Community Services - Regular Meeting

Okay, so it should start that recording.

Make it big.

Seven people entered the waiting room.

Let's go ahead and view them, but I don't know why we're not in video. Do not let... Melanie is good. Stephanie is good. Matthew's good. Barbara. We don't know who white is, but there is a Rebecca white, and that might be fair to... Everyone looks allowable. Is everybody in? Almost, but somehow our video isn't working, even though video was on.

Oh, okay.

Is this your first?

Yeah. I just opened the camera up here, and it's giving a blurry video at least.

Okay, but at least we're on. Can you tell them? I'm just going to start in a minute.

Okay.

Let me admit just a few more people.

Matthew, Rebecca, Crystal, and more. And Susan, just email me.

Hi, I just want to welcome everybody who's joining online. We'll get started soon. Yes, absolutely.

Anyone who hasn't gotten there, a bunch of handouts on the back, just health council business kind of stuff.

Okay.

Health Council, I'm trying to make it... How come we're fuzzy?

I don't know. Because we have a nice 70s vibe going. It's like nice...

Exactly. I was trying to make it...

you know, grid view. We could see everybody.

And there's some handouts on the table back there. We're just getting started here.

Yes! There you go.

There's Barbara.

Hey. Hi, guys. You guys are in a cloud. Are we fuzzy to you? Very. You're like in a cloud.

Could I jump in there?

I can see you. It's just, it's just like, you've got a thing on it.

It is an angelic aura. I feel like I look very seventies, like, you know, very seventies music video.

Okay. Well, I know we're having fun, but we should get. Pack the whip here. It's 1204.

Could somebody online speak?

Barbara.

Hi, Barbara. Hi.

No, we're still not on the room speakers. Can't hear them.

Give us one sec. We're having our usual technical.

Okay. Now, Barbara, say hi again.

Hi, it's Barbara.

Okay. One more time, Barbara, because that was so loud. That was on our end, not because of you alone.

This is Barbara.

Perfect.

Okay. Okay. Hi, welcome to the health council meeting. We're going to get started. Um, Thank you, everybody, for being here. I'm Lisa Hampton, chair. This is Jessica Strung, our staff liaison, wonderful social services director. Okay, let's take the roll real quick. I'm here. Marna Rito, Councillor Rito. Councillor Frears.

Here.

Councillor Granville. Here. Councillor Hemmes.

Here.

Councillor Ibanez.

Here.

Councilor Jones, are you online yet? Okay. Councilor McCleary, I do see you.

Here.

Okay. Councilor Muck? I see you. Are you here, Councilor Muck? Yes, I'm here. Here she is. Thank you. Councilor Phelps?

Here.

Councilor Richens?

Yes.

And counselor white. I see, I see your video. As this Rebecca, I'm sure it's Rebecca and then council Williams. She said she was going to zoom in. So we're one short right now. So I think we have a quorum. So we'll call the meeting to order. Hi, Councillor Williams. Okay, we'll call the meeting to order. Looks like everybody is here. Thank you, guys. This is exciting. Councillor Jones, he'll probably hopefully jump on. Yeah, jump on in a minute. And County Councillor Hand is here. Thank you, our County Council liaison. I can't hear you or see your name. I saw you in the comments. Yes.

I can see your name up there.

Can you hear us, Counselor Han? So we're going to just try to go around the room real quick and introduce everybody. Actually, let me start online. So Stephanie and Crystal Artuleta. And this is Crystal...

Different crystal. Other crystal. She's on two devices.

Let's see. So, Crystal, could you introduce yourself, Crystal, without the last name showing up? I believe that would be me. Are you logged in twice? There's another crystal. I just got on this leak. Okay, we'll go ahead and introduce yourself, please.

Okay, Crystal Archuleta, Health Promotion Specialist for Northeast Region.

Thank you. Stephanie, could you introduce yourself, please? Hello, everyone.

This is Stephanie Gonzalez. I'm the Northeast Region SHIP Under Aging and Disability Resource Center. We help folks navigate Medicare and Medicaid. I turned on my camera, but I look like a ghost.

It's okay. I do that sometimes too. Okay, and who else? Jeremy from the DOH. Could you introduce yourself, please?

Sure. Hello, everyone. Jeremy Espinosa. I'm the Northeast Region Community Epidemiologist with the DOH and the Northeast Region Health Promotion Team.

Thank you so much. We appreciate you coming to our meeting. Now I'm going to have our guests introduce themselves.

Let's start with Jen.

Can you guys see our room or no? Yes, you can. Is there a view where they can see the room?

I don't know that we can't see what they see.

Really?

But the camera should all be picking them up.

Okay. So as long as you can see us. Huh?

Yeah.

Okay.

So it should pick that up.

Okay. All righty. Kelly?

Kelly Gerson. I'm a fellow finance manager with Bosal Community Foundation.

Welcome. Thank you.

I'm Allison Watkins, the Executive Director of the Los Alamos Community Foundation.

And I'm Donna Milanovic. I'm the Executive Director of United Way. I'm also here because we are going to be launching in October of 2-1-1, strengthening that system, that resource system. I wanted to learn all I can learn as quickly as possible.

And we'll get back to you to collaborate on that in October. That sounds great. October is our Domestic Violence Awareness Month as well. Okay. Thank you, guys. I appreciate it. And I saw that Tyler just joined us. And this is... No problem. We have a total. Everybody's here. It's amazing. Thank you, Tyler. Valentina White, could you introduce yourself, please?

Good afternoon. Valentina White with Northeast Region Department of Health Health Promotion Program.

Thank you. We have a couple of whites that we have Rebecca White on our health council. So that's why I was confused. Thank you so much. I did. I miss anybody. Okay, so I guess we'll go to approval of the agenda. Does anybody have any changes or suggestions for the agenda? Are we good with that? Okay, and now we'll take public comment for items not on the agenda. If anybody has public comment. I don't think we really have any members of the public here right now. Do you want to? We can do that. The health council, but I did just take roles.

Yeah.

Yeah. Okay. And then approval of the minutes, Jessica sent out the meeting minutes. And so does anybody have any corrections to that from August? Okay, we'll go ahead and approve the meeting minutes unanimously. And now I'm going to hand it over to Jamie Albach, who is our Los Alamos County Outreach Specialist. And she is going to do some of the ABC suicide prevention training. I believe this takes about...

an hour okay and so i'm going to hand it over to her and then we'll do business after that do you have any comments before no you need me to forward anything from this to share yeah and if you i'm still sitting and progress the slides i've never kept seated yeah i was gonna say you need to forward them so that you can yeah that would be great and then i was gonna say donna do you wanna can you see okay

Or do you want to?

Why don't you go by Stacy if you don't mind? Yeah. Do you want to scoot over a little bit?

I'll scoot that way if somebody.

Jamie's going to be in there.

Jamie's going to stand over there. So here's the thing that was happening earlier that I mentioned you might need to contact IT for. It's something about logging in on a computer that's not a county computer.

This is a county computer.

