PPAL Pathfinder November Edition by PPAL for Families

November 2023 PARENT/PROFESSIONAL ADVOCACY LEAGUE, INC.

Reclaiming Children Award

presented by National Federation of Families In recognition of outstanding efforts at the local and state level on behalf of families and their children experiencing behavioral health or substance use challenges and their families. Join us in congratulating Meri! www.PPAL.net

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FROM THE EXECUTIVE DIRECTOR Hello fellow warriors, In this issue of the PPAL Pathfinder, we address the topic of keeping our children safe. While I’m sure that it’s a constant worry for most parents and caregivers, for those of us with children with mental health struggles, it feels like a very real threat. We often feel that our most important job as parents and caregivers is to protect our children. That number one job became a huge issue when the pandemic hit. None of us knew from day to day whether our kids would be safe or not. When schools began opening, we had to decide whether to send our kids back, keep them home, or lecture them about keeping their masks on. It was a time of incredible uncertainty. I recently had a conversation with a colleague about the relief I would sometimes feel when my daughter was hospitalized. Why? Because I knew she was generally safe. Or at least safer than if she was outside the hospital. Maybe some of you have felt that relief too? As my kids have gotten older, I’ve had to reconcile the fact that I can only do so much. I can arm myself, and them, with information, with good habits (sometimes), and with education about the world. I can rely on my village to help me protect my kids and offer to help protect theirs too. But, ultimately, their safety will not be up to me. It will be up to them. Let’s collectively hope for the safety and protection for all of our kids. At PPAL , we will continue to do what we can to ensure it. Be well,

Pam Sager

Keep In Touch With PPAL! Phone: (866)815-8122 Email: info@ppal.net Website: PPAL.net Facebook: facebook.com/PPAL.net YouTube: @PPALforFamilies

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UPCOMING WORKSHOPS

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WHAT TO KNOW, WHAT TO EXPECT: JUVENILE JUSTICE 102 Wednesday, November 29, 12:00 - 2:00 PM

THE IEP TEAM: BUILDING SKILLS TO HELP PREPARE FOR YOUR CHILD’S NEXT IEP MEETING Tuesday, December 5, 5:00 - 7:00 PM

PLANIFICACIÓN PARA UNA CRISIS DE SALUD MENTAL martes, deciembre 12, 6:00 - 7:30 PM

TALK SAVES LIVES, AN INTRODUCTION TO SUICIDE PREVENTION Thursday, December 21, 8:00 - 9:30 AM

www.PPAL.net

's Staff Spotlight Meet Andrew Hammond, PPAL’s Director of Operations and Development! What is one interesting fact about you? I love to sail - and won my first sailing race last year! What have you been enjoying lately? Pickleball If you could only eat one food for the rest of your life, what would it be? Pizza Please help PPAL welcome Andy Hammond to our team! What is a “Director of Operations and Development” you might ask? As Andy explains, “I’m really here to support Meri, Pam, and everyone” by taking care of the day to day functioning details at PPAL and looking for new funding sources “so that everyone else can focus on PPAL’s families.” Like all of PPAL’s staff, Andy came to this position through his lived experience. His family (including his family of origin) has experience with mental health needs: “I have my own issues around anxiety and depression,” Andy explains, and his two sons both had IEPs and out of district placements. “My lived experience,” Andy says, “facilitated a career pivot from high tech to the great work that we do at PPAL.” Discussing what drew him to PPAL, Andy cites the over 5,000 families who receive direct services through PPAL each year, as well as the many more we touch through our outreach and other programs. He says “I just think that’s phenomenal at a time when those services are so needed.” He also loves the commitment he sees in the PPAL staff: “The folks are so incredibly compassionate and empowering because of our collective lived experience.” We are excited to have him join us! To seek support from PPAL’s family support staff, fill out our Family Support Request Form!

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Meet Zack Lavergne, PPAL’s NEW Family Support Specialist! What is one interesting fact about you? I rescue and rehabilitate axolotls - aquatic salamanders! What have you been enjoying lately? The TV series “America’s Haunted Places.” If you could only eat one food for the rest of your life, what would it be? Tacos PPAL is excited to welcome Zack to the family support team! Zack comes from a human services background, working with adults with developmental disabilities, but like many PPAL parents, had to step away from his career for a time to take care of his four kids. Three of his children are, to use his term, “neurospicy,” and have needed extra support. As he and his wife searched for information and resources to support their kids, they came across PPAL, and Zack remembers thinking idly that it would be an awesome place to work. A couple of years later, as Zack was introducing a family he was helping to PPAL, he connected with PPAL’s Central Massachusetts Program Manager Kristin Solaras, who asked him to send in his resume. We’re so happy that he did! Zack has jumped right into supporting families. “I love being able to use my experience as a parent to help other parents that were where I was.” He explains, “It’s a really empowering feeling.” As a dad, and as the primary caregiver of his four kids, Zack brings a special perspective to PPAL. He says, “I needed support, and there is nothing out there for dads.” Don’t worry, dads - Zack is ready to help! One of his favorite quotes is “Be the change you wish to see in the world.” As Zack says, “[Change] has to start somewhere, so it might as well be with me!”

