Young Adult Mental Health Emergencies

Welcome. Today we're actually going to talk about pediatric and young adolescent, young adult mental health emergencies, and what do you do? How do you recognize them? What are the resources that are available? There are millions of families in the U.S. every day that are actually facing this, and we have a guest today that is a power couple that I will introduce shortly. And so I wanted to really kind of just first sort of set the background a little bit on mental health and mental health conditions in the pediatric and adolescence. First of all, one in five children or adolescents will actually find themselves with a mental health condition, whether or not it's diagnosed or undiagnosed. And what happens is, you know, families, you know, if you have a if you have a child or a young young adult and they fall and break a bone or they have a fever or a cough, you kind of know what to do. What happens with mental health emergencies is they can be really um harder to um to recognize, and they may even it may even be more challenging to actually navigate the healthcare system as far as where do you go. Emergency departments across the country deal with health mental health emergencies. We are open 24-7. People do bring their children and adolescents and and also their their adult selves if that's the case. And we see a significant amount of pediatric and young adult uh mental health diseases and crises. It can range from, you know, anxiety attacks to depression, uh, to schizophrenia to bipolar to eating disorders. Specifically, we have been seeing a very increased incidence of this in the pediatric and adolescent population. One of the reasons why we believe we're seeing this more is because COVID-19, when people caught COVID-19, it actually has a higher concentration of the virus in the brain than it did in the lungs. And so some of the research now is going over what did that pandemic actually do, not only um to us as a population, but what did it do to um our neurodevelopment? So these things can be really, really uh challenging. A teenager experiencing their first psychotic episode might present with confusion or agitation or or just behavior that seems um a little bit out of character. Families can be really scared and terrified. It can be a very isolating experience. Parents and aunts and uncles and grandparents and godmothers and godfathers can kind of question well, how do we get here? What signs did we miss, or did we miss any signs? Um what's gonna happen next? So we're gonna kind of discuss all of this today so that we get a better understanding of what resources are really available to help families advocate for their loved ones and really navigate these difficult situations. Before I bring in the guest, I want to actually just go over just a couple of things, because I get asked this a lot. People say, well, you know, how do you know I even have a mental health disorder? How are these things diagnosed? So I want to actually just quickly kind of go over this and the categories of mental health disorders. So, first of all, mental health disorders are are diagnosed by clinical interviews, and that's where you're gathering personal and medical and psychiatric histories. Um, also, there's behavioral observations of people's mood or cognitive function. Some in some cases there's psychological testing or questionnaires. And then finally, there is the DSM V. The DSM V stands for Diagnostic Statistical Manual. This is a manual that is uh put out and it is a conference of psychiatrists nationwide that actually create this manual. And this manual for every diagnosis, for every mental health diagnosis, has criteria for what actually leads to that diagnosis. So for instance, many of us have been sad for one day, being sad for one day doesn't make you have depression. The DSM book will say, you know, we need there needs to be profound sadness, that they're under that's uninterrupted for a certain period of time. So all of these things kind of get together and actually lead to mental health diagnosis. So I just want people to realize that this is really the DSM V has uh been uh updated um and comes out regularly since the 1950s or so. And in the DSM, they have different categories. So you have different categories of mental health disorders. You have mood disorders, which are like depression, mania, bipolar disorder. You have anxiety disorders, which can be panic, dis panic attacks, uh social anxiety. You have psychotic disorders, and psychotic disorders are where there's kind of like a break from reality. So in a psychotic disorder, someone may have uh visual or auditory hallucination. Those are things like schizophrenia. There are personality disorders where, you know, that's really kind of more where the behavior is is deviating from sort of cultural expectations. So you'll hear people talk about antisocial personality disorder, narcissistic personality disorder, borderline personality disorder. You can have neural development disorders, and those are things like autism and attention deficit disorder and hyperactivity. We have a whole category of obsessive, compulsive, and related diseases, and those are OCD. People talk about OCD, which is obsessive-compulsive disorder, body dysmorphia disorder. There's a category of trauma and stress-related disorders, and these are disorders that are actually uh triggered by an exposure to a traumatic or stressful disorder. Then you also have eating disorders, anorexia nervosa, bulimia. Another category is somatic symptoms, and these are like where someone has a mental health disorder and then it actually presents like they have this chronic abdominal pain, and no one can ever find out what it's related to. So that's like a somatic symptom disorder. So the condition actually presents as a medical complaint. Um then you have dissociative disorders where there's sort of a disruption of identity, a disruption of memory. You can have um dissociative identity disorders, you have a whole category of substance abuse and addictive disorders, alcohol use disorder, opioid use, gambling, addiction, sex addiction, etc. Then you have neurocognitive disorders, which are like your Alzheimer's disease. Sleep and wake disorders, which are things like narcolepsy, where you suddenly fall asleep and you can't stay up, or insomnia. And then there's a whole category of sexual dysfunction and gender dysphoria. So as you can see, um, it is a lot of things that we actually really take into consideration when we actually look at mental health disorders. All right, I'd like to introduce our guest for today. We have today Marla and Dave Thomas. Um, and Dave Thomas is a part of the Grammy winning group Take Six that actually did spread love, if we ever. And uh biggest part of me. Marla, his wife, is a successful realtor, and today they have mental health Mondays with Marla and Dave, and they also run a nonprofit called Loving Beyond Reason. Marla and Dave, Thomas, thank you, and welcome.

