Montgomery Smashing The Stigma
The statistics tell a clear story. The National Alliance on Mental Illness (NAMI) reports that one in five Americans live with a mental health condition. With the support of our City Council, the City began a mental health initiative to help break the stigma. As a small local government, providing treatment for mental illness was not feasible. Still, the City believes we are responsible for being a conduit and connecting people with groups and solutions that are out there when they need it most.
Montgomery Smashing The Stigma
Dr. Tracy Cummings - Suicidal Ideation, Signs, and Treatment
In this episode, we dive into the sensitive but important topic of suicidal ideation, exploring the warning signs, underlying causes, and available treatments. We break down how to recognize when someone might be struggling, the various forms these thoughts can take, and ways to offer support. With insights from Dr. Tracy Cummings, we aim to provide listeners with tools to navigate these conversations with care and compassion. Whether you're supporting a loved one or seeking help for yourself, this discussion offers valuable resources and hope for healing and recovery.
Dr. Tracy Cummings, a 2023 Cincy Best Doc in the Child & Adolescent Psychiatry category, is the Chief of Child and Adolescent Psychiatry and Medical Director of adolescent PHP for the Lindner Center of HOPE. As a staff psychiatrist for Lindner Center of HOPE, Dr. Cummings specializes in the assessment and treatment of children through emerging adulthood and has vast experience working with individuals and families coping with severe and chronic psychiatric issues.
Panel Discussion from August 29, 2024
Hi, everyone. I'm Connie Gaylor and I'm Amy Frederick. Welcome to the Smashing the Stigma podcast. In this episode, we welcome Doctor Tracy Cummings. Doctor Cummings is the chief of child and adolescent psychiatry and medical director at the Lindner Center of Hope.
CONNIE GAYLOR:Tracy was so gracious to be part of our panel presentation back in August on suicide ideation, and we just thought it would be a great follow up. Tracy, to have you come in and talk to us more about about suicide, what you see, you know, the patients that you treat, the kind of factors that come into that. And just to let the people who weren't at the panel kind of know, you know, the the basis of what we were trying to share the night of the panel by everybody who presented their own stories, but also what, you know, what you could tell our listeners to look for or to just to help them understand.
DR. CUMMINGS:Sure, I appreciate that. Thank you. Especially a follow up here in September when it's National Suicide Prevention Month. Right. It's good for us to continue to remind ourselves and those around us. It's a hard topic to discuss, but such an important one. This is a public health concern, and we can be a part of the solution. So that's the hopeful part of these kinds of conversations.
CONNIE GAYLOR:Absolutely. Yeah. Mhm.
DR. CUMMINGS:Yeah. For me I think what I highlighted in the panel was more around the risks that are involved and sort of red flags or warning signs people may be able to see. And then responses and ways to intervene, just as an individual could not as a mental health professional would have to, but to remind us that we all can be a part. So, you know, when we talk about suicide Side risk. It's important to talk about there isn't one particular cause. It's often a very complex situation that someone is involved in. Once they may start to have thoughts about suicide, and then even more complicated, once someone may be engaging in suicidal behaviors or making an attempt to end their life. And so there's time to intervene at those different stages if we are a part of that conversation. And in general, in our state of Ohio, roughly five lives are lost a day to suicide. And our country about 135 a day. So it's an unfortunate number, a large number of individuals. We know that the majority are men. So that's something to keep in mind when we're talking about intervention and things to look out for. But we know there are some other additional populations of people who are at a higher risk. So veterans is one category. Those who identify in the LGBTQ plus community are at higher risk young adults. There's a high risk, you know, so places that have less access to mental health care or places that are more isolated and there's less community engagement and supports, those are all things that are important, um, larger risks. But then when you think about, you know, for us in psychiatry, we're always talking about biopsychosocial and ways that those all interplay to lead to mental health concerns. So biologically would be like your genetic risk factors or predispositions. So that may be a family history of suicide. Strong family history for mental health concerns, substance use, chronic pain, or other major medical things that could be contributing. Depression is a major one that is often associated with suicide. And then sort of the psychological component is sort of temperament. So whether someone is maybe more impulsive or reactive, that can be coupled with a biological factor and a stressor, then that can lead to sort of the perfect storm that may result in suicidal thoughts. And the social part is really any kind of circumstance or stressor that could contribute to someone feeling down or hopeless or incredibly frustrated with their current life situation. So it's often a combination of of those factors. Um, it's thought with studies that's out there, about half of individuals that end up dying by suicide have a known mental health diagnosis. But that would mean there's a lot of individuals that either have never been diagnosed and treated. So if that would have happened, it would lead us to believe that perhaps we wouldn't have been in that situation. But it also lets us know that some people who do not have mental health concerns can still experience suicidal ideation. So that's important for people to remember. It's there's not a prototype of a person who may experience suicidal thoughts can be any age, any gender, any demographic that you pick. Um, they can be impacted.