PPAL's phone: (866)815-8122 Family Support Request Form

www.PPAL.net

PPAL's Question of the Month September 2023 Results When did you first notice concerning behaviors in your child?

Parents Are Saying... 18 yrs+ 2%

14-17 yrs 9% 11-13 yrs 10% 0-3 yrs 41%

6-10 yrs 15% 4-5 yrs 23%

Most parents and caregivers first noticed concerning behaviors by the time their child was 5 years old. 64% 25% 11%

0-5 years 6-13 years 14+ years

If you need help from PPAL right now, request family support here or call us toll free at (866) 815-8122. 6

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PPAL's Question of the Month At that time, most families struggled to get help for their child, 35% getting little or no help despite looking.

If families wanted to discuss these behaviors, they were most likely to speak with pediatricians (78%) and family/friends (65%).

9% Didn't hav…

78%

65%

Pediatrician

Family/Friends

Although families spotted concerning behaviors when their children were quite young, many families struggled to get the information and support they needed at this time. It's clear that there's more that can be done to share information and resources about childhood mental illness. PPAL will continue to partner with families and providers in this area. If you have ideas or want to learn more, please let us know at info@ppal.net.

www.PPAL.net

Didn’t have anyone

50%

School

Multicultural Outreach Team Updates Recently, PPAL’s Multicultural Outreach Coordinator Johana Rodriguez met with the Lynn Housing Authority & Neighborhood Development, or LHAND, and learned about programs they offer to the community. LHAND programs assist unaccompanied young adults, young adult refugees, or young adults with disabilities to find stable housing. LHAND also has programs for families with children to ensure that no young people in Lynn are without a safe place to live. They even offer programs that provide financial counseling to help families identify savings goals and help save a portion of Section 8 rent payments to meet those goals! Live in Lynn and want to learn more? Contact fhousing@lhand.org Don’t live in Lynn but want programs like this? First, see if your town or county offers similar programs; many do! If not, bring information about the programs that you’d like to see in your community to your town representatives and officials and advocate for the services your community wants!

“So many programs! It’s amazing” -Johana Rodriguez, PPAL Multicultural Outreach Coordinator

More information about specific programs in Lynn: A Roof for Every Youth: Lynn’s Coordinated Community Plan to End Youth Homelessness Click here to learn more Support Group for Lynn Families Every Other Friday 6:30 - 8:30 PM In-Person! Programming for children is available! Register with Dalene: ptahsw@verizon.net NSHAG Program The North Shore Housing Action Group (NSHAG) is a financial assistance program that specifically focuses on the needs of 18-24 year olds who are experiencing housing instability. Temporary financial assistance is available for such things as move-in costs, rental stipends, basic furniture, education/trade expenses, child-care, transportation, and more. Learn More. 8

Siemer Program / Project RISE Realizing Intergenerational Success through Education, a Lynn-based program designed to support families with children enrolled in Lynn Public Schools who are either experiencing homelessness or facing any kind of challenge maintaining their housing. Access confidential support in finding or maintaining your housing, increasing your income so that you can afford your housing, and cultivating your family’s educational opportunities and well-being. Learn More

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This is a safe, non judgmental space for making connections, sharing, and helping fellow caregivers raising LGBTQIA+ Youths

Meeting Time: Every Monday Virtually 4:30PM - 6:30PM

Zoom Link: https://us06web.zoom.us/j/83088304499

Get more information: parentsupportgroup@ppal.net www.PPAL.net

PPAL Gives Legislative Testimony At The Statehouse! Meri Viano, Candice Gabrey, and Raquel Negron recently testified in front of the Joint Committee on Children, Families and Persons with Disabilities to support a bill being considered that would revise the Child Requiring Assistance (CRA) process, as well as raise the minimum age of CRAs to 12 years old. Keep reading to see highlights from their testimony on S.101 / H.134, An Act regarding families and children in need of assistance.

Meri Viano, PPAL Associate Director As a professional and parent that had a child in the court as young as 12, it is a continuing battle to prove and oftentimes push people to help and not harm our children. And I have white privilege. Consider what needs to be done to decrease the reality that youth who are diverse, Black, Brown, and Latino are disproportionately entering the courts. They will come to court at a higher risk than the youth who is white. This is not a new problem, rather a problem that continues to be talked about with no solution. Raise the age of the juvenile court jurisdiction from 6 years old to 12, which is more developmentally appropriate and aligns with the delinquency system.

The reality is: court is not the answer

Raquel Negron, PPAL Family Support Specialist I am also a parent who, alongside my son, has been a victim of a CRA (Child Requiring Assistance). I did not know, nor was I ever made aware of what a CRA was, the true impact it would cause, and most of all, entering the court system. The damage it created to my son and my family after it was filed was nothing more than a nightmare of labeling, shame, and judgment, and the spiraling of getting pushed into a system that doesn’t allow you to succeed. 10

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Raquel Negron, PPAL Family Support Specialist As a Latino and Black family, the racial disparities and inequity was devastating. The doors that opened did not help. In fact, it was layers of more problems - a file with probation, along with the consequences of what would happen if he violated his probation, and nothing more.

