Kinder Mind

Understanding Crisis: Behaviors, Best Practices, and Providing Support

Dr. Elizabeth Barlow, LICSW Season 1 Episode 4

What if you had the knowledge to identify a mental health crisis and the ability to step in at the right time? Join us in this heart-to-heart with Teele Becerra, LCSW, an expert on crisis intervention, and learn to recognize the signs of a mental health crisis, from panic attacks to suicidal thoughts. We explore the importance of creating a safe environment for those in crisis and early intervention's crucial role in preventing severe outcomes.

Navigating the world of mental health can be challenging, especially when a friend or family member is in crisis. Teal offers her insightful perspective on respecting an individual's autonomy, balancing it with the need for intervention, and setting boundaries to maintain our own mental health. We challenge the misconceptions around mental health, helping pave the way to more understanding and less stigma.

In the final part of our conversation, we focus on the importance of seeking help during a crisis and discuss resources such as the Crisis Text Line (988). We explore the role of acceptance in the healing process and discuss the significance of prescribed medication as a sign of safety. Further, we delve into the personal choice of medication in context of ADHD and tackle the stigma around this. Teal shares her thoughts on the power of social media as a platform for discussions on mental health and how to access free 24-hour crisis services. Turn the volume up for an enlightening episode that could well be the turning point for someone in need.

Kinder Mind offers therapy services in Illinois, Maryland, Massachusetts, Mississippi, Pennsylvania, Virginia, and Texas. Follow us and feel free to share with anyone looking for therapy in a state where we're located.

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Dr. Barlow:

Welcome to the Kindermind podcast, where we're devoted to opening up conversations and destigmatizing mental health. We'll bring you interviews with practitioners in the field of mental health, researchers uncovering new knowledge and best practices for treating mental health disorders, and individuals sharing their mental health journey. I'm so excited to welcome to our episode four podcast Teele Becerra, LCSW. While we work together to understand crisis behaviors, best practices and providing support and that providing support piece is whether you're a family member or a friend, or even a mental health clinician. So we'll talk through all the examples of that. First off, thanks so much, teal, for making the time to be here to talk through this really important topic with us.

Teele Becerra, LCSW:

Of course, Hi everyone, Hi Dr Barlow.

Dr. Barlow:

Hi. So to kick us off, can you talk us through what really constitutes a mental health crisis? So we know that folks who are experiencing challenges with mental health have different levels of things that they go through. What really is a mental health crisis?

Teele Becerra, LCSW:

Yeah, so you are absolutely correct. I think that a crisis is. Everyone is going to feel a crisis differently. To some people, a panic attack might be a crisis and to other people, a crisis is there at a suicidal ideation level of emotion. It's really important to allow for that broad definition of crisis. But in the psychiatric sense generally, a crisis is when someone is either at risk of hurting themselves or hurting others, whether that be that they are just not in their typical frame of mind and they may not be safe to drive a vehicle and therefore are putting themselves and others at risk for safety.

Dr. Barlow:

Thanks so much for laying that out. I think that's really important to know. So, thinking about what you shared, I know as clinicians we're trained to kind of notice the behaviors that are associated with crisis. For anyone not clinically trained, or even clinicians like myself who really don't work a lot with crisis, what are some key behaviors, like some key indicators of, hey, this person might be in crisis.

Teele Becerra, LCSW:

That's a really good question. Generally, when someone is in crisis, I would say that they're not acting like themselves, maybe making rash or not thought out decisions, potentially not sleeping. One of the big characteristics of suicidal ideation is giving away objects or like possessions to other people, but a crisis can be anywhere between from mania to suicidal ideation. So when we speak about mania as a crisis, my biggest concern is when someone isn't sleeping, when someone is maybe spending money that they don't have and that they cannot potentially pay back and putting themselves into debt or just again putting themselves in harm's way as well as putting others in harm's way. So those are usually the glaring things. Of course, if someone presents to you and says that they are hallucinating, whether by hearing or seeing things, we're definitely going to consider that as a crisis as well. But visually, you can't usually tell when someone is in crisis. It's all based on behavior.

Dr. Barlow:

Okay. That's super important, I think, for folks to know, especially who really are in the mental health field. So maybe they have a family member or a friend who is acting completely different from their typical personality. They're engaging in these risky behaviors, they've got these things going on that could indicate a crisis. I know we talk a lot when we're talking of situations like suicide and substance abuse, about early intervention and prevention and things like that. Can you tell us about the importance and kind of the act of early intervention and prevention when it comes to mental health crisis?

