Announcer:

The following program is a PBS Wisconsin Original Production.

Frederica Freyberg:

The plight of mental health in today’s youth continues to grow.

Reggie Lahti:

You can’t walk through a classroom without seeing someone who might be struggling.

Frederica Freyberg:

Whereby access to a gun during a mental health crisis means life or death and challenging the stigma of opioids.

Ryan Gorman:

The vast majority of our patients are gainfully employed. Family, lots of homeowners, renters, yeah. They’re not the person that most people picture.

Frederica Freyberg:

I’m Frederica Freyberg. Tonight on “Here & Now” we report on the state of student mental health and the resources left wanting. A psychiatrist weighs in on a bipartisan bill training gun sellers to identify a mental health crisis. And Fentanyl has shot opioid deaths to an all-time high, but interventions do work. It’s “Here & Now” for May 12.

Announcer:

Funding for “Here & Now” is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.

Frederica Freyberg:

Tonight, we discuss mental health and suicide. We wanted to let you know as we begin our program. First up, students today are coping with myriad different challenges than their parents and rates of depression and anxiety are on the rise. As part of our 2023 budget coverage, Steven Potter reports mental health support systems cannot keep pace with the growing needs that burden young people in this state.

Jocelyn Lepinski:

Our students are hurting right now in a way that I’ve never seen in my 15 years of education.

Reggie Lahti:

It’s prevalent everywhere. You can’t walk through a classroom without seeing someone who might be struggling.

Steven Potter:

Students today have many of the same challenges they’ve had for generations, keeping up with classwork, juggling things like sports, part-time jobs and friendships. But students today are also dealing with a new challenge, an increase in problems with their mental health. Experts say these problems are widespread and if left untreated, mental health problems can, and in many cases already do, have severe consequences.

Jess Frain:

We’re seeing a lot more struggles and this trend has been going on for a while now. We see a lot of increases in suicidal ideation as well as suicide attempts. So some really alarming stuff. And again, it’s been trending for a while, but seems to really be on an uptick lately.

Steven Potter:

While every student is unique and each faces their own challenges, many young people across the state said they struggle with similar mental health issues such as anxiety, isolation, and depression. A survey released last year by the State Department of Public Instruction, found that 52% of students reported having anxiety. 34% said they were sad or hopeless every day, 22% of students reported harming themselves and 25% of female students have seriously considered suicide.

Jess Frain:

There’s a lot of different research and studies looking into the root cause of what we’re seeing now in our youth mental health. Youth are dealing with a lot of things that us adults didn’t deal with when we were younger. Today’s youth have a lot more information coming at them at all the time, but it is still a lot, I think, for these young people who are still trying to kind of figure out how to manage their own emotions, how to process big information, with the pandemic in the middle of all this. That’s something that was pretty jarring. Being a youth during something like that, during a national trauma is going to really disrupt some of their own growth, their emotional growth, their brain development. And now we’re kind of seeing the aftereffects of that.

Steven Potter:

In addition to the pandemic, young people today are also navigating extreme political division and heavy use of social media as well as a fear of gun violence and economic uncertainty.

Jocelyn Lepinski:

A lot of what we see with our students is trying to find their place in the world, and I think that that’s hopelessness piece, it’s not the best place out there in the world, right? Between climate change and any of the fractious behavior we have between humans. It’s hard for them to look out at that and think like, yeah, I have a future.

Steven Potter:

17-year-old Ava in Winnebago County has dealt with mental health challenges for years.

Ava:

I always had a really bad anxiety and it started when I was really little with my mom and separation anxiety. And then it’s kind of spiraled in just a little bit of depression because when I feel like depression and anxiety you go hand in hand a lot. But I realized as I got older that it’s building up and it needs to be talked about. And I needed someone to help guide me.

Steven Potter:

Ava’s mental health struggles have also impacted her physical health.

Ava:

I have psychological non-epileptic seizures due to the traumatic event in my life and built-up anxiety and always being in fight, flight or freeze mode. So my body physically will freeze when I get super anxious.

Steven Potter:

Eva found counseling and help in an alternative high school program, but not all students in Wisconsin are able to get the therapy and support they need. According to data from the UW-Madison Population Health Institute, there’s an extreme lack of mental health providers in Wisconsin’s rural counties. Some of the worst areas in the state include Florence County, which has just one counselor for every 4,300 residents, Pepin County, which has just one mental health provider for every 7,300 residents. And at the bottom of the list is Buffalo County, which has just one mental health provider for every 13,000 residents. The American School Counselor Association recommends that there be one in-school counselor for every 250 students, but Wisconsin averages one counselor for every 378 students. As a school psychologist for more than 30 years, UW-La Crosse Professor Rob Dixon has seen this staffing shortage problem firsthand.