Bad kid? No sir. No ma’am. In fact he was struggling with mental health and social and emotional problems. As a mother, I didn't know what was going on with my son and I trusted multiple systems to help him.

Candice Gabrey, PPAL Juvenile Justice Program Manager PPAL as an organization believes court is harmful to kids. We have seen it first-hand with the families that we support. We know when a child is pushed towards court, their entire life trajectory is altered. There's nothing that can be accessed through court that cannot be accessed without court. Service providers do not understand the harm that courts can put on a child. They need to be using other community resources. Families are reporting that a CRA is being offered as a menu option and save-all option for accessing support. This is a myth.

As a parent, it’s scary to think that by asking for help for our children, the answer would be court and potential loss of custody.

PPAL is in favor of the changes set forth in Senate 101 / House 134. Our children and families need help and not punishment, and the way CRAs are accessed is traumatizing and damaging to all. Let’s put a stop to the school-to-prison pipeline in Massachusetts. Are you looking for support? Is your child involved in the court systems? Reach out now for support! www.PPAL.net

PPAL's phone: (866)815-8122 Family Support Request Form

Keeping Our Kids Safe: Anti-Bullying Basics Bullying has been around forever and is often glamorized in the media. Remember Draco Malfoy from Harry Potter? Regina George from Mean Girls? Buzz from Home Alone? And while the “victim” usually wins in the movies, they most often don’t in real life. Bullying can have long lasting traumatic effects on our children. Many of us certainly know this too well, as parents/caregivers of kids who may be easily bullied, or be acting as the bully. Overall, 1 out of every 5 school-aged children reports being bullied at school or on social media. And if you’re 9-12 years old, your chances of being bullied rises to almost 1 out of every 2 children. Yes, nearly 50%! 41% of students who were bullied believed it would happen again. And what are they bullied about? Their physical appearance, race/ethnicity, gender, disability, religion, or sexual orientation. [Source: www.pacer.org] 12

Most experts agree that bullying is any behavior that hurts or harms another person physically or emotionally. Bullying usually involves a real or perceived imbalance of power. The student doing the bullying has or is perceived to have more physical, emotional, or social power than the targeted student. And, the victim may struggle to defend themselves or have difficulty stopping the behavior. Bullying takes many forms and with the widespread use of social media today, can be even more damaging than in the past. Cyberbullying is of particular concern because it can be anonymous, hard to detect, persistent, spread to a much larger audience, and potentially permanent. The damage done by cyberbullying can be widespread before the target even knows it exists. 2020 data indicates that one in five 9-12 year olds had been cyberbullied, cyberbullied others, or had seen cyberbullying.

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Anti-Bullying Basics Bullying is not conflict, disagreement, or expressing different beliefs (though such situations could lead to bullying.) In a conflict or disagreement, kids generally have equal power; they’re on an even playing field. When bullying occurs, the playing field is unequal or perceived as unequal. Many of our children who struggle with social-emotional situations might be bullied one day and do the bullying the next. Both are concerning. Our children are still growing, developing, and learning in every way. They have underdeveloped social and reasoning skills. They often lack confidence and compassion - qualities that are learned through experience and teaching. Labeling children as “bullies” or “victims” at this point can negatively impact them. Those labels can stick with them throughout their school experience and perpetuate the notion that the child IS their behavior. Labeling children can suppress their desire to learn and grow and further stigmatize them in the eyes of other students. Instead of labeling the child, label the behavior: “the bullying behavior.” The goal is to teach and resolve the situation, not cast blame or judge.

Common Myths About Bullying Myth: Bullying is a natural part of childhood. Truth: Bullying is learned behavior - and kids can learn more positive behaviors instead! Myth: Verbal bullying doesn’t matter, because words can’t hurt you. Truth: Words can be traumatizing, and are often the most harmful part of bullying. Myth: Kids who experience bullying will grow up tougher. Truth: Bullying doesn’t build you up - it breaks you down. Myth: Telling a teacher about bullying is tattling. Truth: “Tattling” is done to get someone in trouble; “telling” is what you do to get help, and asking for help is always appropriate! Myth: It’s only bullying if the action is repeated over and over again. Truth: Even one incidence of bullying can be harmful and should be addressed. Myth: It’s only bullying if the student doing the bullying intends to harm the student they are targeting. Truth: While it’s important to address the intention and/or purpose of the bullying, the intention and/or purpose doesn’t diminish the negative impact of the behavior on the targeted student.

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Bullying What can you do when your child is being bullied? 1. If your child is the target of bullying behavior, let them know you are there to help. Reassure your child that you will help them find a solution. Let them know that the bullying is not their fault, and that no one deserves to be bullied.

2. Document everything you can, because with bullying, evidence matters. Keep all incident reports, communications from your child’s teacher or school, and so on. Keep a notebook or document where you list every incident your child experiences, even if it’s something seemingly simple like not being allowed to play with a particular student at recess. If your child has been physically hurt, consider having their doctor document their injuries.

3. Every school in Massachusetts should have a Bullying Policy. Read your school’s bullying policy. It should be posted on the school website; if you have trouble finding it, ask for a copy from your child’s teacher, the school office, or anyone in the school administration.

