She.

Hello, and welcome to Arkansas Way.

I'm Karen Walker.

In 2023, 615 Arkansans died by suicide.

According to the Arkansas Department of Health.

The Arkansas Crisis Center and the University of Arkansas for Medical Sciences Department of Psychiatry are collaborating on a project to understand mental health trends and approaches to suicide prevention.

So over the next half an hour, we'll talk about these efforts as well as risk factors, early warning signs, prevention and intervention to avoid negative mental health outcomes.

Please welcome Josh Gonzalez, president of the Arkansas Crisis Center Board of directors, and doctor Elissa Wilburn, clinical psychologist and assistant professor in the UAMs Department of Psychiatry.

Welcome.

Thank you so much for having us.

Yes, yes, yes.

So, Josh, tell us, what services does the, Arkansas crisis Center offer across the state?

Yes, ma'am.

So, the Arkansas crisis center, we are a 24 over seven, suicide and crisis lifeline, essentially.

So we answer for, nine, eight, eight.

So a lot of, Arkansans don't know this yet, and I'm in many conversations where it's just not known as a resource.

So about, I think about a year ago, we transitioned from there used to be A18 hundred number for the National Suicide Prevention Lifeline.

And we realized this is such, it's becoming so widely used and such a more common knowledge.

Now, we they needed a more national standardized phone number, which is like nine, eight, eight.

So that's almost like the 911 for mental health emergencies.

And it helps get just the load off of 911.

And it gets you to a more specialized, crisis counselor.

And it's important for people to know if they ever reach out to nine, eight, eight is it's a a crisis is a crisis.

Your crisis to your life is your crisis.

It's not what somebody else self defines.

And I think that's why it partially it got moved to like nine and a suicide and crisis lifeline because you know we don't want to wait for someone to be like, man, I'm at the I'm at the brink like this.

I'm, I'm just struggling so bad.

I'm thinking about ending my life.

And it would be better for somebody to know there's that resource for you in crisis, not necessarily just suicide.

That's great.

And I hope that and many of our audience members are not aware of that.

So we're glad that you're here today having this important conversation with us.

So I know the UAMs Department of Psychiatry, as well as the crisis Center, are now collaborating.

So how did that come about?

Yeah.

So sometime last year, Josh had connected with our, department chair.

We were having a suicide prevention conference, and I think Josh and the Arkansas Crisis Center team realized that they were sitting on almost 20 years of data, that were hoping to understand the story about.

And so it made sense sometime last year, to kind of collaborate, get together, figure out how can you amass support and understand some of the the research side of things, what story is the data telling?

And, UAMs can provide that research infrastructure.

We can provide the ethical and federal kind of regulation oversight.

And then the crisis center can really provide that hands on, insight into what the how the data is collected.

And, really the real time experience of people who are taking calls.

Yes, that seems like a really good partnership.

So in with your experience so far, what trends are you already seeing in mental health and suicide risk?

Well, I can talk about, so we're this is a really large data set.

So we actually have, like, a data scientist kind of working on this right now, but, so last year we answered about 20,000, interactions with people and a big trend we're seeing right now.

So in, February of this year, our board and us, we made a decision to start answering texts.

We previously were only doing phone calls, and we're the only center in Arkansas that does text.

So pretty much anywhere in Arkansas, somebody text, it comes to us.

And we had over 10,000 of those, this past year.

And what we've noticed is, the majority of them are youth and the majority up to around that 60, 70% number are children under the age of 18.

So I think something really uncommon that, we're we're going to research and I'll let Alissa get into that in a minute.

But is is what is going on with our youth in Arkansas, because when I've shared this number that nobody's known that the numbers this big and the reason we didn't really know is there's this big national backup line.

So previously it was getting farmed out to another state, which is problematic because we know our state, we know the people in our state, we know the resources.

So of course, a local resource will be better.

And once we kind of took on this volume and essentially doubled our our volume from the year before, I think we're at 10,000, 23 and, sorry, 24 and then 25, we hit 20 plus thousand interactions.

It's, it's it's really serious when you see so many youth, just struggling a lot.

And I think we can try to attribute that to a lot of things, high schools just very, very different.

Middle schools, very different than it was ten years ago.

So we're we're spending a lot of time and we can get into those things later of what we're trying to do about that.

But that's an early trend that we're seeing.

Well, well, you know, Doctor Wilburn, what does the findings from all of the data, how is that going to benefit workplaces, faith communities, our health care systems.