If you're an auditory learner, welcome safely to there. If you're uncomfortable turning your neck, you can look down your ceiling.

And we do have an extra chair, because Jamie, if anyone wants to just come a bit higher.

I know you love me.

Why don't you sit here so you can, unless you want to sit next to Kelly. I wasn't sure if Jamie was going to sit in front of the computer, but she's. After being in elementary school. I like to move around while I teach. So just a question. Can everybody online see and hear Jamie?

Yes. Perfect.

Can anybody else online give me a thumbs up emoji if you can see and hear me? It's a little hard to hear.

Can you speak up?

Yes, I can speak up. For those of you who are in the room, the voice projection may feel like a lot at first, but it's good if anybody is hearing impaired and it's good for the folks online. No, you're good. Do you have a microphone that I should have brought? But I was actually anticipating a smaller truth. So thank you all for being here. I really appreciate it. So while we're getting our slide hiccup mended, I'll say that I'm Jamie Aulbach. I have lived in New Mexico since 2017. I was originally, career-wise, a classroom teacher. and taught elementary school for close to a decade. And then I was an elementary librarian for a little while. That's what my master's degree is in, is in library science. And my brother laughs and laughs at that and says, well, how often can you use the Dewey Decimal System every day? It wasn't just that. It was a lot about research. combing through information to see what is reputable and relevant. And it surprisingly has come in handy so much because I have been Jill of all trades in kind of the nonprofit world for a long time, with my biggest concentration being on the prevention of intimate partner violence. And then I connected with social services. I still work part-time with a specific focus on healing sexual trauma and domestic violence. And so you may see me around the county not in this role with this hat on, or you may see me at Family Strengths Network as a part of social services. As I'm wearing my t-shirts that say social services, I'm definitely working for social services.

Okay, I'm going to get you back to that.

One day I was actually taking a bunch of frozen meat to a local food pantry who had connected with a woman who needed some specific food types and they were asking for proteins. And I reached out to them and went to drop off some frozen meat that they could get to the woman. But I was wearing my t-shirt and... going like this. This is not social services. This is just me as an individual and covering up.

Yes.

Yeah, yeah. So we have professional help. Yeah. I ran to grab health.

That's beyond my diagnosis. Oh.

The ABC Suicide Prevention Plus was developed by Marvel Harrison. And she once was a resident of this community, now is working at San Francisco.

Nope.

And ABC Suicide Prevention, sometimes people say, oh, are you doing QPR? Are you doing this program? ABC was kind of, Created as a one hour, not a deep dive, a one hour.

It's the ABC deck, right?

It's the one that has the PowerPoint icon. There's one that's like a fact sheet that also says that. Yeah. But it was developed because suicide was a big problem in our community. So that third one down.

Third one down.

And it's not the whole conversation. I actually had a community member reach out to me and say, I can't believe you're doing that. And at first I was like, ouch, it's like 8 PM. I'm trying to get my kids off and you're slipping into my Facebook DMs. Tell me I'm doing something wrong. And I bristled. I was a little like, but luckily not because of the way I was raised, but I've been trained to approach criticism with curiosity. And the more I integrate that into life, the better the outcomes for me personally and professionally. I said, oh, tell me more. And this was a person who was in the work with all of us. They are very much a part of our community. And they said, you know, ABC and Mental Health First Aid, they all just feel like something to make us feel better. They feel like we put a checkmark, we care about suicide, and then we move on. And is it actually given the madness of hygiene? I think that that is a fair question. I think that I don't have data to say that ABC prevents this many suicides a year. I don't have data to say that Mental Health First Aid, which I'm also teaching later this week, which is a deeper dive, prevents suicides in Los Alamos with this success rate. But what I can say is this starts the conversation. It is not the whole conversation. Mental health first aid gets more into the conversation, but again, it's not the whole conversation. So if you want to have an extended conversation as a health counsel and you would like me to be present and share what I'm hearing from the community, I would love that. But we'll get started with this one because this is where we're going to begin. All right. A lot of you in the room are experts. I am not an expert in suicide prevention, but I am growing my knowledge in that area. I always invite you, if I say something that sounds different than what you've interpreted in the past, please join in the conversation and make it richer. Well, I let them in. Let me just make sure nobody else can. Oh, but I thought so. We'll just dive in with that introduction. This is like, we won't do this in an hour. I'm impressed. All right. So you will receive your partner certification. That doesn't mean that you can go train other people in this class, but it means you're a partner in this work. And I appreciate you being that for so many people. All right. The most important thing. The most, if you walk away with nothing else, suicide is permissible. One time I was meeting with about redoing.

I can't do anything.

Have you heard of your new job that people have called preventionists? And I said, he was like, that doesn't, that's not real. I was like, yeah, it is real. There are a lot of things in our community that are preventable and suicide is one of those. So please know that deeply.

Do you want me to put all of them up?

Yeah. You're here to be a part of that prevention effort. And that's really the only way prevention works is when we make cultural shifts. It's not like, yes, one person can make a difference. I know that all of you have felt that. You've all made a difference at some point. But really, when we shift cultures, that's when we're going to see the greatest impact. And everyone can learn the ABCs, which is why I do like this program. Even if it's not the whole answer, I love how simple it is to learn this. Okay. How many of you have ever gotten mad at the words?

When I was postpartum, no sleep.

Not enough support. When I moved here with a four-month-old and had no family, no friends, every time somebody would be like, please, I have to probably have self-care. I wanted to just shoot them double words. Like, it's so awful to put the protection of oneself on the individual. We really, as a community, have to do community care. Yeah. It's not about one person has to take on caring for themselves all the time. And yet, as much as that's true, I'm taking time off to go to Bahamas next week for self-care. I'm very fortunate that I have the resources to do that, to take time off work, to pay for an Airbnb, which is one of those, it's expensive, but will eventually be paid off. Not everybody has those same resources. And when you're under-resourced, as I have been at times, self-care becomes even harder. I'm very thankful for Family Strengths Network. I'm very thankful for our senior centers and the places that provide opportunities for people to practice self-care without having to gather the resources, schedule the time. It's built in. So today we're going to talk about some heavy things. Most people I know have been touched by suicides. whether it was a loved one, whether you've thought about suicide. That's actually some of the feedback I got from one of the community members. She said, I hate it when everybody in the room talks about suicide like it's, oh, we're going to help those people who have thought about it. And there's no acknowledgement that people in the rooms have considered suicide. And so I just want to be clear that what we're talking about today has probably impacted you on some level, especially those of you who have lived in Los Alamos for a long time. You're very aware of suicides that have happened. And so just please do take care of each other and take care of yourselves as you move through your day, even though this is a long hour and it's not a deep dive. I just want to emphasize you may need time after this to Just maybe give yourself some love or seek some love somewhere else. Right. Proving right along. We'll just keep cruising. We'll just keep cruising.

We'll just keep cruising.

We'll just keep cruising. We'll just keep cruising. We'll just keep cruising.

Sorry, I was trying to get the little, trying to minimize the people so that we could see both sides.