Rob Dixon:

When you’re dealing with a shortage of some of those important staff members and an increase in the number of mental health concerns, it kind of hits it both ways and that’s something that we’re trying to deal with.

Steven Potter:

UW-La Crosse has created an online program for teachers who want to become school psychologists. The program goal, Dixon says, is to attract educators in rural areas.

Rob Dixon:

So can we deliver something in a way that they can keep their jobs and keep their family and keep their roots in their community, but just add the skills. In some ways, give that school psychology away so that they can, they can use those tools and move forward and help the kids that they know in their community.

Steven Potter:

But mental health experts say students need a lot more help right now, and that means more state funding.

Tony Evers:

I’m declaring 2023 the year of mental health.

Steven Potter:

That was Governor Tony Evers back in January during his state of the state address. Since then, he’s laid out a plan that includes more than $250 million specifically set aside for student mental health initiatives. Republicans on the Joint Finance Committee, however, stripped all of it from the state budget.

Rachael Cabral-Guevara:

I’m very saddened that kids are struggling. When I think back to my time these are not things that I personally struggled with to the extent that I’m seeing that kids are struggling with today.

Steven Potter:

Republican Senator Rachael Cabral-Guevara is the vice chair of a Senate committee that addresses mental health and other issues facing children and families. She says she wants more financial support for student mental health issues.

Rachael Cabral-Guevara:

Funding for resources that are already established as well as resources that are available in the future, may that be in grant form, may that be in nonprofits, may that be for profits.

Steven Potter:

But the senator, who’s also a nurse practitioner, stopped short of saying how much funding.

Rachael Cabral-Guevara:

I don’t know if there’s an exact number, but I do believe and I do support the funding to adequately support these programs, so that people can get the help that they need.

Steven Potter:

Young people are turning to another place to get help with their mental health. Each other. At Merrill High School in northern Wisconsin there’s the Raise Your Voice Student Club.

Reggie Lahti:

The mission statement that goes behind Raise Your Voice is we are dedicated to breaking the stigma around mental health. So we do that through monthly meetings with our club members and a lot of activities out in the community.

Steven Potter:

This spring, the club members held a community walk to raise awareness and show support for those with mental health issues. Students like Reggie say they’re becoming more open with each other about their day-to-day mental health challenges.

Reggie Lahti:

I don’t have an issue sitting down and saying like, “I’m very anxious today and I’m having a hard time functioning.” And they will sit there and be like, “That’s okay.” And you know, not every day can be perfect and I can have these really insightful and mature conversations with my friends over how I’m feeling and vice versa, because we all have a general understanding that it’s something that happens and it’s not something that can just, puff, go away.

Steven Potter:

Students say supporting each other and breaking down the stigma around mental health struggles can make a big difference.

Reggie Lahti:

I think that it’s really important to also make our peers understand that this is occurring around you and here’s what you can do to help people. Because that is going to — what goes around comes around. It’s going to come back to you. People are going to help you if you’re down if you help others.

Steven Potter:

For “Here & Now,” I’m Steven Potter.

Frederica Freyberg:

If you are experiencing a mental health crisis, services are available by calling the state’s 988 crisis hotline. Suicides are the number one cause of death among adolescents and the number one way people die by suicide is firearms. As Marisa Wojcik reports, despite the attention mass shootings and homicides garner, suicide by guns far surpasses those.

Marisa Wojcik:

The latest round of mass shooting headlines in the United States has infused fear into the average person sending their kids to school, attending a concert or even going to get groceries. But while the prevalence of mass shootings has dramatically increased, it still remains only a fraction of the deaths caused by firearms. Overall gun-related deaths in the U.S. hit a record high in 2021, at 48,830 deaths. 42% were homicide. Mass shootings accounted for roughly 1.4% of all gun deaths in 2021. But suicide accounted for more than half of all people who died from a firearm at 54%. In Wisconsin, 678 people die from a gun in an average year. In 2020, 62% of firearm deaths in Wisconsin were suicide. And the rate of suicide by firearm in the most rural Wisconsin counties is two times higher than in the most urban counties.