4. Let the school know about the situation, making sure to do so in writing. You may want to start by simply letting your child’s teacher know what’s happening with an email or note. You can also report the bullying to the principal or adjustment counselor, or whoever at your child’s school is in charge of investigating bullying. The school website should include a form for submitting complaints about bullying anonymously, if you so choose. You can also send an email or letter - you should not be required to use a particular form in order to report bullying. If you are later unhappy with the school’s response, you can take the problem up the chain: speak to your district superintendent, and if that doesn’t help, report the problem to the Massachusetts Department of Elementary and Secondary Education (DESE)’s Problem Resolution System at http://www.doe.mass.edu/prs, email compliance@doe.mass.edu, or call 781-338-3700. 14

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What Should the School Do? Every school has its own bullying policy, so their response to bullying may vary slightly. Be sure to familiarize yourself with the school’s particular policy. However, based on rules, guidelines, and a sample bullying policy put out by DESE, most schools, upon hearing of a bullying incident, will: 1. First and foremost, ensure the safety of the student who was the target of the bullying behavior. This can include a number of steps, including a safety plan which lists what steps must be taken to protect the student. Steps might include: Increasing staff supervision at transition times and periods like lunch and recess.

Having a school counselor or other designated staff check in with your child every day or two to keep track of any continued bullying.

Keeping the student/s exhibiting the bullying behavior away from your child, i.e. by reassigning classes or issuing a “no contact” order

Assigning an older student, known as a “peer role model,” to sit with your child at lunch.

Providing a staff escort to help your Putting a plan in place regarding what your child move between classes, so that child can do if targeted again, such as allowing your child doesn’t have to be alone. the child to go to the office immediately to talk to staff who will address the bullying right away and (if desired) letting a child skip class if the child exhibiting the bullying behavior bothers them during it. 3. Once a determination has been made, the

2. The school’s next job is to investigate the allegations of bullying. Generally, the principal or their designee will consider all information related to the incident/s, including student reports and documentation provided by the parent. The principal or designee will interview all students involved, as well as student and staff witnesses. Once a determination has been made, parents should be informed immediately of the finding and of what general steps the school will take to address the situation. www.PPAL.net

school needs to respond to the bullying behavior. Note that due to privacy laws, neither the student being targeted nor their parents will be informed of specific disciplinary actions being taken against the aggressor. However, steps include suspension or (better) in-school suspension as well as learning more appropriate behavior through skill-building and direct instruction. Studies show that by teaching students who have engaged in bullying behavior how to act more appropriately, be more socially aware, and be positive influencers, they can be empowered to become positive leaders and even stand up against other aggressors.

Empower Your Child One key aspect of addressing bullying is addressing the power imbalance by returning power to your child. Continued dialogue with your child is critical to returning that power. The Pacer National Bullying Prevention Center offers another option for returning power to your child - the Student Action Plan: Step 1: Ask your child to think about their experience of being bullied. Step 2: Tease out your child’s ideas about how things could be better. Would it have helped if a teacher been present? If other students had stood up for them? This step is important, because it’s all about helping your child regain power. Step 3: Think about the steps needed to make those changes happen - and follow them! Continue the conversation until the situation is resolved.

What If Your Child Exhibits Bullying Behavior? Addressing your child's bullying behavior is crucial for their personal growth. Start with an open conversation to understand their motives. Teach empathy and compassion by helping them see the impact of their actions on others. Help them understand better ways of interacting with others. Help them be positively curious about “differences” and embrace them - we ALL have something to offer and deserve respect. Model supportive and positive interactions. Set clear boundaries and consequences, emphasizing kindness and respect. Consider involving a counselor or therapist for additional guidance.

The Power of the UpStander One of the most powerful things we can do is to empower students witnessing bullying to stand up for the student being targeted. Research shows that other students speaking out or taking action stops bullying behavior over half the time within seconds! Parents can model this behavior for children, but schools play a crucial role as well. Work with your school to ensure that they are providing opportunities for students to learn to be upstanders. Students can be taught to be upstanders by: telling the bully to stop getting others to stand up to the bully with them helping the victim shifting the focus and redirecting the bully away from the victim telling an adult who can help 16

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parentsupportgroup@PPAL.net for more information!

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Keeping Our Kids Safe: Suicide Prevention The heartache is unimaginable…yet some of you are living it. Every year in the United States, more than 45,000 people take their own lives. Suicide is the second-leading cause of death for teens and young adults, ages 1034 (CDC, 2022). When death by suicide happens, the "suicide survivors" have not only lost someone they care about deeply, but they are left with complex and traumatic grieving and an ongoing struggle to understand why it happened. In 2022, suicide rates in the U.S. reached an all-time high Approximately 25% of young adults ages 18-24 report having seriously considered suicide (higher than any other adult age group.) Over 18% of high school students reported having seriously considered suicide in the past year, with females higher at 24%, and LGBTQ+ teens at almost 47%. Almost 9% of high school students have attempted suicide, with females highest at 11%, black teens at almost 12%, and LGBTQ+ teens at 23.4%. [Source: CDC, 2020]

The need for effective suicide prevention strategies has never been greater.