AMY FREDERICK:Let's talk about some of those signs that you mentioned. And I find one out of five to be such a shocking number. I mean, it's it's hard to believe if you think of five people in your life, one of them is at risk. So what would you say are the most common signs or symptoms that that you that people should be looking for?
DR. CUMMINGS:Um, yeah, I appreciate that question. Really, any kind of change in behavior is a red flag when you couple it with circumstances. So if someone has experienced a recent stressor and lost their job, a divorce, you know, some major situation that may have happened, a breakup is a common one that I hear when I treat young people. Um, plus then you see a change in their behavior and that could be in their words or in their actions. So they may start to make comments like, I don't even want to be here anymore. What's the point of going on? Or, you know, you all would be better off without me. Sort of. Maybe not directly. Speaking of suicide, but almost speaking in a way that suggests there's underlying concerns there. And then behaviorally that could look like withdrawing, not engaging in things they once did. So maybe if they were once involved in different sporting activities or musical activities, they start spending more time alone, staying in their room, maybe not taking care of themselves as they once did. Family might start to notice changes in how someone is sleeping, how they're eating. You know, there can be differences in just the way they emotionally interact. So now they maybe are a little more irritable or come across as angry. And so those are those are some subtle changes for some people. There can be some more obvious red flags, where someone may directly start to talk about how they no longer want to be living. They may start even sort of saying goodbyes or writing notes or giving things away. That's suggestive that they don't intend to continue to live. Those are those are much more of the red flags.
AMY FREDERICK:So then what if you know somebody who you're seeing red flags, somebody saying to you, I just don't want to live here live anymore, or they're withdrawing from an activity that they once loved. What's the first thing that you should say to that person? Because I think people want to help. They don't always know how to help. And sometimes what they think of as helping is more of an order. And you know what I mean? Like, they are trying to jump in and tell somebody what to do, and I don't think that works. So what would you tell somebody to say to someone? Um.
DR. CUMMINGS:Well, I appreciate that. Someone may have sort of a, a gut feeling that someone may not be doing well, and it'll be important to act on that. And so be very intentional about your words and with your time with that person. So when you want to approach that individual, make sure you have the opportunity to give it the time that it may need for you to bring up such an important topic. Um, and I think that being direct is going to be most helpful. You know, I noticed that you haven't been going to this practice anymore, and I've been worried about you. And I want to talk about how you're feeling utilizing a lot of directive from myself. So saying I statements tends to allow someone to be less defensive when I'm asking them questions. Um, and then being able to give them time to respond. And that means I need to not judge what they say. It means I need to not start throwing out comparisons to them, like, oh, that doesn't sound so bad. Or, you know, we can we can figure this out, you know? Listen, it's more about that connection and being empathetic to what their experience is. And sometimes just allowing someone to know that you cared about them, that you noticed, you see them and you want to be someone who's there for them. Sometimes that's all that it really takes. Um, a fear, though, that many people will have is if I ask them, are they thinking of hurting themselves or ending their lives, is that I will be putting that idea into their head. And so people get very fearful. That's not true. Studies have shown that time and time again. If someone is suicidal, they are suicidal. If they are not, you saying those words will not make them so. So it's much more important to ask and then be present. Now sometimes that conversation and connection isn't going to be enough that the risk is much more imminent than that. And so it may require you to ask more directly are you thinking of ending your life? Have you made plans to do so? Because that could allow those around you to help safety plan for that person. And that's kind of getting more into the how do we respond to these situations. But is this a situation where I need to call for support immediately, or can I work with people who are close to this individual to put them in the best position of safety? You know, where they have someone with them, where they don't have access to lethal means. You know, where we have connections in place, where maybe getting them linked up with a mental health care provider, you know, it sort of depends on the level of severity at those times. And so but if you aren't sure, I think erring on the side of safety and getting support is the best way to go.