Frederica Freyberg:

A bipartisan bill making its way through the legislature would provide $150,000 over the next two years toward a grant program supporting suicide prevention in gun shops. The grant money could go to train staff at retailers who sell guns or at gun ranges to recognize signs that someone is considering suicide, provide prevention materials, or provide voluntary firearm storage for the owner of the weapon. We turn to Dr. Tony Thrasher, president of the Wisconsin Psychiatric Association, for his take on this proposal, and thanks very much for being here.

Tony Thrasher:

Thank you for having me.

Frederica Freyberg:

So, what is your take on this proposal?

Tony Thrasher:

I think it’s an excellent first step. Gun violence in Wisconsin, as gun violence nationally, is a public health issue. And it’s worsening, and while most people think of gun violence and the focus is on externalized violence such as homicide or mass shootings, the majority of gun violence in most states now is suicide. So this is a really good first step in a public health sense. Kind of the community looking out for everybody and getting this information into an area where there are a lot of firearms and a lot of people looking to purchase firearms. And whether you’re reaching somebody who is suicidal or a family member of someone who may be suicidal, it’s a really nice intervention that hopefully will have significant impact.

Frederica Freyberg:

So, what would gun retailers be looking for to recognize in someone who might be considering suicide?

Tony Thrasher:

I think there’s a lot of good conversations that happen at any retail intersection and any sort of marketing and sales component. So, I think getting those frontline individuals to look for signs of depression, sadness, mood lability, anxiety even. Sometimes going so far as to look for specific warning signs about people talking about the end of their life or feeling helpless or hopeless might be a really nice intersection for people to intervene or at least talk to somebody and offer services.

Frederica Freyberg:

How would they respond to those signs?

Tony Thrasher:

I think that’s going to be a very interesting scenario, depending upon which group is doing it and in what part of the state you may be. Most counties have crisis service type of intervention, so it’d be a nice pairing to have is if somebody does one of these grants, making sure they know who their mobile crisis workers are. They could come talk to somebody and help them through this. A lot of periods of suicidal ideation are very powerful and very episodic. And so, there’s good evidence that if we can get somebody to somebody when they’re having their worst day, that you can make a big difference. And not just abort that suicide attempt but abort future suicide attempts.

Frederica Freyberg:

Why is that kind of point of contact with a gun retailer or a gun range important?

Tony Thrasher:

I think there’s two components to it. One is, I think, what probably seems most apparent, which is if somebody is feeling impulsively self-harmful, and they don’t have a firearm, that is most likely where they would obtain a firearm. But I think the even bigger picture is one of culture. I think whenever you kind of look at the issue around firearms, it’s naturally can be divisive. Even when we wish in a public health sense that it was not. And so, in this case, by kind of setting up at that shop, we are starting a cultural shift. That it’s okay to talk about being suicidal, and it’s okay to talk about being depressed, even if you are someone who owns firearms or has family members who own firearms. I think it’s a neat way to start breaking down some of that stigma and just opening up the conversation. Hence, why that may be a better cultural component than anything else.

Frederica Freyberg:

Do you think it’s likely that someone would actually voluntarily hand over their firearm if a retailer or another person said, “Look, you look like you’re having a little bit of trouble.”

Tony Thrasher:

I do, and I think we see this a lot in safety planning with people that have suicidal thoughts is they’re already doing this. They’re often sharing it with family members or friends or perhaps engaging in other good means reduction issues like gun locks or specific gun safes they don’t have access to, or the codes are changed whenever they’re having periods of depression. So, I do think having this as another alternative, particularly with a lot of people that kind of work with their firearms on a regular basis, and perhaps ex-military, ex-law enforcement, that relationship with the retailer may be a friendship one, as well. So, you may have some kind of ties in between family, friends. “Who would I feel safe leaving this with for the short term?” I do think there’s a lot of possibilities there.

Frederica Freyberg:

The Department of Health Services reports that the suicide rate in Wisconsin increased 32% from 2000 to 2020. Are suicides still on the rise?

Tony Thrasher:

Yes, scarily enough, the population it’s rising most in is our younger generation. Ages 15 to 24, it is now the number one cause of death, which, if you go back 10 to 15 years ago, seems very, very shocking compared to what it used to be when we focused on things like impaired driving and accidents. But unfortunately, suicides are on the rise, and given that firearms are unfortunately the most lethal way to do that, it makes sense if we’re going to look at reducing suicide, we look at addressing that primary cause, which is firearms.