Want to know more? Looking for support? Contact the Parent/Professional Advocacy League (PPAL) to talk to a parent with lived experience or attend a parent support group or workshop. 18

(866)815-8122 https://www.PPAL.net info@PPAL.net facebook.com/PPAL.net

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One such strategy taking hold at the individual and community level is the American Foundation for Suicide Prevention’s (AFSP) campaign “Talk Away The Dark'' and its program “Talk Saves Lives.” Talk Away The Dark emphasizes that talking is the first step in preventing suicide. We need to bring suicide out of the shadows. Often, when we think someone is struggling, we worry in silence. We don’t know what to say, or are afraid that we’ll say the wrong thing, so we say nothing. If you are in that situation, AFSP recommends that you assume that you are the only person that will reach out to the person struggling. By having a brave, real, open, and honest conversation with the person you care about, you can make a difference, and maybe save a life.

How do you start the conversation? First, let people know that you’re willing to talk about mental health. Share your own story. Have there been times that you’ve struggled and sought help? Let people know that. It helps them to feel safe with you. Approach your loved one privately. Grab a coffee or take a walk. Start by expressing care for them and then follow it with an observation. For example, you might say “I care about you and have noticed that you haven’t been yourself lately. How are you doing?” Make sure they know that they are not saddling you with the problems and that you are willing to listen to the details and go to the dark place with them. But also make sure that you have resources to give them, can offer to help them find a therapist, or make a call if needed. And by all means, follow up: “How are you feeling since we spoke?” can make a real difference.

www.PPAL.net

One of AFSP’s programs, Talk Saves Lives: An Introduction to Suicide Prevention, is a communitybased presentation that covers the general scope of the suicide crisis, the research on what causes people to consider suicide and other factors that might put people at risk, proactive and protective factors for lowering risk and managing mental health, warning signs and behaviors, how to get help, and what you can do in your community (and family!) to save lives. It is powerful and proactive. PPAL is pleased to be able to provide this program to families, schools, and communities. We invite you to join us for an upcoming presentation (see Calendar/Events on our webpage.) This is where you can start to make a difference.

Another strategy gaining momentum is the "Zero Suicide” initiative aimed at healthcare (including behavioral healthcare) providers and systems - so, a framework for system-wide transformation relating to patient safety and safe suicide care (www.zerosuicide.edc.org). While self-described as aspirational, Zero Suicide recognizes that people experiencing suicidal thoughts and urges often fall through the cracks in the health care system. Most people that die by suicide saw a health care provider in the prior year. Zero Suicide requires a transformational, systems-wide approach to improving outcomes and closing gaps. It emphasizes a system-wide commitment to better identify, assess, and support those at risk of suicide. A Zero Suicide Toolkit and other free implementation resources are available to support systems taking on the challenge. The Zero Suicide approach advocates for early intervention, destigmatizing mental health, and promoting an environment where young individuals feel comfortable seeking help. Prevention strategies encompass various aspects of a young person's life, including family, school, and community support systems. 20

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Suicide Prevention Early identification of warning signs and risk factors associated with youth suicide is crucial. Parents, educators, healthcare providers, and peers need to be educated about these signs to act promptly. Encouraging open communication and creating safe spaces for young individuals to share their feelings and concerns can be instrumental in early intervention. Warning signs and risk factors are not always present or evident. Talking with your child as much as possible and, more importantly, listening to them, is crucial. If you feel like something is “off”, pursue it. [see page 23 for warning signs and risk factors]

Fostering a widespread culture that promotes mental health awareness and de-stigmatizes seeking help is vital. Our children need to know that it’s ok not to be ok. And, it’s even better when they share it with others. Educational programs in schools and faith communities, public awareness campaigns, and community discussions can help eradicate the stigma surrounding mental health issues, encouraging early help-seeking behavior by our children.

www.PPAL.net

Community support provides a solid foundation in preventing youth suicide. Creating support networks involving mental health professionals, teachers, parents, community organizations, and community members facilitates a collaborative, team-centered approach to supporting our youth. These networks can provide resources, interventions, and a sense of belonging for our kids, contributing to a safer environment. It’s easier to speak up when we are surrounded by people who care and encourage it.

Preventing youth suicide requires a collective effort. By embracing these strategies and fostering a supportive community that prioritizes our children’s mental health, we take one step in the important direction of eliminating suicide among our kids.

Want to learn more about PPAL and family mental health? Contact us at info@PPAL.net, or by visiting our website at PPAL.net!