Recently. Recently. I was trying to talk about someone in my life. And I knew I wasn't supposed to say committed suicide, but not think of how to phrase it. Why are we shifting away from saying committed?

Sounds like it's crying. Yeah.

Yeah. Yeah. Suicide's pathologized, and this is probably the most uncomfortable part, but suicide often is a very normal response to very abnormal circumstances. It's a very normal response to boundaries being pushed and pushed and pushed for years. to where somebody feels like they have to set the ultimate boundary where no one else, no pain, no person can have control over their life anymore. And when we think about it that way, it's hard to pathologize it. It becomes something that we can compassionately understand, even if we're determined to prevent it. And so I think when we use words like committed, that sounds like committed a crime. I also think about, you know, saying in the past, oh, he was committed into the psychiatric ward. You know, it doesn't, it just has a lot of negative connotation. And so we have transitioned from committed suicide and we're trying to make sure that we use blood.

Oh, sorry. I hit, I hit it.

Sorry. I was trying to read your mind the other way.

Heather keeps stressing out by getting back.

That's like, you know, my daughter recently was like, it's open book, open note. I was like, Yes, absolutely.

Jamie, do the teens use different, I've seen teenagers use different things like unalived or I don't know, there's different words that teens use sometimes when they're trying to say the same thing.

So a lot of social media will not show content if they use the word suicide. So people on some media platforms started to say suicide.

What was it? The unalive or? Yeah.

Unalived. Unalived, right? Yeah.

Oh, yeah. Okay.

And so because it was being used across a lot of social media content, TikTok videos, that language has become more common outside of sacred media. It has shifted to where some people are saying unalive, but originally it The roots of that were so that people's content would get banned. Yeah. Educational. Yeah. Even if it was something like an ABC video. Right. All right. Let's bring up the next one.

And I won't click the answer. You're on your own for the, you've got to guess the next one.

doing it. Absolutely.

You're like, he was threatened. She threatened him. And did not say it with bad intentions, but what is potentially the impact of using the word threat?

It also sounds like it's manipulable. They're just saying.

Yes. It could be an empty threat. It could be what? Manipulate.

Yes. Like a punishment, like you're being threatened with a punishment.

It makes the discussion about suicide. Yes. And so rather than threat, I've really worked to shift my language to does anybody know what we say when someone shares something they just discussed or disclosed? Yes. So, but this does, I always try to pause for just a second whenever somebody brings up the word manipulation. Because this is such a yes and thing. Yes, we want to take suicide disclosures or thoughts of suicide disclosures very seriously. We do not want to averse them like they're MD therapies. And if it is your romantic partner and they are saying, if you break up with me, if you leave me, I will kill myself. That is manipulation. And that should not be addressed as you stepping in as the ABC partner to prevent their suicide. It is very common in domestic violence, even dating violence amongst teens for someone to... Is that her again? express. And sometimes it's coming from a place of heartache, but when someone says, if you leave me, I will kill myself. It has really shifted into a form of control and not something that someone should then be like, oh, it's okay. I'm ABC certified. I'm here to help them. You know, if you're not the romantic partner, if you're somebody outside of the relationship, then maybe you will step in. It's the same person. Sorry. You know, somebody raises. Oh, that kind of sounds like the same thing. Okay. So she's just having internet. It is a different training. And then I think there's one more thing to share after disclosed.

Oh, yeah.

That's terrible. Yeah. Right.

And unsuccessful sounds like also like you wanted it to happen and it didn't work. Yeah. Like, yeah.

You're a high-achieving panel. You've succeeded. Yeah.

Yeah.

And we want people to hear anyone talk.

The origin story for that working, you know, like how did that become what was used for so long? but we're not going to use successful or unsuccessful. And especially, I would just hate to use that phrasing in front of someone who has lost a lot. Like that just feels so disrespectful that that feels like, I had a teacher in Milwaukee say, you're just really woke, aren't you? Oh my gosh. And I said, what do you mean by woke? And he was talking about, you know, what it meant. And I said, you know, I just want to use whatever language makes people feel safe. And if I can change my language to make somebody feel safe, then I usually do it. And it's not a part of like making sure that I next county council meeting have all the right words or making sure that, and I don't always get it right. But if I know words I'm using make people feel really unsafe, then that's just not a match for who I am with or without my role at social services. So instead of successful or unsuccessful, we're just going to say death by suicide. Is that still an okay word to use?

What do you think? What did you say? So it's not like unsuccessful. Right? Because that's the death by suicide. But what if they tried, what if they didn't die?

Would that still be under-attempted? I've wondered that same thing. And as far as I have read or learned through trainings, attempted is still used because it really isn't conveying like a positive or a negative. Right. That's what I learned. But if any of you all know a different phrasing that's more I think I've tried and attended as sentiments, but I also can understand why maybe tried would be, uh, less about like saying that success or.

Okay.

All right. Continuing with our words that matter. And now we're shifting away from words just about suicide, and we're talking about words related to mental health. Now, it's important to know that not every person who struggles with mental health is going to attempt or try to die by suicide. It's very important to note. But we do connect mental health to suicide prevention because mental health care is suicide prevention. What else is suicide prevention? Just real quick. What else is suicide prevention?

Soapbox. Affordable housing.

Affordable housing.

Free and affordable health care.

Free and affordable health care. Social connection. Social connection. Food security. Food security. Child care.

Safe relationships.

Safe relationships. Job security. Support with pain management. A lot of our folks who end up dying by suicide have been in physical anguish for a long time.

Feeling validated and feeling that you matter.

Yes. Okay. Good.

You're good.

All right. So I have really had to work on this. Don't read those.

You guys, the computer is so wonky.

I'm so sorry. So why have I, and maybe not you, maybe not all the time, but why have I stopped saying the letter is crazy? For someone who has a mental health diagnosis or is like crazy or insane, carry a lot of stigma and, or could have been thrown at them and it's an insult.

Yes. Yes. Yes. Sometimes the diagnosis into a negative, like you can say, oh, she's just acting all bipolar. Like it's a, not a diagnosis, not your medical thing. It's like, it's a descriptor.

Yes.

And if you can also label that issue. Yeah.

I had to make my mother stop calling my youngest a psycho.

Yes.

I was like, that's not a good name.

Make another one. My youngest was listening to this moody song that was based off of Roblox that was like, I'm a psycho. And I was like, I don't know. I don't want you to carry that language and start using that as a descriptor for people when, you know, we know people love people who experience psychosis. And children will label them. yeah that's true so you can say whether it's unpredictable the other thing i have to attribute this to somebody years ago that no longer lives in this community they've told me bananas you said anytime you have the urge to say crazy yep say bananas and it works yeah yeah we're wild yeah yeah and so if you hear me say bananas It's been a part of all of this. Yes. Oh, my goodness. And then. Yes, this is as you were saying, Marna. My relative is schizophrenic. Oh, well, this is low. I thought this was like when you're like, oh, you're OCD.

Yeah, I hate that because I have OCD. Yeah.

