Tragic Event Resources for Schools/Educational Settings and Parents

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1 Tragic Event Resources for Schools/Educational Settings and Parents Helpful Tools: Crisis Line Description: The Crisis Line is available 24 hours a day, seven days a week to anyone experiencing a mental health crisis. Serving Maricopa County and parts of Pinal County (ZIP Codes 85120, 85140, and 85143). Toll free: (800) Local: (602) TTY/TDD toll free: (800) TTY/TDD local: (602) For emergency situations always call Partnership Hotline between Magellan Health Services and ADHS/DBHS Description: The Arizona Department of Health Services (ADHS)/Division of Behavioral Health Services (DBHS) and Magellan Health Services of Arizona have set up a 24- hour toll-free hotline to help citizens process feelings of grief, sorrow and depression. The hotline is staffed by behavioral health professionals to offer counseling services to people outside Pima County. Arizona residents can call the hotline to connect with crisis response professionals who specialize in behavioral health. This information and more can be found on the ADHS/DBHS website. Phone Number: CARES ( ) Mental Illness on Campus What You Can Do to Help Description: Tips on how to identify a person in trouble and what you can do to help. ontentmanagement/contentdisplay.cfm&contentid= MORE -

2 The following are attached documents: 1. Crisis card Description: Crisis Response Network provides crisis services for central Arizona. Services include phone intervention and mobile crisis teams. 2. Mental Illness on Campus What You Can Do to Help Description: Tips on how to identify a person in trouble and what you can do to help. ate=/contentmanagement/contentdisplay.cfm&contentid= Magellan Bookmark Description: Bookmark provides a brief description of Magellan Health Services. Bookmark also contains Member Services and crisis contact information. 4. Safe Talk, Suicide Talk, and ASIST training Description: Document describing training to learn how to provide practical help to persons with thoughts of suicide. Website link to Achieve training website. 5. La Voz Spread English Version Description: Article was featured in La Voz newspaper. Article highlights mental/behavioral health topics such as, crisis, accessing services, and signs and symptoms. 6. La Voz Spread Spanish Version Description: Article was featured in La Voz newspaper. Article highlights mental/behavioral health topics such as, crisis, accessing services, and signs and symptoms 7. Handout: Tips on Calling an Agency for Mental/Behavioral Health Services Description: Document provides support and guidance to someone who is calling about mental/behavioral health services. 8. Arizona Response to Intervention Description: School achievement and success require that students be provided both academic and behavioral systems of support. A comprehensive system of behavioral supports ensures that students are ready and able to learn by creating environments conducive to learning and by addressing barriers to learning that students experience. Link: https://www.azed.gov/azrti/systemofbehavioralsupports/rtisbs_fnl3.pdf - MORE -

3 9. School Safety: What Schools Can Do Description: A safe school is one that is free from violent and criminal behaviors and allows staff, students and community members to feel connected to the school and able to participate in its major functions teaching and learning. Link also provides numerous references to examples, studies, and supportive documents. Link: https://www.azed.gov/sa/health/downloads/what_schools_can_do 4_.pdf 10. Guide: Mental Health Crisis Planning for Families and Educators Description: Guide for parents to Learn to Recognize, Manage, Prevent and Plan for Your Child s Mental Health Crisis. 11. Photonovela English Version Description: Created by youth to help identify when someone might need help and how to access services. English version: pdf 12. Photonovela Spanish Version Description: Created by youth to help identify when someone might need help and how to access services. Spanish version: al.pdf 13. Children and Tragedy Factsheet Description: Factsheet with tips on what to look for while helping children recover from a tragic event. 14. Common Responses to Traumatic Events Factsheet Description: Factsheet with tips on some common reactions and signs/symtoms of trauma that may present themselves after traumatic events. 15. Coping with Children s Reactions Factsheet Description: Factsheet with adviced to parents on how to cope with children s reactions after a disaster. - MORE -

4 16. Overcoming Your Fears and Anxiety Factsheet Description: Factsheet with tips on what individuals can do to overcome feelings of anxietey. 17. Post-trauma Do s and Don ts Factsheet Description: Factsheet with tips on what to do and not do after a traumatic event. 18. Teenage Grieving Factsheet Description: Factsheet with tips on common reactions of teenagers who are grieving. 19. Tragedy Aftermath Taking Care of Yourself Factsheet Description: Factsheet with tips on what common responses to a disaster and helpful tips on how to deal with them. The following are resources available on line: 1. How to Get Care through Magellan Health Services of Arizona/How to Refer to Mental Health Services Description: Magellan of Arizona's website provides people with additional information about how to access mental health services. Link: 2. Arizona State Legislature Description: Use this web site as a tool to track pending legislation, plus locate and contact individual legislators, and stay up-to-date on current issues. For an overview of the legislative process in Arizona, please feel free to explore this web site. Link: 3. How Do I Find or Contact my Legislator Description: Search for local legislator by address and zip code Link: 4. National Center for Crisis Management Description: Site provides downloadable crisis documents to aid a school in the development of a crisis response plan. Link: - MORE -

5 5. Title: Mental Health America - Tips for Educators, Students and Parents (after the Virginia Tech Tragedy) Link: 6. Title: National Alliance on Mental Illness (NAMI) - The Virginia Tech Tragedy- Distinguishing Mental Illness from Violence Link: ent/contentdisplay.cfm&contentid=45403

6 The Crisis Line is available 24 hours a day, seven days a week to anyone experiencing a mental health crisis. Crisis Line Serving Maricopa County and parts of Pinal County (ZIP Codes 85120, 85140, and 85143) Toll free: (800) Local: (602) TTY/TDD toll free: (800) TTY/TDD local: (602) For emergency situations always call

7 Qué es Magellan de Arizona? Magellan Health Services de Arizona es la Autoridad Regional de Salud Mental del centro de Arizona, que incluye todo el Condado de Maricopa y parte del Condado Pinal. Los fondos para proporcionar los servicios se obtienen a través de un contrato con el Departamento de Servicios de Salud/la División de Servicios de Salud Mental de Arizona y el Sistema de Contención de Costos de Atención de Salud de Arizona. Cómo presta los servicios Magellan de Arizona? Magellan de Arizona maneja un sistema integral de Organizaciones de Red de Proveedores (PNO, por sus siglas en inglés) y Proveedores de Servicios Calificados (QSP, por sus siglas en inglés), que brindan una gran variedad de servicios para la salud mental y el tratamiento de abuso de sustancias para residentes elegibles dentro del Condado Maricopa y partes del Condado Pinal. Magellan contrata a los proveedores teniendo en cuenta los valores de las elecciones de los individuos que reciben servicios, la diversidad cultural, y la recuperación y el restablecimiento de los adultos, los niños y sus familias. Para obtener una lista completa de las agencias de proveedores, visite com/directory. Cómo recibo los servicios? Después de la inscripción, usted deberá elegir una PNO o un QSP según sus necesidades individuales. Su proveedor le asignará un representante de salud mental que le asistirá en la coordinación de su atención. Para dar inicio al proceso de inscripción o para obtener más información, comuníquese con Servicios para Miembros de Magellan al (800) o a nuestra línea TTY al (800) S Magellan de Arizona (800) TTY (800) Si está en crisis, puede encontrar ayuda. Llame a la Línea de Crisis del Condado Maricopa al (800) o al TTY al (800) Para emergencias, siempre llame al

