Committee to implement 4-year plan - www.icareguam.org

PDN article:  February 23, 2013

The System of Care Expansion Grant’s over-arching goal is to infuse our island community with awareness on children mental health needs and their families through education and training, on workforce capacity development, across agency collaboration, and infrastructure development and sustainability.

Another goal is to institutionalize the philosophy of system of care, core values and best practices in the entire child serving agencies and in our community as the standard of care for services to children, youth and families.

We have seen the good that have come out over the years with the I Famagu’on-ta, child mental health initiative and we want to spread this best practice throughout our island so that every child, youth and family would benefit from this human service framework. 

To achieve these goals we have to sustain the practice beyond the federal dollars.  During challenging financial times, this can be very daunting.  However, with collective efforts of partner agencies, families and stakeholders in our community, supported by new findings in research, and federal technical assistance, we were able to complete the development of a 4-year Strategic Expansion Plan for Guam.  The plan has five main strategies and several sub-strategies with action steps from year one through year four.

We are pleased to report two months after the development of the Guam plan, a major milestone in the plan was achieved when Governor Eddie Calvo signed an executive order on November 8, 2012 establishing the Executive Committee on System of Care (ECSOC).   We celebrated this accomplishment in Adelup last Tuesday in the unveiling of the Expansion Plan and the coming together of the members of the ECSOC to commit to implementing the plan in collaboration with the Guam System of Care Council (GSOCC) and the Expansion Planning Team (EPT).

The establishment of the ECSOC is a sub-strategy of Strategy One:  Implementing regulatory changes and system-wide care standards and protocols across child serving agencies and services providers for continuous quality management.

The committee is comprised of Directors from Department of Mental Health and Substance Abuse (DMHSA), Department of Public Health and Social Services (DPHSS), Department of Education (DOE). Department of Youth Affairs (DYA), Department of Integrated Services for Individuals with Disabilities (DISID), Guam Police Department (GPD), the Judiciary, and the Department of Administration, (DOA).

As a senior level management, the ECSOC will work together in the implementation of the Guam 4-year plan through a coordinated, comprehensive, interagency approach in the development of a continuum of care that is child-centered, youth guided and family-driven, which emphasizes prevention, early intervention, home and community based services for children with mental health challenges and their families.  Special attention shall be given to children who are at high risk.

The ultimate goal of the Strategic Expansion Plan is to create a unified system of care island-wide, across all of Guam’s child serving agencies which includes a broadly supported, sustainable array of home and community based services provided by skilled providers trained in system of care values, principles and best practices which enables children and youth from birth to age 21 to achieve their maximum potential and builds on the strengths of Guam’s diverse families.

In the coming weeks, we will be presenting and elaborating on all the five strategies and sub-strategies of this Expansion Plan.  We invite input from the public into the implementation of the plan.  Please call us at 477-5338/9/5349/1050 for more information, or if interested in helping out.

Written By: Annie F.B. Unpingco , LCSW

Mental health plan empowers parents, kids - www.icareguam.org

PDN Article: Feb. 20, 2013

Ordelia Pritchard, a former teacher and the mother of a child with a mental disability, was one of four new council members sworn into the Guam System of Care Council yesterday in the governor's conference room at Adelup.

The council is responsible for coordinating government services for children with mental challenges and their families.

A $500,000 federal grant will be spent on a four-year plan that includes training, social marketing, workforce development and the development of a home and community-based system of care.

Pritchard's son was diagnosed at a young age with Attention Deficit Hyperactivity Disorder.

"When I was learning about my son's disability I had no one to turn too," Pritchard said.

Her child struggled, with teachers in Guam's public schools telling him he was a bad kid and constantly making him feel like he wasn't good enough, she said.

At one point teachers placed her child by himself in a classroom separate from all the other students because the teachers didn't understand mental health issues, according to Pritchard.

"I'm almost crying talking about it, but if this four-year plan had been in place when my son and I were trying to cope with his mental disability, it would have been great," she said. "And now that this plan is in place it is definitely going to change the level of education about mental health and help children and families cope and feel empowered."

The other three members elected to the council are Sgt. Stephen Amaguin from the Guam Police Department, Rowena Torres-Morrada from the Department of Mental Health and Substance Abuse, and Sen. Dennis Rodriguez.

The executive committee was created by a 2012 executive order by Gov. Eddie Calvo.

It's membership includes representatives from the Department of Mental Health and Substance Abuse, Department of Public Health and Social Services, Department of Integrated Services for Individuals with Disabilities, Department of Education, Department of Youth Affairs, Department of Administration and Guam Police Department.

The committee's job is to oversee and provide comprehensive and coordinated services for children and families for early prevention, early intervention and home- and community-based services for children with mental health challenges.

Ray Vega, director of Mental Health, was selected as chairman of the committee.

Annie Unpingco, an administrator with the mental health agency, said the committee's main goal is to "bring all these organizations together and use whatever resources we have, along with the integrated four-year plan."

The program is funded by a $500,000 System of Care Expansion Planning Grant called Para Todu, which means "for everyone" in Chamorro.