Yeah. Or bipolar or someone used to work with me and was like, co-workers just like such an ADHD puppy. Yeah.

Are you a psychologist? Right. Diagnose them with this.

Yeah. And still like using it to insult or using it to yell out behavior that someone doesn't appreciate. It's just really. Yeah. And so, um, I mean, this is a little different because this is saying my relative is schizophrenic.

Um, let's see what the, someone identified as opposed to that.

Yeah.

Yeah. I would even say has been diagnosed with, because if you say has, it's like, well, who said they have? I mean, was it a professional medical profession?

So I see the shift here. Has schizophrenia rather than is schizophrenic. So I was going off on a different train of thought, but I also see it as a relevant tangent.

Now,

There's this whole person first language movement that a lot of people are way into and I support it. There's also some advocates within different communities who don't want person first language. So for example, I'll use the one I use frequently. My partner, Ryan, who works with Jen is disabled. So I could say, I can put person first and say my partner, Ryan, has a physical disability right but brian will often say i'm disabled i can't separate that from who i am i don't want you to say i have a disability like tomorrow i could not have it That is my lived experience. He said, I don't want you to say I am a man who has blackness.

I am a black man. He has blackness.

My partner has blackness.

You know, and I also understand that.

So generally, and you know, you do whatever is right for your community, your profession. A lot of this, you just have to very observant where you fit into different spaces. But generally, if I don't know that a person prefers that identity-first language, then I will say she has or he has. But then if I know the person well enough to know that they want to be called a Black disabled man or a disabled person, then I will go like that. Like I said, we should all, you know, just like them. If I call myself an Appalachian, I'll be like, thumbs up. Exactly.

Is that kind of like the homeless versus unhoused person or enslaved person versus a slave? Yeah.

I think that you bring up a really good and relevant one with homeless, unhoused, and a lot of times, it's like when my dad goes home and he's like, and a lot of Native people, right? And he's like, what am I supposed to call them?

I'm like, what are you calling my Native friends?

He's like, no, no, no, what am I supposed to call Native, like, is Native okay? Do I need to say American Indian? Do I need to, I'm like, who are you trying to talk to? And I'm like, because if you're talking about the people who live close to you, it's probably somebody who's Cherokee, so say Cherokee. I said, here, I wouldn't say Cherokee, you know. And he's like, well, just in general, I'm like, how often are you like, and he's like, you know what I want. And I do know what he wants. And I'm kind of like messing with them a little bit because he's, the intention is good, but I keep saying to him, you have to just be a survivor evil. And whatever people call themselves, that's how you call them. And there are homeless people in our community who call themselves homeless. And there are also times where I might be in a situation where I would say a person who is unhoused. And I also might say temporarily unhoused. And so it's really about being observant of what people want and trying to respect that as much as possible. And then if you mess up, you say it's married and you want it. And don't make a big deal out of it. Sometimes that All right, what's next? We chose to kill themselves. I know that this one kind of conveys power, and we do want people to have and hold power, but why would we maybe not use this particular phrase? Yeah, it's not like most people who died by suicide have a bevy of choices laid out in front of them and that's what they most of the notes that I've read that have been left by people explicitly state I no longer feel like I have a choice and so it's really important that we again respect how people are naming things instead of us if we are not in it naming it for them and so instead we can use died from a self-inflicted injury. Again, this particular phrasing is not going to be applicable in every situation or every community, but it's an option that I'd like for you to have in your toolbox.

One more. So I have a question about self-inflicted injuries. Perhaps sometimes a person doesn't intend to actually kill themselves, take their lives, but maybe it's a cry for help.

Can you discuss that for me? Yes. So I have a dear friend who once was hospitalized for what they thought was a suicide attempt. But it was really self-harm. My friend was somebody who had been self-inflicting cuts for years. And there are harm reduction classes for people who do cut themselves on their legs, arms, wherever, of how to avoid the major arteries, the most dangerous areas. But that was not a class she had ever been offered or had ever taken. And she cut herself in an area and lost too much blood too fast and was hospitalized, like you said, for what was perceived as a suicide attempt. And really it wasn't even like a cry for help in the sense that we usually think of because it was something that was very private. It was not something she shared with people that was a part of her coping. And self-injury is super common amongst people who have gone through certain types of trauma. And so that does happen. Your wording may be very dependent on the situation. Died from a self-inflicted injury might be applicable if my friend had lost her life at that point because it was a self-inflicted injury. But I also think it's a way of not necessarily determining something's a suicide and stating it was a suicide if we're not certain. Which, because she had had a history of over a decade of self-inflicting wounds, we might know that it was uncertain whether or not she was trying to wound herself in a way that would result in death. All right. I'm going to say I probably don't like either of these. And I remember correctly. But yeah, definitely don't go, what is wrong with me?

Why would you do that?

I don't blend with them. I don't know everyone. I'm the odd person out here. What would you say are the positives of saying, what happened? What triggered this for you?

When did you first begin to think about the citizens at all, the ideations? I like to find the beginning. Mm-hmm. I like it because it gets to the root of what the trauma is and it's rather saying what's wrong with you and actually asking what happened to Dr. Perry. I have a whole book in regards to that.

Yeah. Well, it invites them to tell their story without judging like wrong or right, but it also means that happened to you as if, you know, ignoring that there might be a rather systems or other.

Yeah.

Good job, William, honestly.

Yeah, not in the positive way. Are we ready for the negative? I just, I hear parents like, what happened to you? In an accusatory way, not in a loving, you know. So I feel like because of that, to me, it's ambiguous.

It's blaming.

And it depends on how, you know, who you're talking to, because how well do you know them? Right?

Yes. Okay, so we're getting into all the good pieces here. So what's wrong with you? We can pretty much say we're going to toss that one because this puts all of the blame on the individual. It's something inside them that is deeply wrong. They need to accept responsibility and accountability for whatever is wrong with them. This one, I'm sure, can be used very lovingly and very well. And culturally, this is not a match for me. Culturally, it may not be a match for some of you. What happened to you, I do see the positives of it saying, like, something has been going on. Right? You didn't get into this moment of crisis without there being probably years of struggle, trauma, injustice, discrimination. And... I don't know. This is a cultural mismatch for me. But it may not be for you. And if you know the person well, you may know whether or not to use this phrase.

I also think with what happened to you, you are saying that something happened. And with mental illness, sometimes there's... My family was great. I grew up with a family where everything was... And there's not necessarily trauma that has to be there to have these feelings. And so assuming that something bad happened to someone is making an assumption that that is what led them to the place that they're at when...

it doesn't necessarily have to be you know anything more than an emotional trigger that isn't caused by a cause and effect relationship yes i absolutely i'm glad that you brought that forward um because it does imply like oh for you to turn out like this they're not so about something really you know um which can also be part of the gear in a moment of needing someone to listen I've just never heard this phrase without it being followed by, you used to be. But again, I'm not from, so.

