SD Behavioral Health Mental Notes | Spring 2024 Edition

Take an Inside Look at Behavioral Health on South Dakota's Reservations.

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How the Division of Behavioral Health is Prioritzing Mental Health for K–12 Students.

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SPRING 2024 EDITION

Mental Notes Progress & Updates from the South Dakota Department of Social Services, Division of Behavioral Health

SD Behavioral Health

Take Note: You Matter, No Matter What.

Statewide campaign aims to eliminate behavioral health stigmas Behavioral health — from mental health concerns to substance use — is everyone's business. That's why the South Dakota Department of Social Services (DSS) Division of Behavioral Health launched a new campaign in 2023 aimed at eliminating stigmas and promoting behavioral health support.

Titled "Notes to Self," the campaign was developed to generate awareness, promoting resources and emphasizing the roles we can all take in support, prevention and early intervention.

"We South Dakotans tend to take pride in being 'tough' and 'resilient'.

However, we want people to know that they aren't alone in whatever struggles they might be facing," said DSS Cabinet Secretary Matt Althoff. "Our team is working tirelessly each day to help South Dakotans in need. This campaign, which gathered market research from South Dakotans, aims to reach citizens in every corner of our state and target particular demographics where suicide has been more prevalent."

The campaign features ads across the state to educate residents and promote resources available to help those in need including video, radio, digital marketing, social media ads, print, billboards and movie theater

Notes to Self Campaign Billboard near Sisseton advertising. Launched during the Second Annual Suicide Prevention Conference in August, the campaign was created in partnership with the Department of Social Services, Division of Behavioral Health, and other state agencies. Using a series of notes and reminders, the campaign focuses on little things we can all do every day to remind people that they belong and that their mental health matters.

"With this campaign, we're encouraging South Dakotans to offer help to others through small actions, words, gestures, and acts of care," said Jennifer Humphrey, Strategic Initiatives Program Specialist with the Department. "We are hopeful that this genuine type of outreach can work for both prevention messaging and help those who need it during times of crisis."

As the campaign evolves, additional efforts are being launched targeting Native American populations, veterans, working professionals and ag producers who may be at higher risk for behavioral health concerns.

Those experiencing mental-health-related distress are encouraged to call 988, the Suicide and Crisis Lifeline. 988 was launched one year ago and provides 24/7 access to trained crisis specialists.

For more information about 988 and The Helpline Center, visit https://www.helplinecenter.org/9-8-8/.

The South Dakota Department of Social Services is dedicated to strengthening families to foster health, wellbeing and independence.

For more information, please visit SDBehavioralHealth.gov.

South Dakota Statistics

Behavioral Health By the Numbers contacts from Jul. '22 to Mar. '24. Top to Self " 71 million "Notes 16,000+ 988 concerns were suicide, anxiety and depression. campaign impressions individuals took the mental health 7,000+ quiz on SDBehavioralHealth.gov

to 122,000 visitors SDBehavioralHealth.gov

South Dakota survey respondents are somewhat or very 63% oflikely to use 988 if they know someone in need of help.

Reaching Out

Concerned about someone's mental health? Just ask.

"What's on your mind?"

"You don't seem like yourself. Everything okay?"

Addiction, depression, anxiety or any mental health concern can feel overwhelming. So when the world seems too big, remember this small note.

See your worth. See your future. And when you’re ready, see someone.

You’re worth the fight. Find help at SDBehavioralHealth.gov

"I care about you, and I'm here to listen."

"Can we spend some time together?"

"You matter to me. I'm here for you."

Four Facts about Addiction Substance use disorders can affect anyone, including our relatives, neighbors and friends. It's up to us to stop the stigma around addiction and open the lines of communication to get informed and get help.

1. Science has shown that addiction is a disease, not a choice or moral failing.

2. Substances alter your brain, sometimes permanently, making it even harder to get help.

3. Substance use disorders often co-occur with mental health disorders.

4. The most widely used substance in South Dakota for adults ages 18+ is alcohol, so substance use disorders often go untreated or unrecognized.

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MENTAL NOTES 988 Helpline

"You never know when you are going to need it for yourself, or a friend, or a family member, and 988 just sort of sticks with you."

Saving Lives in South Dakota

— Janet Kittams, Helpline Center

Five Things You Should Know about the Mental Health Lifeline In the last year, you might have heard about 988. But for a lot of South Dakotans, it's still unclear what 988 is and who it's for. 988 in South Dakota is a partnership between the South Dakota Department of Social Services, Division of Behavioral Health and the Helpline Center. 988 is answered 24/7 by a team of trained, local counselors at the Helpline Center.

When it comes to suicide, mental illness, substance use and other emotional issues, it can be hard to reach out for help. 988 is all about bridging that gap, offering a lifeline for those in need.