Steps to Take When a Child Expresses Suicidal Intent or is Actively Suicidal

Stay Calm and Listen: Approach the child in a calm and non-judgmental manner. Encourage them to talk about their feelings and thoughts. Sit Alongside Them: Even if your child doesn’t want to talk, just be with them. Show them that this is the most important thing in your life at the moment. Call a Suicide/Crisis Hotline: In Massachusetts, dialing 988 connects you someone who is trained to talk with folks experiencing suicidal ideas. Ask your child if they would like to talk with someone. You can initiate the call if it helps. Seek Professional Help: If your child has a mental health professional (therapist, counselor, NP or psychiatrist), contact them immediately for guidance and assistance. Remove Access to Means: Ensure that the child does not have access to any potential means of self-harm, such as medications, sharp objects, or firearms. Stay with the Child: Do not leave the child alone if they are in immediate danger. Stay with them until professional help arrives. Crisis Care: If the child is an immediate danger to themselves or others, seek support. Call Youth Mobile Crisis in your area for a crisis evaluation, or the Behavioral Health Help Line, which can connect you with Youth Mobile Crisis. Youth Mobile Crisis in Massachusetts is connected with the Community Behavioral Health Centers. If it is safe to do so, you may be instructed to bring your child to the CBHC for a crisis evaluation. Or, if it is safe to do so, you may be instructed to take your child to the nearest emergency department. If you can’t transport your child safely, call 911 and be sure to state that you have a “MEDICAL emergency” and need an ambulance, not police. Support for You: And finally, seek support for yourself. You do not have to go through this alone! You can contact PPAL to find support from someone with lived experience, participate in support groups, attend educational workshops, and have your voice heard about improving the mental health system.

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Warning Signs of Youth Suicide Expressing Suicidal Thoughts or Ideation: Verbalizing a desire to die or expressing feelings of hopelessness and despair

Lack of Interest in the Future: A sense of purposelessness, lack of interest in the future, and a feeling of being trapped

Isolation and Withdrawal: Social withdrawal, disconnecting from friends and family, and avoiding activities they once enjoyed

Sleep Disturbances: Significant changes in sleep patterns, either sleeping too much or experiencing insomnia

Changes in Behavior and Mood: Drastic changes in behavior, mood swings, agitation, irritability, or extreme sadness that seem out of character

Risk-Taking Behaviors: Engaging in reckless behavior without concern for consequences

Giving Away Belongings: A sudden and unexplained desire to give away personal possessions or put affairs in order

Sudden Improvement in Mood: Paradoxically, a sudden improvement in mood after a period of depression, may indicate a decision to attempt suicide

Risk Factors for Youth Suicide Mental Health Conditions: Depression, anxiety disorders, bipolar disorder, schizophrenia, and substance abuse disorders

Previous Suicide Attempts: A history of prior suicide attempts increases the risk of subsequent attempts

History of Trauma or Abuse: Physical, emotional, or sexual abuse, or other traumatic experiences in a person's life

Family History of Suicide: A family history of suicide or suicidal behavior

Access to Means: Easy access to lethal means such as firearms, medications, or other potentially harmful items

Isolation and Lack of Support: Social isolation, lack of a support system, or feeling disconnected from family and friends

Bullying and Peer Pressure: Persistent bullying, cyberbullying, or peer pressure can significantly impact a young person's mental well-being

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Loss or Grief: Recent loss of a loved one, breakup, or any other significant life event causing grief or emotional pain

Who Do You Call During A Mental Health Crisis? In Massachusetts, there are a number of resources available to you and your children during a mental health crisis. The decision of which number to call when, or whether to go to the emergency department or local Community Behavioral Health Center (CBHC) is often confusing and overwhelming. The goal is always to keep your child or young adult safe in the least restrictive and most helpful environment. Hospital emergency departments (EDs) are generally not the answer. Most EDs are well equipped to handle medical emergencies of the physical type. Few are really well equipped to handle mental health emergencies. Waits are often long, and can be frightening for children and youth (often the parents, too.) Fortunately, there are other options that might help calm a crisis situation without a hospital visit. Let's break some of those down for you. It’s important to know that these services are available to everyone in Massachusetts. There is no cost to call any of these services nor is insurance needed, and your immigration status is not asked. REMEMBER: Your safety and the safety of your child comes before everything else. If there is a chance of immediate danger to your child, yourself, or to someone else, call 911. What is a mental health crisis? According to the American Psychological Association (APA), the most common sign of crisis is “a clear and abrupt change in behavior.” Changes in behavior could mean a sudden outburst that threatens harm or destruction, a desire to harm one’s self or others, or engaging in reckless or unsafe behaviors. Signs of a mental health crisis will differ from person to person. You as a parent will have the best perspective on what constitutes a crisis for your child or in your family. Trust your instincts and please ask for help when you need it. You do not have to go this alone. 24

(866) 815-8122

START HERE IF There is an immediate danger of harm to your child, yourself, or others…

Why connect: There is an immediate danger of harm to your child, yourself, or others. 911 offers emergency response in any situation that requires immediate assistance from the police, fire department, or ambulance. First responders may help diffuse the situation or transport to an appropriate facility.

What to expect: Even if you’ve asked for an ambulance only, the police may still show up. Keep in mind, most police officers have limited training in mental health crises. Stay calm and work with them on diffusing the situation until the ambulance arrives. The ambulance will likely transport your child to the nearest hospital emergency department. Unless your child is very young, you may not be able to ride with them in the ambulance. Follow them to the hospital as soon as possible. If you need help while there, you can contact PPAL MonFriday during business hours at 866815-8122 or www.ppal.org.

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How to connect: Call or text 833-773-2445, chat to masshelpline.com, 24 hours a day, 365 days a year. Calls, texts, and chats are answered by trained human services staff with a clinician readily available. Interpretive services in over 200 languages are available. Deaf or hard of hearing persons can also use the BHHL by contacting MassRelay at 711. Families find: Training levels and experience for first responders with mental health crises differ dramatically. It’s best to use this option only in the case of a true emergency. If possible, find out if your community first responders have been trained on mental health crisis situations. Above all else, remaining as calm and rational as possible when working with the first responders will go a long way toward resolving the situation.