Teele Becerra, LCSW:

Yeah, so I think the best form of prevention and intervention is just awareness. I think that the word suicide is very taboo and to the point where now on social media platforms you cannot use the word suicide or you might get flagged. So a lot of folks like on social media will use the term on the live just to talk about suicide because it is so taboo. That I think that's the first point of prevention is by talking about it and by talking about these warning signs like giving possessions away and engaging in risky behaviors.

Dr. Barlow:

So, just thinking about the importance of early intervention and prevention, somebody's off their meds, just like being a supportive friend or family member, and your friend or family member has these behaviors or has this diagnosis. What are some things you can do to intervene and prevent, or even connecting them with a helping professional, or just anything you can think of in terms of intervention and prevention?

Teele Becerra, LCSW:

Yeah, when, if you have a family member or friend who you know is at risk of maybe suicide, an ideation has been in the past. I think it's really important to ask them what they need for those moments where they may go back to those behaviors and thoughts that are unsafe. Some people don't realize when they're becoming unsafe. Those who have mania might not even realize it until they're looking back weeks later. Oh, that, that pattern of behavior is something I experienced monthly. Or even folks who have diagnoses like premenstrual dysphoric disorder. They they will have mania or thoughts of self harm, thoughts of suicide during their menstrual period and they don't realize that until they're out of it.

Teele Becerra, LCSW:

So I think it's really important for anyone to one know that you are supportive person to them and know and ask that person in your life how can you support them? But then I think it's really important to talk to them about this when they are feeling safe, so they can identify what they need in those moments. A lot of people who experience crisis, whether that be one time or many times in their life, are probably not going to ask for help or identify when they're experiencing a crisis. So I think the most important part of that early intervention piece is to know what those signs are. If you are living with someone or working with someone that experiences crisis frequently, I think, as I said with the just talking about it in general, will create a safer space for someone to know that they can come to you when they're feeling unsafe.

Dr. Barlow:

That's so important, because I know that a lot of us like to think that we're supportive and that we want the best for others, and we make all of these statements, I feel like a lot of times too, with the best of intentions, but then when that thing that we're supportive of actually happens and we feel the fear from that, or like the uncertainty which causes fear around that, because maybe you don't have a lot of experience supporting or dealing with somebody that's going through a crisis, that's when it can take shape and create that sense of freeze. So you don't know what to do, you don't know what to say, maybe you do nothing at all, which kind of leads me to that next question I have. If you're not a mental health professional and you recognize that something's very off with your friend, what is that next step? What should you do? Is it a conversation? Should you call 911? What does that look like in terms of the timeline of helping support someone in crisis?

Teele Becerra, LCSW:

It's a really important question. I think that this question has two different answers, right. So it really depends on what type of crisis this person is in, because if they aren't safe or if they, let's say, are a parent and their children are being neglected because of that, that is when it is your duty almost if you feel so like you care for this person because they're part of your life to potentially have interventions such as, like crisis services, which most police departments have, mobile crisis teams and social workers or clinicians that work alongside of the police department to assess individuals when they're unsafe. So when you know someone is truly unsafe and they're at risk or going to hurt someone or someone else, you definitely need to bring in authorities. I know that there's a huge stigma with police intervention and I completely understand, and so typically you would be calling maybe the non-emergency number instead of 911, which then when the department is trained, those clinicians are trained on how to react and most situations don't cause like flashing lights with ambulance and police showing up at someone's house, which can also obviously cause a visual disturbance to the community of neighbors, if you have them. The other part, of course, if someone is unsafe, they're going to hurt someone else, hurt others. They or you just have a suspicion that they're unsafe, even if they haven't said outwardly that they're going to hurt themselves or others, so that you should get someone involved that knows what they're doing.

Teele Becerra, LCSW:

And the other part that I think is really hard for people to deal with when it is a loved one that is struggling is if they're not actively going to hurt themselves or others. There's very little that we can do unless, going back to the previous question you've already had a conversation with them to find out what is most useful. Some folks choose I'm going to go back to mania some folks choose not to take medication and so therefore they may experience mania and they may experience auditory or visual hallucinations, and that's their choice. Especially if someone is an adult, like over the age of 18, they have every bit of agency to make that choice. So I think that again goes back to having that conversation with that person. You can preventatively to determine what is going to be the most helpful.