8 Who is Magellan of Arizona? Magellan Health Services of Arizona is the Regional Behavioral Health Authority for central Arizona, which includes all of Maricopa County and part of Pinal County. Funds for services are provided through a contract with the Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS) and the Arizona Health Care Cost Containment System (AHCCCS). How does Magellan of Arizona deliver services? Magellan of Arizona manages a comprehensive system of provider network organizations (PNO) and qualified service providers (QSP) who deliver a variety of behavioral health services such as medication, substance abuse treatment, crisis assistance and other support services for qualifying residents of Maricopa County and parts of Pinal County. Magellan contracts with providers around the values of service recipient choice, cultural diversity, and recovery and resiliency for adults, children, and their families. For a complete list of provider agencies, visit Directory. How do I get services? After enrollment you will choose a PNO or QSP depending on your individual needs. Your provider will assign you a behavioral health representative who will assist you in coordinating your care. To begin the enrollment process or for more information, contact Magellan Member Services at (800) or our TTY line at (800) Magellan of Arizona (800) TTY (800) If you are in a crisis, help is available! Call the Crisis Line at (800) or TTY at (800) For emergencies, always call

9 Mental Illness on Campus ~ What You Can Do to Help Times of anxiety and feeling down are common experiences in college, but did you know that they may be part of a treatable mental health condition? The latest research reports that feeling depressed to the point where students have trouble functioning impacts about 40% of students while 15% have a serious clinical depression. Suicide is a serious problem in college---about 1,100 lives a year are lost to this largely preventable outcome. The 2005 National College Health Assessment (NCHA), a survey of nearly 17,000 college students conducted by the American College Health Association, revealed that 25% reported they felt so depressed it was difficult to function three to eight times during the past year and 21% reported they seriously considered suicide one or more times during the past year. In the NCHA survey, students also ranked depression as one of the top ten impediments to academic performance. While colleges and universities have a role in ensuring the health and safety of people on campus, students themselves are often the first to recognize when a problem might exist and are likely the first to be able to engage before the condition becomes a more serious issue. How can you tell if a Person is in Trouble? Take conversations about suicide or homicide very seriously. A person who jokes about suicide or homicide may be struggling with a deeper sense of hopelessness. Most people who commit suicide have told someone, often in the days preceding the event. Sleep problems are often a symptom of more serious health problems. Roommates who have big changes in sleep patterns may be at risk for psychiatric illnesses. For example, if a person who usually sleeps ten hours, midnight to 10 am, suddenly begins waking up at 5 am and acts agitated or begins pacing, this could be a sign that they may be experiencing a deeper problem that should be addressed. Bulimia and Anorexia are eating disorders that often co-occur with anxiety and depression. Behaviors such as patterns of binge-eating, recurrent inappropriate behavior to control one s weight, self-induced vomiting,

10 excessive exercise, expressions of an intense fear of gaining weight, or an ongoing preoccupation with weight and food despite being may be signs of a more serious psychiatric illness that needs medical attention. Alcohol and drug use compound all risk. Alcohol risk is higher in sororities and fraternities, but the risk remains for most college students as alcohol is often a part of acceptable campus social life. Guns are very high risk in combination with alcohol and other drugs; these two in combination are very dangerous. Be aware of expectable life stresses. Relationship breakups, future career stress, exam pressure, peer pressure and judgment, loneliness, financial stress, and even graduation can compound all other risks. Be mindful of other possible, less expectable but very real stresses--for instance the realization that one may be gay, that one is being bullied or discriminated against, the death of a parent of grandparent, or divorce can compound self harm risk. What to do if you suspect a person is in trouble or at risk. Follow your instincts. People have been wired for Millennia to detect unusual or risky social situations, and your instincts can be a key to helping someone get the help they need. If you feel sad around the person, remember feelings can be contagious, and you may be sensing their own internal despair. If you want to avoid the person, note that, too. Do not hesitate to tell someone in authority on campus about your concerns. Don't worry alone. If you live in on-campus housing, start with your Residential Assistant/Advisor who can offer more information and resources or will often know the best approach and services available to you. You can also go to the Campus Counseling Center for information and assistance about what is available on your campus community. If you feel you can, approach the person with concern, not judgment. Easy comments such as I sense you are (sad, troubled) etc. can begin a discussion and possibly invite the person to talk about what they are experiencing. Gently suggest they get help, offer to go with them if you feel comfortable with that. However, safety should always come first yours. Offer information on college mental health services. Don t be afraid to use them as they help people every day deal with the stresses of college life.

11 Offer information on web sites that might be helpful. Students rely on networking and the Internet as primary information sources. NAMI has a NAMI on Campus section at that also features discussion group networking options that may offer the person support and information to help them manage their own situations. Additionally, there are over 1,100 local NAMI affiliates in communities across the country. Visit to Find Support that is the most convenient. Meetings and groups can offer hope and support to students. There are often dozens of campus student groups operating all days of the week, including support and networking groups for mental illness and stress management. Find out what may be available and encourage the person to attend. If you feel comfortable, offer to go to a first meeting with the person, or find another person who might offer to make the meeting more inviting. Be gentle with yourself. Even the best doctor cannot predict all bad outcomes. People sometimes hide their feelings and behavior to avoid consequences. Remember that you are ultimately only responsible for your own behavior. Reviewed by Ken Duckworth, M.D., 2007 Permission is granted for this fact sheet to be reproduced in its entirety, but the NAMI name, service mark, and contact information must be included. NAMI on Campus 3803 N. Fairfax Drive, Suite 100, Arlington, VA 22203, Ph: , Website:

12 4. Safe Talk, Suicide Talk, ASIST and Mental Health First Aid trainings Description: Please go to the website listed below for a full list of training. In particular: ASIST Applied Suicide Intervention Skills Training Purpose: The goal of this two-day, highly interactive, practical, practiceoriented workshop is to provide skills to all individuals to apply first-aid suicide intervention in times of individual and family crises. Training Highlights: - Reduce fears about suicide. - Increase knowledge for utilization in effective intervention. - Increase competence and confidence in suicide first-aid skills. - Develop practical intervention skills to effectively deal with suicidal situations. - Understand that suicide is a preventable problem. Safe Talk, Suicide Talk - In only a few hours, you will learn how to provide practical help to persons with thoughts of suicide. Expect to leave safetalk more willing and able to perform an important helping role for persons with thoughts of suicide. How does safetalk help prevent suicide? - SafeTalk prepares you to be a suicide alert helper. You are aware that opportunities to help a person with thoughts of suicide are sometimes missed, dismissed and avoided. You want persons with thoughts to invite your help. You know the TALK steps (Tell, Ask, Listen and KeepSafe) and can activate a suicide alert. As part of the KeepSafe step, you connect persons with thoughts to persons trained in suicide intervention. Helpers trained in suicide intervention complete the helping process or connect the person with more specialized help. Why use safetalk to learn to become alert? - A carefully crafted set of helping steps and the use of creative educational processes make it possible for you and up to 30 others in your community to leave safetalk willing and able to be suicide alert helpers. safetalk is the result of some twenty years of work at learning how to develop useful suicide prevention abilities in a short program. Mental Health First Aid - Mental Health First Aid is the initial help given to a person showing symptoms of mental illness or in a mental health crisis until appropriate professional, peer or family support can be engaged. In the 12-hour, two-day course, Mental Health First Aid training

13 teaches people a five-step action plan to help someone in a mental health crisis or someone showing symptoms of mental illness. To help remember the steps, course participants learn a mnemonic, A-L-G-E-E: - A: Assess for risk of suicide or harm. - L: Listen non-judgmentally. - G: Give reassurance and information. - E: Encourage appropriate professional help. - E: Encourage self-help and other support strategies. In central Arizona, Mental Health First Aid trainers have reached more than 500 community members since the statewide initiative launched in spring Those who are interested in becoming trained in Mental Health First Aid should visit the Arizona Department of Health Services website dedicated to this initiative implementation, The website contains additional information on the program and a list of upcoming training sessions and contact information for instructors if anyone wants to host the training for their group or organization. Mental Health First Aid USA is disseminated by the National Council for Community Behavioral Healthcare, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health. To learn more about the Mental Health First Aid program, visit Sign up for these FREE trainings at the Achieve website: https://magellan.learn.com/az

