>> Narrator: The following program
is a PBS Wisconsin Original Production.
>> Reporter: The plight of mental health in today's youth
continues to grow.
>> You can't walk through a classroom
without seeing someone who might be struggling.
>> Reporter: Whereby access to a gun during
a mental health crisis means life or death,
and challenging the stigma of opioids.
>> The vast majority of our patients are gainfully employed.
Family, lots of homeowners, renters, yeah.
They're not the person that most people picture.
>> I'm Frederica Freyberg.
Tonight on "Here & Now"
we report on the state of student mental health
and the resources left wanting.
A psychiatrist weighs in on a bipartisan bill
training gun sellers to identify a mental health crisis.
And Fentanyl has shot opioid deaths
to an all-time high, but interventions do work.
It's "Here & Now" for May 12th.
>> Announcer: Funding for "Here & Now"
is provided by the Focus Fund for Journalism
and Friends of PBS Wisconsin.
[bright music]
>> Tonight, we discuss mental health and suicide.
We wanted to let you know as we begin our program.
First up, students today
are coping with myriad different challenges
than their parents.
And rates of depression and anxiety are on the rise.
As part of our 2023 budget coverage,
Steven Potter reports mental health support systems
cannot keep pace with the growing needs
that burden young people in this state.
>> Our students are hurting right now
in a way that I've never seen
in my 15 years of education.
>> It's prevalent everywhere.
You can't walk through a classroom
without seeing someone who might be struggling.
>> Steven: Students today
have many of the same challenges
they've had for generations, keeping up with classwork
juggling things like sports, part-time jobs and friendships.
But students today are also dealing with a new challenge,
an increase in problems with their mental health.
Experts say these problems are widespread
and if left untreated, mental health problems can,
and in many cases already do, have severe consequences.
>> We're seeing a lot more struggles
and this trend has been going on for a while now.
We see a lot of increases
in suicidal ideation as well as suicide attempts.
So some really alarming stuff.
And again, it's been trending for a while,
but seems to really be on an uptick lately.
>> While every student is unique
and each faces their own challenges,
many young people across the state said they struggle
with similar mental health issues
such as anxiety, isolation, and depression.
A survey released last year
by the State Department of Public Instruction,
found that 52% of students reported having anxiety.
34% said they were sad or hopeless every day,
22% of students reported harming themselves
and 25% of female students
have seriously considered suicide.
>> There's a lot of different research and studies looking
into the root cause of what we're seeing now
in our youth mental health.
Youth are dealing with a lot of things that us adults
didn't deal with when we were younger.
Today's youth have a lot more information coming at them
at all the time, but it is still a lot, I think,
for these young people who are still trying to
kind of figure out how to manage their own emotions,
how to process big information,
with the pandemic in the middle of all this.
That's something that was pretty jarring.
Being a youth during something like that,
during a national trauma is gonna really disrupt
some of their own growth, their emotional growth,
their brain development.
And now we're kind of seeing the after effects of that.
[people chanting]
>> Steven: In addition to the pandemic,
young people today are also navigating extreme
political division and heavy use of social media as well
as a fear of gun violence and economic uncertainty.
>> A lot of what we see
with our students is trying to find their place
in the world, and I think that that hopelessness piece,
it's not the best place out there in the world, right?
Between climate change
and any of the fractious behavior
we have between humans.
It's hard for them to look
out at that and think like, yeah, I have a future.
>> Steven: 17 year old Ava in Winnebago County has dealt
with mental health challenges for years.
>> I always had a really bad anxiety
and it started when I was really little
with my mom and separation anxiety.
And then it's kind of spiraled in just a little bit
of depression 'cause when I feel like depression and anxiety
you go hand in hand a lot.
But I realized as I got older
that it's building up and it needs to be talked about.
And I needed someone to help guide me.
>> Steven: Ava's mental health struggles
have also impacted her physical health.
>> I have psychological non epileptic seizures due
to the traumatic event in my life and build up anxiety
and noise being in fight, flight or freeze mode.
So my body physically will freeze when I get super anxious.
>> Steven: Eva found counseling and help in an alternative
high school program, but not all students in Wisconsin
are able to get the therapy and support they need.
According to data
from the Madison Population Health Institute,
there's an extreme lack
of mental health providers in Wisconsin's rural counties.