Teele Becerra, LCSW:

Otherwise, I think it's a case by case basis, which is not really a helpful answer to this question. But if you have a friend or concerned about and you know that they're safe and other people around them are safe. I think it's a kind of tread lightly conversation. If you feel comfortable, if you feel like that person is like your partner or you, your best friend or whoever they are, your sibling, if you feel like they will receive the conversation well in that moment, I think that is okay to ask them.

Teele Becerra, LCSW:

I've been noticing these behaviors. Is everything okay? Maybe this is not the first time that you've seen this happen, like I've noticed a pattern of behaviors over time. I'm just I'm worried about you. I think that can be a really hard conversation to have, especially because you don't always know how someone can react and people who are in crisis don't always react the way they would if they were in crisis. So that's it's a little bit of a hard. I wish there was a very clear like line and direction on what to do when someone is safe but in crisis, because it really is a case by case basis.

Dr. Barlow:

For sure, and one of the reasons I'm so glad that you were able to join us today is because I know you have a really established history of experience working in crisis. Are there any specific experiences that you're able to share with us and the listeners about a time when you have been involved as a helping professional in a crisis situation, or, if you've been involved as a friend or family member in a crisis situation, anything you're comfortable sharing?

Teele Becerra, LCSW:

So I have done extensive work in the crisis field. You're right, I used to work in psychiatric emergency services. Previously, I worked in the state of Massachusetts, where we are lucky enough the community of Massachusetts is lucky enough to have emergency services teams and every single catchment area, which, basically, it's not based on county, it's based on towns and where they are located, and so I loved doing the work that I did. I worked in mobile crisis as well as hospital crisis, and I was experiencing a crisis. They would call and I was the triage clinician that would either schedule them a same day psychiatric emergency evaluation or I would route them to the hospital. So I have one example that comes to mind that kind of draws to the last question that you asked about that, and I was talking about that fine line between you know what to do if someone is safe and what to do if someone is not safe.

Teele Becerra, LCSW:

If someone reached out to us and asked for support for their friend Unfortunately again back to the whole agency piece when someone is over 18, they have full agency to choose whether or not they need a psychiatric evaluation unless they're unsafe or putting anyone else in harm's way. So this person that reached out was talking about an adult, which already is, usually leads to us. At the time we would say and this is still current that if they're 18, over 18, they have to call back and schedule themselves. Unfortunately, they have that right, or the right to not get an evaluation. And this friend was really concerned about their friend who was experiencing some auditory hallucinations as well as mania and psychosis, in which they felt that they were connected to a higher power. So oftentimes folks will hallucinate that they are Jesus or another spiritual figure or that they have a direct connection with God or Jesus or whomever that they have a connection to. And the friend was really looking for support for the person in crisis because they knew that wasn't normal behavior for their friend and I was in a tricky position again coming from a place of I love that you're reaching out about your friend, but they have to call for themselves and basically was able to talk this friend through.

Teele Becerra, LCSW:

Similarly to the last question, what can you do when your friend is like this? And so I guided this friend on how to communicate with them that they were concerned about their behavior and we talked through. They had a child and the child was still getting their needs met, so that wasn't a concern. This person doesn't drive, so they weren't leaving the house, they weren't driving other individuals and really all of their beliefs about themselves as a part of that psychosis were not hurt like harming anyone. They were not having auditory or visual hallucinations, command hallucinations telling them to hurt themselves or hurt someone else.

Teele Becerra, LCSW:

So really what I coached this friend through was to just support their friend and continue to allow this person to have their psychosis and unless it gets unsafe, there's little we can do as mental health professionals, unfortunately, besides to if you have the rapport with them, to coach to see if they can recognize that these are not true statements that they would typically have. And unfortunately, that's the thing that stinks about this experience. That stinks about just having loved ones who experience crisis, because there's not always anything that you can do and sometimes the answer is just let them live their life and hopefully they will be able to return to their typical state of mind and until then we can't really do much unless they're unsafe.

Dr. Barlow:

That's such a hard spot to be in and I know a lot of people can really empathize with that situation and spot of you can only do so much. I think historically that's been one of those challenges that I continuously hear from clients is what can I do? What can I do? And one of the hardest but most freeing parts of therapy, in my opinion, as a therapist, is helping clients come to that space where they understand their level of control, that they do have and those things outside of their control.

