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Lydia Gallegos
-Mental Health & Wellness Counseling Program

Personal Goal: To heal from my own trauma from last year in regards to my brother's passing.

Professional Goal: To gain the skills and knowledge in mental health needed to make an impact in my community.

In this course I want to learn how to approach crisis and trauma adequately to help me in the mental health field while becoming a more helpful person all around.

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Notebook from 2019, Developmental Psychology

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Introductions and Assessing Prior Knowledge.
This first assignment gave me a chance to reflect on my prior knowledge of trauma and grief, and even led me to open my notebook from a class in 2019 to gather information for my introduction post. It was nice to review some things that may have slipped out of my mind over the years and to know what areas I will need to improve my knowledge in. In a way, it started the foundation for my graduate school career.
"This course will be very beneficial in the position of a youth community impact coordinator. Having experience and knowledge in crisis management, trauma, and group facilitating will help me thrive in communities and help our youth. As a youth community coordinator, it will be important to implement these experiences and the aspects learned in this course in future programs, projects, and communities."
https://angelo.blackboard.com/webapps/blackboard/content/listContent.jsp?course_id=_74109_1&content_id=_3348134_1

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Reference Guide for Mental Health Disorders.
This assignment was fun to do. I felt that I was refreshing my memory in the disorders I learned about in some undergrad classes and even learned more as I did research. Working with excel also gave me the opportunity to practice that skill on the computer. I know I will save this reference guide and use it in my future role, and I even showed my family how neat it was to just have around.

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Developmental Discussion on Trauma.
These discussion boards gave me the chance to get out of a comfort zone and watch something I knew would be uncomfortable and heartbreaking. Although it was difficult to watch the Trials of Gabriel Fernandez, I learned a lot about child abuse and the many failures of child protection services that should not have happened. I was able to watch this documentary and reflect on what I learned from it. The resources in this unit were very helpful and informational in trauma and the many types. I enjoyed reading the ACE Studies and looking more into their demographic statistics.

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Adverse childhood experiences (ACEs) are categorized into three groups: abuse, neglect, and household challenges. Each category is further divided into multiple subcategories. Participant demographic information is available by gender, race, age, and education. The prevalence of ACEs is organized by category.

ACEs Definitions

All ACE questions refer to the respondent's first 18 years of life.

Abuse

Emotional abuse: A parent, stepparent, or adult living in your home swore at you, insulted you, put you down, or acted in a way that made you afraid that you might be physically hurt.

Physical abuse: A parent, stepparent, or adult living in your home pushed, grabbed, slapped, threw something at you, or hit you so hard that you had marks or were injured.

Sexual abuse: An adult, relative, family friend, or stranger who was at least 5 years older than you ever touched or fondled your body in a sexual way, made you touch his/her body in a sexual way, attempted to have any type of sexual intercourse with you.

Household Challenges

Mother treated violently: Your mother or stepmother was pushed, grabbed, slapped, had something thrown at her, kicked, bitten, hit with a fist, hit with something hard, repeatedly hit for over at least a few minutes, or ever threatened or hurt by a knife or gun by your father (or stepfather) or mother's boyfriend.

Substance abuse in the household: A household member was a problem drinker or alcoholic or a household member used street drugs.

Mental illness in the household: A household member was depressed or mentally ill or a household member attempted suicide.

Parental separation or divorce: Your parents were ever separated or divorced.

Incarcerated household member: A household member went to prison.

Neglect

Emotional neglect: Someone in your family never or rarely helped you feel important or special, you never or rarely felt loved, people in your family never or rarely looked out for each other and felt close to each other, or your family was never or rarely a source of strength and support.

Physical neglect: There was never or rarely someone to take care of you, protect you, or take you to the doctor if you needed it, you didn't have enough to eat, your parents were too drunk or too high to take care of you, or you had to wear dirty clothes.

¹Collected during Wave 2 only.
Items were reverse scored to reflect the framing of the question.