What is 988?

The 988 Lifeline is the new three digit number for any kind of mental health support, including depression, thoughts of suicide, anxiety, addiction or any other emotional trouble. Staffed by local mental health professionals, the 988 Lifeline offers support right here in South Dakota for people in crisis, those, who just need to talk and even support people worried about someone in their life.

Make the Right Call Who Should Call 988?

988 was created for anyone to call, text or chat and connect with local support.

Whether you have behavioral health concerns about yourself or a loved one in your life, you can call 988 to find help.

How can it help?

Asking for help is a big first step, but 988 can also help with long-term support or specialized services, connecting people to mental health resources in their area and providing information on nearby clinics, therapists or support groups.

This service allows people to access the care they require and ensures a more streamlined and efficient process.

Where is it Available?

Across South Dakota, 988 is staffed with local professionals to connect you with care and services in your area. In rural communities, on reservations and

in urban areas, 988 is a 24/7 resource for mental health support.

Why is 988 Important?

988

For mental health support, those in crisis, depression, suicidal thoughts, addiction and emotional trauma.

988 is a number everyone should know, because you never know who might need it.

"By prioritizing mental health resources like 988, we acknowledge that everyone deserves support, and that seeking help is a sign of strength, not weakness," says Janet Kittams, Chief Executive Officer of the Helpline Center. "The significance of 988 lies in its potential to save lives by providing a lifeline of hope and support."

Mental health disorders are often a silent disease, and it's easy for symptoms to go unnoticed. If you ever feel the weight of depression, anxiety or addiction, know that a listening ear is always waiting on the other end of the line.

To help spread the word about 988 and download free promotional materials, visit www.helplinecenter.org/9-8-8/988-promotion

911

For emergency dispatch in the event you have harmed yourself or others, or have immediate plans to.

211

For community resources and services like financial support, food assistance, transportation or housing.

How to Support Mental Health at Work Stress, tension and fatigue — we've all felt it. But when occasional stress turns into something more persistent like depression, it's our job to step in and help out.

Despite the wide open spaces of South Dakota, it’s our kindness that keeps us together. And our character that keeps us strong. Looking out for your neighbor means more than offering a helping hand. It means checking in on their mental health, too.

Bottling up feelings never helps them go away, but talking about them can. If you or someone you love struggles with depression, anxiety, addiction or any behavioral health concern, know that hope is always near.

1 in 6 South Dakotan lives with a mental illness. Prioritizing mental health isn't just essential for your employees — it helps your workplace be more productive, boosts culture and reduces turnover. Start with these five steps to support employee self-care.

1. Make it okay to talk about mental health.

Stigmas build invisible barriers to getting help. So, start by eliminating them, making it okay to prioritize and talk about mental health.

Work with human resources to develop an open-door policy regarding mental health.

Share self-care tips with employees, and encourage them to take breaks and use timeoff to support their mental health. You can also create policies to support overall wellness, from reimbursing employees for gym memberships to encouraging daily walks.

2. Check in with employees and staff often.

As you're meeting with employees to talk about work goals, make sure you're asking about their mindset, too.

• What is your stress level right now? How are you coping?

• What are you excited about?

• How are you balancing work with life? What's keeping you energized outside of the office?

The Notes to Self campaign is earning positive feedback from South Dakotans, like what we heard on this ad:

"Loved your ad that shows the two-finger wave...took me back to the early '50s riding with my dad. He said it didn't make any difference if you knew them or not — it was a sign of friendliness and respect. I loved those simple gestures."

Answering these questions can help you see if someone might be struggling, along with assessing workload to prevent burnout.

3. Study the signs to look for.

Know the signs of depression to look for, both in your professional and personal relationships.

• Loss of interest in activities • Isolating themselves from friends, family or activities • Difficulty concentrating • Signs of excessive stress like insomnia, irritability or loss of appetite • Talking about death or suicidal ideation If you suspect someone might need help, talk to your HR department. Together, you can make a plan to check in with that employee, listen and connect them with help.

4. Promote behavioral health resources

Create a list of behavioral health resources for employees, from mental health insurance benefits to the Employees Assistance Program and counseling resources.

The 988 Lifeline is also a free confidential resource available 24/7 for any mental health, substance use or emotional concerns.

Share these resources through posters, emails, online tools and more, especially during the holidays or other peak stress times.

5. If someone asks for help, respond right away.

If a coworker reaches out to you for help, respond right away. The most important thing is to let that individual know that you care about them and are listening. It's not your role to be their therapist, but instead to work with HR to connect that person with help. The worst thing you can do is ignore the call for help or hope it goes away on its own.