Can I ask you a quick question? On the third one there, I've seen in recent obituaries in this community where you knew the person died from suicide, but they typically will say so-and-so died from a battle with mental illness and you infer, because you know, is that something you could, like you would say so-and-so died from cancer, right? Instead of died from a self-inflicted injury. Like, have you been seeing that too?

I see a lot of phrasing, whether somebody has died by suicide, has died of a long-term illness. People phrase obituaries often in whatever feels comfortable for that family. And I really respect that every family gets to choose how they share the news of a death. So obituaries aren't a great place to collect data. I would say obituaries, I'm fine with them using whatever language feels best for them. With you all, I invite you to use the word suicide more often to destigmatize and to make sure that we're putting language out there that shows we're not afraid to talk.

Okay.

We'll load them. Sorry.

It's like a filler screen probably for my like jumpy finger.

Yeah. Okay. Risk factors. Now, as woke as that teacher in Milwaukee thought I was, I am also not super judgmental if you say the wrong thing. So I don't want you to feel like I better not say poverty because I don't want, I want you to share what you've heard the risk factors are and then we'll kind of go through them and you can see like we can bust up some myths that are really common or we can confirm that there are certain risk factors.

So what do you think the risk factors are?

Sorry.

Isolation. Isolation. Bullying. Yes. Mental health concerns. Traumatic events. Reading too much of the newspaper.

Feeling like the way...

like reading or doing school language or things that people do but it's the world around them it's existential because it's economic it's financial it's the environment it's it's All of it.

It is normal to feel fear about the world. That is not an abnormal response to what we see.

Availability of a weapon.

Availability of a weapon, yeah.

Health crisis.

Health crisis. Family separation. Family separation, which ties in with isolation. Lack of support systems anywhere.

Including family.

That's interesting.

Do we have any isolation in Los Alamos? That's my whole family.

My whole family is in Ohio.

Yeah.

All of their children have moved, right?

And then people...

And a lot of us have moved here away from our families that are across the country to be in a remote mountain town.

Mental counselors, 12-step programs, meetings.

You are so educated. What I will ask you to do is zoom in to Los Alamos. Because that's where we're at right now. You may not all reside here, but that's where we're in this moment. And since this is a Los Alamos Health Council, let's zoom in. And as we go through the risk factors, just if you feel comfortable, you can always pass. If you feel comfortable, give me a thumbs up if you feel like it applies to Los Alamos and a thumbs down if you feel like it's not really what is most predominant in our area. Let's go. Previous suicide attempt. Okay, mixed thumbs. History of depression or mental illness. Serious illness such as chronic pain. Criminal or legal problems.

Especially in this small town where everybody didn't know about it.

Yeah. Job loss. Serious financial problems. Impulsive or aggressive tendencies. Substance use. Current or prior history of ACEs. If you're unfamiliar with ACEs, think of them as the adverse childhood experiences, so childhood traumas.

And a sense of hopelessness. I think that's really true in the teens. They feel trapped. Okay.

And then we'll pause before we go into relationship risk factors. So I saw a lot of thumbs ups, but it's funny when I came here in October of 2017 and I went to eat at Pajarito Groom Hub, I was sitting there and I overheard one of the servers telling the other table Los Alamos is a bubble of just like well-being. We don't have the problems that New Mexico has. It's like utopia here. It's just you'll never want to leave now that you're here. The part I didn't like was they said it's like 1950s. I think these were great for everybody. So why is it that the server at Poverito Group Hub, probably doesn't work there anymore, but said, Los Alamos is so perfect, but when we went through those risk factors, you all were thumbs up, thumbs down, thumbs up.

Because from the outside looking in, we are. We have more queue clearances and more security and safety. Your prime rates are lower here than the rest of the state. Poverty is lower here than the rest of the state. Though, I've been talking to a lot of people, that gap is diminishing. Pensions are no longer a thing. Housing rates have skyrocketed. So that gap that used to hold Los Alamos in that bubble is shrinking. Our bubble is thinning. And there are a lot of seniors that have a paycheck to paycheck. It's the one person living at the last. I mean, I talked to Karen Les, Los Alamos. I was talking to her about what she paid for her house when she moved here, how her husband has a full pension. And when I told her that I paid a half a million dollars for my piece of duty house that needs so much remodeling, she was shocked because she lives in a, she was selling a house that she then sold for over a million dollars. And that is not, my reality even though we live in the same town because we moved here 20 years ago.

I think off the hill their view of what life is like here is so far skewed that you know she wasn't from here she's like oh this is what it is but even when I go from my job here to Christus in Santa Fe everybody seems to think a certain way about the people who are all here and have a certain opinion about how everybody here is but unless you're here you don't know.

And I think in that sense, the sense of perfection is an aggravating factor because if you are struggling and there's a sense that you shouldn't be struggling, you know, I'm a right to struggle. No one else is struggling. That is infinitely more isolating than being in a community where your experience is more normalized.

When you're around so many people like are doing really, or like comparing a family where both parents work at the labs versus only one, like that's a huge difference. difference in family lifestyles and freedom, but also in income.

Can I share a quick, when I worked at the high school for a year in the counseling department as the secretary, and we talked about food insecurity, right? The People might come into the kids might come in because they don't have a lot of food at home. It was really eye opening to me to see the kids that would come in whose parents were so high up at the lab. You knew they had the money to fill the house with food, but they were so checked out of their children. So they were off traveling and going to conferences and all that. They made probably a million dollars, but they had no time. rich for their kid who couldn't drive to the store. So the kids still had no food, but it wasn't financial. No. What was it?

Lab orphans. Wow. But it's not lack of money. Yeah.

It's not an income thing. Yeah, and that just blew my mind working there. We would be providing food, because I would think food if you don't have the income to provide it for your children, but it wasn't that.

So, I heard... Go ahead, Jeremy.

Okay.

yeah yep yeah because i mean it's called secret city for a reason we'd like to keep it yeah well that's why we can't determine suicide rate is a miscounting because it won't be discussed no and nor and nor should it necessarily be

Even though we love those numbers and they help us to get funding, they help us to make reports. It's like, I don't want everyone to feel like they have to disclose for our data. Right. If someone does not want to report to the police, if someone does not want to go to a SANE nurse locally. It may not show up as a data point for us, but that's really the least of their concerns in that moment, which makes it hard for a health council. It makes it hard for social services, but it's really not what is most important in that moment. So I love that you said people off the hill have a skewed view. I worked in Espanola for years, and I'm very much a think that that's a true statement. And I think people on the Hill have a very skewed view. You came up with that phrase. I did not say a skewed view of what it's like here. And, you know, I talk to residents all the time. Somebody was like, oh, it's good that you're doing a sexual assault for like off the Hill is that sort of thing.

It's like,

But again, it's also, I feel like you're talking about that skewed view. It can be people who moved here 10 years ago versus those of us who have moved in the last five years, like talking to board members when I've had that conversation. And we've been in this community for the last 20, 30 years. And when I'm saying that this is, again, they're like, well, but should we be doing more in the Valley? Should we be doing more? And I'm like, can we... work on here first, and I would love to, and people are so welcome to come look, but I'm like, but also, like, do you see, do you realize how much my life is different than yours when you moved here, right, yeah, it's, even stuff like, oh, no, that's in White Rock, I don't want to drive that far, like, even, yeah, it being so,

It's not only just the community, it's the world.