14 Magellan Health Services de Arizona está dedicada a fortalecer el sistema de salud mental del centro de Arizona. Mayo es el Mes de la Concientización de la Salud Mental, una excelente oportunidad para aprender más sobre las enfermedades mentales y dónde solicitar ayuda. Es un periodo en el que profesionales, organizaciones, escuelas, comunidades, hospitales y medios de comunicación unen esfuerzos para crear conciencia sobre la importancia de la salud mental y reducir el estigma que impide que las personas reciban la ayuda profesional que requieren. Para Magellan de Arizona, esta labor es de todos los días tomando en cuenta que en Estados Unidos, uno de cada cuatro adultos y uno de cada cinco niños es afectado por una enfermedad mental sin importar raza, nivel de educación o estatus socioeconómico. La falta de acceso a los servicios de salud mental continúa siendo un problema serio entre las minorías en todo Estados Unidos. Si bien la falta de seguro médico juega un papel importante en el acceso a los servicios de salud, las creencias culturales, la falta de información y entendimiento de las enfermedades mentales también son barreras claves que impiden que las personas se atiendan. De acuerdo a la Asociación Americana de Psiquiatría, Los Hispanos o Latinos suelen tener diferentes percepciones al solicitar servicios de salud mental y sentirse estigmatizados por hacerlo. Por ejemplo, algunos tienden a confundir la depresión con el nerviosismo, cansancio o inclusive hasta un malestar físico creyendo que se trata de algo temporal o pasajero. Como resultado, las personas afectadas por una enfermedad mental pueden no reconocer los síntomas como tales y que requieren la atención de un especialista en salud mental. Si bien muchas de las barreras que impiden que los hispanos soliciten tratamiento son comunes entre otros grupos étnicos, la Asociación Americana de Psiquiatría señala que los hispanos utilizan los servicios de salud mental mucho menos que otros grupos étnicos. Como la Autoridad Regional de Salud Mental en el estado (RBHA por sus siglas en inglés), Magellan de Arizona está Richard Clarke Presidente, Magellan de Arizona dedicada a fortalecer el sistema de salud mental del centro de Arizona. Un sistema, que además de brindar esperanza, recursos y recuperación a aquellos en nuestro cuidado, facilita el acceso de servicios a las comunidades más vulnerables elegibles para tratamiento de salud mental. En Magellan de Arizona creemos que las personas que reciben servicios de salud mental deben recibirlos de manera respetuosa basado en sus preferencias individuales, valores, necesidades, idioma de preferencia y creencias culturales. Para lograr esto, apoyamos a nuestro personal y red de proveedores para aseguranos de proporcionar un servicio culturalmente competente. De esta manera, construimos relaciones más estrechas con la gente y la comunidad que servimos, proporcionamos un mejor servicio y ayudamos a fortalecer la comunidad del centro de Arizona en general. Como parte de nuestro esfuerzo por facilitar el acceso de servicios de salud mental a las comunidades más vulnerables, Magellan ha recopilado esta serie de información y recursos de salud mental para ayudarle a entender mejor la causa y síntomas de las enfermedades mentales y donde pedir ayuda. La mayoría de la información contenida en estas páginas fue extraída de documentos del Instituto Nacional de Salud Mental (NIMH por sus siglas en inglés) y del Departamento de Salud y Servicios Humanos (DHHS por sus siglas en inglés), quienes autorizan y fomentan la reproducción de sus publicaciones para mejorar la salud pública. Por favor tome tiempo suficiente para revisar y compartir esta información con sus seres queridos. Si usted o alguien que conoce requieren de servicios de salud mental o contra el abuso de sustancias, comuníquese con Magellan de Arizona llamando al (800) Magellan de Arizona y nuestros proveedores brindan a las personas elegibles para AHCCCS y a sus familiares, una voz en el proceso de recuperación y la oportunidad de elegir dónde y cuándo solicitar ayuda. Verdades Sobre La Salud Mental Aproximadamente uno de cada cinco adultos mayor de 18 tiene un desorden de salud mental diagnosticable. (National Institute of Mental Health) Las enfermedades mentales son más comunes que el cáncer, la diabetes o las enfermedades cardiacas. (American Surgeons General s Report) Las enfermedades mentales afectan a cualquier persona, independientemente de su edad, estatus económico, raza, religión o cultura. Las enfermedades mentales afectan tanto a hombres como mujeres. (National Alliance for the Mentally Ill) Las enfermedades mentales suelen desarrollarse durante la adolescencia y juventud. Sin embargo, estas pueden presentarse a cualquier edad. Los jóvenes y personas de la tercera edad están más propensos a padecerlas. (National Alliance for the Mentally Ill) 4 de las 10 causas principales de incapacidad (años perdidos de productividad) en Estados Unidos y otros países desarrollados son las enfermedades mentales, las cuales incluyen depresión crónica, trastorno bipolar, esquizofrenia, y el trastorno obsesivocompulsivo. Muchas personas sufren más de una enfermedad mental en algún momento de su vida. (National Institute of Mental Health) Con tratamiento y cuidado apropiado, entre el 70-90% de las personas con enfermedades mentales logran reducir los síntomas de manera significante y tener una mejor calidad de vida. (National Alliance for the Mentally Ill) Más de 2/3 de las personas con enfermedades mentales en Estados Unidos viven en la comunidad y mantienen vidas productivas. (National Mental Health Association) Los Hombres y la Depresión Instituto Nacional de Salud Mental Señales y Síntomas Sentimientos de tristeza, ansiedad, irritabilidad o sentirse vacío Pérdida de interés en el trabajo, la familia y actividades que antes disfrutaba incluyendo el sexo Problemas de concentración o mala memoria Dormir o comer demasiado o poco Pensamientos suicidas o intentos de suicidio Síntomas físicos persistentes tales como dolores de cabeza, trastornos digestivos y dolores crónicos que no responden a tratamientos Problemas para cumplir con sus responsabilidades La Buena Salud Mental No Tiene Edad Departamento de Salud y Servicios Humanos Una mente sana es tan importante como un cuerpo sano. El tener buena salud mental no significa que usted nunca se sentirá triste, solo o abatido. Pero cuando estos sentimientos trastornan su vida o permanecen en su ser por mucho tiempo, puede ser que haya un problema más grande. Sentimientos inusuales de tristeza o depresión pueden ocurrir cuando tiene que mudarse de su hogar; sus seres queridos se enferman o fallecen, tiene que depender de otros para ir a lugares o para hacer cosas simples que usted solía hacer por sí mismo o sus problemas de salud física parecen abrumadores. Si su depresión o los cambios en su comportamiento duran más de dos semanas, hable con su médico u otro profesional que provee cuidados de salud. Explíqueles exactamente cómo usted se está sintiendo y aclare que es diferente de cómo usted solía sentirse. Ellos pueden diagnosticar algún problema y sugerir opciones de tratamiento. Comparta sus sentimientos con un amigo, algún miembro de la familia o con un consejero espiritual. A veces estas personas pueden distinguir cambios que usted no nota. Si usted o alguien que conoce requieren de