CONNIE GAYLOR:Within the treatment, when you are treating somebody that that's came, you know, to your practice with, with suicide ideation or maybe have had an attempt but didn't succeed. Um, is this something where you can just treat them as an outpatient, you know, where they come in and meet with you regularly? Or is this, you know, something where somebody's going to have to be admitted? Um, and and is it like, I'm assuming it's just kind of all over the board, but what would be your first course of treatment? I guess if if somebody came to you with this?
DR. CUMMINGS:Yes. So we're kind of leading into sort of what would be the levels of care that someone may require, you know, suicidal ideations or behaviors is really a psychiatric emergency. Um, so typically we're talking about intervention right away. So oftentimes that may be someone ends up speaking to someone in the emergency room or someone who's at a response center that's available 24 over seven. And they may try to start with safety planning. If there are people around who can do that. Some people don't have that. Those kinds of supports in place where that safety could be assured. And therefore, oftentimes in order to get someone in the safest space, there May 1st need to be an inpatient hospitalization, where there's 24 over seven nursing care and mental health care that's being provided around the clock. Once that crisis period settles down, then that may look something more like a partial or a day program, which exists for both teenagers and adults that are out there kind of helping. All right. Let's integrate back out into some of your day to day stressors, but still have some intense treatment and therapy because in that treatment you're going to be building up protective factors and coping skills and things that could allow someone to navigate when the next hard thing might come up or while while they're still trying to move forward. So how do they regulate their emotions a little bit better? What are some alternative actions to what I've been doing. So that happens in those treatment settings. And then usually after that that's more of the outpatient level of care for that, where you may come in for medical management if you're on medication or that may look like psychotherapy. Oftentimes it's both of those together. Um, and there will be times where someone may have chronic suicidal thoughts, but they are able to state that they are not currently planning to end their life or have any intention of ending their life, but they have sort of these chronic thoughts. Those may be able to be managed at a lower level of care than inpatient, but again, that's going to really depend on their circumstances and who all else is involved that can keep them connected and safe.
CONNIE GAYLOR:So I imagine when you're treating and you know, I'm just going to say young adult or youth that you're not just treating them now the whole family is involved. One how to process what they're feeling, but also how to make it a safe environment for the rest of the family, especially if you have if it's a young adult, you have multiple children in the home. How's it affecting everybody else? When when that one event or attempt or thoughts come out? I just feel like that's going to be a ripple effect across the whole family.
DR. CUMMINGS:Yeah, it's a it's a scary situation and people will handle that differently. And we know that homes have different levels of communication at baseline and also ways of showing affection at different ways. Or also even their handling of distress can vary. So that is really important with the young people as we have whomever they may be living with. Um, whoever is in that caretaker role will really need to be able to help with the supervision and putting away things that could be utilized. You know, no access to firearms, putting away, locking up medications, you know, different kinds of things that may potentially be utilized specifically if the person has given a plan, taking that into consideration of what that would entail. And realistically, for some households that safe, all those safety measures that would be required may not be feasible. And so that's often when those levels of care also become important. Because even if someone wants to with all of their might to help this person that they care about, for whatever reason, that home situation may not be able to maintain that safety. And so sometimes you do have to err on the side of hospitalization just to, to help with that part.
CONNIE GAYLOR:So Lindner offers that, um, for people, you know, and, and you think about, you know, areas where people just don't have these resources, you know. Um, I wonder how do those people get get the treatment that they need? You know, um, I know there's we've really expanded the type of treatment, you know, with Covid showed us that, you know, now you're doing a lot of treatment virtually. Um, and is that as effective? Do you feel like do you do that now? Currently we do.
DR. CUMMINGS:Yeah we do. Um, and that's that's really with group level services at Lindner Center. So there can be, um, you meet with a group of individuals and work on skills. Um, we also have that for therapy for one on one therapy. And we have it for medication management. So with one of the prescribers that can happen via telehealth as well. Um, it seems like there was a you know, obviously for a while there we had no choice. That's what we had to switch to. And we were all trying to figure it out together. Um, now it's remained as an option because for some people that is more convenient. Otherwise they drive Yeah, a really far distance. And it takes out a significant part of their day. You know, for a 30 minute or 45 minute long appointment. And so it is an option. Some people prefer it. Other people do not. Right. You know, there is a difference in terms of some of the connection. You know, you that you don't you can't see maybe all of the body language that you would appreciate if someone is sitting right next to you or sometimes the feel in the room. Yeah. That you can have with someone. Um, but if that's what you have. Yeah, that's that's what you will utilize. Right. Um, but you're absolutely right. For those areas that have less access to care, there tends to be more risk. Mhm.