Dr. Barlow:

It makes it hard when it's a friend, it makes it feel impossible when it's a family member, because there's that next level of connection and to see that someone you love and care about is hurting and hurting themselves maybe not harming and self-harm of cutting and things like that, things that we know to be self-harm. But, like you said, emptying their bank account, buying a new car, they can't afford engaging in sexually promiscuous behaviors like things that are gonna. They're gonna go through that mania, they're gonna go through that period and then they're gonna come to the realization oh, what was I doing? But then, like you said, they have their own agency, they're their own person. It's up to them whether or not they wanna get help and if they choose not to get help and then this bleeds over into the other person the friend or family member's life, and continues and starts to take a really negative toll on that.

Dr. Barlow:

Unfortunately, it does enter into that period where you have to ask yourself like I really love and care about my friend or family member, but it is. What is it doing to me and what am I gonna do about that and how can I put cautions and boundaries or things in place so that I'm not allowing the fact that they're not getting help to continue to make me lose sleep or not have an appetite or take time away from my family and work, like things of that nature. So no, it's definitely a tricky situation, especially, as you mentioned earlier. There's a huge stigma. There's a stigma around all of mental health, and that's why I love that I have the opportunity to bring practitioners and experts in the field, like yourself, on the show so we can really open up these conversations about mental health and make it feel not so scary. Tell me, in your experience working in crisis and really in the mental health profession, what are some misconceptions or stigmas surrounding mental health crisis and how can we address them effectively.

Teele Becerra, LCSW:

The great question, I think the biggest stigma, is that folks feel as I'm saying this as a clinician, as a therapist folks feel that if they do seek out help professionally and say, hey, I am having these thoughts of self harm, I'm having these thoughts of suicide, I am having thoughts of maybe hurting someone else, that they are automatically going to get hospitalized, and I think that deters I know that deters people from getting help because they think, okay, if I share with my therapist today that I'm thinking about cutting myself that automatically they're gonna be hospitalized.

Teele Becerra, LCSW:

The truth of the matter is that their one is a huge crisis, just in general, of having access to higher level of care, so, like inpatient care, right. But the other part of this is that we're not automatically going to hospitalize you. There are criteria you have to meet in order to be hospitalized and it's better that you're sharing it, because when you're hiding it, it is more scary to individuals to find out later. And that would be more of a concern to me if someone did not share with me how they were feeling and that, in fact, they have been harming themselves for months and now they have harmed themselves so severely that they have to be hospitalized. So I think that is another part of prevention. But the stigma exists that just asking for help is gonna automatically put you in the hospital, and that's completely incorrect.

Dr. Barlow:

Okay, so, for our listeners who might be experiencing a crisis themselves or, like you mentioned before, they've got those occurrences of mania, or going through their cycle when they're on their period, they've got those times of harmful behaviors. What is one thing you'd like to say to those folks in terms of reaching out, getting support? Maybe they're not working with a therapist, maybe they've never opened up about this before. Maybe they didn't even know it was a problem. They just thought that's the way they are. What is something you'd like to share to our listeners who might be experiencing that, in terms of how they can reach out for support and what steps they can take?

Teele Becerra, LCSW:

Yeah, ultimately, do not be afraid to ask for help. Tell someone, tell your friend, tell your family, tell someone that is safe, that you know is going to support you, that loves you unconditionally. Tell someone that you trust. But tell someone that just the act of telling someone how you feel in itself is healing, because it is that first step to getting help, whether regardless of it is a therapist or not, or your doctor or whomever. Telling someone opens you up to potentially getting help in the future. So I think my biggest piece of advice is telling someone.

Teele Becerra, LCSW:

There's so many resources out there on where to find a therapist, and I think one of probably the best resources that we have in the US and I actually don't know if it's accessible from other countries but we have the crisis text line, which I think is probably one of the best resources that I've ever found and ever referred people to, because it is a anonymous, 24 hour support text service, so you will text that number at. Whatever the number is seven four one. Seven four one.

Teele Becerra, LCSW:

I haven't memorized Whatever hour of the day like. I am feeling unsafe. I'm having a panic attack, I'm thinking of harming myself and thinking of harming others. I'm experiencing mania. I don't know what to do and that person is going to be there to walk you through how to get support and they are crisis counselors that are trained and how to help you. So if you don't have a person that you can trust in your life that you have personally, I highly recommend the crisis text line as the first person that you tell, because sometimes it is actually easier to tell someone that doesn't know you at all how you're feeling, because it can feel so hard to tell people that you love because you don't want to hurt their feelings.

