ODNI Mental Wellness Course
Disclaimer
The information provided in the following training material is for informational purposes only. This content is not and should not be constructed as medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. The opinions, materials, and information contained in the training, other than the information at the cited Government websites, are provided for educational purposes only and should not be interpreted as necessarily representing the official policies or endorsements, either expressed or implied, or EEOD, NCSC, ODNI, or the U.S. Government. The material contained in this training course may be subject to copyright. Further reproduction or dissemination by any means is subject to original copyright restrictions and is generally prohibited without the copyright holder’s permission.
Welcome
We spend much of our lives working with the goal to accomplish the mission and in the process, interacting with coworkers who share this same goal. To accomplish this goal while also enjoying our job, we recognize the importance of fostering a supportive workplace environment. This includes knowing how and when to offer support to our coworkers and when to be aware of our own need to sometimes seek support for ourselves. This issue of support is sometimes more difficult when dealing with the area of mental disorders. There is a great deal of misunderstanding about mental health that can be made more confusing when we see reports of violent incidences occurring on government grounds and media presentations suggesting the perpetrators often have severe mental illness. This can cause us to unconsciously link violence with mental disorders; however, in this course you will learn the truth about mental disorders, including the belief that high incidences of violence are associated with mental illness is actually a myth. And while there are times when behaviors of security concern do overlap with mental disorders and require further review, the overwhelming reason for an employee to visit an agency’s Employee Assistance Program (EAP) is to have an objective, trained professional help sort out generally temporary and minor emotional problems the employee is currently dealing with.
Demystifying Myths Overview
This course will take approximately 30 minutes to complete. It is designed to bring a mindfulness to the community about mental disorders and help answer some key questions: 1) What is the truth and what are simply myths surrounding mental disorders? 2) Should individuals with a mental disorder be able to hold a clearance? 3) How does inappropriately talking or gossiping about an individual’s mental disorder with coworkers cause hurt to that individual and further reinforce a myth or stigma? How is it the opposite of providing support and empathic understanding? 4) Do you unknowingly have a problem that would benefit from seeking treatment at an EAP? 5) How do you report behaviors of concern which may or may not be related to a mental disorder? After completing the course we encourage you to seek out additional information regarding mental wellness as part of a focus on ensuring a healthy and supportive workforce. Let’s watch out for each other and offer support in a caring way.
Celebrities and Mental Health
14.8 Million American adults have major depression.
Video Transcript
[Music]
Psychological conditions are common. Studies show that as many as 1 in 4 individuals experience a psychological condition at some point in their lives. Yet the stigma of having a psychological condition remains a concern of many individuals, including cleared personnel. In an attempt to reduce the stigma of psychological conditions, several celebrities have come forward with their own stories. Dwayne "The Rock" Johnson has been candid in describing his history of depression. Leonardo DiCaprio has discussed his symptoms of obsessive compulsive disorder. J.K. Rowling, author of the Harry Potter book series, has discussed her past depression. Catherine Zeta-Jones has shared about her bipolar disorder. Lady Gaga has been open in discussing her experiences coping with post-traumatic stress disorder. Psychological disorders are not a sign of weakness, nor do they prevent you from living a healthy and productive life. Behavioral health treatment works, and seeking treatment when needed shows good insight and judgment. Do not let shame, stigma or fear prevent you from seeking the care which can help you.
Interview with a Psychologist
Video Transcript
Dr. Martin Petrillo, PhD, ABPP Chief Psychologist Assessment Services
[Dr. Petrillo] The largest obstacle faced by people who could benefit from mental health care is the stigma attached to it. Although the stigma is not quite to the degree it was even a generation ago, it still remains. A 2010 study by the CDC indicated that the vast majority of people, over 87% in that study, agreed that the mental health treatment is effective in helping people live normal lives. However, when asked if others were caring and sympathetic to those with mental health symptoms the number dropped to 57%. Perhaps the most telling, was that when asked if others were sympathetic and caring to those with mental health symptoms the number dropped even further to 25%. So, we can see that the stigma associated with mental health care is present and very influential. But, we don't need a study to tell us that, just think about the words that are used to describe people who seek mental health assistance.
[Music] [TITLE CARD: What is the biggest obstacle facing people who can benefit from mental health care?]
[Dr. Petrillo] We've all heard the derogatory phrases, such as he is a whacko, she is psycho, he's not playing with a full deck. We would never describe someone in such a derogatory way who was suffering from diabetes or heart disease, yet as a society we feel less restrained when describing someone who has a mental health disorder.
[Music] [TITLE CARD: What do you mean by "type of words used to describe people who seek mental assistance"?]