servicios de salud mental o contra el abuso de sustancias, comuníquese con Magellan de Arizona llamando al (800) Los servicios de Magellan están disponibles para niños y adultos y son cubiertos por Medicaid o AHCCCS/KidsCare. Además de sentimientos de depresión, algunos de los siguientes cambios en el comportamiento pueden sugerir la existencia de otros problemas emocionales: Afectarse o disgustarse fácilmente Falta de energía para hacer las cosas que quiere hacer o las cosas que solía hacer Cambios en sus hábitos de dormir Creciente falta de memoria Llorar mucho Pasar mucho tiempo solo Perderse con frecuencia Sentirse con miedo a las cosas Cambios en sus hábitos de comer Tener problemas con el manejo de dinero Creer que no puede hacer algo útil, algo que valga la pena Sentirse confundido Sentirse desalentado o abrumado Pensar que no vale la pena vivir la vida Pensar en hacerse daño a sí mismo La depresión es un trastorno médico serio para el cual existe tratamiento. Es una enfermedad cerebral que puede afectar a cualquiera incluyendo a los hombres. Tan solo en Estados Unidos más de seis (6) millones de hombres padecen de depresión cada año. Sea ejecutivo, empleado en construcción, escritor, policía, estudiante, rico o pobre, con muchos seres queridos a su lado o esté solo, no está inmune a sufrir depresión. Sin embargo, algunos factores como antecedentes de depresión en la familia, problemas de estrés, pérdida de un ser querido o alguna enfermedad crónica, pueden hacerle aún más vulnerable a padecer de depresión. Tanto los hombres como las mujeres pueden padecer de este trastorno. Sin embargo, los hombres suelen manifestarlo de manera diferente. Los hombres por lo general se quejan de fatiga, irritabilidad, pérdida de interés en el trabajo o pasatiempos favoritos y problemas de sueño, y no se quejan tanto de otros síntomas como sentimientos de tristeza, falta de auto estima y culpabilidad excesiva. Si bien las mujeres con depresión tienden a cometer más intentos de suicidio, los hombres tienen mayor probabilidad de morir por suicidio. Por ello y muchas más razones es importante aprender a reconocer los síntomas y buscar ayuda profesional. Tenga presente que no todas las personas que sufren depresión manifiestan todos los síntomas. Algunos tienen pocos síntomas, mientras que otros pueden tener muchos. La severidad de los síntomas varía de una persona a otra y también puede variar con el transcurso del tiempo. Trastornos de Ansiedad Instituto Nacional de Salud Mental Los trastornos de ansiedad suelen desarrollarse gradualmente y puede Los trastornos de ansiedad afectan comenzar en cualquier punto del ciclo de aproximadamente a 40 millones de adultos vida, aunque los años de mayor riesgo son estadounidenses de 18 años de edad o más aquellos entre la infancia y la mediana edad. (aproximadamente 18%) cada año, llenando Los síntomas pueden mejorar o empeorar a las personas de miedo e incertidumbre. A diferencia de la ansiedad relativamente con el tiempo, y generalmente empeorar en leve y transitoria causada por un evento momentos de estrés. estresante (tal como hablar en público o Las personas con trastornos de la primera cita amorosa), los trastornos de ansiedad duran por lo menos seis meses y pueden empeorar si no se tratan. ansiedad pueden visitar a su médico varias veces antes de descubrir que tienen este trastorno. Pueden pedirle a su doctor Los trastornos de ansiedad son ayuda con dolores de cabeza o problemas clasificados y divididos en diferentes tipos para dormir, los cuales pueden ser y categorías como el trastorno de pánico, síntomas de un trastorno de ansiedad, pero el trastorno de estrés postraumático, el no siempre reciben la ayuda que necesitan trastorno obsesivo-compulsivo y trastorno de ansiedad generalizada. Cada trastorno inmediatamente. Puede tomar tiempo para de ansiedad tiene diferentes síntomas, pero que un doctor determine que una persona todos los síntomas se agrupan alrededor de cuenta con un trastorno de ansiedad y no un temor o pavor irracional y excesivo. algo más. Si bien es perfectamente normal Los trastornos de ansiedad suelen ser preocuparse por la salud, el dinero o acompañados por otras enfermedades problemas familiares, las personas con físicas o mentales incluyendo el abuso de trastornos de ansiedad pasan el día llenas sustancias lo que puede hacer más difícil de preocupaciones y tensiones exageradas detectar los síntomas y empeorarlos. En por éstos y otros motivos todo el tiempo, algunos casos, estas otras enfermedades incluso cuando hay poco o nada que las provoque. En ocasiones, el simple necesitan ser tratadas antes que la persona pensamiento de cómo afrontar el día les responda favorablemente al tratamiento produce ansiedad. para el trastorno de ansiedad. Hoy en día existen tratamientos Investigaciones y hallazgos clínicos revelan que los hombres y las mujeres hablan distinto o en el caso de lo hombres, sencillamente no hablan sobre los síntomas de la depresión. Muchos no aceptan que tienen un problema de depresión, se reúsan hablar de cómo se sienten y pedir ayuda influenciados por sus creencias culturales u origen étnico. Por ejemplo, el rol tradicional del hombre en la comunidad Latina puede contribuir a que el hombre se reúse ha expresar sus sentimientos sobre la depresión. En lugar de reconocer sus síntomas, pedir ayuda o solicitar el tratamiento apropiado, los hombres con depresión independientemente de su origen étnico pueden recurrir al alcohol o las drogas cuando están deprimidos, frustrados, desanimados, enojados, irritados y algunas veces violentamente abusivos. Algunos hombres enfrentan la depresión dedicándose de manera compulsiva a su trabajo, tratando de ocultar la depresión a sí mismos, la familia y los amigos; otros hombres pueden responder a la depresión mostrando comportamiento temerario, es decir arriesgándose y poniéndose en situaciones peligrosas. La depresión al igual que otros trastornos emocionales no conoce género, nacionalidad, diferencias étnicas o culturales. Sin tratamiento, la depresión puede llevar a problemas personales, familiares y financieros. Afortunadamente, la depresión como la mayoría de las enfermedades mentales es una enfermedad real para la que existe un tratamiento. Con un diagnóstico y tratamiento apropiado, la mayoría de las personas pueden y suelen recuperarse. Señales y Síntomas Se preocupa demasiado por las actividades de cada día Se preocupa mucho más de lo que debería Tienen problemas para concentrarse Se sobresalta con facilidad Insomnio, despierta con frecuencia y no se puede relajar Tienen dolor de cabeza, muscular, estomacal o dolores inexplicables Temblores o tics (movimiento nervioso) Está irritable, suda mucho y se marea o le falta el aire Tiene que ir al baño seguido efectivos para los trastornos de ansiedad y se continúa descubriendo nuevos tratamientos que permiten a las personas vivir vidas productivas. Si cree que usted o alguien que conoce padece un trastorno de ansiedad, busque información y ayuda lo antes posible. Magellan Health Services de Arizona, Inc. es la Autoridad Regional de Salud Mental del condado Maricopa y partes del condado Pinal. Los fondos para servicios son proporcionados por contrato con el Departamento de Servicios de Salud de Arizona/División de Servicios de Salud Mental de Arizona y el Sistema de Contención de Costos de Cuidado de Salud del Estado de Arizona (AHCCCS).