"We want our young adults to know if they have a mental health problem that the government of Guam is there for them and will give them the tools to become productive members of society," Lt. Gov. Ray Tenorio said.

Pritchard said her son's uncle, who also has a mental disability, didn't have proper services when he was a child.

She said he's been in and out of jail and now is struggling to find work.

"He would say all he wants is to work, pay his bills and provide for those he cares about -- you know, just like a normal person. But none of these systems were in place back when he was young," Pritchard said.

Pritchard said she believes the program will give other children the stepping stones to grow and live a normal life.

"They want to live a normal life like everyone else, but society has to give them the chance and the hope to do it," she said.

Torres-Morrada, from Mental Health, and Pritchard said they believe an important first step is getting parents and the entire community informed and educated.

"Parents feel helpless, they don't know where to go, and we want to make them knowledgeable," Pritchard said.

Written By: Armando Cordoba, Pacific Daily News

Guam Systems of Care plan expanding - www.icareguam.org

KUAM.com-KUAM News: On Air. Online. On Demand.

Kuam Article, February 19, 2013 

Guam - Recent tragic events both nationally and locally have shed a light on the challenges people are facing and the behavioral needs of our community. And several government agencies and families joined together this morning to announce an expansion of the Guam Systems of Care Strategic Plan.

"This is bring awareness to the community, that we have needs in the community and children shouldn't be forgotten," stated I-Famagu'on-Ta administrator Annie Unpingco. She says with recent tragic events, it's important to bring all the government child-serving agencies together to aid in the multiple and changing needs of children and their families. Today with several government agencies announced the expansion of the strategic four-year plan of the Guam Systems of Care. "It's bringing all the agencies together and wrapping services around the child and the family," she added.

The plan involves five major strategies including implementing regulatory changes and system-wide care standards and protocols, developing and supporting a home and community-based system of care, attaining sustainable funding, providing training and promoting workforce development and implementing an anti-stigma social marketing campaign.

Lieutenant Governor Ray Tenorio stated ultimately the goal is to help people at a young age and help them progress in life while they confront it. "To be able to guide their frustration, their anger, their shortcomings or just the state of their physical or mental faculties in a way that doesn't destroy other people's lives, and that's what we're here trying to accomplish," he said.

And with that, Tenorio swore-in four members into the Guam Systems of Care Council, including Committee on Health chair Senator Dennis Rodriguez, Jr., who said especially in light of recent tragedies on island, looks forward to helping put together a comprehensive plan of action to deal with the behavioral needs of our people, especially our children.  

"So I guess for my part in the Legislature is to listen to these professionals and see what needs to be done on the legislative side to implement the plan of action that they presented today," he said.

Unpingco added that 51 family members and 49 agencies make of Guam's System of Care including Guam Police Department, Public Health, Department of Education, Judiciary of Guam, DISID and Mental Health, all of whom were present today and committed to support the vision of opportunities for all children from birth to 21 with mental health challenges.

Mental Health's director, Rey Vega, was selected as the executive committee for systems of care chairperson. Unpingco hopes to hold its first meeting in March and work collaboratively and ultimately break the stigma of mental illness. "Everyone has emotions," he explained. "Mental Health should be like any health, and if you get help for having a toothache and a stomach pain why not a heartache."

Unpingco hopes to hold quarterly meetings with the first possibly in March.

by Ken Quintanilla

New approaches may help treat children - www.icareguam.org

Jan. 26, 2013 PDN article:  New Approaches may help treat children. 

In recent years, powerful new imaging technologies and other approaches have allowed scientists to track the development of the brain in young children.  These studies offer a way to understand how the intellectual abilities and behavioral maturity of children at various ages are rooted in the developing brain.   

These studies also offer the best possibility for understanding the origins of mental illness, which may lead to more targeted screening tools, development of new medications and therapeutic interventions. Research suggest that vulnerability to mental illness and resilience is rooted in development.  Both risk and resilience are shaped by genes and environment interacting together, through childhood and adolescence. 

Some of the most commonly diagnosable and treatable mental illness in children and youth are the following:  attention deficit hyperactivity disorder, anxiety disorder, bipolar disorder and depression.  Attention deficit hyperactivity disorder (ADHD) symptoms includes difficulty staying focused and paying attention, difficulty controlling behavior, and very high level of energy and activity.  Studies show that the number of children being diagnosed with ADHD is increasing, but it is unclear why. Using brain imaging technology like magnetic resonance imaging (MRI), scientists have observed that in some children, ADHD may be related to how the brain is wired or how it is structured.  For other children with ADHD, the brain development follows a normal but delayed pattern. 

Different types of psychotherapy are effective in treating ADHD.  Behavioral therapy helps teach practical skills such as how to organize tasks, manage time to complete homework assignments and to work through difficult emotions.  Therapists also teacher children social skills such as how to share toys, waiting their turn, and how to ask for help. 

Studies show that interventions that include intensive parent education programs can help decrease ADHD problem behavior because parents are better educated about the disorder and better prepared to manage their child’s symptoms.  They are taught organizational skills and how to develop and keep a schedule for their child.  They are also taught how to give immediate and positive feedback for behaviors they want to encourage, and how to ignore or immediately redirect behaviors they want to change. 