START HERE IF This is a mental health crisis but there is NOT an immediate danger of harm to your child, yourself, or others…

Note: The BHHL is unique to Massachusetts and can only serve individuals located in Massachusetts. In other states, callers would use 988.

Why connect: Your child needs any level of mental health or substance use support and/or resources, including crisis support such as suicidality. BHHL staff can provide immediate connection with mobile crisis support in your local area, warm handoffs to available CBHC’s and other services, and resources for follow up and ongoing information and support. The BHHL is a service of the Massachusetts Department of Mental Health. How to connect: Call or text 833-773-2445, chat to masshelpline.com, 24 hours a day, 365 days a year. Calls, texts, and chats are answered by trained human services staff with a clinician readily available. Interpretive services in over 200 languages are available. Deaf or hard of hearing persons can also use the BHHL by contacting MassRelay at 711.

Families find: Generally, families are finding that calls are answered quickly, warm hand-offs to crisis services are offered when needed, and coordination with community-based treatment options is provided. To the extent appropriate, the BHHL is most likely to provide callers with a warm hand-off to their local CBHC. This gets you immediate contact with local services. 26

What to expect: BHHL staff will work with you to find options that support you and your family’s needs. BHHL can connect you with crisis care, urgent care, outpatient care, CBHC’s, and outside clinicians (if available), and with community resources, like PPAL, that might be helpful on an ongoing basis. They will stay on the line with you until you are connected to the resource you need (commonly called a “warm handoff”.) Generally, the BHHL will first do a risk assessment to determine if and what level of crisis/emergency services might be needed. If you are calling during a crisis, they can connect to 911, 988, or mobile crisis in your community if necessary. There is a trained clinician available to the caller, if needed, at all times. Adult peer specialists are available. The BHHL staff will follow up with all individuals who have contacted the BHHL to ensure that their needs have been met.

(866) 815-8122

START HERE IF This is a mental health crisis but there is NOT an immediate danger of harm to your child, yourself, or others, AND you or your child would like someone to talk with…

Why connect: Your child needs mental health support and/or resources, including crisis support such as emotional distress or suicidality and is able to engage in discussion that might help diffuse or calm them. While the 988 specialists can provide information and resources like the BHHL, PPAL’s experience indicates that it is best utilized where talking through the situation may help avert a further crisis. Since it is nationwide, it is also available when you are out of state. What to expect: Trained Suicide and Crisis Lifeline specialists who are not licensed clinicians, answer all calls, texts, and chat. They provide free, confidential emotional support to all callers. They also offer assistance with de-escalation and safety planning to help individuals through the crisis with the least restrictive means possible. They can connect to 911 or the BHHL. Mass Substance Abuse Helpline for those looking for substance abuse treatment or resources. Call 800.327.5050 or Text: “HOPE” to 800327. The Substance Abuse Helpine is the only statewide, public resource for finding licensed and approved substance use treatment and recovery services. www.PPAL.net

How to connect: Call or text 988, chat to 988lifeline.org/chat, 24 hours a day, 365 days a year. Calls, texts, and chats are answered by trained Suicide and Crisis Lifeline Specialists. Interpretive services in over 200 languages are available. PLEASE NOTE: You are connected to a 988 call center based on the area code from which you are calling. If you are calling from an area code different from your physical location, there may be a delay in getting local information. For example, if your cell phone has a 305 area code but you now live in Boston, you will be routed to a South Florida (305) call center. Families find: The area code situation noted above can be frustrating. Also, because this line is experienced in engaging callers in conversation, it is generally better for the adult population experiencing a mental health crisis. Non-Emergency Assistance Helpline provides a wide range of helpful resources for families regarding food security, childcare, housing/shelter, domestic violence, and transportation. Call 211, any time, 24 hours a day, 365 days a year. In addition, 211 provides non-emergency information during disasters regarding shelter locations, disaster assistance programs, and volunteering.

Considerations When Calling 911 For A Mental Health Emergency

The decision to call 911 to help during a mental health crisis is a big one. Watch and share these videos to know more about what you CAN control when seeking help from community crisis services. Its important to have all the information to plan for the crisis to the best of your ability. Reach out to your village. Remember that this is just a moment on your child’s path. You will get through this.

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PPAL's Question of the Month October 2023 Results Do you feel comfortable advocating for your child?

Parents Are Saying... Caregivers shared they feel comfortable advocating for 66% most of the time 30% some of the time their children generally.

96%

When asked about barriers to more public advocacy for children’s mental health, 63% answered they are not ready. Here’s what makes advocacy hard...

57%

I’m too busy, tired, or overwhelmed to add anything else.

40%

I’m worried about my family’s privacy.

26% I don’t know how to advocate.

I t's clear that parents and caregivers have what it takes to advocate for their children. So why is it harder to advocate more generally for children's mental health? Life and mental health stigma. PPAL will continue to work on new ways to support family advocates. If you have ideas or want to learn more, please let us know at info@ppal.net. One more time this really does take a village.