CONNIE GAYLOR:With medication. Um, is is it something that can be short term or long term. If you have a patient and and you know, maybe there's a, you know, another diagnosed mental illness that they're dealing with and, and suicide ideation kind of runs along with it concurrently. Is that something medication is very effective on. And if so, does that look like a long term usage. Or is it something that helps to manage through a certain point. And then, you know, because you see all these commercials on TV, if you take this, there is a risk of suicide, suicide ideation. And so it makes you wonder, okay, what is is it effective. And and it's certain purpose. And then they can come down off of that. What do you see in the usage of that.
DR. CUMMINGS:Yeah. So sort of going back to the, the, the risks involved with suicide depending on what that person's diagnosis Agnosis may be that will determine sort of the duration of of treatment. So it may look different for someone who had no other underlying concern but this one stressor versus someone who maybe has, you know, a depressive disorder plus an anxiety disorder and a substance use disorder. And this stressor, we that may look like a longer term treatment depending on what all their needs might be. Our medications are certainly not perfect in psychiatry, but really with any medication, right, there are side effects or adverse effects that can occur. What you mentioned in terms of the black box warning, um, that comes up quite often. I do think the intention of the warning, of course, is Good natured and to allow people to know. But we also know that untreated depression has a very high rate of suicide. And so I think in for a lot of young people, that black box warning is very scary to them and sometimes inhibits somebody from using treatment because of that. Now, one thing for any of us in the mental health world, when we're treating someone, we're going to always be assessing for safety and trying to ask those questions. So if someone already comes in having these suicidal thoughts, we may choose to use a medication, and we're going to be seeing if that's changing in any kind of way or what their response may be. And if someone's never had suicidal thoughts, but we're treating them for anxiety or depression, and we use a medicine that has that black box warning on it, we're going to be saying we want to No. Should any of these kinds of thoughts come to be? You know, it's tricky because sometimes, you know, these medicines don't work immediately. It takes a while. And so sometimes someone's natural progression of illness may be that they didn't originally experience suicidal thoughts, but some weeks later they do. And that becomes complicated, right? Because if we started a medicine and then is it because of the medicine, or is it because that was the course of their illness that they started to develop these thoughts? And that's where some of the discussion around that black box warning can be a little complicated. Um, because it's a little hard to tease it out. But bottom line, we don't want someone to have those thoughts for whatever reason. Um, it may be leading to it. So if someone did develop it from medication and it seems very temporally linked from when they started, of course that would be changed and monitored. There are a couple of medicines in psychiatry that have specifically been shown to help reduce suicidal ideation, and so sometimes those are utilized as well. Again, depending upon someone's circumstances and what they what they might need. Mhm. Yeah. And there's you know this sometimes leads to discussion of why some people feel less inclined to use medicine and want to use other interventions like TMS, like transcranial magnetic stimulation or ect. Um, for the electroconvulsive therapy, things that are not medication, you know, but a different modality for addressing often some significant psychiatric symptoms.
CONNIE GAYLOR:And you've seen good success with that alternative treatment.
DR. CUMMINGS:Very good success with those treatments. Again, it's different I think people tend to know and feel more comfortable with taking a pill. You know, we're accustomed to if we have a headache, you know. You know, people feel more comfortable with that. So the commitment to utilizing a different modality of treatment feels different. Um, you know, ECT requires anesthesia. And so that that's pretty intensive. For some people that's requires recovery time you know. And even though the treatment itself may be brief, there's going to be some initial phase and then downtime from that. Tms you don't require anesthesia and you come in. It's a very brief session, but it is five days a week for multiple weeks in a row. And so that's a level of commitment that also can be challenging, especially if someone doesn't feel well. Right. You know that. And to need to get themselves to the appointment every day or multiple times a week, depending on which modality. And it kind of comes back again to having what kind of connections are there and supports to make that feasible for someone? Yeah.
CONNIE GAYLOR:And you know, that kind of you had made a statement, you know, we're talking about the community, you know, and and my mind does keep going back to teenagers and young adults, um, who are in a school environment so many hours of the day, then they come home and, you know, they're only waking hours so much with their parents who may not see all the signs. Do you often hear from from counselors or teachers or somebody at school? Um, and it may be that it's more of an existing patient because I know there's that, that HIPAA, you know, but how do, um, it's like, how do we connect the dots of their community environments to, to see those red flags if parents aren't seeing it? How do we know if school is seeing it?