Find help at SDBehavioralHealth.gov

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Depression doesn't discriminate, regardless of your profession. Call, text or chat 988 for local, around-the-clock support.

Putting a Stop to Stigma Identifying Where Stigmas Start and How You Can End Them A stigma is an unfairly held belief or perception, usually negative, that shapes how you see a group of people, a situation, a condition or a set of actions. People may hold them about themselves or about others. But the one thing stigmas share is that they're usually rooted in shame, causing people to feel disgraced, tarnished, overlooked or unwanted.

When it comes to mental health and substance use, stigmas have spread for years.

People may hold unfounded beliefs that those living with mental health conditions are unpredictable or dangerous. Or that those living with addiction are making an active choice to use substances, when scientific studies show that addiction is a disease — not unlike diabetes or other physical medical conditions.

Stigmas create barriers — to communicating, to understanding each other and to getting help. So how do we stop them?

First, recognize the stigmas you already carry. It's okay to admit it — we've all heard and grown up around stigmas in one form or another, and some may be so deepseated that it can be hard to identify them. But without looking inward, you can't fully address the stereotypes you may be carrying and how to change them.

Next, educate yourself. Even if you don't live with a behavioral health disorder, someone you know and love probably does. Learn about mental health, substance use and depression. The more you can arm yourself with facts, the more aware you'll be of your attitudes, behaviors and even the language you choose to use moving forward.

Connection to Culture A Look at Mental Health on the Reservation This excerpt was featured in the November 2023 edition of 605 Magazine, produced in partnership with the South Dakota Department of Social Services, Division of Behavioral Health.

Mental health challenges are pervasive across millions of people, and current statistics show that they're more prevalent than ever on indigenous reservations across South Dakota and the nation at large.

There are nine distinct Indian reservations in South Dakota. These include Cheyenne River, Crow Creek, Flandreau, Lower Brule, Oglala, Rosebud, Sisseton Wahpeton, Standing Rock, and Yankton. 605 Magazine was able to have an open conversation with a few locals living on the Pine Ridge Indian Reservation and Crow Creek Indian Reservations to see how they continue to work toward what is accessible and available to treat some of these important issues—and even more importantly—stay connected to their culture.

As chairman of the Great Crow Creek Sioux Tribe, Peter Lengkeek has seen a lot, including the decline of mental health among the youth.

"My current background is chairman of the tribe, but going further back I do have a background in mental health and behavioral health, as well as domestic violence and sexual assault prevention and intervention," said Lengkeek.

Lengkeek currently sits as a volunteer on the suicide task force in Fort Thompson, and has been doing that for 15 years.

He says many factors had contributed to the mental health decline, including what resulted post pandemic.

"We had some parents or guardians who passed away, so we had children who were orphaned due to this pandemic," said Lengkeek. "What we are seeing is a lot of grief in our youth. We have lost students, parents, guardians, a lot of elders, and that is what I am encountering out there when I go out on these [suicide task force] calls is a lot of grief."

He continued, "We don't get those teachings anymore on how to grieve and mourn in a healthy way like we used to from our ancestors long ago.

So a lot of people don't know how to grieve or mourn in a healthy way,

because there is a healthy way to do it, and just like anything else, there is a bad way to do it."

Also due to lack of law enforcement, Lengkeek says methamphetamine and fentanyl have become a large issue.

"Drug dealers and traffickers are coming and going here constantly," said Lengkeek. "It's played a huge factor in the mental health of our youth."

It's traditions and connections to the culture that Lengkeek says he's had the most success with.

"I provide people with comfort, love, compassion, prayers, ceremony and song, and that is how I address [mental health]," said Lengkeek. "When I go out on a call, I rely on tradition and culture, and it hasn't failed me yet."

The interest of connecting to culture has become more prevalent, and Lengkeek thinks this connection will help others in their healing journey.

"Here in Crow Creek we started a few years back doing an annual Wiping of the Tears Ceremony where everybody who has lost someone that year will come to the ceremony and we will take care of them in that way."

"When I talk about connection, that was a beautiful thing about our traditions and our culture and our Dakota ways; it provided healthy ways of dealing with life in general, no matter what we encountered," he explained.

"Those ceremonies are brought to us by the White Buffalo Calf Woman.

We are supposed to maintain those and practice those regularly because those ceremonies help us to deal with everyday life."

Lengkeek realized the importance of this connection himself when he returned from the United States

Finally, you can reduce stigma by showing support. Be there for the people in your life, check in with those around you and listen without judgment when they open up to you. Everyone deserves a safe space — without stigma — to be heard, be seen and belong.

Marine Corp and was struggling with Post Traumatic Stress Disorder (PTSD), addiction, and self-harming thoughts.

"What saved my life was connecting with our culture, our traditions, our language, our way of life. And that is why I am still here today." he said.