Frederica Freyberg:

Are there areas of the state that are suffering more?

Tony Thrasher:

Unfortunately, we start to see a lot of suicides, more so in rural areas than urban areas. I’m not so sure that’s a causative, as much as a correlative, but those are definitely areas with less resources, or it’s harder to get to the resource. And so, unlike Madison or Milwaukee, where your therapist may live within a 5-minute drive, you’re talking about people that live in areas that may not get to those services without driving hundreds of miles. So, in addition to other risk factors in the rural area, particularly farming communities where we’ve seen a rise in suicides over the past two years as well.

Frederica Freyberg:

So, other than not having kind of the mental health supports, potentially, what else is driving those trends?

Tony Thrasher:

You tend to see in the rural communities not just like you said probably a lack of connection to services, but also, you’re in a much more isolated area. So, we know a lot of treatment for depression and mitigation against suicide is connectedness, community. And while there are wonderful communities, they can be more spread out the more rural you get. You also find a higher possession rate of firearms in that area, too. So, once again, something that is of high suicide risk is much more probably obtainable in some of those areas than in other sections that have lower suicide rates. Which once again, when people are having their worst days, what you want to do is have a safe environment around them. And the more firearms there are, the less safe it becomes.

Frederica Freyberg:

So, you have described this as kind of a good first step, and you think that other professionals like yourselves in and in public health think the same?

Tony Thrasher:

Yes, very much so. And I think the nice thing about the public health realm is twofold. One is we’re dealing with it as a community. This isn’t an issue where we say it’s your job, or it’s your job, or they should be doing more. If it’s a true public health problem, then we all get together to try to fix it in doing what we can from each of our specific specialties. And secondly, public health interventions have worked. Seat belts have worked. Catalytic converters in cars have worked. Putting child-proof tops on medicine bottles has worked. Public health interventions can mitigate large-scale kind of risks to our health. And I think this is no different. So, it’s nice that this is kind of a first step, but I hope we continue to enlarge it in a public health sense, as we look at gun violence really as probably the primary public health thing facing our society right now.

Frederica Freyberg:

And what would the next steps be in your mind?

Tony Thrasher:

It would be nice to see further consideration of education beyond retail gun shops. Really getting this out into the open. I think education is huge because there’s a lot of people that own firearms that themselves have never been suicidal. So, you don’t think about it as a risk, as opposed to saying there’s other people that are in your house. There’s other people in your orbit. There’s other people you’ll come into contact with. They may be feeling that way, and as such, we want to mitigate their risk too. And of course, another consideration down the road is many states have initiated some ways to remove firearms based upon other criteria, against people’s will, which this bill is not that. This is a volitional possible handing over firearms, but there are other things, such as emergency restraining protective orders, that have been seen in other states across the country that has either reduced suicide rates or sometimes reduce violence to others rates as well.

Frederica Freyberg:

All right, Dr. Thrasher, thanks very much.

Tony Thrasher:

Thank you for having me.

Frederica Freyberg:

In other difficult news, opioid overdose deaths are reaching all-time highs, with Fentanyl remaining the leading cause. But in a hopeful trend, harm reduction interventions have meant deaths have not doubled, as was feared without such efforts. Zac Schultz has more.

Zac Schultz:

Fire Station 31 in South Milwaukee isn’t used to respond to fire calls anymore, but the firefighters inside are still dealing with emergencies. Captain Dave Polachowski says this cabinet is where they store the HOPE Kits they distribute to opioid users.

Dave Polachowski:

We have a few things inside here. Most importantly for harm reduction we have Narcan inside of here.

Zac Schultz:

Polachowski runs the MORI program, the Milwaukee Overdose Reduction Initiative. They follow up every drug overdose call and attempt to provide help, but lately many overdoses have been fatal. On April 4th the fire department called a press conference to announce there have been 17 fatal ODs in just three days. But that was just the beginning.

Dave Polachowski:

That was a rough couple days. A lot of fatal overdoses. Like we said, the 17, which I think one of the oldest one being like 83 years old which is really unheard of. Right after that, I think, I believe we had another 17 within I think four to five days after that. So you had over 30 in about a week period which is just a horrific number for, you know, a city our size.

Zac Schultz:

Polachowski says there were more than 640 fatal overdoses last year and the number would’ve been higher if it weren’t for the harm reduction measures like free Narcan and Fentanyl testing strips.