Thanks for having us.

Yes, absolutely.

Dr. V, I'll tell you this. Um, it's really a labor of love.

I as we are listening, I just want to say that this is I appreciate your your opening because when it sounds like a lot of information, and but very few people really break down all the variants and the variance in in mental health. And so the way that, you know, I'm I'm really hoping that people really took that in, and I and almost, you know, the the joke of it all is it sounds like all of us. And and when I say that it sounds like all of us, I think people need to really understand that mental health, like everything else, there's a spectrum, and it's really just a consensus norm. And the brain and is is very much like everything else when you have organs and we accept that other things have deficits.

You can have kidney problems, right? That's not an issue. Everyone accepts there's no stigma around having kidney disease.

Right.

You can have lung disease, you can have heart disease, but if you have a mental health condition, suddenly no one wants to actually deal with that straight up and head on. Yes, so much stigma surrounding it. And I'm and I'm glad that you made the distinctions between to actually deal with that straight up and head on.

Yes, yeah.

And I'm and I'm glad that you made the distinction between what I like to say, you know, one of the things about social media is that if you if you give it too much weight, everybody's a narcissist nowadays. Uh narcissism is literally the term de jure uh running amok on social media. And just because you're selfish doesn't necessarily mean you're a narcissist.

Right.

And we can have narcissistic traits from time to time and behave that way.

Absolutely.

It doesn't necessarily mean we're a diagnosable narcissist. So, I mean, those are the things that those distinctions are very important. And I like what Marla just said about it sounds like all of us, because that's the way we normalize uh being treatment. Right. Normalize treatment because this is really about children. And it's very difficult to diagnose a child with uh certain mental uh illnesses like schizophrenia or even borderline or some of the personality disorders, they might show the symptoms early, but it would be inappropriate for the doctor to say this is definitely a personality disorder because as children grow, they go through different phases. Absolutely behave differently.

Absolutely.

So the thing that I would like to tell people all, and I say this all the time, why don't we normalize like we go to a doctor for a checkup when our kids are very young, four, five years old, start taking them to therapy. Yes. Even if nothing is wrong, just a checkup.

Well, so so therefore you they're they're and we'll get into our experience, but the it's uh what we realize is that right now, especially in the minority community, um mental health you you you get to a point where it looks like it's attached to something's wrong with you. You're going to therapy, like you've got this issue versus you don't feel that way when you get your car tuned up. That's right. Unless you have an electric vehicle. So the reality is if we normalize some of this as a as a routine understanding of care, it's not so shocking and it's not so it's not an indictment later on.

Absolutely. I I think also too, people don't realize that we all deal with very stressful things in life occasionally, and those are stresses and strains on our um our mental illness, just like if you ran a marathon, it would be a stress or a strain on your heart, right? I I know that um, you know, after uh I live in Washington, D.C. and after 9-11, you know, with those planes, you know, possibly coming to the to the to the White House and the Pentagon and everywhere, I had severe panic attacks after that. Like I had to go see a therapist, right? And and you know, one of the one of the first things she told me was to turn off the news, which I was like, duh. I don't know why I didn't think of that. And sometimes you really do need to speak to somebody outside of yourself to actually get a grip on what's going on. And and a lot of us have different challenges. We're all gonna have, you know, loved ones in our family that that may die, you may lose a job, you may deal with divorce, um, you may have any number of things going on. And it's okay if you need some support during those time periods.