Anxiety can be a normal reaction to stress.  It can motivate and help us accomplish an important activity.  It can help us study harder for an exam, or keep focused on preparation of an important report or speech.   However, when anxiety becomes an excessive, irrational dread of everyday situation, it has then become a disabling condition.   

Examples of anxiety disorders are obsessive compulsive disorder, post traumatic stress disorder, social phobia, specific phobia, and generalized anxiety disorder.  Symptoms of many of these disorders begin in childhood or adolescence. High quality cognitive behavior therapy (CBT) with or without medication can effectively treat anxiety disorders in children. 

Research on early childhood stress is showing how early trauma can alter the brain’s stress response system and contribute to future risk of anxiety and mood disorders. 

Bipolar disorder, also known as manic-depressive illness, is a serious brain disorder characterized by episodes of mania , feeling very happy “up” or more active than usual, and very sad “down” which is depression.  These episodes are associated with unusual shifts in intense mood and energy.  Early onset bipolar disorder, which starts during childhood or during the teen years, may be more severe than forms that first appear in older teens and adults.  

Children who are depressed may complain of feeling sick, refuse to go to school, worry excessively that a parent may die and may become quite insecure and clingy.  Older children and teens may sulk, be negative, grouchy  and get into trouble at school. 

Girls are more likely than boys to experience depression, and as a child gets older the risk for depression increases.  According to the World Health Organization, major depressive disorder is the leading cause of disability among Americans age 15 to 44. 

A combination treatment of medication and psychotherapy works best for most youth with depression and youth are more likely to respond to treatment if they receive it early in the course of their illness. Depressed teens with coexisting disorder such as substance abuse problems, which mask the depression, are less likely to respond to treatment for depression.   

For more information on brain development and treatment of mental illness in children, visit the 
National Institute of Mental Health at www.nimh.nih.gov or www.samhsa.gov, or call I Famagu’on-ta at 477-5338. 

Annie F.B.Unpingco, LCSW Administrator, I Famagu’on-ta, Child Adolescent Services Division, Department of Mental Health and Substance Abuse. 

You can help put an end to bullying - www.icareguam.com

January  19, 2013 PDN article.  You can help put an end to bullying. 

Bullying is a pervasive problem in our society.  It can happen at home among families, in the work place and in the community at large.  It is about power and control which often leads to violence. Bullying is quite prevalent and troublesome among our student population as it seeks to dominate and manipulate especially the most vulnerable person who lacks the skills to protect himself or herself.  With society’s advancement in technology, the bullying could be most destructive, invasive and widespread such as cyber-bullying. 

Children are teased, threatened or tormented by bullies every day.  It is a big problem that creates a climate of fear.  Bullying interferes with learning in school and may lead to increased absenteeism and dropout rates.  Students feel less safe and less comfortable to be in school when there’s high level of bullying. 

Bullying is a learned behavior and therefore can be unlearned.  It can occur as early as two years of age.  Bullying can be either direct or indirect.  Direct bullying is usually seen and felt readily, such as pushing, tripping, threatening, intimidating, etc.  Indirect bullying is very different, it is much more difficult to identify and often is more difficult to correct. Some examples of indirect bullying are deliberate exclusion of a person from a group, spreading rumors and name-calling.   

Typically, boys engage in direct bullying and girls in indirect bullying, although not always the case. The longer bullying continues, the harder it is to change.  According to research, bullies identified by age 8 are six times more likely to have a criminal conviction by age 24.   

Bullying children may become bully adults and more likely to become child and spouse abusers.  Bullying may be linked to other delinquent, criminal and gang activities, such as shoplifting, drug abuse, and vandalism.   

Bullied children grow socially insecure, anxious, tormented, and defenseless with decreased self-esteem and increased depression rates, even into adulthood.

Victim prevention:  Here are some ways to prevent your child from becoming a victim of bully:   

• "Bully-proof” your child by instilling self-confidence in him/her.  Give him/her positive affirmations and self-talk to build his/her self-esteem.   
• Help your child to establish good social skills.  
• Teach your child to be assertive and speak out for himself or herself.   
• If your child is being bullied, let him/her know that it is not his or her fault. Teach your child to seek 
• help and to report it to you and to other caring adults immediately.   

15 minutes a day: 

Did you know that research has found that remarkable things can happen if parents and caregivers spend at least 15 minutes of undivided time a day listening and talking with their children?  Research also tells us that children do look to their parents and caregivers for advice and help about difficult choices and decisions.   

So, do 15 minutes a day.  Make time to listen and take time to talk with your child, to learn more about your child and to promote healthy child development.  This, 15 minutes a day can be adapted by teachers, counselors, and other adult involved in the lives and future of our children. 

Lastly, let’s remember the example of Martin Luther King Jr., a great American leader who preached and modeled non-violent protest in our country’s civil rights movement in the 60’s. 

Annie F.B. Unpingco, LCSW  Administrator, IFamagu’on-ta/Child Adolescent Services Division, Department of Mental Health and Substance Abuse.