15 Déficit de Atención e Hiperactividad (ADHD) Instituto Nacional de Salud Mental El Déficit de Atención e Hiperactividad o Attention-Deficit/Hyperactivity Disorder (ADHD por sus siglas en inglés) es un trastorno común en la infancia y puede afectar a los niños de distintas maneras. El ADHD hace que a un niño le sea difícil concentrarse y prestar atención. Algunos niños pueden ser hiperactivos o tener problemas para tener paciencia. El ADHD puede hacer que a un niño le resulte difícil desempeñarse bien en la escuela o comportarse en su casa. Diversos estudios han demostrado que en los últimos años alrededor de uno de cada 10 niños en los Estados Unidos ha sido diagnosticado con ADHD. Investigadores del Centro para el Control y Prevención de Enfermedades encontraron que del 2007 al 2009, nueve por ciento de los niños entre los 5 a 17 años fueron diagnosticados con este trastorno comparado al 7 por ciento entre 1998 y el año Además de esto, algunos estudios sugieren que aunque los niños Latinos tienen un alto riesgo de desarrollar ADHD, la probabilidad de ser diagnosticados y recibir tratamiento es mucho menor ya que a los padres se les dificulta reconocer los síntomas por diversos factores culturales. Qué causa el ADHD? Nadie lo sabe con seguridad. Algunos estudios Señales y Síntomas Falta de Atención Se distrae fácilmente, se le olvidan las cosas o detalles, constantemente cambia de una actividad a otra y se le dificulta seguir instrucciones Hiperactividad Habla demasiado, corre por todos lados, toca y juega con todo lo que ve, constantemente está en movimiento o tiene dificultad para realizar actividades tranquilas Impulsividad Se muestra impaciente la mayor parte del tiempo, hace comentarios inapropiados, expresa sus emociones y actúa sin importarle las consecuencias sugieren que los genes juegan un papel importante pero al igual que otras enfermedades, el ADHD probablemente se debe a la combinación de varios factores. Además de la genética, los investigadores analizan actualmente cómo factores ambientales, algún daño cerebral, la nutrición y el entorno social pudieran contribuir al desarrollo de ADHD. Sobre las señales y síntomas Aunque es perfectamente normal que los niños se distraigan, sean hiperactivos y hasta impulsivos algunas veces, para los niños con ADHD este tipo de conductas son más severas y frecuentes. Para ser diagnosticado con este tipo de trastorno, el menor tiene que presentar los síntomas por lo menos durante seis meses y ser más comunes que en cualquier niño de su edad. Si detecta que su niño presenta uno que otro síntoma de vez en cuando, probablemente no es ADHD. Sin embargo, si manifiesta varios de los síntomas la mayor parte del tiempo, ya sea en casa, la escuela o al jugar, es recomendable atender este asunto. Mente Sana en Cuerpo Sano Relación entre su salud física y su salud mental Qué son los medicamentos siquiátricos y paraqué se recomiendan? Instituto Nacional de Salud Mental Los medicamentos siquiátricos pueden ser una parte efectiva de tratamiento de enfermedades mentales como la esquizofrenia, depresión, bipolaridad, trastornos de ansiedad y déficit de atención e hiperactividad. En ocasiones los medicamentos son combinados con tratamiento como la psicoterapia. Con la ayuda de estos medicamentos muchas personas con enfermedades mentales pueden vivir vidas productivas. Sin ellos, algunas personas podrían experimentar síntomas mas graves hasta incapacitarlas. Cómo se utilizan dichos medicamentos? Los medicamentos siquiátricos son utilizados en el tratamiento de enfermedades mentales. Si bien no curan la enfermedad, ayudan a reducir o eliminar los síntomas problemáticos y mejorar el funcionamiento diario de las personas con desórdenes siquiátricos. La efectividad de los medicamentos varía en cada organismo. Algunas personas obtienen excelentes resultados y los requieren solo poco tiempo. Por ejemplo, una persona que sufre depresión puede sentirse mucho mejor después de tomar medicamentos por unos meses y no necesitarlos jamás. Sin embargo, personas con problemas de esquizofrenia, bipolaridad, depresión o ansiedad crónica quizá requieran consumir medicamentos por más tiempo. Dra. Maritza Irizarry Sunshine Pediatrics Muchas veces no nos damos cuenta cómo nuestra salud mental y nuestras emociones afectan todo lo que hacemos, cómo nos comportamos y hasta nuestra salud física. Si bien es importante cuidar nuestro cuerpo y las funciones de nuestro organismo, es igualmente importante, reconocer las señales de alerta que pudieran implicar la necesidad de una evaluación mental o psicológica sea para nosotros como padres o para nuestros hijos. Recordemos que la dificultad principal en el diagnóstico de Enfermedades Crónicas Ligadas a la Depresión De las personas que sufren un ataque cardiaco entre el 40% - 65% también padece depresión Enfermedad de Parkinson 40% Esclerosis Múltiple 40% Derrame Cerebral, 10 27% Cáncer 25% Diabetes 25% Síndrome de Dolor Crónico 30%-54% las enfermedades mentales reside en que la mayoría del tiempo no queremos aceptar que sufrimos estas condiciones y si reconocemos los síntomas, nos reusamos a buscar ayuda por temor o vergüenza sin imaginar que la relación entre la salud física y la salud mental es fundamental para nuestra salud y bienestar en general. Enfermedades mentales ocasionadas por enfermedades físicas A través de los años hemos visto que pacientes con enfermedades crónicas, como diabetes y asma, sufren trastornos mentales como depresión y ansiedad. Se estima que hasta un tercio de las personas con síntomas graves de una condición médica experimentan depresión. No obstante, tanto los pacientes como sus familiares generalmente ignoran los síntomas de la depresión pensando que el sentirse deprimido es normal para alguien que esta luchando con una enfermedad seria y crónica. Sin embargo, la depresión causada por la enfermedad Cuándo Solicitar Ayuda Profesional Si ha hecho lo posible por mejorar su salud mental y emocional y no logra sentirse bien, entonces es momento de buscar ayuda especializada. Las recomendaciones de un profesional dedicado podrían motivarlo a realizar cosas que quizá no podría hacer por usted mismo. Señales de alerta que pudieran requerir atención inmediata:» Sentir que no vale la pena seguir viviendo» Pensar constantemente en la muerte, tener ideas suicidas o planificar como suicidarse» Tomar riesgos que ponen en peligro su vida y la de otros a su alrededor» Pensar en lastimarse, lastimar a otros, destruir cosas o en cometer un crímen Departamento de Salud y Servicios Humanos (DHHS, por sus siglas en inglés) La información es poder! crónica puede agravar el problema especialmente si la enfermedad causa dolor y fatiga, o limita la capacidad de la persona para interactuar con los demás. La obesidad y la depresión La obesidad es un problema de salud creciente, que además de predisponer a trastornos mentales produce muchas complicaciones, problemas cardíacos, metabólicos y alteración en la salud en general. Al igual que las enfermedades crónicas, la obesidad ha sido relacionada también con el desarrollo de depresión y problemas de ansiedad. No podemos precisar qué ocurre primero, si el trastorno mental o el aumento de peso. Generalmente esto depende de factores personales. Lo que sí sabemos es que hay factores genéticos que predisponen tanto al desarrollo de obesidad como a trastornos mentales. Se estima que alrededor de un 61% de los estadounidenses tienen problemas de sobrepeso o son obesos. Encuestas indican que uno de cada cinco adultos mayores de 30 años se considera obeso. Independientemente de lo que suceda primero, la clave es reconocer que si está luchando contra una enfermedad crónica o problema de sobrepeso y está sufriendo depresión o algún problema de ansiedad por ello, consulte de inmediato con su médico. De esta manera se buscará un tratamiento que trate ambas condiciones de manera simultánea, como un programa para perder peso que incorpore asesoría psicológica, por ejemplo. Recuerde que en el caso de la salud mental existen agencias en el Valle, donde puede dirigirse sin necesidad de ser referido por su doctor, como por ejemplo Magellan de Arizona, llamando al donde se le atenderá en español si es necesario. Qué debo preguntar a mi doctor si me receta algún medicamento psiquiátrico? Usted y su familia pueden ayudar a su doctor a encontrar el medicamento ideal para usted. El doctor debe conocer su historial médico, enfermedades prevalentes en su familia, si padece algún tipo de alergia, si está con otros medicamentos, suplementos alimenticios o hierbas medicinales y otra información sobre su salud en general. Después de tomar el medicamento notifique a su doctor como se siente, si experimenta algún efecto secundario o cualquier otra inquietud que tenga sobre el medicamento. Preguntas que usted o algún familiar debería hacer a su médico al recetarle algún medicamento Cuál es el nombre del medicamento? Para qué es el medicamento? Cómo y cuando debe tomarlo? Qué cantidad debe tomar? Qué debe hacer en caso de olvidar tomarlo? Cómo y cuándo debe dejar de tomarlo? Si tendrá algún tipo de reacción con cualquier otro medicamento que este tomando? Si es necesario evitar algún tipo de bebida o alimento mientras consume el medicamento? Si debe tomarse antes o después de ingerir algún tipo de alimento? Si es seguro consumir alcohol mientras tome ese medicamento? Cuáles son los efectos secundarios y qué hacer en caso de experimentarlos? Dónde puedo conseguir ayuda? Si usted o alguien que conoce requiere servicios de salud mental o contra el abuso de sustancias, comuníquese con Magellan de Arizona llamando al (800) o TTY (800) Los servicios de Magellan están disponibles tanto para niños como adultos y son cubiertos por Medicaid o AHCCCS/KidsCare. Para mayor información de cómo solicitar AHCCCS, los requisitos de elegibilidad/ ingresos, recursos, reglas de participación para los programas y lugares donde puede someter una solicitud en persona, comuníquese al Magellan de Arizona cuenta con personal que habla español para responder a sus llamadas y preguntas. Por favor comuníquese con Magellan para aprender más sobre los recursos disponibles para el cuidado de la salud mental o contra el abuso de sustancias en el centro de Arizona. Magellan lo conectará con el proveedor de servicios en su área que más le convenga. Si usted o algún familiar experimenta una crisis, y requiere apoyo psicológico, comuníquese con la Red de Respuesta en Casos de Crisis. La Línea de Respuesta Servicios de salud mental cubiertos por AHCCCS Evaluación y tratamiento Servicios de salud mental y abuso de sustancias Diagnóstico, terapia y consejería Administración de casos Transporte Servicios en localidades y medicamentos en Casos de Crisis es gratuita y está disponible las 24 horas del día, los siete días de la semana para cualquier persona que experimenta una crisis de salud mental en el condado Maricopa y partes del condado Pinal. Para emergencias, llame siempre al Si usted o alguien que conoce, fue diagnosticado con una enfermedad mental recientemente y le gustaría aprender más sobre su condición para ayudar en el proceso de recuperación, las siguientes agencias pueden enviar por correo material impreso sobre las enfermedades mentales más comunes a personas con acceso limitado a Internet o computadora (800) 950-NAMI Depression and Bipolar Support Alliance