I feel like so many people who were here, we came up in the late 90s to work here, and people who've lived here all their lives are second or third generation. It's

I feel like a lot of them live under a bubble and are not only not aware of what's going on in their community, but the world itself. I mean, if they were to drive down Central Avenue in Albuquerque, you can see this drug addiction and the homelessness and the poverty and just, so.

I tell people that the Los Alamos is a trap for people. that we move here and thank you anymore for our divorce purpose uh reason we start that is because women don't understand that you're gonna move here without four men but move to the town with a partner that works in the labs your relationship breaks apart you no longer make enough money just to save yourself and only your partner can afford to live here yeah so that's when domestic violence you feel trapped that's where the hopelessness comes in because you cannot as a single parent provide for a family with multiple children and both if you turn over

So I'm a deep diver in a room full of deep divers. Now I'm forwarding.

Family or loved one's history of suicide.

This is very much true.

Sometimes there is a history of suicide in the family. That is not a death sentence for younger generations, that they will die by suicide. I try to explain that to my children all the time, that we have family history in different areas. That doesn't mean that that's your fate, but it means we have to treat everything with a little extra caution. Whether it's addiction, suicide, things like this, we have to be very aware and very careful. Loss of a relationship is a risk factor. High conflict or violent relationships. Yes, because you know what? I felt like somebody was going to take me out. I might feel like my last little bit of control was to take myself out before they have the chance to. And again, I say this stuff just to remind us all that suicide is understandable, even if we want to do everything we can to prevent it. We've got to think about prevention as resources and safety options, not just ABC classes, although this is a good part of it. And the one that we're all aware of, social isolation. I am telling people now, call 988 just when you're feeling lonely. Don't just wait to call when you are planning to die by suicide. Call 988 when you're feeling alone. And I hope people also share that message. I must have told 20 people that at the farmer's market today. And sometimes people, it's so well-received, they take a loop, come back, and then they say, come in, and say, I'm so glad you're here. And then other people are like, why is this going to be coming to me and not listening? And that's okay. But somebody has to be in the community, be stigmatizing, talking about things for peace and comfort, and that's why you're here.

And just to Becca, what you said, this is very prevalent with trailing spouses.

Yeah, the isolation.

The time to leave.

We'll hang out. Right. Community risk factors. Again, I'm going to ask you to move your thumbs if you think this is a our community issue. I'm already sick of this. Social health care. Okay. Okay. The impact of the suicide in the community. I know we're often afraid, especially we think of it as a youth thing, although I think it spans across multiple age groups. But I know particularly when we see a young person die, it's the other social circle. And we've seen it happen.

Yep. We've seen the cluster. Yep.

Stress of acculturation. Does anybody have to... That is alteration when they come to this community.

I need a definition of our culture. What does that word mean?

The culture, the area around you. grew up in Denver, and then you come up here and it's like, there's nowhere to go. Everything shuts down at 8 o'clock in the whole culture.

So you've heard like culture shock. It's like having to adapt to that.

So if you came here and didn't know how to play Dungeons and Dragons, you didn't like hiking and all the outdoor stuff that everyone doubts, you know?

The subculture, the lab has subculture. Well, that's true, too.

Yeah.

A lot of people come from different countries.

Yeah. Yes. Yeah, for sure.

Yeah. Yeah.

And that was the thing. I mean, I'm 63. It was a thing when I was in high school. And it seemed to be among the girls that had a pact.

Was it there?

No, it was in Western New York.

That's really interesting. Acculturation in this town can be very challenging. And it does, it really... matters very little where you're coming from, even if it's a different area of New Mexico. Sometimes this community's culture is very unique, very specific, and very narrow at times. And community violence.

And that's not, that's part of the secret. That's not spoken about to an extent, the domestic violence, the rapes. Those sort of things.

Right. I think there was a time when I would have said to people, oh, yeah, it's like very low violence. And then just reading how many sexual assaults on minors there have been and how it's just it's hard to not now perceive that we do have community violence that needs to be addressed. Even if on paper, sometimes we look at that. All right. Next slide. Historical trauma and discrimination. This is super important to highlight. This is something that is left out of some suicide prevention trainings. But oftentimes when I say, what are risk factors for dying by suicide? People will say being native or being LGBTQ. It's kind of, yes, but you're almost placing the blame on the person's identity when really it's not their identity. It's the historical trauma of, I remember, you know, I'm 43, but I remember holding a prom my freshman year of college. We held like a prom for LGBTQ folks because so many of us if we were queer did not go to prom at our high schools. And so we held a big prom and people came from all over the state to this. And this was only, you know, I'm 43. So it was like 25 years ago. That's not even like a generation that's, you know. And so the historical trauma for folks who are in the queer community, for folks who are indigenous, for people who may sometimes check demographically certain boxes. It's not, oh, it's because they are native or because they identify as queer. It's because of the historical trauma and discrimination that compounds. Yeah. I'm a deep diver and this is like, I don't have time. All right, societal risk factors. We're going to have to fly through these. Uh, there's no stigma in this town for right. We solved that. Yeah. Right. No need for any quorum. Stop it.

Sorry, Kelly.

Okay.

I was good.

I would say the opposite, like job security. Yeah.

stigma.

It's a great barrier to death by suicide. Although today I distributed the medication bags that I brought to take old medication and deactivate it and then be able to dispose of it at home. Because if you're anything like me, you know that Nambe will take your expired medication or the stuff you're not using anymore, but you just You must remember to take it, get in the car, drive it over. There's just no lifetime built in for that sometimes. So getting out of those medications. If you need gun locks or those medication disposal bags, please let me know. I'm short on the bags after today at the farmer's market because I distribute it a lot. I thought we have access to get more. Unsafe social media portrayals of suicide. We could really dive into this, and we're not going to. But as you watch media, consider what you see being said or shared about suicide. And is it ever romanticized? And being a victim of scamming. Okay, and I will add to this also revenge porn. So... Being the victim of a scammer who drains your bank account in some way, promising you either love or a business opportunity, whatever it is, makes people very vulnerable to considering death by suicide. And then also something that I have seen as someone who worked at J-Jab is revenge porn, where you exchange nude photographs with someone, or perhaps you just send one way. And then they say, if you break up with me, I'll share your nudes. Or in the case of one young child, woman, girl, one girl said, if you don't give me marijuana every week, I'm going to share all your penis pictures. It can be extremely devastating for the person that feels like their new photographs are going to be released amongst their friends, parents, coworkers, their teachers, people in town. So this is a really important thing that we take very seriously of teaching young people and adult people about sharing weird photographs. safely or choosing not to share. Again, that's a deeper dive. But if you know that that's happening to someone, please connect them with suicide prevention resources because it is an extremely difficult time.