Participant Demographics

Demographic information is from the entire ACE Study sample (n=17,337).
Note: Research papers that use Wave 1 and/or Wave 2 data may contain slightly different reports of participants' demographic information.
ACEs Prevalence

The prevalence estimates reported below are from the entire ACE Study sample (n=17,337).
Note: ³Collected during Wave 2 only (N=8,629). Research papers that use Wave 1 and/or Wave 2 data may contain slightly different prevalence estimates.
Note: Research papers that use Wave 1 and/or Wave 2 data may contain slightly different prevalence estimates.
Source: Centers for Disease Control and Prevention, Kaiser Permanente. The ACE Study Survey Data [Unpublished Data]. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2016.

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Adverse childhood experiences (ACEs) are categorized into three groups: abuse, neglect, and household challenges. Each category is further divided into multiple subcategories. Participant demographic information is available by gender, race, age, and education. The prevalence of ACEs is organized by category. All ACE questions refer to the respondent's first 18 years of life.

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American Counseling Association. (2014). 2014 ACA code of ethics. https://www.counseling.org/docs/default-source/default-document-library/2014-code-of-ethics-finaladdress.pdf

Conroy, J., Lin, L., Stamm, K. (2021).

The demographics of unmet need for mental health services. American Psychological Association. https://www.apa.org/monitor/2021/04/datapoint-mental

Futures Without Violence. (n.d.). CULTURAL CONSIDERATIONS. http://promising.futureswithoutviolence.org/program-readiness/programpractices/cultural-considerations/

Texas Health Steps. (n.d.). Criteria for Referral. https://www.txhealthsteps.com/static/warehouse/1076-2010-Dec-3-613e1rq5n8it02j4p7qv/section_2.html

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The demographics of unmet need for mental health services

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The percentage of U.S. adults who received mental health services in the prior year trended upward for all racial and ethnic groups.

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https://www.nimh.nih.gov/health/statistics/mental-illness

https://screening.mhanational.org/screening-tools/depression/?ref=http://depression-screening.org&show=1

https://www.nctsn.org/trauma-informed-care/secondary-traumatic-stress/introduction

https://txssc.txstate.edu/videos/dating-violence/

https://psychology.fandom.com/wiki/Basic_counseling_skills_module:_Theoretical_approaches_to_counselling

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National Institute of Mental Health (NIMH)

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Mental illnesses are common in the United States. It is estimated that more than one in five U.S. adults live with a mental illness (57.8 million in 2021). Mental illnesses include many different conditions that vary in degree of severity, ranging from mild to moderate to severe. Two broad categories can be used to describe these conditions: Any Mental Illness (AMI) and Serious Mental Illness (SMI). AMI encompasses all recognized mental illnesses. SMI is a smaller and more severe subset of AMI. Additional information on mental illnesses can be found on the NIMH Health Topics Pages.

Definitions

The data presented here are from the 2021 National Survey on Drug Use and Health (NSDUH) by the Substance Abuse and Mental Health Services Administration (SAMHSA). For inclusion in NSDUH prevalence estimates, mental illnesses include those that are diagnosable currently or within the past year; of sufficient duration to meet diagnostic criteria specified within the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); and, exclude developmental and substance use disorders.

Any Mental Illness

Any mental illness (AMI) is defined as a mental, behavioral, or emotional disorder. AMI can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment (e.g., individuals with serious mental illness as defined below).

Serious Mental Illness

Serious mental illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.

Prevalence of Any Mental Illness (AMI)

Figure 1 shows the past year prevalence of AMI among U.S. adults.

In 2021, there were an estimated 57.8 million adults aged 18 or older in the United States with AMI. This number represented 22.8% of all U.S. adults.

The prevalence of AMI was higher among females (27.2%) than males (18.1%).

Young adults aged 18-25 years had the highest prevalence of AMI (33.7%) compared to adults aged 26-49 years (28.1%) and aged 50 and older (15.0%).

The prevalence of AMI was highest among the adults reporting two or more races (34.9%), followed by American Indian / Alaskan Native (AI/AN) adults (26.6%). The prevalence of AMI was lowest among Asian adults (16.4%).