Yeah.

So first and foremost, we're hoping that the data that we see and the trends that we're seeing are actually helping immediately inform how the crisis center is even talking to people, collecting data so that they can better provide service and support to whoever's calling in.

Beyond that, we're also hoping that this informs, any sort of, space where, teens and others are interacting.

So, for instance, we want to understand what are sort of the combination of risk factors, what are things people can look out for?

For instance, are there signs that teachers can pay attention to, what are the questions that might really connect with kids while they're at school?

And what are the interventions?

What's the type of support that's going to be most helpful?

We're also hoping that this data is going to help inform how people are trained, and how people talk about suicide, how people talk about, just really this, We're hoping that this helps people understand suicide better and feel more equipped to have these conversations, wherever that might be.

You know, some people may be wondering, well, if I call the end of the hotline, how are you guys going to use my information?

Do I have to worry about my story?

Yeah, that's a really important question.

What we want people to know is that when we do research, we are looking at trends.

We're looking at overall patterns.

We are protected by and have to uphold standards, with the IRB.

And the IRB is responsible for making sure that we are protecting human rights.

And so we are not, looking at individual data, we're looking at it as a whole.

And so, we also will not see anyone's names or, identifiable information associated with the data that we're looking at.

I know we talk about youth, so there are lots of parents out there who are sometimes concerned about their children.

So what resources are available?

So if a parent is concerned about the mental health of their child, I'll let you answer.

Sure.

Your youth psychologist, let's let you go there.

Yeah.

So of course there is nine, eight, eight or the crisis center.

That's.

Yeah, that is always available.

There's also a service that is available to any resident in the state of Arkansas and that is are connect.

Now.

So that is a, virtual service that is provided, for anyone ages four years old and up and, unfortunately, it is not free.

It used to be, but it is a service that helps connect, parents to mental some brief short term mental health services with the effort to, find a longer term provider.

Well, that's good because people need resources.

I know, Josh, you started out on the hotline, didn't you, before you became part of the crisis center?

Staff there.

So in your experience, what do you think person should do?

We know parents are responsible for the kids, but what should a person do if I feel like a friend or a neighbor?

Maybe having some health, mental health issues or struggles?

Yes, ma'am.

Yes.

It's, it's definitely a hard thing.

My experience on the line.

So I, answered our line for two years, and I moved to the board.

I've been with the center for about five years now, and in that experience, I've, I've developed that very human kind of like this stuff is very real.

It's very hard on families.

And, I think just reaching out for support, whatever it may be like calling the crisis center.

And remember, like I said, a crisis is, is a crisis, too.

And it doesn't have to be what somebody else perceives as a big thing.

And with, the crisis center, you can actually call in on behalf of someone.

So I was just talking to someone a few days ago, actually, and said, hey, like, if, he had somebody he was living with, and I was like, you can call the crisis center if you're ever worried.

And one of our call specialists can kind of walk you through, like, what is it like to build a safety plan?

Right?

So let's say I have a friend who I'm a little just a little worried.

He's depressed.

You know, he's not really interested in the things he used to be.

And I'm just like, this doesn't feel right.

I've maybe asked him about suicide, and he's like, no, I'm.

I'm just really depressed.

And so I might say, well, let's kind of build you if you, if you start getting to a dark place, what's and this is something everyone can do for someone they love like 2 or 3 people you can call.

Oh, okay.

Okay.

Like if you start feeling bad, like 2 or 3 people you can call and then just building that list and what's like building future commitments with people, hey, let's make some plans next week.

Let's do something like build out a future, for them.

And there's also a website.

My safety plan, I believe georgia.com, but you can if you Google my safety plan, it's going to pull up and I'll help walk through a safety plan you can make with someone because that's really important.

Suicide can be, can be a really impulsive thing and that makes it just so difficult.

So if you can have somebody just like, here's step one, two, three, 4 or 5, if I'm feeling if I start feeling really, really bad, that can be helpful.

And the final number on that list should be nine, eight, eight because we'll we'll always answer, that's wonderful.

And having a safety plan I hadn't thought of that.

So that's a good tool that we can use in helping with suicide prevention.

It give someone something to fall back on if they're feeling that they're in crisis.

Still.

Yes.

If there's one thing you could say to someone right now who's struggling, what would you say?

Doctor Wilson?

I would say your experience matters.

You're not alone.

Very good, very good.

Well, we're going to get ready to take a break, but stay tuned.

We have more to come on.