Can I add a deep dive kind of thing? Back to the lethal means of suicide, for people that are interested in gun safety, I have found some people who are very much gun owners, proponents of Second Amendment. Sometimes when you talk about gun safety, there's a hesitation like, oh, you're just part of this group that wants to take all my guns away, which is not true. But talking about suicide, especially if there are other people in their house, teenagers or older adults, is a really good way to open that conversation. And then it's like a two for one. You're talking about lowering the risk of suicide and gun safety with the gun locks. Guns are used in like 60% of suicides and they are nearly always lethal. And men use guns. guns in 90% of the suicide attempts by men, 90% are with guns. So when we talk about men's mental health in particular, access to lethal weapons tends to be the primary source. And so if it's hard to talk about one of these items, like sometimes I have found it's easier to open the gate to talking about gun safety when we talk about like positive mental health, men's mental health. If you have a firearm and you've been drinking and that sometimes like clicks on for them the need for the safety uh the gun locks so it's um kind of an easy way into that conversation construction or um professions where like the oil fields um mining uh they're both more likely to be gun owners and they're uh

men in those professions are more likely to die by suicide.

They also have that high rate of chronic pain, high rate of isolation. They meet all of these.

Before we go on, let me just point out, we have about 12 minutes left. So what I would recommend here is that we just table our staff and chair and council reports, and then maybe go for questions. more 10 more minutes and then take a few questions. Does that work? Okay. And then if people want to stay afterwards, I don't know how you want to do that. We kind of have a hard stop at 1.30, but.

So let's go to what ABC. Perfect. Okay. So ask the question. I'm going to invite you all to do something uncomfortable, but I'm a things that based educator. So you don't, you only do it if you're ready for this challenge. which is to say out loud, are you thinking about suicide? So on three, we're going to ask that question out loud, just out into the room. You don't have to like turn to a partner. It might be a little intense.

You're welcome to. I'm used to this.

Are you thinking about suicide?

Great.

Now, of course, I'd rather say, I would love to soften the language, but it's not great to soften the language because oftentimes people will be like, I'm not thinking about hurting myself. I'm thinking about taking myself out. And so they will, in that moment of vulnerability, not respond the same way. Saying, are you thinking about suicide? Or are you thinking about killing yourself? Is a great and important skill. to perfect. So go home, look in the mirror and practice asking that question and just make sure you're not doing any micro facial expressions that are about your own decision, but the other person might perceive or a judgment of them. So just practicing it a lot so that you can make sure you're not accidentally curling your lip up slightly or scrunching or practice it. Next up.

Okay.

Hold on to let's yeah. Show these really quickly. Oh yeah. Oh yeah. I'm not going to go through them one by one, but don't forget about the person.

It's very blaming.

One of these that I probably have done in the past is say like, think about your children. I think that's really common. It makes sense why we would think that's the right approach, but we're just not going to make it about anybody but that person. We're not going to make it about the Bible. We're not going to make it about their parents, their children. We're just going to say, are you thinking about suicide? Are you thinking about yourself? Whatever feels culturally best for you.

All right.

And then we'll just kind of now. Here's what I like about these. It's gonna be kind of a formula almost. Starting with sometimes people in your situation think about killing themselves. Acknowledges that it's not a totally unimaginable, out there, nobody else. It acknowledges that that happened, right? So starting with that, sometimes when people experience this, sometimes people are in your shoes. People are always worried about planting this weed. You're not going to. I get it. You know, maybe if you're talking to like an eight-year-old, you might want to dial it and adjust it differently. But if you're talking to an older teen, adult, elder, you're not planting a seed. You're addressing something and bringing it to light. Whatever is shoved down is not going to be processed. It's not going to be. And that's where all that hopelessness comes from. Whatever is brought to light, like you may have heard name it, detain it. Sometimes we just have to say it out loud before we can actually address it. Let's keep going. All right, we're going to keep going because we're low on time. So are you thinking about sort of that? Are you thinking about killing yourself? All right. I would love to do scenario work with you, but there's two reasons. I don't think this is a good idea right now. One is when you're in a rush for time, it's really hard to create a comment-informed safe container. And scenario work and role-play work, even if we do it lightly, this isn't the best environment. I'm happy to do that with your group, but we would need to create a little bit more of a safe container and not be so touched right now. So I will just highlight sometimes when a person is going through what you were experiencing, they think about killing themselves. I don't like saying, are you suicidal? But we'll leave it up to you. You know your people best. All right. We're going to go past practice number two.

And... Oh my gosh. Sorry. I've just hit a whole bunch.

Sorry. B is be present, which I kind of already alluded to a little bit in practicing in the mirror is just taking away the, oh my gosh, what's going to happen next? What do I do? Just breathe. I would almost say B could be breathe and be present in that moment. Try to let go of judgment. Try to let go of problem solving for the person. Like, hey, I've got to do this. I've got to do that. Just being present is really the second step in this. Right? We'll keep going. And then let's see. Which is what I think you all are already great at. This is probably not one unique practice that much, but you can think about whether or not you've connected someone to resources when they're in crisis. And there are many resources, right? Just as you said, FSM is doing suicide prevention by creating so many good opportunities for connection. Social services is doing suicide prevention and making sure people have emergency food bags or signed up for food distribution and a multitude of other resources. I know all are doing suicide prevention and connecting to these different organizations in town, but the one we'll focus on in this training is the national number for someone who is thinking about killing themselves. And what is that number? Let's see if you're right. You are right. It is 988.

That's like the quiz sticking on the health council. Good job.

I think 988 second graders because I don't say when you're thinking about killing yourself because that's not appropriate for any age. It's when you are feeling desperate, when you are feeling alone, when you need someone to hear what you need to say, 988 is a wonderful resource. And 988, a lot of people ask, does that automatically trigger police to come out? No, it does not. I cannot guarantee you that 988 will not advise you to call 911. I cannot guarantee that they may not reach out to 911. But that's not the first step. It's not like they pick up the phone and then they push the 911 button. There are often supports of people who call 988 and they're not connected with 911. They are supported in that moment and they build some type of safety plan or child connecting with those resources. So because this is shallow and not deep dive,

I have one more thing. Yeah.

we talked in the director's round table is that when we say people are in crisis, 988, when you're in an emergency, when it is the point where you are about to make a choice you cannot come back from, please call 911. It is then an emergency. If someone is telling you that they are in that place, don't be like, well, call 911. No, if someone is telling you that this is something they are doing, considering doing right this moment, if you look away completely for a second, I will, that is an emergency.

I think that's a great distinction.

And at the health clinic, we ask everybody, every single person for an appointment has to go through the questions. Are you feeling suicidal? And 30% change. And so it's really nice to be able to make sure and say, this is confidential, because when they face to face, they lose that feeling of confidentiality, even though it's there. And to be able to call and be on the other side of a computer or a phone. I also didn't know there was a text.

That's good to know for the teens. And people can be connected to folks who are trained specifically for identities they hold or certain types of trauma they've experienced.