You know what's interesting about what you just said, and I and I know this that I'm about to say is gonna help somebody. I always let people know now that Dave and I have done, have been down this road and have been, you know, with our own family for so long and have gotten, you know, gone to the professionals and and set, you know, and studied with those who are at the top of you know the field when it comes to books and borderline personality disorder and schizophrenia and all the things. I I let people know now that the you you brought up something right there, stress. And I'm gonna say it again. Stress is the number one thing that causes mental health fracture. And and now I'm gonna say this, and it's gonna make I I like to link things to just things that are common sense. I want you to think about children when they're babies to uh preschool age, right? Their whole environment is usually in in you know the standard case, your family. Then you go to your first issue, your first time to begin to individuate is preschool. Oh, I like this these kids over here. I develop friendships, and but it's it's it's it's general because that's just the stage of life. Then you leave elementary school and now you begin to enter your first collision with stress for most kids.

Right.

The expectation of socialization. And and you're you know, you're junior high, and you're you you're waking up to you know you know your sexual self and and your attractions and things of the sort, and then you go from junior high to high school, and then the stress of all of the things you've picked up to now, and then what are you gonna do with your life?

Right.

And and and and and now what? And and are you gonna are you gonna perform academically? And are you gonna perform in a sport? And and then are you gonna go to school? You know you're gonna be 18. You gotta you gotta make it, you gotta do something. So I look at that and I and I and we look at, and I'm gonna tie this to my retro view of my my son in particular, our son, who is now 35, and he is diagnosed with bipolar one schizoaffective disorder. And we started seeing some of these things in junior high, in his first time in junior high. We didn't identify it as that because we didn't know better, we didn't know. Right. But but right.

And I I'll add this that not only did we not identify it as that because, and this is something for uh parents to understand as well. Uh if you don't know to look for that, you're automatically gonna think this is a behavioral development issue that needs to either be punished away or explained away, or just have some conversations with, or you know, if you believe in spanking, then you know, those are the things that you approach, then it's really a mental health issue that is developing and you're just not aware. And if you're not in the habit of already taking your kids to therapy, it might be too late before you actually find out.

So so this is interesting. So, what sort of early signs did you see that you didn't really know how important they were? Or what early signs did you see and you did realize something was important?

Well, two two things, ironically, um, is that we between our our eldest child, our daughter, and our middle child, which is our son, we have three, um, there were seven different identifiable diagnoses uh uh in time. One was diagnosed at 21, the other one was diagnosed at 23, to you know, to for a full understanding. But with both, here are the early signs. With the with the oldest, which is personality disorder based, um, she never really connected. Ever, period.

Um, you know, they should be should be walking around 12 to 14 months, talking around two and a half, three years old. Um, and I think that um, you know, when you get older, people forget that the men that the milestones when you're talking about someone who is 10 to 16 years old, a lot of it has to do with socialization. And how are they socializing at school? How are they performing at sh at school? Um you know, are they kind of checking out? Um it can sometimes be assumed that, well, maybe they're a loner or maybe they're lazy, right? It can kind of be passed off as that when really what you probably need to do is go get go get go get go get checked. Go get go get checked. So, so tell me how did how where did you first go? Like, where did you first go for help? Or tell me what how how did your what did you do?

Well, we were blessed that uh Marla's mom, uh she uh worked for the VA. Okay. And by the time she retired, she was the head of nursing for all of uh Southern California VAs. Uh but one of her specialties as she was matriculating through her career was uh psychiatric nursing.

Okay.

And so she had so much experience that she would tell us certain things like early on, hey, you know what? Uh you our our oldest daughter and I, and and and I'm gonna say this up front that we we are reluctant to say her name only because we we we don't mind sharing to help other people, but sometimes you can only share to the extent that it's not gonna hurt somebody else, if that makes any sense.

Right, right, right.

Um and so we have to be uh aware of that as well.

People can you know you can and and it with our story is out there, it's pretty public. Yeah, exactly. So we just we like Dave said, though, just we don't harp on the name, but definitely, you know, we are good identifying the fact that this is our experience.