Dave Polachowski:

Otherwise, I’m sure we would be well over a thousand here in the county. But that was a — that was a kick in a stomach. With all that we’re doing, when you see something like that happen in such a short time, it’s like, ah, you know, what are we doing here?

Zac Schultz:

What should we be doing differently? I mean, there’s an increase in the amount of assistance that’s out there. There’s the testing strips, there’s the Narcan, there’s programs like this and yet we’re still seeing this, this dramatic increase.

Dave Polachowski:

Yeah. I don’t know if I have an answer to that, to be honest.

Ryan Gorman:

It’s shocking, right?

Zac Schultz:

Ryan Gorman is an addiction counselor for Community Medical Services. He says the people in the drug using community don’t need a press conference to understand what’s happening.

Ryan Gorman:

They’re aware of it, I think, in a much more real sense than the rest of us are experiencing it.

Zac Schultz:

Gorman says drugs are being cut with other substances to increase their narcotic effect.

Ryan Gorman:

The supply is tainted and it’s not getting better. The prevalence of actual heroin is almost nonexistent from what we see. Urinalysis and just word on the street. It just doesn’t exist anymore. So the presence of fentanyl and then fentanyl being adulterated with even more complicating substances being added to that, I think, that’s the — that’s what’s responsible for the sharp increase in overdoses.

Zac Schultz:

The latest ingredient being added to drugs is xylazine, most commonly used as an animal tranquilizer. But since it’s not an opioid, Narcan won’t reverse its effects.

Dave Polachowski:

I think it’s very serious and a part that’s really scary about it is the fact that Narcan doesn’t work on it.

Zac Schultz:

But Gorman doesn’t want people to lose focus about what’s causing the fatalities.

Ryan Gorman:

And I really want to be explicit about it. It doesn’t present the same degree of danger as fentanyl. Fentanyl is still the thing that’s killing people en masse, right? It is a very, very dangerous drug.

Zac Schultz:

As the opioid epidemic grows, the way we handle the impact has to change as well. For Captain Polachowski, that means going to the user and offering them ways to be safer.

Dave Polachowski:

People call it enabling. We don’t look at it like that. We say it’s enabling you to stay alive until you are willing to get treatment. So while some people look at having Narcan out in the community is you’re just allowing people to use more drugs. Well, if the Narcan isn’t there, they’re going to potentially die and never get the help that they need.

Zac Schultz:

For Ryan Gorman, that means opening up this new medication assisted treatment center in Pewaukee where the waiting room contains a table for kids who are there with a parent.

Ryan Gorman:

The vast majority of our patients are gainfully employed, family, lots of homeowners, renters, yeah. They’re not the person that most people picture.

Zac Schultz:

How much of the social view of drug use and how to do harm reduction has changed as drug use has moved out of certain populations and are already stigmatized?

Dave Polachowski:

Yes.

Zac Schultz:

And become more known in suburbs, in wealthier areas among people who have more privilege.

Dave Polachowski:

Well, you know what, it’s funny. I mentioned that before. I’ve been everywhere in the county. In some areas where you just say, “Ah, you know, it doesn’t happen over [there.]” It absolutely happens there.

Ryan Gorman:

I think people attribute the rise in overdoses in the suburbs to there suddenly being opioids here, and that’s not my experience. Right? I grew up in the suburbs and they’re always — they’ve always been there. They’re just more dangerous.

Zac Schultz:

Reporting from Milwaukee, I’m Zac Schultz for “Here & Now.”

Frederica Freyberg:

And finally tonight, a Dane County judge said this week he will order the Wisconsin Elections Commission to abandon a previous decision they made dismissing a complaint over Wisconsin Republican false electors and ordering the commission to take that complaint back up again.

The complaint, filed by the liberal group, Law Forward, was about the 2020 slate of fake Wisconsin GOP electoral ballots cast for Donald Trump. In a closed meeting last year, the WEC unanimously rejected the complaint. That was after the Wisconsin Department of Justice decided with the Republican electors’ argument that their actions were a precaution while Trump’s challenges to the election were still moving through the courts. The WEC must take up the complaint again, except without Commissioner Bob Spindell, who acted as one of the false electors, but refused to recuse himself from the Commission’s vote on the complaint.

For more on this and other issues facing Wisconsin, visit our website at PBSwisconsin.org, and then click on the News tab. That’s our program for tonight. I’m Frederica Freyberg. Have a good weekend.

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Funding for “Here & Now” is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.