Mental health issues and disorders.

Welcome back.

And I'm Karen Walker, along with my guest, Arkansas Crisis Center board president Josh Gonzalez and clinical psychologist and assistant professor Doctor Lisa Wilburn in the UAMs Department of Psychiatry at UAMs.

We've been talking about the partnership between both organizations to better understand mental health trends and strengthen suicide prevention efforts.

Josh and Doctor Wilburn, let's start with risk factors and early warning signs.

So how do depression and anxiety present when someone reaches out in crisis?

Let's I'll let you start with just.

She's she's a psychology expert here.

I'll give my crisis counselor kind of perspective.

That sounds good.

I think a lot of what we see when someone is experiencing depression, is statements like, things are not going to get better.

This really heavy sense of hopelessness, or I can't see getting through whatever it is that they might be going through.

What I think people don't sometimes equate to crisis is, anger and irritability.

We know that anger is a secondary or an emotional byproduct of stress, and we know when people are feeling an overwhelming amount of stress that exceeds their perceived ability to cope.

We see a lot of anger come out, and sometimes that's accompanied by feeling that impulse to be aggressive.

Sometimes that's towards yourself, sometimes that's towards others.

So that's something to really pay attention to.

Of course, when people are saying things like, I can't go on, I don't want to be here anymore.

Sometimes I don't, you know, I want to go to sleep and not wake up.

I just want things to end.

I want the pain to go away.

Those are some examples of things that we might hear.

Yes, yes.

And I know, Josh, what are some warning signs you've seen, like with depression and anxiety, that it may be escalating to, to where a person may want to harm themselves.

Deviation in behavior is a big one.

Like how did someone used to be versus how they are now.

And when I was on the crisis line, a lot of the the calls that worried me the most, honestly were the very calm and and quiet ones.

If someone was having a anxiety attack or really panicked or something generally that can be calm de-escalated through your tone of voice and and providing a stable interaction.

But when somebody is very calm and uncertain, those are always the ones that kind of worry me when they've made up their mind and in a way.

So I think that the biggest thing is, is noticing these things early on, because when I look at the Arkansas Crisis Center, where the we're almost like the final line of defense, we don't have to be.

But people, people use us that way.

And we're that we're almost like a paramedic as a metaphor for getting people to longer term care.

And I think it's really important as the community, just transparently suicide becomes less taboo and people talk about it, more people get trained in it, more.

There's probably ten, 20, 30 opportunities before somebody calls us to intervene.

So I think it's really important for people to get educated on how to have conversations about suicide, how to know these warning signs like, there's, we offer trainings, mental health first aid, applied suicide skills intervention training.

There's all these things you can go find resources for.

And I think the more as a collective we do that, hopefully people will see these warning signs we've talked about.

And they can be very personal to someone, you know, so you kind of there's things you can see from the outside, but as you get to know someone, you'll pick up on these more.

And if you're trained to, you know, you'll be able to intervene.

That's good.

Training is so important.

I know we talk about anxiety and depression, but, Doctor Wilburn, how does ESD or, trauma show up when people are in crisis?

Yeah.

So sometimes we are talking to people who are maybe actively reliving an experience.

And so sometimes they're they actually kind of shut down.

They are dissociating, if you will.

Because their brain is elsewhere.

And so they're having a hard time constantly reading, potentially in conversation.

They might seem a little distracted or out of touch.

Sometimes we can see, you know, lots of kind of, mood disturbance.

And so, crying easily, thinking negatively, maybe about themselves, saying things like, this world can't, you know, I can't trust the world around me.

This world is unsafe.

Yes, I know earlier you mentioned stress.

People are stressed.

Finances, work, caregiving just like pressure itself.

So what role does stress play in, mental health?

How does it affect that mental health?

Quite a bit.

Quite a bit.

Stress is sort of like a pressure cooker.

This is something I learned in graduate school that has stuck with me in my practice.

Some people have found it helpful to think about it this way.

But if every one of us has, like, a cup of water that symbolizes our capacity to deal with stress.

And for some people, that water level is so consistently high.

It doesn't take much.

It can take a minor inconvenience in the day.

It could take a, maybe relatively minor stressor to occur for that water to spill over.

So stress is huge, and it's not realistic to think that stress is going to completely go away.

Stress is actually really helpful.

Part of being a human.

It motivates us and it helps us survive.

It's just a matter of how do we kind of relieve some of that pressure?

How do we get that water level down just enough so that we're not on that brink of a crisis?