16 Magellan Health Services of Arizona is dedicated to a strong behavioral health care delivery system for central Arizona. Dear Readers, I wanted to reach out with a message of hope and recovery for those you love that might be living with a mental illness. It can be anything from depression or schizophrenia to uncontrollable rage or abuse of drugs or alcohol. Mental illness does not discriminate. In any given year, one in four adults and one in five children in the U.S. is affected by a mental illness regardless or race, level of education or socioeconomic status. Lack of access to mental health services continues to be a serious problem among minority populations across the U.S. While lack of insurance plays a huge role in accessing health care, cultural beliefs and lack of understanding of mental illness are also significant barriers to care. According to the American Psychiatric Association, Hispanics/Latinos often have different attitudes about accessing mental health services, and may feel highly stigmatized for doing so. For example, Hispanics/ Latinos often mistake depression for nervousness, tiredness, or even a physical ailment, and may see it as something that is temporary. Affected individuals may not recognize their symptoms as those that require the attention of mental health specialists. Although many of the barriers that deter minorities from accessing treatment are true for all populations, the American Psychiatric Association indicates that Hispanic Americans use mental-health services far less than other ethnic and racial groups. As the Regional Behavioral Health Authority (RBHA) for Maricopa County and part of Pinal County, Magellan Health Services of Arizona is dedicated to a strong behavioral health care delivery system for central Arizona. A system of care that not only provides hope, resources and recovery to those Richard Clarke, Ph.D., CEO, Magellan Health Services of Arizona in our care, as well as access to services to under served populations eligible for mental health care. At Magellan of Arizona we believe that all behavioral health care recipients must receive effective treatment in a manner that is respectful of individual preferences, needs and values and compatible with their preferred language and cultural beliefs. To accomplish this, we support our staff and network providers to ensure delivery of culturally competent care. By doing so, we are building stronger relationships with the people and the community we serve, providing better care and ultimately, help strengthening central Arizona s community as a whole. As part of our ongoing effort to facilitate access to mental health care to vulnerable populations, Magellan has compiled this comprehensive review of mental health information to help you better understand the cause and symptoms of mental illness and when and where to seek professional help. Most of the information included on these pages was retrieved from documents by the National Institute of Mental Health and the U.S. Department of Health and Human Services, which fully authorize and encourage the reproduction of their publications in an effort to improve public health. Please take the time to review this handout and share the information with people you know. If the possibility of mental illness or substance abuse is a concern for you or someone you care about please call Magellan of Arizona at (866) Magellan of Arizona and our provider partners give AHCCCS eligible individuals and their families a voice in the recovery process and choice to seek care when and where they need it. Men & Depression National Institute of Mental Health Fast Facts About... Mental Health About one in five adults 18+ has a diagnosable mental disorder. (National Institute of Mental Health) Mental illnesses are more common than cancer, diabetes, or heart disease. (U.S. Surgeon General s Report) Mental illnesses can affect persons of any age, income, race, religion, or culture. Mental Illnesses affect both males and females. (National Alliance for the Mentally Ill) Mental illnesses often appear for the first time during adolescence and young adulthood. While they can occur at any age, the young and the old are especially vulnerable. (National Alliance for the Mentally Ill) 4 of the 10 leading causes of disability (lost years of productive life) in the United States and other developed countries are mental disorders, which include major depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder. Many persons suffer from more than one mental disorders at any given time. (National Institute of Mental Health) With proper care and treatment, between 70-90% of persons with mental illnesses experience a significant reduction of symptoms and an improved quality of life. (National Alliance for the Mentally Ill) More than 2/3 of Americans who have a mental illness live in the community and lead productive lives. (National Mental Health Association) Good Mental Health is Ageless U.S. Department of Health and Human Services A healthy mind is as important as a healthy body. Being in good mental health doesn t mean that you ll never feel sad, lonely, or down. But when these feelings disrupt your life or go on too long, there may be a bigger problem. Unusual feelings of sadness or depression can happen when you have to move from your home; people you love get sick or die; if you have to depend on others to get around even to do the simple things you used to do yourself or when physical health problems seem overwhelming. If depression or other changes in your behavior last longer than two weeks, talk with your doctor or other health care professional. Tell them exactly how you re feeling, and let them know how this is different from the way you used to feel. They can check for any problems you may be having, and can discuss treatment options with you. Share your feelings with a friend, family member or spiritual advisor. These people can sometimes notice changes that you might not see. If you or someone you know needs mental health or substance abuse services, contact Magellan of Arizona at (800) or TTY (800) Magellan s services are available for children and adults and are covered by Medicaid or AHCCCS/KidsCare. In addition to feelings of depression, some of the following changes in behavior may suggest other emotional problems: Being easily upset Changing sleep habits Increasing forgetfulness Being afraid of things Changes in eating habits Neglecting housework Crying a lot Being confused Getting lost a lot Having trouble managing money Not having the energy to do the things you want to do, or used to do Believing that you can t do anything worthwhile Staying alone a lot of the time Spending little or no time with friends Feeling hopeless or overwhelmed Thinking life isn t worth living Thinking about hurting yourself Signs and Symptoms of Depression in Men Feeling sad or empty, hopeless, irritable, anxious, angry or very tired Loss of interest in work, family, or once-pleasurable activities, including sex Not being able to concentrate or remember details Not being able to sleep, or sleeping too much Overeating, or not wanting to eat at all Thoughts of suicide, suicide attempts Aches or pains, headaches, cramps, or digestive problems Inability to meet the responsibilities of work, caring for family, or other important activities Depression is a serious but treatable medical condition a brain disease that can strike anyone, including men. In America alone, more than six (6) million men experience depression each year. Whether you re a company executive, a construction worker, a writer, a police officer, or a student; whether you are rich or poor; surrounded by loved ones or alone; you are not immune to depression. Some factors, however, such as family history, undue stress, the loss of a loved one, or serious illnesses can make you more vulnerable. Both men and women are affected by depression. But men can experience it differently than women. Men may be more likely to feel very tired and irritable, and lose interest in their work, family, or hobbies. They may be more likely to have difficulty sleeping than women who have depression. And although women with depression are more likely to attempt suicide, men are more likely to die by suicide. For this and many other reasons, it s important to recognize the symptoms and seek professional help. Keep in mind that not everyone who is depressed experiences every symptom. Some people experience only a few symptoms; some people suffer many. The severity of symptoms varies Anxiety Disorders National Institute of Mental Health Anxiety Disorders affect about 40 million American adults age 18 years and older (about 18%) in a given year, causing them to be filled with fearfulness and uncertainty. Unlike the relatively mild, brief anxiety caused by a stressful event (such as speaking in public or a first date), anxiety disorders can last at least six (6) months and can get worse if they are not treated. Anxiety disorders are classified and divided into different types or categories such as panic disorder, post-traumatic stress disorder, obsessive compulsive disorder and general anxiety disorder. Each anxiety disorder has different symptoms, but all the symptoms cluster around excessive, irrational fear and dread. Although it is perfectly normal to worry about things like health, money, or family problems, people with anxiety disorders are extremely worried about these and many other things at all times, even when there is little or no reason to worry about them. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with anxiety disorders from doing everyday tasks. Anxiety disorders tend to develop slowly. They often start during the teen years or young adulthood. Symptoms may get better or worse at different times, and often are worse during times of stress. People with anxiety disorders may visit a doctor many times before they find out they have this disorder. They ask their doctors to help them with headaches or trouble falling asleep, which can be symptoms of anxiety disorders, but they don t always get the help they need right away. It may take doctors some time to be sure that a person has an anxiety disorder instead of something else. Anxiety disorders commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, which may mask anxiety symptoms or make them worse. In some cases, these other illnesses need to be treated before a person will respond to treatment for the anxiety disorder. Effective therapies for anxiety disorders are available, and research is among individuals and also over time. Research and clinical findings show that women and men may talk differently or in the case of men, not talk about the symptoms of depression. Many men do not recognize, acknowledge, or seek help for their depression. They may be reluctant to talk about how they are feeling based on cultural beliefs or ethnic origin. For instance, traditional gender roles in the Latino community may further contribute to an unwillingness to talk about feelings of depression. Men with depression, regardless of ethnic background, may be more likely to turn to alcohol or drugs, or to become frustrated, angry or irritable instead of acknowledging their feelings and asking for help. Some men may throw themselves compulsively into their work or hobbies, attempting to hide their depression from themselves, family, and friends; other men may respond to depression by engaging in reckless behavior. Depression and other mood disorders cross all national, cultural, ethnic, and gender boundaries. If left untreated, depression can lead to personal, family, and financial difficulties. Fortunately, depression, like most mental disorders is a real and treatable illness. With appropriate diagnosis and treatment most people can and do recover. The darkness disappears; hope for the future returns, and energy and interest in life becomes stronger than ever. Signs and Symptoms Worrying very much about everyday things Trouble controlling their constant worries Hard time concentrating Easily startled Trouble falling asleep or staying asleep Feeling tired all the time Headaches, muscle aches, stomach aches, or unexplained pains Have a hard time swallowing Tremble or twitch Irritable, sweat a lot, and feeling light-headed or out of breath Have to go to the bathroom a lot uncovering new treatments that can help most people with anxiety disorders lead productive, fulfilling lives. If you think you have an anxiety disorder, you should seek information and treatment right away. Magellan Health Services of Arizona, Inc. is the Regional Behavioral Health Authority for Maricopa County and Parts of Pinal County. Funds for services are provided through a contract with the Arizona Department of Health Services/ Division of Behavioral Health Services and the Arizona Health Care Cost Containment System (AHCCCS).