Lengkeek says during a house call, he typically starts with prayer with him "and the creator." The community and family then follow up to make sure they're okay, have food, and have a place to stay. Homelessness is also a huge issue, according to Lengkeek.

"That is what I see contributing to the mental health of our youth," he said. "They have no home, they have no family structure, they have no spiritual or physical connections with the creator, the earth, the universe, our people, or with themselves."

Along with house calls, Lengkeek also offers equine therapy Wednesday nights for men and Thursday nights for women with his horse Koda (which in Dakota means friend). This, he says, can teach others how to set healthy boundaries for yourself and for others.

"The way I see and understand things and human beings is that a lack of skills leads to insecurity and insecurity breeds fear," he described. "We are constantly reacting from a fear base, and it comes out in outbursts, arguments, and fights, so I spent a lot of time with my horse teaching skills, internal skills and external skills."

As far as the traditional circle, Lengkeek sees it growing, especially with the youth.

"Ancestry is huge; it is a necessity," he said. "We have to know where we come from to know where we are going in life, and if we don't know where we come from then we have no idea where we are going."

Dates to Remember April 27, 2024

National Prescription Drug Take Back Day

April

Alcohol Awareness Month

May

Mental Health Awareness Month

May 12–18, 2024

SAMHSA National Prevention Week

August 1–2, 2024

South Dakota Suicide Prevention Conference

August 31

International Overdose Awareness Day

September

National Suicide Prevention Month

September 8–14, 2024

National Suicide Prevention Week

October 10, 2024

World Mental Health Day

October 29, 2024

National Prescription Drug Take Back Day

November 23, 2024

International Survivors of Suicide Loss Day

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MENTAL NOTES Mental Health 101:

Teaching Young Minds that They Matter DSS partners with educators to promote mental health in schools Mental health disorders can affect anyone — including children. According to the National Survey of Children's Mental Health, about 1 in 4 South Dakota children aged 3–17 has or meets the criteria for one or more mental, emotional or developmental problems.

Kids and teens are at a pivotal age where learning how to process their emotions and develop healthy coping skills can set them up for a better life of mental and physical wellness. To help students develop these skills, the South Dakota Department of Social Services and the Department of Education are teaming up to supply South Dakota students and educators with mental health tools they can use in and outside of the classroom.

In 2024, South Dakota sixth graders will have the opportunity to receive a 160-page journal with mental health prompts, questions and mood-boosting activities. Journaling is proven to help people improve their mood and process complex emotions, which is especially important as students begin middle school. Each page is designed to help students more effectively recognize, communicate and cope with what they're feeling.

South Dakota counselors and educators will also receive a special card pack.

Designed for K–12 students, these "care cards' contain exercises, activities, games, prompts and other strategies educators can use in one-on-one sessions with students as they work through emotional concerns. The cards also contain information on 988, refusal skills for substance use and ways to cope with grief.

Finally, the Department will also share mindfulness videos and outreach kits with stickers, magnets, posters, pencils and more to promote mental health and break stigmas.These efforts complement toolkits that were already distributed on South Dakota college campuses last fall to promote the 988 Lifeline and raise suicide prevention awareness.

Some Signs Aren’t This Clear.

Which is why it’s important to learn the warning signs of suicide. Educators play an essential role in a student’s life and are often the first to notice when mental health problems arise. Encourage your students to express their feelings and teach them that it’s okay to ask for help. When you shape healthy minds, you shape a better world.

Educators can look forward to receiving these materials in the fall. Until then, for more information and to download existing outreach materials and toolkits, visit:

SDBehavioralHealth.gov./outreach-toolkits

Check in on Your Child's Mental Health The switch to a new year can be exciting, scary or anything in between. So there's no better time to check in with your child about mental health.

Both young and older students can experience a variety of mental health challenges including stress, anxiety or depression. Because mental health affects how we think, act and feel, look for changes in: • Energy levels: mental and physical fatigue • Academic performance • Mood: fluctuations, outbursts or weeks of persistent sadness • Eating habits or withdrawal from social interactions In any case, a conversation can make all the difference, giving your child an opportunity to open up and let them know you're here to support their wellbeing. Here are some open-ended questions to get the conversation going.

"Is there anything on your mind right now?"

"What makes you happy and angry at school?"

"What are the best and worst part of your week?"

Check in with your child regularly at mealtimes, before bed, on the drive to and from school — whenever you have a moment alone for one-on-one listening.

Note to Self: Prevention is Possible. Find resources at https://sdsuicideprevention.org/professionals/school-staff

South Dakota Educators Association Print Ad — February–January

Finding Help Wondering where South Dakotan can look for help?

With several statewide resources, even in rural areas, help is accessible for everyone.

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