If you need help from PPAL right now, request family support here or call us toll free at (866) 815-8122. www.PPAL.net

“Where Is The Data?”

What We Learned At PPAL’s Statewide Meeting Featuring Educational Advocate Dixie Jordan! PPAL was fortunate to have Dixie Jordan, a nationally recognized educational advocate and cultural competence trainer, join us recently to talk about school advocacy for parents. Keep reading for tips about Individual Educational Program (IEP) Advocacy! The federally-mandated Free and Appropriate Public Education (FAPE) is necessary to provide our children with the best access to opportunity, and it should be backed up with DATA. Don't start statements with 'I think' because you need to rely on data. Always have everything in writing! Send emails following conversations. IEPs should be driven around the unique needs of your learner, not necessarily relying on commonly used interventions for a specific diagnosis. Progress should be considered not only in academics but social skills and anything else required for being a successful citizen in the world. Evaluations should comprise all areas of a child's suspected disabilities and include the functions of behavior. Behavior is information. Laws are legal documents and all information must be in writing or it doesn't exist. It's all about accountability. Parents should always ask: "Tell me more about that?", "Where's the data to support that?" and "How will we know when there is progress?" Get a copy of and learn the school rules. Specify where your child is struggling and address it. There should be no punishment for non-compliance.

Additional Resources:

Special Education Timelines IEP vs 504 Antecedent/Behavior/ Consequence (ABC) Sheet

(866) 815-8122

PPAL’s Kristen Solaris Rocks the Radio! PPAL’s outreach is always looking to reduce the stigma surrounding mental health and get the word out about how we can help families and children! Recently, Kristen Solaras, PPAL’s Central Massachusetts Program Manager, did just that in an extensive and informative radio interview with Ernie Floyd, host of the Kiva Center’s “Coffee and Wellness” program on WUTY 97.9 FM, Unity Radio. Kristen discussed a number of important topics, including what PPAL is and what we offer: educational workshops and meetings, parent support groups, and 1-to1 support to policy influence and advocacy at the individual, community, and state legislative levels. She discussed the importance of lived experience in peer support work, and how relationship-driven support work can add the emotional and personal assistance sometimes lacking in a more clinical model. She talked about how state agencies have come to recognize the importance of peer support, the shift to virtual support over the pandemic, the difficult transition many families have when supporting children with mental health needs turning 18, and much more! Did you know that PPAL offers family peer to peer support? All of our staff have experience in children’s mental health - we are your peers! The sponsor of the Coffee and Wellness radio show, the Kiva Center, is a peer support organization as well - offering peer support for adults and young adults. Thank you Ernie and the Kiva Center for inviting us on the show! Stay tuned for more on PPAL in the media, and more on Kristen and PPAL’s wonderful DMH Central Massachusetts Program!

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info@ppal.net (866) 815-8122

Parent/Caregiver Support No sign up required for most groups. Groups that do require registration or booking include an email but are not clickable

ASK THE ADVOCATE

MONDAY

School Related Issues VIRTUAL / PHONE BY APPOINTMENT parentsupportgroup@ppal.net

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Changing to MONDAYS 12/4

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PPAL EN ESPAÑOL PARENTS OF TRANSITIONAGE YOUTH GROUP

WEDNESDAY

Grupo de Apoyo Hispano

VIRTUAL

PPAL'S PAGE

YOUTH MOVE MA

School Problem Solving Clinic

Parents Raising LGBTQIA+ Children

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TUESDAY

North Central MA Caregivers of Teens & Young Adults

North Central MA Family Support Group IN PERSON & VIRTUAL

5:00 PM - 7:00 PM

IN PERSON & VIRTUAL

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THURSDAY

FRIDAY

Create & Connect Parent Support Group

Grandparents Connections

Family Connections

11:30 AM - 1:30 PM

12:00 PM - 2:00 PM

Support Group for Lynn Families

VIRTUAL

VIRTUAL 2nd Thursday each month

Caregivers of Teens & Young Adults

Grandparents Connections

VIRTUAL

6:00 PM - 8:00 PM

VIRTUAL 4th Thursday each month

6:30 PM - 8:30 PM

Sibling Support Program

CLICK FOR MORE INFO! Click support groups to get zoom link unless otherwise indicated

VIRTUAL 1st Thursday each month *Pre-Registration Required emily.rubin@umassmed.edu

VIRTUAL

12:00 PM - 2:00 PM

IN PERSON For families and children *Pre-Registration Required Email Dalene: ptahsw@verizon.net Every Other Friday

6:30 PM - 8:30 PM

5:30 PM - 7:00 PM Caregiver Support Group VIRTUAL

5:00 - 7:00 PM

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Community News and Resources

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“Develop enough courage so that you can stand up for I think the hardest part of having a child yourself stand up with a delayand of anythen kind is the fight: The fight for services. for somebody else.” The fight for people to understand who

– Maya Angelou

your child is and what they need. The fight for knowledge, because knowledge is power. And the quiet fight you have within yourself wondering if you’ve left no stone unturned. -jessie doyle

PARENT/PROFESSIONAL ADVOCACY LEAGUE, INC.

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(866) 815-8122