reality is that after a loved one’s death we look at life through a different lens.

Recently I read an article in the American Journal of Psychiatry about a study done by Columbia University’s Mailman School of Public Health that revealed that there is a link between sudden grief and the onset of mental health disorders like mania, post-traumatic stress disorder (PTSD), and depression.

The article did not surprise me at all.  Our daughter’s death was sudden and traumatic.  At the time where I was working in a large teaching hospital where every day I was called to the emergency department  to provide care to families whose own loved ones died after car accidents and other traumas.  I found myself feeling overwhelmed.

While my faith in God didn’t waver – I knew God didn’t cause the accident; it was caused by the careless decision of an adult who chose to speed and accelerate through a red light – I sure was angry with God.  I knew that was normal too.  However, it still created a significant amount of spiritual distress along with the emotional distress of grief.

Fortunately, I mentioned this one day in passing when I was with a good friend.  She stopped the conversation and asked me to tell her more.  She gently suggested that while my feelings were normal, I was also showing signs of depression beyond the grief as well as symptoms of post-traumatic stress.  “You’re doing so much to take care of everyone else; you need to take care of yourself.”

Because of her willingness to listen and look for the signs, she was able to see what I couldn’t see for myself.  My grief, which I thought I was managing (“and you are doing so very well,” she said) was something I didn’t need to work so hard to cope with it on my own.  We agreed on a plan: I would go and talk with my family physician, who was just as supportive, and we too agreed on a plan – counseling, a short course of medication, and becoming a participant in a grief support group for a time rather than being a leader of one.

There are times when grief’s accompanying depression, anxiety, emotional and spiritual distress becomes too difficult for the bereaved person to bear.  That’s when the right resources need to be activated.  Families, friends, and co-workers need a basic knowledge of grief in order to normalize the bereaved person’s experience and provide them support.  We also need to understand when a bereaved person needs additional mental health support when the trauma becomes difficult to manage.

That plan didn’t “cure” my grief or take away the sadness that I still carry with me (as the author of the book I read says must happen).  There are times when it comes back with a vengeance.  During most of those grief-bursts I find I can manage with the resources I have in place that work for me:  meditation, exercise, activating my support system – however there have been a couple of times when I’ve gone back to my doctor for help in identifying appropriate short-term interventions.

Of course, there are other examples of mental health issues that we can face in our daily lives.  Stress has been shown through studies to be on the rise due to a number of factors.  Living with a chronic or life-threatening disease, caring for a sick or elderly family member, post-traumatic stress, or dealing with the magnitude of responsibilities one has to make ends meet can all cause emotional and spiritual distress.  Sometimes these lead to mental health issues that need further attention.

I was fortunate that I had a friend, who while not a professional health provider, knew enough about basic mental health ten years ago to recognize that  I was struggling.  She didn’t try to talk me out of my grief, placate me with platitudes, or take the easy way out my ignoring my comments altogether.  Instead, she listened and took the step of faith and friendship to tell me I needed to check in with a professional about what I was feeling.

Knowing the indicators of a potential mental health challenge is something that all of us, professionals and non-professionals alike, need to be aware of.  In fact, it is something that I would urge we set aside time to learn more about.

Educational opportunities are becoming more and more available within our communities and online.  Many are being designed for those who don’t work in professional care fields, but who want to become more informed about mental health issues, what signs need to be looked for, and how to respond.  Check your community organizations, not just mental health centers, but also community colleges who are offering short-term, free, or low-cost programs.

Professionals who encounter mental health situations on a regular basis and those who work with the general public, including educators, health care providers, and religious leaders, need to make learning more a priority of their continuing education.  There are an increased number of programs now available.

Because of what I have learned from my own experience, I have been able to help others by now teaching health professionals what they need to look for in order to care for not only their clients’ bodies and minds, but also their spirits.  Those who are experiencing grief, serious illness, post-traumatic stress, or facing the end of their lives need the understanding, support, and resources necessary not only to cope, but to find meaning and comfort.

Let us not be afraid to talk about, learn more, and recognize mental health issues – not just in those we love, but also in ourselves.  Read.  Take a course.  Be part of the discussion.  Make a difference.

6 Risk Factors for Suicide

Recently, three people have died by suicide in downtown Greensboro, North Carolina in less than a year by jumping off the top of a parking garage.  If three people have died just in one small area within Greensboro, how many die annually in North Carolina? The answer is a figure that is historically higher than the rest of the nation which averages of over a thousand suicides per year.

suicide-preventionNews-Record.com reported on the latest suicide committed by a 35 year old local woman on June 18, 2013:

This is the third suicide from an eight-story parking garage in downtown in less than a year. On Aug. 4 one man jumped from the Bellemeade Street parking deck. A second man jumped from the same parking deck on Sept. 1. That parking deck is about a block away from the Marriott parking deck. Read More

When faced with suicides that make the local news or impact a loved one, we often ask ourselves how this could have been prevented.

Here are six factors that can help identify who is at risk for suicide.

1. A previous attempt:  It is estimated that for every completed suicide, there are anywhere from 11 to 25 attempts.  Hospitals see at least eight times more patients for self-inflicted injuries than the average number of suicides per year.  In the case of suicide, past behavior can be a predictor for future behavior.

2. Family:  Those with a family history of suicide are at higher risk.  Not only are genetic factors inherited from family, but maladaptive patterns of coping can be learned.  Some people may feel they are destined for suicide if those in generations past died from suicide.  Those who have experienced physical, sexual or emotional abuse in their families are also at risk.

3. Depression: Not all people who die by suicide are experiencing acute mental illness.  However, having a history of depression or other mental illness can make coping with everyday life difficult and is a risk factor.  Some studies cite that up to 90 percent of those who commit suicide have been diagnosed with depression or bipolar disorder.

  1. Substance Abuse: A 2009 study showed that 25 to 40 percent of suicide victims had alcohol in their bodies at the time of death. About 69 percent of suicide deaths occur by prescription drug overdose. The use of drugs and alcohol can cloud judgment, enhance impulsivity and
  2. Sexuality and gender issues: Individuals who are lesbian, gay, bisexual, or transgender can be outcasts in society and face stigma and discrimination on a daily basis.  This, along with negative family reactions, conflict with spirituality/religious affiliation, higher rates of violence and substance abuse make this population vulnerable. Suicide among LGBT youth is particularly high, with up to 30-40 percent attempting suicide.

6. Access to means: An immediate risk factor for suicide is one’s access to the means used to commit suicide.  Are there guns and knives in the home? Is medication being stockpiled? How likely is it that someone could access these things?

These are just a few risk factors.  Others include being bullied, PTSD/Military involvement, being male, incarceration, living in a rural community, physical illness, lack of treatment, hopelessness, and grief or loss.  As a graduate school professor once told me, “Suicide happens when the world throws a situation at you that you don’t have the resources to cope with besides death.” Any stressful situation may lead to someone considering suicide.

How to help:

Be a good listener. Be non-judgmental. Offer hope that things can get better with help. Pay attention to mood and the risk factors listed above.

Don’t be afraid to ask “Are you thinking about suicide?” This shows you are not afraid of the situation and clears up any gray areas.

Offer to find local resources and help. Find a licensed mental health professional who can help.

Call 911 if situation is imminently life-threatening.

More about how to help a suicidal person here:

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