Figure 1

*Persons of Hispanic origin may be of any race; all other racial/ethnic groups are non-Hispanic. NH/OPI = Native Hawaiian / Other Pacific Islander | AI/AN = American Indian / Alaskan Native

Mental Health Services - AMI

Figure 2 presents data on mental health services (including virtual services) received within the past year by U.S. adults aged 18 or older with any mental illness (AMI). NSDUH defines mental health services as having received inpatient treatment/counseling or outpatient treatment/counseling, or having used prescription medication for problems with emotions, nerves, or mental health.

In 2021, among the 57.8 million adults with AMI, 26.5 million (47.2%) received mental health services in the past year.

More females with AMI (51.7%) received mental health services than males with AMI (40.0%).

The percentage of young adults aged 18-25 years with AMI who received mental health services (44.6%) was lower than adults with AMI aged 26-49 years (48.1%) and aged 50 and older (47.4%).

Figure 2

*Persons of Hispanic origin may be of any race; all other racial/ethnic groups are non-Hispanic. Note: Estimates for Native Hawaiian / Other Pacific Islander and, American Indian / Alaskan Native groups are not reported in the above figure due to low precision of data collection in 2021.

Prevalence of Serious Mental Illness (SMI)

Figure 3 shows the past year prevalence of SMI among U.S. adults.

In 2021, there were an estimated 14.1 million adults aged 18 or older in the United States with SMI. This number represented 5.5% of all U.S. adults.

The prevalence of SMI was higher among females (7.0%) than males (4.0%).

Young adults aged 18-25 years had the highest prevalence of SMI (11.4%) compared to adults aged 26-49 years (7.1%) and aged 50 and older (2.5%).

The prevalence of SMI was highest among AI/AN adults (9.3%), followed by adults reporting two or more races (8.2%). The prevalence of SMI was lowest among Asian adults (2.8%).

Figure 3

* Persons of Hispanic origin may be of any race; all other racial/ethnic groups are non-Hispanic. NH/OPI = Native Hawaiian / Other Pacific Islander | AI/AN = American Indian / Alaskan Native.

Mental Health Services - SMI

Figure 4 presents data on mental health services received within the past year by U.S. adults 18 or older with serious mental illness (SMI). The NSDUH defines mental health services as having received inpatient treatment/counseling or outpatient treatment/counseling or having used prescription medication for problems with emotions, nerves, or mental health.

In 2021, among the 14.1 million adults with SMI, 9.1 million (65.4%) received mental health treatment in the past year.

More females with SMI (67.6%) received mental health treatment than males with SMI (61.3%).

The percentage of young adults aged 18-25 years with SMI who received mental health treatment (57.9%) was lower than adults with SMI aged 26-49 years (67.0%) and aged 50 and older (71.0%).

Figure 4

*Persons of Hispanic origin may be of any race; all other racial/ethnic groups are non-Hispanic. Note: Estimates for Asian, Native Hawaiian / Other Pacific Islander, and American Indian / Alaskan Native groups are not reported in the above figure due to low precision.

Prevalence of Any Mental Disorder Among Adolescents

Based on diagnostic interview data from National Comorbidity Survey Adolescent Supplement (NCS-A), Figure 5 shows lifetime prevalence of any mental disorder among U.S. adolescents aged 13-18.¹

An estimated 49.5% of adolescents had any mental disorder.

Of adolescents with any mental disorder, an estimated 22.2% had severe impairment and/or distress. DSM-IV based criteria were used to determine severity level.

Figure 5

Data Sources

1. Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-9. PMID: 20855043

2. Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report .

Statistical Methods and Measurement Caveats

National Survey on Drug Use and Health (NSDUH)

Diagnostic Assessment:

The NSDUH AMI and SMI estimates were generated from a prediction model created from clinical interview data collected on a subset of adult NSDUH respondents who completed an adapted (past 12 month) version of the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (Research Version, Non-patient Edition) (SCID-I/NP; First, Spitzer, Gibbon, & Williams, 2002), and was differentiated by level of functional impairment based on the Global Assessment of Functioning Scale (GAF; Endicott, Spitzer, Fleiss, & Cohen, 1976).