Some of the worst areas in the state include
Florence County, which has just one counselor
for every 4,300 residents,
Pepin County, which has just one mental health provider
for every 7,300 residents.
And at the bottom of the list is Buffalo County,
which has just one mental health provider
for every 13,000 residents.
The American School Counselor Association recommends
that there be one in-school counselor
for every 250 students, but Wisconsin averages one counselor
for every 378 students.
As a school psychologist for more than 30 years,
UW-La Crosse professor Rob Dixon
has seen this staffing shortage problem firsthand.
>> When you're dealing with a shortage of some of those
important staff members
and an increase in the number of mental health concerns,
it kind of hits it both ways
and that's something that we're trying to deal with.
>> Steven: UW-La Crosse has created an online
program for teachers who want to become school psychologists.
The program goal, Dixon says,
is to attract educators in rural areas.
>> So can we deliver something
in a way that they can keep their jobs
and keep their family and keep their roots
in their community, but just add the skills.
In some ways, give that school psychology away
so that they can, they can use those tools and move forward
and help the kids that they know in their community.
>> Steven: But mental health experts
say students need a lot
more help right now, and that means more state funding.
>> I'm declaring 2023, the year of mental health.
>> Steven: That was Governor Tony Evers back
in January during his state of the state address.
Since then, he's laid out a plan that includes more
than $250 million specifically set aside
for student mental health initiatives.
Republicans on the Joint Finance Committee, however,
stripped all of it from the state budget.
>> I'm very saddened that kids are struggling.
When I think back to my time
these are not things that I personally struggled
with to the extent
that I'm seeing that kids are struggling with today.
>> Steven: Republican senator
Rachael Cabral-Guevara is the vice chair
of a Senate committee that addresses mental health
and other issues facing children and families.
She says she wants more financial support
for student mental health issues.
>> Funding for resources that are already established as well
as resources that are available in the future,
may that be in grant form
may that be in nonprofits, may that be for profits.
>> Steven: But the senator who's also a nurse practitioner
stopped short of saying how much funding.
>> I don't know if there's an exact number,
but I do believe and I do support the funding
to adequately support these programs,
so that people can get the help that they need.
>> Steven: Young people are turning
to another place to get help with their mental health.
Each other.
At Merrill High School in northern Wisconsin
there's the Raise Voice Student Club.
>> The mission statement that goes
behind Raise Your Voice is we are dedicated
to breaking the stigma around mental health.
So we do that through monthly meetings with our club members
and a lot of activities out in the community.
>> Steven: This spring, the club members held
a community walk to raise awareness
and show support for those with mental health issues.
Students like Reggie say they're becoming
more open with each other
about their day-to-day mental health challenges.
>> I don't have an issue sitting down
and saying like I'm very anxious today
and I'm having a hard time functioning.
And they will sit there and be like, that's okay.
And you know, not every day can be perfect
and I can have these really insightful
and mature conversations with my friends
over how I'm feeling and vice versa,
because we all have a general understanding
that it's something that happens
and it's not something that can just, puff, go away.
>> Steven: Students say supporting each other
and breaking down the stigma
around mental health struggles can make a big difference.
>> I think that it's really important to also
make our peers understand that this is occurring
around you and here's what you can do to help people.
Because that is gonna,
what goes around comes around.
It's gonna come back to you.
People are gonna help you if you're down
if you help others.
>> Steven: For "Here & Now", I'm Steven Potter.
>> If you are experiencing
a mental health crisis, services are available
by calling the State's 988 Crisis Hotline.
Suicides are the number one cause
of death among adolescents
and the number one way people die by suicide is firearms.
As Marisa Wojcik reports, despite
the attention mass shootings
and homicides garner, suicide by guns far surpasses those.
>> The latest round of mass shooting headlines
in the United States has infused fear
into the average person
sending their kids to school,
attending a concert
or even going to get groceries.
But while the prevalence of mass shootings
has dramatically increased,
it still remains only a fraction
of the deaths caused by firearms.
Overall gun-related deaths in the U.S.
hit a record high in 2021, at 48,830 deaths.
42% were homicide.
Mass shootings accounted for roughly
1.4% of all gun deaths in 2021.
But suicide accounted
for more than half of all people
who died from a firearm at 54%
In Wisconsin, 678 people die from a gun
in an average year.
In 2020, 62% of firearm deaths in Wisconsin
were suicide.