17 Attention-Deficit/Hyperactivity Disorder (ADHD) National Institute of Mental Health Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood making it difficult for people to inhibit their spontaneous responses responses that can involve everything from movement to speech to attentiveness. In recent years, studies have shown that nearly 1 in 10 U.S. kids have been diagnosed with ADHD. Researchers from the U.S. Centers for Disease Control and Prevention found that between 2007 and 2009, an average of 9% of children between the ages of 5 and 17 were diagnosed with the disorder. This compared with just under 7% between 1998 and In addition, limited available research suggests that Latino children are at a great or greater risk for developing ADHD, although they are much less likely to be identified by their parents as displaying problematic behavior and subsequently are less likely to receive proper assessment and treatment due to several practical and cultural factors. What Causes ADHD? Scientists are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD probably results from a combination Signs and Symptoms Inattention Easily distracted, misses details, forgets things, frequently switches from one activity to another, and has trouble following instructions Hyperactivity Talk nonstop, dash around, touching or playing with anything and everything in sight, constantly in motion, difficulty doing quiet tasks or activities Impulsivity Very impatient, blurt out inappropriate comments, show emotions without restraint, and act without regard for consequences of factors. In addition to genetics, researchers are looking at possible environmental factors, and are studying how brain injuries, nutrition, and the social environment might contribute to ADHD. About Warning Signs Although it is normal for all children to When to seek Professional Help be inattentive, hyperactive, or impulsive sometimes, for children with ADHD, these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child must have symptoms for 6 or more months and to a degree that is greater than other children of the same age. If you spot just a few signs, or the symptoms appear only in some situations, it s probably not ADHD. On the other hand, if your child shows a number of ADD/ADHD signs and symptoms that are present across all situations at home, at school, and at play it s time to take a closer look. ADHD can lead to problems at home and school, and affect your child s ability to learn and get along with others. It s important for you as a parent to be able to spot the signs and symptoms, and get help if you see them in your child. Healthy Minds, Healthy Bodies The relationship between our physical health and our mental health Dr. Maritza Irizarry Sunshine Pediatrics Often we forget how our mental health and our emotions affect everything we do, from the way we act to our physical health. Although it s important to take care of our bodies, it s also important to be able to recognize the warning signs that could imply the need of a mental or psychological evaluation, either for us as parents or for our children. Mental illness often goes under-diagnosed and under treated, primarily because of stigma. Chronic Conditions and their Link to Depression: Of those who experience a heart attack, 40%-65% also experience depression Coronary artery disease (without heart attack): 18%-20% Parkinson s disease: 40% Multiple sclerosis: 40% Cancer: 25% Diabetes: 25% Chronic pain syndrome: 30%-54% People refuse to accept they have such conditions. Even when symptoms are present, shame and fear keeps a lot of individuals from seeking help. However, the relationship between our physical health and our mental health is vital to our emotional well-being and overall health. Mental Illness caused by Chronic Illness Throughout the years, we ve seen how patients with chronic illnesses such as diabetes and asthma suffer from mental illnesses like anxiety and depression. It is estimated that one third of people with chronic illnesses in the U.S. experience depression. Yet, some of these individuals along with family members ignore the symptoms of depression thinking it s perfectly normal to feel that way. If untreated, depression could make health problems worse, especially if individuals dealing with a chronic illness are experiencing pain, fatigue, or difficulty interacting with others. Obesity and Depression Obesity is a growing health problem in the U.S. In fact, it is estimated that about 61% of Americans are overweight or obese. National polls indicate that one in five adults 30 years or older considers themselves obese. Obesity cannot only lead to chronic health conditions such as heart and metabolic problems, but it has also been linked to the development of mental illnesses, such as anxiety disorders and depression. We cannot determine which occurs first, the mental disorder or the weight gain this probably depends on personal factors. However, we do know genetic factors put an individual at a higher risk of developing obesity and mental health disorders. Regardless of what comes first, the key to a healthy lifestyle is recognizing the signs and symptoms associated with a chronic illness, weight gain and mental illnesses (like anxiety disorder or depression). Take charge of your health and inform your doctor immediately if you experience any of these symptoms. By doing this, your doctor can help you find a treatment option that meets your physical and mental health needs. For instance, your doctor may recommend participating in a weight loss program that utilizes psychological support. Remember that there are agencies in the Valley where you can get mental health services without a referral from your doctor. Magellan Health Services of Arizona offers help in Spanish at (800) Overcoming stigma and expressing to your doctor how you feel without fear of being judged or criticized is key in helping you find the right treatment options that allow you to have a healthy mind and a healthy body. What are psychiatric medications and who gets them? National Institute of Mental Health Psychiatric medications are used to treat the symptoms of mental disorders such as schizophrenia, depression, bipolar disorder (sometimes called manic-depressive illness), anxiety disorders, and attention deficit-hyperactivity disorder (ADHD). Sometimes medications are used with other treatments such as psychotherapy. Many people with mental disorders live fulfilling lives with the help of these medications. Without them, people with mental disorders might suffer serious and disabling symptoms. How are medications used to treat mental disorders? Medications treat the symptoms of mental disorders. They cannot cure the disorder, but they make people feel better so they can function. Medications work differently for different people. Some people get great results from medications and only need them for a short time. For example, a person with depression may feel much better after taking a medication for a few months, and may never need it again. People with disorders like schizophrenia or bipolar disorder, or people who have long-term or severe depression or anxiety may need to take medication for a much longer time. What should I ask my doctor if I am prescribed a psychiatric medication? You and your family can help your doctor find the right medications for you. The doctor needs to know your medical history; family history; information about allergies; other medications, supplements or herbal remedies you take; and other details about your overall health. After taking the medication for a short time, tell your doctor how you feel, if you are having side effects, and any concerns you have about the medicine. Things you or a family member should ask your doctor when a medication is prescribed: What is the name of the medication? What is the medication supposed to do? How and when should I take it? How much should I take? What should I do if I miss a dose? When and how should I stop taking it? Will it interact with other medications I take? Do I need to avoid any types of food or drink while taking the medication? What should I avoid? Should it be taken with or without food? Is it safe to drink alcohol while taking this medication? What are the side effects? What should I do if I experience them? Is the Patient Package medicine available? Where Can I Get Help? If you or someone you know needs mental or substance abuse services, contact Magellan of Arizona at (800) or TTY (800) Magellan s services are available for children and adults and are covered by Medicaid or AHCCCS. If you ve made consistent efforts to improve your mental and emotional health and you still don t feel good then it s time to seek professional help. Because we are so socially attuned, input from a knowledgeable, caring professional can motivate us to do things for ourselves that we were not able to do on our own. Red flag feelings and behaviors that may require immediate attention» You feel like life is not worth living anymore» You think a lot about dying, have thoughts of suicide, or have planned how to kill yourself» You are taking lots of risks that are endangering your life and/or the lives of others» You feel like hurting yourself, hurting others, destroying property or committing a crime Reprinted with permission from the U.S. Department of Health and Human Services (DHHS) For more information on how to apply for AHCCCS or questions regarding eligibility, income, resources, program participation rules, or the nearest branch to apply in person, please call (602) Magellan of Arizona has English and Spanish speaking staff available to answer your calls and questions. Please contact Magellan of Arizona to find out more about mental health and substance abuse resources available to you. Magellan will connect you to a service provider that best fits your needs and is in your area. If you or a member of your family is in crisis, call the Maricopa Crisis Response Network at (800) or TTY Mental Health Services covered by AHCCCS Evaluation and treatment Services for mental disorders and substance abuse Diagnosis, therapy and counseling Case management Transportation Services in facilities and medication (800) for immediate help. The Maricopa Crisis Response Network is available 24 hours a day, seven days of week to assist anyone experiencing a mental health crisis in Maricopa County. For emergencies always call Knowledge is Power If you or someone you know was recently diagnosed with a mental illness or substance abuse disorder and wish to learn more about their condition to help with their recovery process, the following agencies can mail printed materials about the most common mental illnesses to individuals with limited access to the Internet or a computer (800) 950-NAMI Depression and Bipolar Support Alliance