It makes that makes sense and makes sense.

You know, Josh, you were talking about speaking to a lot of teens.

Our teens love social media, don't they?

How is social media affecting our teens mental health?

Yeah, I think the research on it is is poorly.

You know, just I and I think it there's so many different elements because right now, a teen, there's so many different buckets, that people can fit into different groups and different clicks.

And you have social media.

Which part of it is just the speed information, transfers as well.

And the feedback is everything just move so fast.

And that jealousy and envy kind of can fester.

Well, this person and we all know sometimes I call Facebook Facebook like, you know, it's it's a highlight reel of our life sometimes.

And I think there's people who are breaking the chain of that and sharing those real stories.

But, you know, not someone is going to post, man, I'm having the worst day of my life.

They're going to post that photo of them smiling and being cheerful and just things are going great.

And, you know, that person may be depressed to posting that.

So I think it's just important to know, like, that isn't real, right?

Like that's not the real world.

Real life isn't this highlight reel of of good things happening.

Like Alyssa says, we're always going to have stress.

And I think the more youth know that and are educated on, the reality of what life is going to look like, you know, it's going to you're going to be on the freeway sometimes you're going to be on the dirt road sometimes.

And just when you're on the dirt bumpy road, like, we just need to get you back to the freeway.

And it's just hard with all this, these validation loops and all of the different buckets you can fit into.

And it it makes communicating hard with you.

To be honest as well because adults it's it's just a we didn't experience that.

So there's almost like a, a translation thing that has to go on.

So we're starting a, peer to peer youth support service as well.

The crisis center is to help teens directly connect with teens that aren't in crisis.

So it's going to be, Teen Connect.

And that's something launching in about three months.

That will be a resource as well.

Well, that's going to be wonderful.

And listen, how are you guys getting the word out about that?

Will schools know that that resource will be available for our state?

Yes, ma'am.

So we, we're going to have a big marketing blast when that comes.

Right now we're building our team were there's about two other of these teen peer supports in the country, and we've connected with them, like getting input because, Arkansas traditionally hasn't been the first to implement something, but we are becoming one of the early adopters of this new, kind of cutting edge, peer support.

So, Arkansas Blue Cross Blue Shield through blue new foundation.

Just they just funded the whole program.

That's awesome.

What a win for Arkansas.

Yes, ma'am.

Yes, yes.

So, doctor Wilbur, what are some signs that sometimes friends or family or coworkers miss when, you know, walking alongside, their family members and coworkers?

Yeah.

I think just to echo what Josh said, I think what we see, is, slight changes in behavior.

So sometimes we noticed that, people are not maybe engaging in their social network as much.

They're not talking and participating in things maybe they normally did before.

Sometimes, giving some prized possessions away to, things that you wouldn't expect.

We have a lot of teens, that rely on, social media as well, and digital forms of communicating and so paying attention to how people are talking about how they're doing.

And I think just to carry on that, like it's important to just have these conversations like, hey, how are you doing?

Like, really like, I know we all just say good when we're passing each other, but like, how are you actually doing?

Like, when's the last time maybe just audit whoever's listening to this?

Your life.

When, when have you asked that?

Like, you've truly sat someone down like, hey, how are you?

How are you really doing?

And just sit there and be present with them, because I think so much of that we get caught up in our lives, we get so busy and all of this.

But sometimes making that pause and just really deeply checking in with someone is like a very effective way to see.

Because because sometimes we just we just don't see it because we're, we're so, in our own lives and that's that's fine.

But I, I think just remember, having that human touch point in connection with someone is very valuable.

Well, you know, that is so true because I remember being at a conference as they were talking about doing the second ask, not just, how are you doing?

Ask again.

And sometimes you'll be surprised that you're going to get a different answer if you look someone in the eye and that's that second time.

So I want to just thank you for coming on today, and I want to just give you an opportunity right now.

If you can just have one overall message that you want Arkansans to know about mental health and suicide prevention, what's that message?

I don't want this to sound cliche.

It's, but I, I don't want us to underestimate the power of sharing our story and asking about someone's story.

As human beings, we have these internal stories all the time, and sometimes that does include suicide.

Thinking about harming ourselves.

So ask and talk to the people in your life and in your circle, ask how people are doing.

But also don't be afraid to talk about some of the struggles that you might be having.

Thank you.

Thank you so much for joining us today and having this very important conversation that concludes our program.

Thanks for joining us, and we'll see you next time.