And the rate of suicide by firearm
in the most rural counties is two times higher
than in the most urban counties.
>> A bipartisan bill making its way
through the legislature would
provide $150,000 over the next two years toward a grant program
supporting suicide prevention in gun shops.
The grant money could go to train staff at retailers who
sell guns or at gun ranges to recognize signs that someone is
considering suicide, provide prevention materials,
or provide voluntary firearm storage
for the owner of the weapon.
We turn to Dr. Tony Thrasher, president of the Wisconsin
Psychiatric Association, for his take on this proposal,
and thanks very much for being here.
>> Thank you for having me.
>> So, what is your take on this proposal?
I think it's an excellent first step.
Gun violence in Wisconsin, and gun violence nationally,
is a public health issue.
And it's worsening, and while most people think of gun
violence and the focus is on externalized violence such as
homicide or mass shootings, the majority of gun violence in most
states now is suicide.
So this is a really good first step in a public health sense.
Kind of the community looking out for everybody and getting
this information into an area where there are a lot of
firearms and a lot of people looking to purchase firearms.
And whether you're reaching somebody who is suicidal or a
family member of someone who may be suicidal,
it's a really nice intervention that hopefully will have
significant impact.
>> So, what would gun retailers be looking for to recognize in
someone who might be considering suicide?
>> I think there's a lot of good conversations
that happen at any retail intersection
and any sort of marketing and sales component.
So, I think getting those frontline individuals to look
for signs of depression, sadness, mood lability, anxiety.
Even sometimes going so far as to look for specific warning
signs about people talking about the end of their life or feeling
helpless or hopeless might be a really nice intersection for
people to intervene or at least talk to somebody and offer
services.
>> How would they respond to those signs?
I think that's going to be a very interesting scenario,
depending upon which group is doing it
and in what part of the state.
You may be-- most counties have crisis service type of
intervention, so it'd be a nice pairing to have as if somebody
does one of these grants, making sure they know who their mobile
crisis workers are.
They could come talk to somebody and help them through this.
A lot of periods of suicidal ideation are very powerful
and very episodic.
And so, there's good evidence that if we can get somebody to
somebody when they're having their worst day,
that you can make a big difference.
And not just abort that suicide attempt,
but abort future suicide attempts.
>> Why is that kind of point of contact with a gun retailer
or a gun range important?
>> I think there's two components to it.
One is, I think, what probably seems most apparent,
which is if somebody is feeling impulsively self-harmful,
and they don't have a firearm, that is most likely where they
would obtain a firearm.
But I think the even bigger picture is one of culture.
I think whenever you kind of look at the issue around
firearms, it's naturally can be divisive.
Even when we wish in a public health sense that it was not.
And so, in this case, by kind of setting up at that shop,
we are starting a cultural shift.
Then, it's okay to talk about being suicidal,
and it's okay to talk about being depressed,
even if you are someone who owns firearms or has family members
who own firearms.
I think it's a neat way to start breaking down some of that
stigma and just opening up the conversation.
Hence, why that may be a better cultural component
than anything else.
>> Do you think it's likely that someone would actually
voluntarily hand over their firearm if a retailer or another
person said, "Look, you look like you're having a little bit
of trouble. "?
>> I do, and I think we see this a lot in safety planning with
people that have suicidal thoughts is they're already
doing this.
They're often sharing it with family members or friends or
perhaps engaging in other good means reduction issues like gun
locks or specific gun safes they don't have access to,
or the codes are changed whenever they're having periods
of depression.
So, I do think having this as another alternative,
particularly with a lot of people that kind of work with
their firearms on a regular basis, and perhaps ex-military,
ex-law enforcement, that relationship with the retailer
may be a friendship one, as well.
So, you may have some kind of ties in between family, friends.
"Who would I feel safe leaving this with for the short term?"
I do think there's a lot of possibilities there.
The Department of Health Services reports that the
suicide rate in Wisconsin increased 32%
from 22, 000 to 2020.
>> Are suicides still on the rise?
>> Yes, scarily enough, the population it's rising most in
is our younger generation.
Ages 15 to 24, it is now the number one cause of death,
which, if you go back 10 to 15 years ago,
seems very shocking compared to what it used to be when we
focused on things like impaired driving and accidents.
But unfortunately, suicides are on the rise,
and given that firearms are unfortunately the most lethal
way to do that, it makes sense if we're going to look at
reducing suicide, we look at addressing that primary cause,
which is firearms.