Right. So so you had a family member that had some knowledge and then could say, hey, you might want to get this shot.

Literally. And so we would go in and then you know, you go to one uh uh psychologist and they would diagnose with one thing, and you know, sometimes, and this is this is the thing that people have to understand as well. Uh not every doctor, uh, and please forgive me, uh Dr. V, but not every doctor is as skilled or knowledgeable or has knows how to apply wisdom to the medical knowledge that they have as every other doctor. Absolutely. So we would get one diagnosis and we would say, man, that just doesn't fit. There's characteristics outside of this diagnosis that don't quite fit.

Right.

So you go to another doctor and you finally get to a doctor that can fully explain all the things that behaviors that you've been seeing uh in a diagnosable way. And that's that I'm glad you brought up the DSM uh five. Uh because you know, and even then there are going to be little nuances that could be in the cracks, but diagnosis is mainly for treatment.

Right, correct, correct.

When it comes to, especially when it comes to medication, so uh the treatment protocols are specific to the diagnosis.

Absolutely. So the accurate diagnosis is really, really important because I think that people have to have the stamina and the motivation to keep trying and going to those different therapists till they get something that works. Because you were talking about, uh Dave, that you know, you originally did you go to a psychiatrist or a psychologist?

Because I want to just psychologist first.

Okay, all right.

I would love for you, Dr. V, to make that distinction. I can I can make it, but uh as uh as well. I'm glad you asked that question because there is a difference.

Yes, there is a very, very big difference. And I know the names kind of sound similar, but I'm gonna I'm gonna keep it really simple for people. A psychiatrist is a medical doctor that has gone to medical school and has gone and done a residency, right? And they are able to prescribe medication and they sometimes also do therapy, depending upon what they feel comfortable doing. They may or may not have a psychologist in their office, but psychologists work separately. Psychologists, you know, are are actually probably not the best person to go to for a diagnosis. And I'm just and I'm I'm gonna say that because they haven't done a medical residency program. So when you do a when you're a medical doctor and you do a residency program, you actually spend four years working in mental health hospitals and mental health outpatient. So you see the most extreme forms and a larger variety of mental health uh diseases. When you when you're a psychologist, a psychologist could have their masters or their PhD. They often work in an outpatient setting, they get their experience in their in an outpatient setting, and they don't actually do a formal residency in a mental health hospital. The other thing about a psychiatrist, which is the physician, it is very important that you some medical diseases will look like a mental health disorder. So you've got to be able to Separate first. And when people come to the emergency department, one of the first things we do is we medically clear that we make source. Is this a medical diagnosis? You can have a test and it looks like you have a mental health disorder. So I just want to just kind of explain to people the difference between a psychiatrist, which is a physician. When the medical school did a residency, and a psychologist, which is not a physician, did not do a residency and cannot prescribe medication.

So I really appreciate that distinction because that's what we ran into. Because when you're talking to a psychologist, like you're explaining, Dr. V, uh there's a few things that are very important for you to have a successful therapy session uh ongoing uh with a psychologist. You have first of all, you have to also be some somebody that uh the child wants to talk to. The child really doesn't have a good rapport with that uh psychologist, the talk therapy is not really going to be as successful as you would like. But what we found out was that uh certain psychologists, when they find out that, you know, we're trying to go to some talk therapy, but we're I'm coming up with some things that might be a little bit more concerning. That's when a good psychologist refers you to a psychiatrist because they believe that you uh you are diagnosable. But again, to be diagnosed, you got to go to the psychiatrist, like you said. Yeah. So that's what we ran into. So we were going through different psychologists at the beginning, and they would say, Well, this is what I think, but it just was wasn't meeting the standard for the DSM. So by the time um our oldest daughter started in her therapy, she was in maybe fifth grade.

It was in fourth, fifth grade.

Uh, and then by the time we started understanding that, hey, this is might be a good thing to start taking our kids to therapy, we started our son probably around sixth grade.

Okay.

Sixth, seventh grade, yeah.

Okay. So you so you went to a couple of psychologists, and then you finally went to a psychiatrist, and then they both were diagnosed?

Well, that that was that was a long that wrote that that spread of time was a lot longer. Meaning that, so remember our the formal the diagnosis for our daughter came at twenty-one.

Okay.