DR. CUMMINGS:Yeah, very grateful for a lot of schools trying to incorporate a lot of mental health involvement teachings for students, but also awareness for staff. And a lot of schools have even embedded some mental health care within their systems. So but that does require someone to have identified this patient, this person, um, at that point, not a patient, but this person as needing some support in some way. And then either they will work with the family. Sometimes that means going back to working with their pediatrician, if that's who they're connected with at first. If they don't have a, you know, psychiatrist or therapist outside of the school setting, that may be their person who helps guide them to services. And we definitely get a lot of referrals from school based therapists Arabist to our day program. For example, when they've seen that someone has started to struggle, maybe attendance with school or maybe come for part of the day, but are really struggling for the rest of it? And have they've been sharing with them low mood or these other concerns? So school school involvement is so key. Um, coaches can be another great avenue of someone who has a good connection and relationship with young people. Um, if they're involved in any other kind of organisations, if it's, you know, volunteering, if it's a religious organisation, something where people can see that change in behaviour that we talked about and then can sort of step in and say, here's what I'm seeing. I think we need to get you some help. Um, you're absolutely right, though. Even when teenagers do have some time at home, they may not Share at home with what they're feeling. It may come out more to their peers. You know, there's that stage of life where communicating more with your peers is normal than communicating with your family. That's that's a part of us growing up. Um, and that can make some of their peers feel very ill equipped to handle some of the statements that some people may share with them, and they shouldn't have to feel like they need to fix those situations. Um, but helping our young people also know when we need to involve someone else. You know, I think secrets. Secrets aren't a good thing. No. You know, so if you've been told that, here's this. But don't tell anybody. That's that's a bit of a red flag there. Or if you know someone is engaging in unsafe Behavior, whether they've posted about it or they've shared about it verbally, it's it's not tattling to get them help. It's actually a pretty strong act of courage to step up and connect someone with what they need because you care about them, right? And not see it as they're going to be mad at me. Um, because we can't control how somebody else reacts to our choices. We just have to know, I'm doing this because I care about this person, and I want to see them get help.
CONNIE GAYLOR:Do you, um. I'm looking at you and Amy because you both have students in school still. And do you feel like the schools, um, are educating, you know, the kids on being able to have that conversation like you just talked about with somebody or even if they went to their own parent to say, my friend is doing this. Do you feel like education is out there in school to to coach them through these things? I mean, I know like 1 in 5, there's 1 in 5 and mine and some other organizations and schools. But what do you what's your responses to that? Do you feel like it's there?
AMY FREDERICK:Well, I'll go first. I do feel like there's a definite shift. I think there's more of a focus on mental health. My daughter is 16 and she's a lot more sensitive than I am sensitive to other people and their feelings than I ever was at 16. I mean, I think the school I don't know all of it. She's a typical teenager. She doesn't tell me everything. But she does say that, you know, they've viewed the Kevin Hines, uh, before we had him. They have talked to other their counselors more involved than mine ever was. My counselor was more about your schedule than how you were feeling, but. And I'll I'll tell another story. When I was a teenager, I did have a classmate who took her own life. And I'm just curious. The school was exactly how you said was worried about the copycat, but I. And it was never mentioned. We never talked about it, but I can see if that happened today. A totally different shift. What would you tell a teenager whose friend has maybe taken their life and then comment on Connie's question about schools? Have you do you think schools are doing a better job?
