Editor's note: In part one of this series, The Scoop's guest speakers, counselors Ovita Perez of the Guam Behavioral Health and Wellness Center and Leanna Borja of Jose Rios Middle School, talked about the stress that comes with the pandemic and the changes that have been forced upon us.

In this second and last part of a Nov. 14 presentation on mental health for teens, the counselors talk about the help that's out there for teens and the community. They also discuss the stigma associated with mental health issues, as well as the fear of sharing their worries with parents.

Jonathan Pizarro: Are there a lot of youth now typically calling the Behavioral Health hotline, and has that number seen an increase in calls during the pandemic?

Guam Behavioral Health and Wellness Center counselor Ovita Perez: We've had some youth call in. What's interesting is that not as high in a typical age mark period. Right now, we saw about anywhere from 25 to 30 intake cases that came through. But yes, there are some news about calling the hotline, and some are from out of the community.

I think the decrease in number is primarily because a lot of our referrals come from the schools. So with the schools closing down, there is not much there. But the ones that are coming in are mostly – we have a lot of aggression, we have a lot of suicide-like ideation, we have anxiety, panic attacks. There are some – one or two cases – where we had substance abuse psychosis. There is some ... control issues, and a lot of trauma related to children being taken away from their homes for whatever reason. Then they find themselves in shelters.

... There is a lot of this coming through, and youth do call. And if they can't get through the 647 hotline, then they can always call 311. It's an easier number to remember. In 311 there's some little voices which direct you if you want to talk to some advisor counselors. So if you can't remember the ... number, then they can just dial 311.

Jose Rios Middle School counselor Leeana Borja: I think ... that a decrease in numbers ... speaks to the fact we still have stigmas associated with mental, social and emotional wellness. And I'm so glad that you guys are doing this forum today because you're helping to break that stigma. And hopefully more people ask for help, more teens ask for help. And I think part of the issue too is you're in your own homes ... and the sense of privacy that you guys really need, and want and desire, is not always available because you're in your homes and it's hard to find a quiet and private spot. But you know, little by little we can chip away at that stigma, together.

Sia Taisipic: Mrs. Ovita Perez, regarding Behavioral Health, among the issues you mentioned earlier in your previous answer, what other types of mental health issues are you seeing among Guam's youth during this pandemic?

Ovita Perez: A lot of it is anxiety and depression. ... We're forced into this online learning thing. ... (Before the pandemic) when things were not working at home, they channel all their energy toward school. So when that went down, it really amplified a lot of depression. So anxiety and depression have been the top in the cases we've seen from people. That's why it's very, very important to let them know to reach out, because this is really a time where we're all trying to figure out what's going to happen tomorrow, right? And I think the validation of your emotion (and reminders that) you're not alone are very crucial.

Kai Leigh Harrison: Ms. Leanna Borja, have you had parents (of students) reach out to you during the pandemic specifically?

Leanna Borja: We do get a lot of referrals from parents. And you know it really is a partnership, especially during a pandemic, (because) our parents are the ones that are spending the most time, you know, they're taking part in their child's education more so than they usually do.

... They're reaching out to us and I know Jose Rios is not the only school. We try to keep a constant flow of information and resources out to our students and their families via handouts. We always give a handout, every single week, during our hard copy distribution, and then that gets distributed into the Google Classrooms for our online students. And so we're constantly putting our name out there, our office out there, the resources that we provide. And the support that we provide in addition to what we post on to our website.

So yes, we have gotten parents giving us some information on their child and, of course, approval to work with them.

Alexandra Duenas: In regards to mental health awareness and kids being scared to reach out to guardians and parents, what advice would you give them for stepping into those uncomfortable conversations?

Ovita Perez: Let them know that we have a crisis hotline, that that number is 647-8833 or -8834. Guam Behavioral is open 24 hours, 7 days a week and this is going to go straight into the holidays.

The thing about the holidays coming up is that even the stress and the depression and the blues feeling amplifies, so let them know that there is help out there and to reach out. Also, reach out to your counselors at school. If you can't talk to your parents, reach out. Have your friends call for you and advocate for each other, but let them know that they are not alone and we are all feeling it.

Trust me when I tell you that although I am the professional, you know I do have doses of depression at times. Sometimes I feel like I am a prisoner in my own home. Right? So we're all feeling that, that's why it's very, very important to have some form of communication with the outside world. And again, the help is out there, there is help

Leeana Borja: One of the things you really want to do is identify an adult that you feel comfortable with, even if it's a relative like an aunt, or in the school system, you know? Definitely your counselor, that's what we're here for and that's the conversations we can have – a counselor-to-student conversation: "How do I talk to my parents about what i'm going through?" Then we can do roleplaying, just to go through all the different scenarios that might happen.

I want you guys to know, you know I'm a mom too and sometimes the first reaction I give is not the best reaction, but that doesn't mean I don't love my child, right? Or I don't love my daughter because I came at it in an angry way. It just means the conversation needs to happen again and again. These are your parents and they love you. And if you have situations with your parents that they are kind of the ones giving you stress, that's something else you want to talk to your counselor about or a trusted adult, and that's something we can attack that way. But nine times out of 10 ... you just need to get over that hurdle of fear because your parents love you.

Sophie Nochefranca: What should teens be on the lookout for or be aware of when it comes into falling into depression as a result of this pandemic?

Leeanna Borja: It's definitely changes in mood. That's why we need to watch out for ourselves. Ms. Perez keeps saying we need to make sure that everybody knows we're in this together, they have support, they're not alone. Everybody is going through it – however young.

Even my 5-year-old, she gets concerned if we go outside – even if it's outside to play – and she doesn't put her mask on, so it's affecting us in all ages. So help each other be aware of the changes that we are going through and monitor that and provide support because sometimes you can't see it within ourselves.

But if you yourself wake up one day and you're like, "Man, I really haven't gotten out of bed before 11 o'clock for a whole week now. I'm not eating well. I just realized I skipped dinner. I don't know why I can't sleep." Those are the things you should watch out for. And if anxiety is all you're feeling every single day ... that's a time to look at yourself and take care of yourself and reach out for support.

Eunice De Belen: Do you have any final thoughts, last words of encouragement or advice for students who are struggling with their mental health?

Ovita Perez: Again, it's really knowing that you're not alone. ... Try to take time for yourself. Self-care is very, very important. I can't emphasize that enough, you need to take care of yourself. ... Try to just stay calm, find someone to talk to when you're feeling down. Exercise, really going out there and just breathing in that fresh air when you're taking walks. When we're working telehealth, I sometimes change my routine and I work outside and take my laptop (and go outside) just so I can have that fresh air. So self-care is very, very important – before you can go out and help others you need to be OK yourself.

Leeana Borja: Absolutely, I agree. Self-care is so important and then keeping up that connectedness with your relationships with your family, your friends. And then knowing you're not alone.

I promise you it's scary when you think about talking to a teacher or talking to your school counselor, talking to your parents, talking to an aunt, talking to a friend. It's scary but once you make that jump, you'll realize that we're all in this together, we're all going through a little bit of something that the other person is going through and we can help each other. Because that's the only way we're gonna make it out, to help each other and then definitely get that fresh air. Get that sunlight, just the endorphins make us happy when we go outside, so try to get that in as much as possible, too.

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