The diagnosis, the the con the confirmation, and we'd other things had been tossed around, but when we understood and had a full grip on what was happening with our son, that diagnosis came at twenty-three.

Okay, gotcha. All right.

And and and there's so many things looped into that, which is why it was amazing to hear you. I've never really listened to a doctor before who's sharing information with people be so detailed because our son, it took a minute to uncover his situation because he had an addiction issue. Yes in coming out of high school into his early adulthood.

Right.

And that went as far as heroin.

Right.

So and then he went to rehab for 18 months and and there wouldn't there was never another drug, but outside of that, that's when his diagnosis came. So he got he he was he did an 18 month live-in program for rehab, and then at 21 went to college, and then at twenty and then fractured his junior year mentally.

Right.

And that's when we understood, whoa, this is something altogether different. And he went and his diagnosis with the psychiatrist happened at twenty-three, and we said, Oh, uh now we understand.

Right. And I and w and and to just concisely uh piggyback on what Marla's saying, all up until that point, he had been diagnosed with anxiety disorder. Um as a child, ADHD Exactly. And so when when we say di the finally diagnosed at 23 or at 21, what we mean is the diagnosis that finally fit all of the characteristics that we had experienced in in behavior.

Yeah. And I will say, and I will say this, you know, I was the the the greatest issue for parents, Dr. V, is denial. And I want to assure parents that that's normal, but the quicker you open your mind to other op to other options or possibilities, and the better you're gonna be equipped to support whatever because in other words, you know, there's so many things, and we I mentioned the ADHD, and that happened when he was young.

Right.

And David, in particular, and we're you know, we're very again, we're very open, he was like, oh psh, we're live in the south, you know, my son is you know, being a minority, there's no way. Because they suggested medication. Right. And we didn't. And he was three. He was a he was a he was preschool age.

He was preschool age, yes, yes.

He was about four, he was he was about four, yes, he was preschool age. But they were like, look, you know, there's a problem here. And they was like, Are you kidding? They just, you know, we're not doing that.

Wait, and on top of it, my dad was a psychologist. Nope.

Okay, wait. We've got a we've got a caller online too, Miss Daniels. Uh, you have a question here to uh to ask?

Go ahead. I do. Listen, Dr. V, I am thoroughly enjoying this show today and just and welcome your guests. I feel like I'm talking to myself with your guest. You know, I have unfortunately um lost my daughter in this battle, but she would have been 34 this year. And what's happened is as I'm listening to your guests, Marla uh and Dave, and my daughter's name is Marla, just what that looked like when the children were younger. And I always tell people when they say, How do you feel you lost your daughter? And I say, you know what, you guys, God loved her more. And I knew at three, five, seven, and nine, and I always encourage people, because I identify with you, you just have no idea about when we see these precursors. And I tell people, I'm not a doctor and I don't play one on TV, and whether I saw a psych a psychologist or a psychiatrist, we as parents knew. We know that there is something different there. And even though I took my daughter to counseling and tried to do the play therapy, I always encourage people to not deny what they see when our children are showing evidence of these spirits that are rising up and it comes into some storm of psychosis. Um, and for us in in our families in the community, like you said earlier, Dave and Marla, don't not talk about it.

Right.

You have to engage with one another to support one another, because more than likely your neighbor, your cousin, whomever, maybe having the same struggle. And we can't deny that we have to help one another in supporting and not outcast that family or outcast that child when they're dealing with these precursors of this psychosis. Right. And I just wanted to just say I'm just thrilled with your show today.

Well, thank you. Thank you very much for calling in.

Well, it sounds like uh, and I I want to say the caller's name correctly. Did you say Ms. Daniels?

Yes, Miss Daniels.

Uh the what I hear really, even in her tone of voice, that I can appreciate is an acceptance of the issue. And to me, one of the biggest things, Mar Marla and I had an acceptance rate that was completely different. Marla went on in, and let's deal with it head on right away. For some reason, even though, like I said, my dad was a psychologist, it seemed like an indictment on my parenting on them to even accept things that were, you know, behavioral issues, especially so young, it seems like, and I and I I don't uh mint any words, I grew up in a household where I was spanked on a regular basis.

Right.