Veterans. Veterans, yeah.

And so it's a, it's a really good resource. And I just want to go back to what Jen said. I want to acknowledge what would happen if I disclose to you, I am, and you call 911. What would happen?

I don't know. When I was at Norman, I know an ambulance came to get her and they, it was very helpful.

So what would happen to you? Neighbors. Well, if everyone would know you. Yeah. Right. Okay. There's that.

Well, if you called 988 and said you were... Oh, 911. The police and ambulance and fire, all three responses would show up. With lights on.

And then where will they take me?

To the emergency room.

They'll take me to this emergency room.

Yeah.

And... But who do we, like, what's our crisis response team at this emergency?

We don't have an on-call psychiatrist that is through video health.

So we really don't have an appointment with somebody on a screen. And then what happens?

And then that psychiatrist will make a determination on your level of need, whether you have a 72-hour hold at the medical center or if you could be released. If it is a 72-hour hold, the discharge planner at the hospital will likely meet with you to figure out continuity of care, if it's a med change or a connection to a PCP.

And if you're a child, if you're a youth and you're not an adult, you will be put in a room with a gown, you'll be isolated from your parents and that potentially they'll do, you know, drug and alcohol testing on you.

Oftentimes people are released within a few hours from LAMC. And I'm not making any judgments about this because I've never worked over there. I am not ready to say whether like they should do this, that, I don't know. I've never been in their shoes, but I've been in the other shoes of, taking someone to the emergency room and then them being released in three hours and we're in the same exact position where they're also saying they're going to die by suicide, but because when they were on the telehealth appointment, they said they were not. And so I also just want to highlight how important it is to have 988 because it's not the same response system. That same person at one point went to Santa Fe to a different hospital to try to receive appropriate care and they were admitted and they were put into a psychiatric unit, but psychiatric units can be very scary. There was screaming, there was no, there's no immediate treatment, right? They were there and they were monitored, but they were sharing space with a lot of people with a lot of different needs and it was very scary for them. So yes, call 911 because that may be the best you can do in the situation. And if you do not feel that you were in an emergency situation, 988 is a great option that reduces the amount of trauma someone is likely to experience if they are experiencing suicidal ideation or planning in our particular community.

So if someone goes here, there is no transfer to a facility. They don't, like, it'll be a seven-foot hold. We do not have a... contract, like, so OE closed. We now have a contract with St. Vincent and Espanola to then transfer patients. We don't have something like that for patients to transfer to a medical, a mental health facility.

If the ER doctor makes a determination that somebody needs care at another facility, they can authorize an ambulance was my understanding, but there is no existing standing protocol to just if mental health goes someplace else.

like lifelink or to presbyterian do you have slides to do there we go it's really really hard to be able to get into the coffee yeah That's how they do it, and those kids fall to the ground, so they don't want to get help anymore. So that's one of the things I say, that this thoughts are going, and getting referrals is trying to help. And even the school support, our youths aren't getting supported at the schools, and we're recommending to sort of like seek, seek for help. because of their mental health. And when they don't get supported like that, we're failing their mental health. So that's one of the things that I wanted to bring up in my experience in this hospital. On referrals, I have never seen even a 16-hour hold on kids who are committing suicide.

And I think it's based on the psychiatrist. I don't want to necessarily turn this into and we're out of time, like a referendum on the hospital. But I will say that is part of the regional like Senate Bill three work is building additional behavioral health supports, both mental health and substance use for adults and young people zero to 18. The transportation is a huge gap, but that's one of our identified goals is in how to figure that out. And if you think about like how all the things are connected, if there is a call and someone is suicidal, medical protocol is you get them to the nearest place for evaluation. And that is going to be our hospital. That is going to be the ER. There isn't enough demand to have a 24-7 psychiatric staff, you know, hence the video health. But with the the places that have come online in Rio Arriba and Santa Fe County, the CCBHCs, the Renewal, the Recovery Center in Santa Fe. So there are conversations have started within what transportation would look like. For example, this is not in existence yet, but the ideal system would be police and EMTs respond They have an online access to a psychiatrist who can make that determination to get someone to LifeLink or detox on the spot, right? The system doesn't exist yet, but the group of us that are all brainstorming this all the time, and we have money from the state... to pilot what would a vehicle look like? Is it Jessica wearing a cap that says, honk, honk, jump in. I'm going to drive you. What are the safety features? If someone's actively suicidal, I've been with someone trying to drive them somewhere that tried to open the car door going 70 miles an hour on the highway. And it was just because I happened to have the child locks on in the back seat that we didn't have a physical health issue falling out of a car. So there's a bunch built into it. which is all to say like health council, like we can make this change as we.

And thank you. I didn't like. Yeah.

Yeah. So this is obviously not designed for a room such as yourself, full of professionals that have experience and lived experience, but it's a good way to get the conversation started. And I would encourage you to email me your questions. And please remember, because we're ending on a Debbie Downer note, which is my specialty, to be like, you know what's awful. But what was wonderful is that you were here online or in person and that you are equipping yourself with tools like asking the question directly, practicing being present, even though a lot of you are caregivers, problem solvers, and you're used to going into solvent mode. Practicing being present and then connecting people so that you don't take it on yourself to be the savior. None of you, when you get your little ABC prevention partner card, that is not your savior card. That is not. You are now personally responsible for saving people. Do not take it upon yourself. Connect. Don't say, I'll solve your mental health. I want you instead to connect people to resources, connect them to social services and other opportunities around. Thanks for being here and being such a big and kind of group. I appreciate you. Thank you, Jamie. Thank you, Jamie.

Thank you. And anybody online, if I don't have your email information, if you could just actually send it to Jamie, I think.

If you want to give me a list of everyone's email who attended.

I can, but there are a couple people who I don't have.

If you could add it to the list, give me a list, and I can make sure that you all get your cards confirming that you did attend those blogs.

Thank you so much. We appreciate it. And we will continue next month where we stop today. So we're adjourned for now. Let me put the email in the chat and then we'll just turn off the Zoom. Thanks so much, you guys, for coming.

Thanks for state extra.

That was great. But it was like, we all were like, no, we want to jump in with all our answers.

It's so hard. Jamie. That was also funny. Jamie, just when you were asking, like, wait, I don't have to answer. I know all these answers. Like, Jessica, don't jump in. It's for health council to learn. It's so hard to not.

Salamis, New Mexico.gov. Correct. Correct. Okay. We're going to end the meeting. But what was Tracy? Okay. Tracy.

She's one of the other DOH.

And then Valerie.

Valentina is who I send my reports to.

Did we know Crystal?

Crystal's our health promotion specialist.

But there's two Crystals.

I think she was on twice.

I could have gone on twice, guys. I'm sorry.

Nope. I know it's you. Okay. Tracy, we thought you... Okay. I know. I think I know everybody else here.

Can you scroll up?

Because Stephanie left a message about.

Oh, just her introduction. Okay. I thought she was. I'm going to let you guys go now.

Thank you. Bye-bye.