The assessment included diagnostic modules assessing the following: mood, anxiety, eating, impulse control, substance use, adjustment disorders, and a psychotic symptoms screen.

The assessment did not contain diagnostic modules assessing the following: adult attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, schizophrenia or other psychotic disorders (although the assessment included a psychotic symptom screen).

People who only have disorders that are not included in these diagnostic modules may not be adequately detected. However, there are known patterns of high comorbidities among mental disorders; these patterns increase the likelihood that people who meet AMI and/or SMI criteria were detected by the study, as they may also have one or more of the disorders assessed in the SCID-I/NP.

Population:

The entirety of NSDUH respondents for the AMI and SMI estimates were the civilian, non-institutionalized population aged 18 years old or older residing within the United States.

The survey covered residents of households (persons living in houses/townhouses, apartments, condominiums; civilians living in housing on military bases, etc.) and persons in non-institutional group quarters (e.g., shelters, rooming/boarding houses, college dormitories, migratory workers' camps, and halfway houses).

The survey did not cover persons who, for the entire year, had no fixed address (e.g., homeless and/or transient persons not in shelters); were on active military duty; or who resided in institutional group quarters (e.g., correctional facilities, nursing homes, mental institutions, long-term hospitals).

Some people in these excluded categories had AMI and/or SMI, but were not accounted for in the NSDUH AMI and/or SMI estimates.

Data regarding sex of the respondent was assessed using male and female categories only. Gender identity information was not collected in the survey.

Survey Non-response:

In 2021, 53.0% of the selected NSDUH sample of people 18 or older did not complete the interview. This rate of non-response is higher than in previous years. Please see the Background on the 2021 NSDUH and the COVID-19 Pandemic section below for more information.

Reasons for non-response to interviewing include the following: refusal to participate (30.1%); respondent unavailable or never at home (18.8%); and other reasons such as physical/mental incompetence or language barriers (4.2%).

People with mental illness may disproportionately fall into these non-response categories. While NSDUH weighting includes non-response adjustments to reduce bias, these adjustments may not fully account for differential non-response by mental illness status.

Data Suppression:

For some groups, data are not reported due to low precision. Data may be suppressed in the above charts if the data do not meet acceptable ranges for prevalence estimates, standard error estimates, and sample size.

Background on the 2021 NSDUH and the COVID-19 Pandemic:

Data collection methods for the 2021 NSDUH changed in several ways because of the COVID-19 pandemic: the 2021 NSDUH continued the use of multimode data collection procedures (both in-person and virtual data collection) that were first implemented in the fourth quarter of the 2020 NSDUH. Overall, 54.6% of interviews were completed via the web, and 45.4% were completed in person. In 2021, the weighted response rates for household screening and for interviewing were 22.2% and 46.2%, respectively, for an overall response rate of 10.3% for people aged 12 or older.

Given the use of multimode data collection procedures throughout the entirety of the collection year and the rate of non-response, comparison of estimates from the 2021 NSDUH with those from prior years must be made with caution.

Please see the 2021 National Survey on Drug Use and Health Methodological Summary and Definitions report for further information on how these data were collected and calculated.

National Comorbidity Survey Adolescent Supplement (NCS-A)

Diagnostic Assessment and Population:

The NCS-A was carried out under a cooperative agreement sponsored by NIMH to meet a request from Congress to provide national data on the prevalence and correlates of mental disorders among U.S. youth. The NCS-A was a nationally representative, face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States. The survey was based on a dual-frame design that included 904 adolescent residents of the households that participated in the adult U.S. National Comorbidity Survey Replication and 9,244 adolescent students selected from a nationally representative sample of 320 schools. The survey was fielded between February 2001 and January 2004. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview.