18 TIPS ON CALLING AN AGENCY FOR MENTAL/BEHAVIORAL HEALTH SERVICES Step 1: Step 2: Step 3: Step 4: Step 5: Step 6: Step 7: Step 8: Pick an agency you would like to call from the attached list. Pick up the phone and dial the number. Let the person on the phone know that you want to know more about their services. Ask if they have (whatever type of help you need) services. Ask about how much the services cost. Ask if they have a sliding fee scale (where you only pay what you can afford). If they offer the services you need, ask to make an appointment. Verify the time and day of appointment, the name of the person you will meet, and the address of where the appointment will be held. Ask any other questions you may have then thank the person for helping you.

19 AZ Response to Intervention (RTI) System of Behavioral Supports Overview School achievement and success require that students be provided both academic and behavioral systems of support. A comprehensive system of behavioral supports ensures that students are ready and able to learn by creating environments conducive to learning and by addressing barriers to learning that students experience. Response to Intervention (RTI) is a problem-solving model that utilizes prevention logic as its basis; that is, the proactive implementation of strategies at the school level, classroom level and/or student level prior to the development of academic or behavior problems. An effective system of behavioral supports will decrease the development of new problem behaviors and prevent the worsening of existing problem behaviors. The tiered levels within the RTI model provide for a continuum of behavioral supports for students. All students are provided the Universal Level (Tier 1) supports; approximately 80 percent of students will perform well under these conditions. Approximately 15 percent of students, those with more risk for problem behavior, will require Targeted Level (Tier 2) supports directed to the specific needs of the individual or small group of students. The remaining five percent of students that have already displayed problem behaviors require Intensive Level (Tier 3) supports. A primary component of a comprehensive system of behavioral supports includes the teaching of pro-social behavior skills needed to facilitated learning. At each level, pro-social skills are taught, monitored and acknowledged. Commonly addressed skills include the meeting of school behavior rules and expectations, communication skills, self control, responsibility and empathy. Support strategies also include the redesigning of environments to eliminate routines and physical arrangements that maintain problem behaviors and the involvement of families in efforts. A comprehensive system of behavioral supports utilizes data-based decision making and a continuous improvement process in which teams regularly, systematically, and honestly evaluate outcomes and areas for improvement. Success relies upon professional development that builds knowledge and skill in district and school personnel and facilitates the change process throughout the organization. This document describes in more detail the following components of a system of behavioral supports: Data-Based Decision Making Curriculum, Instruction and Strategies Professional Development Data Based Decisions Data-based decision making is the collection, management, analysis, and utilization of relevant data to make informed decisions. This process is utilized at the school, classroom and student levels within a system of behavioral supports. It therefore guides the necessary system changes as well as student interventions. 1

20 Key features of effective data-based decision making processes include: data are accurate, valid and easy to collect; data are presented in user-friendly format (e.g., graph format); data are available when decisions need to be made; data collection staff understand the value of their work (how the information is used in decision making); the leadership team is trained in collecting and using data; and a team approach is used for decision making. Data-based decision making also requires the development of procedures that ensure proper analysis as to whether gains are being achieved and the actions that should occur next. (Sugai 2007) The process of implementing a system of behavioral supports begins with a school-wide needs assessment involving analysis of disciplinary, safety and climate data from multiple sources. This process aids the school (and district) in setting goals and creating action plans. These data sources are also used to determine appropriate strategies and programs for prevention and intervention, measure progress toward goals, and evaluate the effectiveness of the strategies. A system of behavioral supports utilizes a continuous improvement process, such as the US Department of Education s Principles of Effectiveness, illustrated below. Needs Assessment Measurable Goals & Objectives Evaluation of Outcomes Research- Based Strategies This process is also utilized for small groups of students and individual students receiving Targeted and Intensive Levels of supports. The primary sources of data needed for implementing a system of behavioral supports include the following: Universal Level (Tier 1) School safety and disciplinary incident data in aggregate by student, location, time of day, referring individual, and grade level Disciplinary action information in aggregate, including detentions, suspensions, and expulsions, as well as corrective actions taken, such as behavior intervention groups Attendance data, dropout data and causal factors in aggregate Student survey information (anonymous and in aggregate) capturing high risk behavior and school safety and climate perceptions Staff and parent survey information (anonymous and in aggregate) capturing school safety and climate perceptions School health office data in aggregate Process data for evaluating the fidelity of implementation of the Universal system 2

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