Dr. Barlow:

Oh, absolutely, that's such a great point. And also there might be that fear in there because of what we talked about with that stigma. What are they going to think about me? Are they going to think that I'm not safe to be around, or safe to have their children around, or they even safe enough to watch their dog? There's just all these fears that kind of come into your mind when you have to admit to someone that you're maybe not that person that they thought you were, or you're not perfect because, as our ego is a very important part of what makes us so, then when we do things that feels like we're challenging that ego, we're taking pieces away from it, it can feel terrifying because we worry that's really going to change who we are to the world.

Dr. Barlow:

And I think you mentioned a really great word healing. So, thinking in terms of individuals who go through a mental health crisis, they engage in these risky behaviors. They obviously in the moment don't recognize what they're doing, what's going on. Everything is moving so fast and there's really not that level of cognition there that says, hey, you're doing something wrong, you need to stop fast forwarding to when they do have that perspective and they can look back on that and reflect what, as a therapist, what are some things that these folks can do around self-care and really not beating themselves up and not blaming themselves for what they just went through? Good question.

Teele Becerra, LCSW:

I think just accepting that this is. I think a lot of the stigma comes internally, like you said, from the fear that people are going to perceive you a different way, and I think, along with healing, is that piece of acceptance. You didn't. No one wakes up one day and decides that they want to have intrusive thoughts of self-harm right, no one wants that for them. No one wants to have to deal with that on a daily basis or monthly basis or what have you. But I think when people accept that this is who they are or what they're experiencing in that moment it doesn't mean who they are as a person, but, like biologically, chemically, something is going on that they need support with, and so I think the term self-care is grown around a lot, right?

Teele Becerra, LCSW:

People identify self-care as bubble baths and having tea or your drink of choice when you lay out in the sun or whatever. But self-care is really just listening to your body and what it needs, in my opinion, and so that could be a bubble bath. Maybe baths relax you, but ultimately it could be taking your meds. I did also want to mention that one of the signs as a clinician that is concerning to me, when I can tell when someone is being unsafe, even if they're not intentionally trying to hurt themselves or others, is when someone decreases or stops taking their meds because they feel like, oh, I'm great now. Usually that feeling of I'm great now is because their meds are working. So when someone stops taking their meds for a long period of time without the help of a psychiatrist, that is also somewhere I would be concerned that they're in a crisis.

Dr. Barlow:

I love that, throw that in there. No, I love that call out so much. It's interesting because I'm not a therapist and I know you're not either. That's immediately gonna be like oh okay, a pill, you need a pill that's gonna fix everything. I'm definitely not that therapist.

Dr. Barlow:

I ride that line of I will always refer you to a prescriber if things seem like they are something that can't be tackled with just therapy. But at the end of the day, like it's not my call to write you a prescription. I'm not a prescriber, but there's nothing that hurts about talking to a prescriber and I know we're not. This isn't the medication podcast or like that episode where we're talking about medication. But that's a really important point because I think a lot of stigma also comes from medication and so a lot of clients that I've worked with one of my specialties and backgrounds is an ADHD. When I do need to have a conversation with a client about okay, you've tried to change your behaviors on your own, you've put these things in place, you're using these skills that you've learned, but you physically can't make yourself change this behavior and you're running up against a brick wall. Now it's time for me to like get you referred over to a prescriber to have a conversation about ADHD medication.

Dr. Barlow:

A lot of what I hear is oh yeah, no, I don't think I wanna take meds like I just I don't know, I don't feel good about it. And my response is always I hear you and I don't think anybody enjoys taking medication and that's not the goal. The goal and the point of it is there's only so much that you can physically do. The other part of that is chemical and you can try to do these behaviors, you can try to put these things in place to kind of safety net yourself with these behaviors If that does not work or if it works for a little bit and then stops working and you can't physically make this change. Now you know it's a chemical challenge. There's a chemical imbalance, there's something chemically preventing you from being able to be healthy or have healthy behaviors. So I love that you mentioned that. I know I got off on a medication tangent a little bit.

Teele Becerra, LCSW:

No, I appreciate it.

Teele Becerra, LCSW:

You're absolutely right. We're not as social workers, as therapists, we don't prescribe meds. We're taught in school that we're not supposed to talk about meds, talk about dosing, and I absolutely am not advocating for us to do that. But I think that is a really important piece of taking care of yourselves. Self-care can be as basic as brushing your teeth and taking your meds, and some people need more than that. Some people that is at their baseline they take their meds every day, they shower every day, they brush your teeth every day, but they still have rough days and self-care may look different.