I wasn't abused, I didn't consider it abuse, but I mean that's just how I thought you have to address behavioral issues that are you look some some slight maladjustments, that's how you take care of it. Right. You know, uh we were I was raised in a southern Christian home where you know the tenant was spare the rod, spoil the child. Right. But not necessarily, you know, every instance requires that. And that's something that we have to learn and we have to accept as well.

Did you oh go ahead? And I and I have to jump, I have to say this in to it to actually highlight something that Miss Daniel said. Ladies and gentlemen, all who are listening, please hear me. I my tenet is see something, say something, and do something. And I do not mean that this conversation, and I'm only saying this because I am this public, because that's just the life I was I was actually put into. Right. And that's just how it played out. That doesn't mean to announce or broadcast on social media.

Absolutely.

Oh, well, she says see something, say something, do something, or she speaks out on no, because that's not what I'm saying. But amongst ourselves, that it's we don't want to discuss it. It it's it's almost like Dave said, there's some strange, this is my fault, and that that is that is a deterrent always to be able to find the right path to be able to get the proper help.

Absolutely. Absolutely. Um we have another caller online too, Tammy?

Hi, yes, this is a m much needed conversation, um, and I really appreciate the transparency as well as the the information. My question is cultural and I guess also biological. And cultural, I mean, was there a reluctance to accept certain things that you were identifying from a spiritual perspective? Because a lot of times, you know, we over-spiritualize things, we pray it out, we cast it out, and we don't deal with it in a practical way. And then also I know certain conditions can be hereditary, even if it's not directly, and maybe they're unaddressed, you know, because culturally we don't call things what they are. But I just wonder, was there also a history within the family line um where they can now see um, you know, a a a connection?

Okay, so my let me just tell you this yes and yes.

Okay.

So ironically, Dave mentioned his dad was a psychologist. Well, when we started understanding the the the the uh depth of our yeah, the depth of the diagnosis with our children, we are a young adults at that point, the actual statement from his dad, the psychiatrist, was they need to identify more with Christ. That was an actual statement. And I said at that point, because by then the kids are we we're we're we're you know uh uh tens of thousands of dollars in out of pocket with solution finding. Right. Because they're they're they're too old to be on your insurance. And I said to his father, I said, Dad, is Jesus in the pills? Because when he's on his medication, he's fine.

Right.

So I'm asking you, in other words, that and that was a that was actually literally a tag. He's looked at me because that's what and he and not no fault of his, God rest his soul. That's the way he understood it. And then to answer your second question, absolutely, and that's why I've distressed over the silence inside of our families. Mental health on all sides, deep, deep, deep, and and it just is like a tornado. It hops around, and and you you know that the storm is there, but you're never sure it could destroy this house and leave the neighbor's house untouched.

Right.

That's what mental health is in our family. So it literally, I say this all the time. And my oldest daughter, by the way, has a different father. So I've got dynamics on all sides, including my family, his family, he himself, all the things, and sir. So I've got dynamics on all sides, including my family, his family, he himself, all the things. And so to me, my thing is, man, if I had only known that these things, I could have approached the the solutions earlier and different, which is what I've dedicated myself to do with my grandsons.

Well, I appreciate you paying it forward, right? Because we don't know what we don't know, but now you do. And so kudos to both of you for the work that you're doing and Dr. V for this platform. And I just want to close by saying, from a spiritual perspective, we gotta be really, really um careful to not be punitive. I do think the church in particular is starting to recognize the connection between both spirituality uh and mental health and allowing for the science to um be more prominent in its teachings, and I think that's growth on our part, and I think it's becoming more of a safe space, but it's taken us so long to get there. Thank you again.

Thank you for calling in. So so the other question I have, the other question that I have uh uh for you guys is you know, did you ever have to, you know, um go to the emergency department or interface with the 911 or police or anything along that line um in your in your experience with uh both of your children?

Yeah, I would say this. Uh with both children, um we had emergencies. And it and I would say this briefly, uh, to get real proper mental health help, unfortunately, our system is designed uh to use data for that for that type of help, especially for people who can't really afford the the the help that they really need. Um and I mean by when you talked about Medicare going away, um unfortunately for a good health care, they say how many hospitalizations have you had before you can be approved for certain programs.

Right.

Uh and I think that's wrong. We got to fix that. I'll just say that there. But my wife, Marlett, has become a specialist when it comes to de-escalation because of our interaction with police. And I'll let the police and I'll let her uh actually explain that a little bit.