>> Are there areas of the state that are suffering more?
>> Unfortunately, we start to see a lot of suicides,
more so in rural areas than urban areas.
I'm not so sure that's a causative,
as much as a correlative, but those are definitely areas with
less resources, or it's harder to get to the resource.
And so, unlike Madison or Milwaukee,
where your therapist may live within a 5-minute drive,
you're talking about people that live in areas that may not get
to those services without driving hundreds of miles.
So, in addition to other risk factors in the rural area,
particularly farming communities where we've seen a rise in
suicides over the past two years as well.
>> So, other than not having kind of the mental health
supports, potentially, what else is driving those trends?
>> You tend to see in the rural communities?
Not just like you said probably lack of connection to services,
but also, you're in a much more isolated area.
>> So, we know a lot of treatment for depression and
mitigation against suicide is connectedness, community.
And while there are wonderful communities,
they can be more spread out.
The more rural you get, you also find a higher possession rate of
firearms in that area, too.
So, once again, something that is of high suicide risk is much
more probably obtainable in some of those areas than in other
sections that have lower suicide rates.
Which once again, when people are having their worst days,
what you want to do is have a safe environment around them.
And the more firearms there are, the less safe it becomes.
>> So, you have described this as kind of a good first step,
and you think that other professionals like yourselves
in and in public health think the same?
>> Yes, very much so.
And I think the nice thing about the public health realm is
twofold.
One is we're dealing with it as a community.
This isn't an issue where we say it's your job, or it's your job,
or they should be doing more.
If it's a true public health problem,
then we all get together to try to fix it in doing what we can
from each of our specific specialties.
And secondly, public health interventions have worked.
Seat belts have worked.
Catalytic converters in cars have worked.
Putting child-proof tops on medicine bottles has worked.
Public health interventions can mitigate large-scale kind of
risks to our health.
And I think this is no different.
So, it's nice that this is kind of a first step,
but I hope we continue to enlarge it in a public health
sense, as we look at gun violence really as probably the
primary public health thing facing our society right now.
>> And what would the next steps be in your mind?
>> It would be nice to see further consideration of
education beyond retail gun shops.
Really getting this out into the open.
I think education is huge because there's a lot of people
that own firearms that themselves have never been
suicidal.
So, you don't think about it as a risk,
as opposed to saying there's other people that are in your
house.
There's other people in your orbit.
There's other people you'll come into contact with.
They may be feeling that way, and as such,
we want to mitigate their risk too.
And of course, another consideration down the road is
many states have initiated some ways to remove firearms based
upon other criteria, against people's will,
which this bill is not that.
This is a volitional possible handing over firearms,
but there are other things, such as emergency restraining
protective orders, that have been seen in other states across
the country that has either reduced suicide rates or
sometimes reduce violence to others rates as well.
>> All right, Dr. Thrasher, thanks very much.
>> Thank you for having me.
In other difficult news,
opioid overdose deaths are reaching all-time highs,
with Fentanyl remaining the leading cause.
But in a hopeful trend, harm reduction interventions
have meant deaths have not doubled,
as was feared without such efforts.
Zac Schultz has more.
>> Narrator: Fire Station 31 in South Milwaukee
isn't used to respond
to fire calls anymore, but the firefighters inside
are still dealing with emergencies.
Captain Dave Polachowski says this cabinet is where
they store the HOPE Kits they distribute to opioid users.
>> We have a few things inside here.
Most importantly for harm reduction
we have Narcan inside of here.
>> Narrator: Polachowski runs the MORI program
the Milwaukee Overdose Reduction Initiative.
They follow up every drug overdose call
and attempt to provide help, but lately
many overdoses have been fatal.
On April 4th
the fire department called a press conference to
announce there have been 17 fatal ODs in just three days.
But that was just the beginning.
>> That was a rough couple days.
A lot of fatal overdoses.
Like we said, the 17, which I think one of
the oldest one being like 83 years old
which is really unheard of.
Right after that, I think,
I believe we had another 17 within
I think four to five days after that.
So you had over 30 in about a week period
which is just a horrific number for, you know,
a city our size.
>> Narrator: Polachowski says there were more
than 640 fatal overdoses last year
and the number would've been higher
if it weren't for the harm reduction measures
like free Narcan and Fentanyl testing strips.