Teele Becerra, LCSW:

I think that exercise can do a lot for your mental health, and I'm not saying you have to go to the gym, get a gym membership and work out every day, but even just getting some fresh air, standing outside, hopefully with the sun shining because I love the sun and the sun should be out all the time everywhere and take getting fresh air, going for a walk, like that all can be self-care. But sometimes the most basic thing, if you cannot do anything else in your day to take care of yourself, it is taking your medication, but also accepting that, like you said with your clients, like they're like oh, I absolutely not, I do not even want to think about that and that is their absolute right. But sometimes that is what you need and that can be the piece of self care that you get done. The one thing you do to take care of yourself every single day is take your medication. Again, some people choose to absolutely not take medication and they have like hallucinations, and that is their choice.

Dr. Barlow:

Absolutely. And I think, to like another again, like completely their choice. I'm not here to persuade anybody one way or the other for sure, but then, like one of my comments that I love as a go to is Okay, how many cups of coffee do you drink in the morning or throughout the day? What is your goal for that coffee? Your goal is to give you energy, wake you up and keep you productive.

Dr. Barlow:

So then, obviously, a lot of these psychotropic medications are either controlled substance or you need prescription to get them. So I'm not trying to compare coffee to a psychotropic drug, but there's a purpose there, and I think that's that key point. If your purpose is to live a better life without these risky behaviors or ADHD, like in my example, you're going to need something to make that happen if you have tried and failed, because one of my things that I just hate for clients to go through is they do the work, they try really hard and they want the positive change venomately, and then they continue to fail. So then they get in those like self blaming behaviors and thoughts of I'm not good enough, I'm not strong enough. If I were stronger, I could then XYZ, and that's where it's like, really, given that psycho education it's not you, it's your chemicals.

Teele Becerra, LCSW:

It's your brain, like you said. I think it's interesting. We're talking about ADHD in this podcast, about crisis, but along lines of caffeine, the way that caffeine affects the brain for one person is different than the other. So a lot of times with medication, I bring up ADHD, because caffeine can actually make the ADHD brain go, become sleepy, which is hilarious because it's a stimulant for some and not for others. But that is that's how everyone's brain is different. Not one medication is going to work for every single person, and I think that's also where a lot of people get discouraged because they either.

Teele Becerra, LCSW:

There are a lot of people I have heard from like a lot of clients who have said I went to this prescriber and they just wanted to throw all these medications at me, or they said I didn't need any, or they didn't listen to me. I'm really glad to have formed relationships with a lot of psychiatrists who do listen and who want it to be your choice of what you can take, and I think that's the most important part in this is that you do have that agency I'm going to keep using that word that, if you go and have that conversation with a psychiatrist, just because you're meeting with a psychiatrist, like you said, does not mean you're going to leave with a prescription. They might make suggestions. They most likely will make suggestions on what. Also, if they give you a prescription and you decide to fill it and then say, you know what, I don't want to try this right now, that's okay too, because it is your body ultimately, but there are.

Teele Becerra, LCSW:

It comes to a point where, if you're having symptoms so severe that you are unsafe or making others unsafe and medications may help, that's okay, and I think that they're like that's a huge stigma. Right, it is okay to take medication and I'm really glad that we're in this space now where social media is so prevalent. I think, obviously, it can be so harmful, but I am on the side of social media. That is okay with talking about taking medication and okay with taking medication in general. Right, if it helps you, that's okay. Like it doesn't mean that you weren't. You didn't choose to be born into this world with a brain chemistry that makes you sad every day.

Teele Becerra, LCSW:

I think it's important to have these conversations right, so to provide safe spaces for your family members who may be struggling, or friends or whomever in your life that is struggling to have these conversations and it can feel really awkward or uncomfortable. But I think at least a lot of my clients I know they communicate with others and I do the same through like ticktocks and reels, and so sometimes a video or a podcast use. This podcast will open up a conversation of hey, I was listening to this podcast and I learned about suicidal ideation and like how to support my friends, and I know that you've dealt with that in the past like how can I support you? And so I think it's all about having that conversation, because that is actively fighting against the stigma of accessing health and mental health care.