DR. CUMMINGS:Yeah, I do think it has improved for sure. And I think some schools are better than others. We work with a lot of different schools, and some make a very strong intention to incorporate as much as they can into mental health awareness. And there's even, you know, some more recent requirements for school to provide some schools to provide some suicide prevention work. I know I recently got an email from my son's school saying, if you want to opt out of your child receiving this I'll serve as a lecturer. Then you need to let us know. Otherwise, we are providing this to all of the students. Um, which I think is important and probably it could have its own podcast on why someone may not want that, um, discussed. But, you know, and I know I personally have taken part in a middle school and high school education that is sort of required for other school systems on providing some of that. But again, it depends on that school system, on what all they do and include in that kind of teaching and training. Some schools will go so far to even have their own organizations, like if you've heard of the Hope squad before where they're doing specific things, we're empowering teens to be able to feel more comfortable navigating some of those situations before tragedy happens. Now, to speak to your point about how do we deal once something like this has happened? And again, I think that also varies from school system to school system. You know, hopefully there's sort of some immediate grief counseling availability for individuals, including teachers and staff and families who are involved in that community trying to rally around supports. It may also mean we dial up our awareness of, okay, does this now lead to a certain group that may also be at a higher risk for how they're feeling, because they were particularly close to that individual? And who do we need to support a little bit more with our services. Um, it may need to be. They bring in some additional people to work with them. It's. I'll also allow a lot of processing that needs to happen. If they're angry, let them feel angry and share how they're angry. If they're really sad, let them be sad and talk about how they're feeling because it can't just be. We don't want to address this because then that sort of something that sends a message like, oh, so if I have thoughts like that, I shouldn't talk about it because no one wants to hear. Instead of sending the message of if you are in a situation that's similar to this, we want to know because we want to help and we want to prevent another loss of life. You know, I think it's sort of making it less taboo to share some of our feelings and even some of the dark spaces that people can feel in so that we can see recovery happen, and so that we can see people do well instead of having them carry that burden secretly inside. And so that and and that may vary from teen to teen, right. Um, in terms of how they feel comfortable sharing your 16 year old and my 15 year old may be completely different on how they want to do that. But if we as parents let them know I'm here when you're ready to talk about it, and then even saying like, do you want me to respond? Or do you want me to just listen? Because sometimes we have a tendency and I'll speak for myself of wanting to problem solve, you know, hop in and say, well, what about this, this and and this and try to try to fix it. Sometimes that's not what's needed. Sometimes it's just I need to just say what all I'm thinking about. Um. And that might make me uncomfortable as a parent to hear some of those thoughts. And it may bring up emotions for me, for things in my past or all of my experiences that I've had. And so that will require me to regulate how I feel, so that they can continue to feel how they need to feel. And that takes a lot of work. It's not easy to do that and sit with some things that are really hard.
AMY FREDERICK:No, I agree. I'm a lot like you. I'm the parent who just wants to problem solve. Here's what you should do. I think that's a really good point. I don't think there are enough people listening. I think there are more people who are just trying to. And I I'm guilty of that just like anybody else. I just want to help and problem solve. And you think you're helping?
DR. CUMMINGS:Well, right. Because we feel like action is help, because we don't tend to think of listening as an action. But it's a really, really important action that a lot of people aren't good at Doing. Um, and sometimes our kids will really model us, you know what our behaviors are, how we handle something. So it is an opportunity for us to also share maybe if the child is being quiet, not saying much. It may be that you share a little bit about, you know, for me, I've had this experience in my life and just let them know, like, oh, okay. They do sort of know what I'm talking about. You know, they were my age once and those sorts of things. That's that's just being human. Um, for our, our teenagers. And it's already hard enough to be a teenager, but then to not know who you can talk to and share what your concerns are with. That's that's just an added layer.
AMY FREDERICK:I agree. Yeah.
CONNIE GAYLOR:Yeah. That's so good. Um, awareness for the parents is as important of of how to react and talk to your talk to your kids. I'm reminded of something and something that came up during our panel discussion that I feel like we just need to say is we talked about the presence of social media and the effect. But you made such a good comment that night because we all just think of all the negativity. And there is um, but you made a comment that some people don't have community right around them, but they can find it sometimes through social media. So some of these, you know, these groups, you know, we talked about the LGBTQ, um, maybe they're in in such a dark space because they have nobody around them, but they find that on social media. And so that's the one case where the social media may provide them support. And I only say that because I do want to to find some contrast that some things can be used for good or can can be positive, even though we think about them so much in the negative. And, you know, do you have any any thoughts on that that you'd want to just to just leave with, you know, with our listeners? Because the first thing I think people think is take away their phones, limit all of their access, you know, which would have a detrimental effect all on its own. If you tell a teenager you can't have no communications, but, you know, what are your thoughts about that? Um.