Um absolutely. Well, first the first thing is I'm just gonna break this down in steps. It's not your fault, all who are listening, um a person with unchecked mental health issues often becomes episodic. The first thing you must always consider is safety.

Absolutely.

So in considering safety, and we think safety protect my protect myself, the first thing is it's you also want to be sure that you're protecting the one who's affected.

Right.

Um, and keeping life, keeping it safe for them. So the first thing I always do is I I advise people clear the area. If if your if your loved one is in a home, remove everything out of the house, pets, anything living needs to go. Number two, and anything sharp. Yes, if you have to and you can and you when you call 911, the bottom line is I always meet the police outside of the the site. And I let them know I am I'm the one who called.

Right.

That is my son we're going to deal with. Here are here is here is his diagnosis, and this is the best way. There needs to only be two people. He hears voices, and we and I brief them away from the incident.

Right. Right.

And then I stand nearby and I don't speak. There can only be one person speaking because what you realize is a uh if you have to call the police, the police are not mental health professionals. No, they are not. They're there to neutralize and make an make something safe.

Yes.

It's a threat. They're gonna neutralize a threat. And and the threat in this moment is the affected one. So if mom and dad are screaming and ah, they're my baby, and you you're going to charge a situation and and it's gonna be much harder for you to get control of it.

Right. Right.

Um and then and then you just literally they st you you have to remember that just because they're having an episodic break does not mean they're unintelligent.

Correct.

What we didn't say is both of our children were super smart.

Yes.

So a lot of people say that you tend to put learning disability, it's not true.

Absolutely, absolutely. A lot of people actually assume that because someone's mentally ill that they've got cognitive deficits. And that is not true. And you know, one of my favorite movies was The Beautiful Mind, where um it was the mentally ill professor that won the Nobel Peace Prize. And so, you know, it it doesn't you can have a very, very academically smart child that can still struggle with mental illness. They do not go together.

Right.

Yes.

And and I have to throw this in, Dr. V, along with it, when you make that first phone call to the 911, if if that's the route that you have to take, and now there is 988, which is strictly about mental health suicide um prevention. But if but if if physical safety is in play, please inform whoever picks up the phone that this is a mental health situation and to have the pet team or the smart team accompany officers to the scene. So they're gonna need to be the ones that make that di that that make that call to say this this situation needs to be handled by this person going to an actual mental health scenario versus a criminal issue.

And they'll also have the mental health facility that the uh uh person needs to be taken to already identified, and so everyone knows what the plan is. And the main thing is, I guess, along with this de-escalation that Marla's talking about, is to have a plan in advance so that you can calmly help the authorities walk through the process that they need. Because, like Marla said, the police unfortunately are the first uh responders when it comes to mental health, and they're not trained mental health professionals. Uh they're trained to neutralize threats.

So in Maryland, by means necessary. Yes, by any means necessary. So so we are fortunate in Maryland. So if if for some of my listeners that are in the state of Maryland, Maryland actually has a behavioral health unit that goes out with the police on 911 calls. And um I I know about it only because I have a family member that had a mental health emergency. Um we were very concerned and reluctant to call 911. And we we did uh uh essentially because we were more concerned about her safety. Um, and unbeknownst to me at that particular time, um I did not know about this program, but Maryland has a whole behavioral health unit that actually accompanies the police on any call that they get through 911 um where they suspect that it may also involve a mental health emergency.

I think it's really, really popular around the country as well, uh Dr. V. And usually uh in some places where they know that that's the protocol, a lot of times they just don't have enough staffing. So that is pretty much the protocol generally nowadays uh in most places.

So so let me let me ask you, you know, as as you know, many of us have family and friends that may be dealing with this stuff. What sort of things can we do to support our family and our friends that's helpful? And what sort of things did people who were good hearted and thought they were supporting you do that maybe wasn't helpful. So that that way we can kind of figure out what are the things that we need to do if we have uh a niece, nephew, or a family in our community that's actually dealing with this.

Well it's like everything else in life. You can't really do anything without being educated. You need to actually get the right information. And so David and I, we've been through classes at NAMI, which is the National Alliance of Mental Illness. That's a national organization.