Dr. Barlow:

I know that you have some really great resources for our listeners, either for themselves or to share with anyone they know that's going through a mental health crisis. Do you want to go ahead and provide our listeners with those now?

Teele Becerra, LCSW:

Yeah, I talked about the crisis text sign before. It is actually accessible 24 hours a day, every single day, in the United States, canada, the UK and Ireland, which is really amazing. So if you are listening to this in another country, you, if you're in the UK, please use the crisis text line. So you're going to text home H O M E to 741 741. And again, that is a free, 24 hour crisis service. I like to get this out to anyone and everyone. And then the other number, which is just local to the United States, is 988. So a lot of people know that we use nine move one for emergency services, and now we have created nine. We, the United States, has created 988, which is a number that you can call if there is anyone, if you or anyone else is in a psychiatric emergency, and they will connect you to those call centers that I used to work at, as well as the ones that have, like mobile crisis units with police departments or mobile crisis units through nonprofits in your community, and so that is the central number for the US to access immediate crisis support.

Teele Becerra, LCSW:

I also wanted to mention that I know I'm not a parent, but I have cared for a lot of kids and it's when you have a child or you care for a child that is like a different type of love, and I think it can be really hard for parents to accept when their child is hurting because they created that child or has have raised that child as their own and they don't want to feel like maybe they made a mistake in parenting or done done something wrong or knowing genetics, that the brain chemistry, like you must have. There must have been something during pregnancy. None of that is true. You are a great parent and I think you need to give yourself credit for recognizing when your child feels unsafe and just ultimately trying to get them the best support that they need. But I think this also goes into where it's really hard is that once your kid is over 18, they are an adult, and so that is one of the things that I used to come into contact with all the time.

Teele Becerra, LCSW:

Working in emergency services is a mom would call for their 19 year old son, for example, and there's very little that we can do unless that 19 year old again is unsafe or someone else is unsafe that they're threatening to harm because they have to consent to that help, and so I know that must be a terrible situation to be in and I'm I've never been in that situation again as a, not a parent, but I can only imagine and empathize that that is probably one of the hardest situations to watch your kids struggle.

Teele Becerra, LCSW:

But I think that's where that prevention piece comes in. Most importantly is like trying to know the signs and, especially if you have a history of mental health disorders in the family or in yourself, to familiarize yourself with those diagnoses and have those conversations with your kiddos when they are age-appropriate and able to talk with you about their emotions. I say age-appropriate but I think that it needs to be a conversation that's had when we talk about our emotions and labeling our emotions, starting as toddlers and building it up. Obviously you're not going to talk about suicide to a five-year-old when their teenager is talking about depression and other diagnoses and maybe any family histories and just opening up a safe space for when they are feeling unsafe. If they ever feel unsafe or they know someone else in their life that's unsafe, then they can come to you and ask for help and get that support.

Dr. Barlow:

I know that moment of what parents go through when something goes wrong and maybe it's not mental health crisis, maybe it's their kid acting out, or maybe they got arrested or whatever happens that immediate statement you make either out loud or in your head where did I go wrong? That's not a thing. But if you know that you were a good parent, you were most likely a good parent, but you made a very good point. The communication is the game changer. Being that person, like you mentioned earlier when you were saying reach out to someone that's safe if you're in crisis or you need support. Being that person that is safe for your child to reach out to and share that things are going wrong. Or hey mom, hey dad, I'm having a challenge with this. Being that safe person for your child is everything. Just fostering that piece of communication and letting that be known by your child. Hey, yeah, you're going to make mistakes. I'm your parent, so I'm going to have to put consequences in place for you when you make mistakes. I will never love you any less. I'm never going to judge you for this and make you feel unsafe. Please always talk to me, always communicate with me. Keep those lines open.

Dr. Barlow:

I think that can be a huge difference between finding out unfortunately when it's too late, after the fact, when something has happened that's catastrophic and maybe there's been self-harm, or is it still called a successful suicide, death by suicide, yeah, or if they've had a death by suicide. If you can get that communication going and fostering that at a young age, there's always hope. It's not a guarantee, but there's always hope that you will be that person that your child reaches out to Exactly. Thank you so much again for joining us today. Teele on this episode Understanding Crisis Behaviors, best Practices and Providing Support. Until next time, I'm Dr Barlow. The Kinder Mind Podcast is produced by Dr Elizabeth Barlow, edited by Marco.

Dr. Barlow:

Antonio with music by Pax Minerva.