>> Otherwise, I'm sure we would be well over a thousand here
in the county.
But that was a, that was a kick in a stomach.
With all that we're doing,
when you see something like that happen
in such a short time, it's like, ah, you know,
what are we doing here?
>> What should we be doing differently?
I mean, there's an increase
in the amount of assistance that's out there,
there's the testing strips, there's the Narcan,
there's programs like this
and yet we're still seeing this, this traumatic increase.
>> Yeah. I don't know
if I have an answer to that, to be honest.
It's shocking, right?
>> Narrator: Ryan Gorman is an addiction counselor
for community medical services.
He says the people in the drug using community
don't need a press conference to understand
what's happening.
>> They're aware of it, I think in a much more real sense
than the rest of us are experiencing it.
>> Narrator: Gorman says drugs are being cut
with other substances to increase their narcotic effect.
>> The supply is tainted and it's not getting better.
The prevalence of actual heroin
is almost nonexistent from what we see.
Urinalysis and just word on the street.
It just doesn't exist anymore.
So the presence of fentanyl
and then fentanyl being adulterated
with even more complicating substances
being added to that
I think that's the, that's what's responsible
for the sharp increase in overdoses.
>> Narrator: The latest ingredient being added
to drugs is xylazine,
most commonly used as an animal tranquilizer.
But since it's not an opioid
Narcan won't reverse its effects.
>> I think it's very serious
and a part that's really scary about it
is the fact that an Narcan doesn't work on it.
>> Narrator: But Gorman doesn't want people to lose focus
about what's causing the fatalities.
>> And I really want to be explicit about it.
It doesn't present the same degree of danger
as fentanyl.
Fentanyl is still the thing that's killing people in mass,
right?
It is a very, very dangerous drug.
>> Narrator: As the opioid epidemic grows
the way we handle the impact has to change as well.
For Captain Polachowski, that means going
to the user and offering them ways to be safer.
>> People call it enabling.
We don't look at it like that.
We say it's enabling you to stay alive
until you are willing to get treatment.
So while some people look
at having Narcan out in the community
is you're just allowing people to use more drugs.
Well, if the Narcan isn't there
they're gonna potentially die
and never get the help that they need.
>> Narrator: For Ryan Gorman, that means opening
up this new medication assisted treatment center
in Pewaukee where the waiting room contains a table
for kids who are there with a parent.
>> The vast majority of our patients are gainfully employed,
family, lots of homeowners, renters, yeah.
They're not the person that most people picture.
>> How much of the social view of drug use and how to
do harm reduction has changed as drug use has moved
out of certain populations and are already stigmatized?
>> Yes.
>> And become more known in suburbs,
in wealthier areas among people who have more privilege.
>> Well, you know what, it's funny I mentioned that before.
I've been everywhere in the county in some areas where
you just say, ah, you know what doesn't happen over,
it absolutely happens there.
>> I think people attribute the rise in overdoses
in the suburbs to there suddenly being opioids here,
and that's not my experience.
Right?
I grew up in the suburbs and they're always,
they've always been there.
They're just more dangerous.
>> Narrator: Reporting from Milwaukee,
I'm Zac Schultz for "Here & Now".
>> And finally tonight,
a Dane County judge said this week
he will order the Wisconsin Elections Commission
to abandon a previous decision they made
dismissing a complaint
over Wisconsin Republican false electors,
and ordering the commission
to take that complaint back up again.
>> Reporter: The complaint,
filed by the liberal group, Law Forward,
was about the 2020 slate
of fake Wisconsin GOP electoral ballots
cast for Donald Trump.
In a closed meeting last year,
the WEC unanimously rejected the complaint.
That was after the Wisconsin Department of Justice
decided with the Republican electors' argument
that their actions were a precaution
while Trump's challenges to the election
were still moving through the courts.
The WEC must take up the complaint again,
except without Commissioner Bob Spindell,
who acted as one of the false electors,
but refused to recuse himself
from the Commission's vote on the complaint.
>> For more on this
and other issues facing Wisconsin,
visit our website at PBSWisconsin.org,
and then click on the News tab.
That's our program for tonight.
I'm Frederica Freyberg.
Have a good weekend.
♪ ♪
>> Announcer: Funding for "Here & Now"
is provided by the Focus Fund for Journalism
and Friends of PBS Wisconsin.