DR. CUMMINGS:It it's something that I don't get through a single day of work without talking about cell phone usage, which is interesting, right? I go to medical school and I learn all of these specific things, and that is not at all what someone wants to talk to me about. It's their concerns about cell phones. Um, and so it's important for us to look at all of the features involved with it. You know, there can be really good communication with people that are important in our lives that don't live near us via social media. It can be an expressive platform for some individuals. You know, they can make music or art in different ways and share it around, and that can make them feel really good about what they're doing. They can find some of these communities where they don't have it in the physical world around them. I unfortunately work with a lot of teenagers whose, you know, households don't accept them as an individual entirely, and so they are compelled to find like minded individuals and someone who will support them through social media. So those things are are protective and helpful and and good. Yes. We could talk about the detrimental effects for sure, but I think it's kind of a good representation of our world in general is that we kind of have to hold two things true at once. You know, something can be a little bit good and a little bit bad at the same time. And those both can be true. And we still have to then figure out for that individual, where does that scale fall? Because not for every kid or not for every adult for that matter. Their use of electronics is going to be detrimental. But for then someone else, it may be incredibly detrimental. And so it brings it all sort of back to the table of they're an individual and we need to do what's best for that individual's circumstance and utilizing what they have around them, what supports they may need to add in to help make them successful. And that might not look the same as the person next to them. But it's a it's it's such a great point to bring up because again, in general, we would rather be proactive on how we help someone instead of reactive. But I think a lot of the way our world works is in the reactionary mode instead of us starting in the beginning and say, you know, I want to help us work on this together, here's what I'm noticing. Let's lay some ground rules. Let's put together some boundaries on how we want to use this. And then that way when something comes up, it's not such a fight about how we're going to intervene because we already had laid, um, you know, some planted some seeds over here in the beginning, and it allows you then to fluctuate based on a person's circumstances at that time. And I think that's just what we what we need to do in general. You know, um, for for teens in particular, a, a lot of life is fluctuating. And we got to be able to be nimble with that to best help.
CONNIE GAYLOR:Yeah. That's good. That's a good word to be nimble, because sometimes as parents were so structured in how we're going to manage or discipline or whatever, and we have to learn to rethink that because it's not the same as it was for us. It's not what our parents did for us. It's a different generation. It's a different world that they're living in. And we have to be willing to, you know, to roll with that instead of being so stringent on how we handle things, you know.
DR. CUMMINGS:Well, and even the difference between one of my children to the other, it's different, right, for them. And so being you have to be able to accommodate that as well. Um, it's not one size fits all, which is sort of that gray area of psychiatry anyway. That can make people feel a little bit uncomfortable with it because it's not so clear. Like, here's the break, right here is what we're going to fix. And then there's that. Now it's fixed. There's often that a lot of nebulous gray area. Um, and it just points me back time and time again to we have to individualize care to what someone needs at that point in their life.
CONNIE GAYLOR:Well, we could keep going with this on and on. But I know that that you have things to do and you have work to get to. Um, is there anything that you would like to say that, that we haven't touched on that, that we really need to to make sure we include?
DR. CUMMINGS:I mean, I think I would just want to add, if people want to have additional trainings to help feel more confident if they find themselves in a conversation with a person or want to help intervene, they exist. There are a lot of local trainings that are out there. Some are virtual, some are in person. You've mentioned 1 in 5 before. They they have great resources. Nami is another one in our area that has a lot of great resources. So I would encourage people, if they want to have a bit of a class on it or learn more, they, they can um, also to remember nine, eight, eight from the Suicide Prevention Lifeline, similar to like A911 call. But this is really meant to help address mental health crises. Of course, you can still use 911 if that's the number you remember in that time to use. But nine eight, eight is there, and we'll connect you to a mental health professional 24 over seven. And that can help then guide you with next steps, um, as needed I think remembering that the help is around if you need it.
CONNIE GAYLOR:Would you mind sharing how somebody would reach out to Lindner?
DR. CUMMINGS:Oh, and 100%. So if you look on our website, you can see the list of services. Use chat that you can use through there. If someone wants to call in. Our number is 513536 hope H-o-p-e. Um so you can dial in and intake will connect you to different services that you may be interested in. Um, if you don't know which services you're interested in, that's okay. Someone can help you navigate that part as well. Um, but five, three. Six. Hope.
CONNIE GAYLOR:Awesome. Well, we thank you so much for coming in. Um, doctor Cummings, we we know this isn't the last conversation we're probably going to have. It'll probably extend into other things. You've been a great partner with the city on our mental health journey, and, and and we really value you. So thank you very much.
DR. CUMMINGS:Well, I appreciate it. This is important work that you're doing and you should be very proud.
CONNIE GAYLOR:Thank you.