And there's definitely a NAMI chapter near you. They're the largest mental health uh uh organ help organization, uh nonprofit around uh in in in the United States. So yeah, they're very helpful. We took classes there just to understand, and that was that was one of the biggest things that helped us to understand how to deal with someone who's here who's having auditory hallucinations. Uh we had to do an exercise where literally we were told to follow some instructions while people were shouting in our ear, and it was almost impossible. So that's that level of education was important.

So they they set it up so wait, wait, they set it up as as it as as if you as if you were hearing voices and it's Yeah, I was in tears because when you understood, which is our son gave up his license, he's like, I can't even focus, like I can't so he had a couple of accidents and he says I shouldn't be driving. I shouldn't be driving. And so the bottom line is, but we allowed, we didn't we once we understood, and this is the next thing, you know, please table your blame. I know it's hard. And and you know, the one of your callers asked about genetics. That's where it gets to be deep because it's like, well, wait a minute, it you know, the finger pointing is almost natural. Don't point the finger because it you know, there's no the we need to deal with what is. It's not helpful. It's and it's not and it's not about again the tornado. It we know that the storm exists in our family. We it's not. About who created the storm. God created the storm.

Right.

So so table your blame. That's number two. Number three, I think that one of the most helpful things is to understand without, like they said, especially in the black community or in minority communities, without a punitive consequence. So we understood, once we got we got an understanding, my son says, it's he's I said, D, what are you laughing at? Um I'm talking to the network. Okay. So literally, and he used to just hug me because the reality is that's what he's going through.

That's what he's going through, yes.

What good does it do for me to say, look, boy, you you're not, those are voices. You're not hearing anything. And and the fourth thing is if you have somebody just episoded it, that is their reality. A lot of the time the anger comes from you trying to convince them that is what it what is real. This conversation between me and you, we are in a consensus reality, you and I right now.

Right.

Well, if somebody else is over here, it doesn't mean anything other than you trying to tell them that they're ridiculous or they're crazy.

It doesn't change your experience. It yeah, it doesn't change your experience. And it and it can actually make them angry and it can actually make them withdraw.

Absolutely. Right. And and and it and it's natural to do, which is why I go back to education. Right. Once we educated ourselves, we understood how to how to talk to them. We understood our you know, and our to be honest, the per dealing with our child who has the personality disorder is is way harder than dealing with our son who's actual has schizoaffective disorder and bipolar one.

Yeah, no, no, personality disorder is gonna be difficult.

So you have to just learn how to talk and communicate and do all that. And I'm and the final thing I need to say, and I'm gonna give this a Dave a diagnosis, this is the final one. Do not hang a diagnosis around your loved one's neck like an identification card.

Absolutely.

It's only I say it's like handlebars on a bike.

Right.

I can't really steer the bike without knowing what what the handlebar is the diagnosis. Now I understand what to do and how to lead this situation with the bike. But the it's not the handlebar is not the identification of what a bike is.

Yes, yes. No, that's very, very important.

I'll just say to generalize uh the the main thing to do in all of these situations as you're dealing with an episode or as you're dealing with uh some of these behaviorals that are behaviors that are hard to deal with, is to always try to take the energy out of the system. Uh when because part of the episodic behavior is almost a tumultuous emotional energy that's hard to contain, and that just kind of continues to feed back and cycle in on itself, and that's what kind of that's the best way for me to describe what an episode actually looks like, and that episodic behavior. So always try to keep that energy down. And for some people's personalities, that's easier than it is for others, but that's something that's necessary to work on, which is why I say find the local NAMI chapter and take some classes if this is something that you suspect that you are dealing with.

Let me give people that information. NAMI is N like a Nancy, A like an Apple, M like a Michael, I.org. NAMI.org. Well, folks, that's a wrap. I want to thank you, uh, Marla and and Dave so much. We've had a lot of fun talking today.

Yes. Uh our organization, our nonprofit mental health organization is Loving Beyond Reason. And we specifically did with parents who have children that are had to become adults, and it's you have no control over their uh uh uh uh medical help and helping them to seek their medical help.

Yes.

They're adults and so they can make their own decisions that makes it far more difficult as a parent because you're a parent and you know that the child, even though they're chronologically an adult, they don't know.

They're not really an adult. Thanks. Yeah, I will get that website and put it on my I will get your website and put it on my website, and we'll be back here next week where you can be informed and empowered about your health.