Survey Non-response:

The overall adolescent non-response rate was 24.4%. This is made up of non-response rates of 14.1% in the household sample, 18.2% in the un-blinded school sample, and 77.7% in the blinded school sample. Non-response was largely due to refusal (21.3%), which in the household and un-blinded school samples came largely from parents rather than adolescents (72.3% and 81.0%, respectively). The refusals in the blinded school sample, in comparison, came almost entirely (98.1%) from parents failing to return the signed consent postcard.

For more information, see PMID: 19507169 and the NIMH NCS-A study page.

Last Updated: March 2023

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An overview of statistics for mental illnesses. Mental illnesses are common in the United States. One in six U.S. adults lives with a mental illness (43.4 million in 2015). Mental illnesses include many different conditions that vary in degree of severity, ranging from mild to moderate to severe.

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Reflection On The Importance of Cultural Competence

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Reflection On The Importance of Cultural Competence

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To be culturally competent we should be asking ourselves questions that are relative to all different cultures and areas that are relevant in delivering adequate mental health services. Our culturally diverse community may hold different and unique needs that health services should accommodate for.
Some questions to ask:
Do we ask families how we can meet their needs?
Are we examining shelters and other items for cultural relevancy? Have we made efforts to collaborate with under-served communities?
(Futures Without Violence, n.d.).

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Local Emergency & Non-Emergency Support Services (Abilene, TX)

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Local Emergency & Non-Emergency Support Services (Abilene, TX)

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Betty Hardwick Center
Mental Health America of Abilene
Elm Creek Psychiatry
Oceans Behavioral Hospital

Suicide Prevention Hotline
800-273-8255
suicidepreventionlifeline.org

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Criteria to be considered for referral:
-If a child demonstrates behavioral or emotional problem that may cause a threat to themselves or those surrounding
-If said behavioral or emotional problem disrupts day-to-day functioning
-History of abuse/neglect/removal from home
-Significant changes in emotional or behavioral functioning

Local resources to be referred to:
Health and Human Services Commission (HHSC)- funds health -care coverage in Texas for children and adolescents.
Texas Integrated Funding Initiative (TIFI) and Community Resource Coordination Groups (CRCG)- these programs provide services to special needs children and adolescents

(Texas Health Steps, n.d.).

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Graph on unmet need for mental health services (2021)

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Graph on unmet need for mental health services (2021)

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"Despite upward trends in the receipt of mental health services, the percentage of adults with perceived unmet need for mental health services also trended upward across all racial and ethnic groups" (Conroy et al., 2021).

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Psychological First Aid Online Certification.
The videos and interactive course play through was very helpful. Disasters can happen anywhere at anytime. I really enjoyed the different people and scenarios in this online certification as it did not just focus primarily on one person or group who may need help in times of crises. Learning how to aid victims during times of crises will be important in my line of work as a mental health professional.

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Crisis Prevention and Threat Assessment Presentation

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Crisis Prevention and Threat Group Assessment.
Working as a group gave me the opportunity to communicate professionally with my other classmates. It also gave me a chance to get to know them a bit more and research this topic of dating violence together. My group and I were able create a well put together presentation and learn how to research a crisis prevention plan.

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Trauma 6332- Group Work_ Dating Violence

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https://www.counseling.org/Resources/aca-code-of-ethics.pdf

The American Counseling Association Code of Ethics is used for developing and advancing the counseling profession while urging the respect and dignity of others (ACA, 2014).

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Working this assignment I was able to put myself in the shoes of a potential client and work through their issue(s). This assignment gave me the opportunity to analyze the specific parts their case study and essentially break it down to three main components: Achieving a Relationship, Breaking Down the Problem, and Commitment to Action. Using the ABC Model of Crisis Intervention, I was able to put myself in a position as a counselor and analyze a case that could be seen in my future role in the mental health field.

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Ethical Codes connected to my future role

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Ethical Codes connected to my future role

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C.2.d. Monitor Effectiveness- this code is set for counselors to actively monitor themselves. This will help counselors improve in any area that may be needed.