[Dr. Petrillo] Mental illness is not rare, in fact some estimates put the rate of mental health conditions at 1 in 3 adults in a lifetime. I think that statistic highlights 2 very important facts; the first is that the prevalence rate is very high and the second is that there is a lifetime rate, meaning for the majority of people, mental health symptoms don't last a lifetime. What is unfortunate is that most people with mental health symptoms do not seek appropriate care and suffer needlessly. Another fact that is important to keep in mind is that mental health treatment works. It is effective, relatively inexpensive, and typically takes less time than most people think it would.
[Music] [TITLE CARD: Have the counseling services within agencies across the IC been an effective strategy?]
[Dr. Petrillo] Yes, it has been very effective. It's hard to prove a negative, and therefore difficult to say that days lost to sick leave or effectiveness at work have improved, however, there have been studies looking at similar programs that have demonstrated very clear benefits. The Rand Corporation published a research article in 2015 looking at the effectiveness of college and university counseling centers on their students. The study found that graduation rates were higher among students who utilized the counseling services than those who didn't. If you think about it, there are parallels between our IC agencies and universities; both are large organizations comprised of highly educated people who face similar demands, such as shrinking resources and high pace, and both are somewhat self-contained. I'm a firm believer in the benefits of having counseling services readily available and I am certain the benefits far exceed the costs.
Wellness Magazine
Nuts and Bolts Volume 1
A magazine dedicated to addressing stigmas, demystifying myths, and unveiling truth about those living with mental disorders. Take some time to go through this magazine, and remember the key facts; you may see them again towards the end of the course.
Page 1 and 2 - I Suffer in Silence
Words can wound. Our language is filled with slang terms that get carelessly spoken but can sometimes be perceived as rude or stigmatizing by those living with a mental illness. Statements like, “Are you crazy?” or, “He is nuts” can sometimes serve to reinforce stigmas when heard by someone with a mental disorder. The title of this magazine is an example of this and was left as is to emphasize this point. Some content developers thought having “Nuts” in the tile of this magazine was a clever play on words, while others felt it was demeaning. It was decided to use the title as a learning opportunity to illustrate that sometimes, even with the best intentions, individuals could misperceive certain words and suffer harm. So, think before you speak if using language that reflects a mental condition.
Stop the stigma of mental illness.
Page 3 - Facts
One in three have first-hand experience with mental illness. One in four adults experience mental illness in a year. That’s 61.5 million Americans. One in seventeen live with a serious mental illness.
Page 4 - Healthy
Recent evidence suggests that good nutrition is essential for our mental health and that a number of mental health conditions may be influenced by dietary factors.
Page 5 and 6 - Myths and Facts about Mental Illness
Myth: Mental disorders aren’t real illnesses, like heart disease and diabetes.
Truth: Mental disorders, like heart disease and diabetes, are legitimate physical illnesses. Research shows that brain chemistry, genetics, and life events are causes for mental disorders, and they can be treated effectively.
Myth: Mental disorders will never affect me.
Truth: Approximately 1 in 5 adults in the U.S. experience a mental disorder in a given year. Even if you never experience a mental disorder yourself, it is very likely that a family member, friend, or co-worker will experience challenges.
Myth: People don't recover from mental disorders.
Truth: People can and do recover from mental disorders as many different kinds of treatments, services, and supports are available. Most people with disorders show genuine improvement over time and go on to lead stable, productive lives.
Myth: All people who consider suicide want to die. There is nothing that can be done about it.
Truth: People who contemplate suicide are undecided about living or dying. They may gamble with death, leaving it up to others to rescue them. Frequently they call for help before and after a suicide attempt. The Suicide Prevention Lifeline (800.273.8255) can save a life.
Myth: In the scheme of illnesses, mental disorders are rare.
Truth: Mental disorders are more common than AIDS, cancer, diabetes, and heart disease.
Page 7 - Gossip
If your coworker entrusts you with personal information, refrain from repeating it. Avoid the temptation to treat it as a bit of juicy gossip. Gossip often shames and embarrasses the coworker, but it also speaks volumes about those who spread it.
If tempted to gossip, stop first and ask yourself why you would want to repeat the information. If it isn’t out of kindness, out of the spirit of helping, then it’s best to keep the information to yourself.
Page 8 - Anxiety Signs
1. Feeling nervous, anxious, or on edge
2. Not being able to sleep or control worrying
3. Worrying too much about different things
4. Having trouble relaxing
5. Being so restless that it is hard to sit still
6. Feeling afraid, as if something awful might happen
Page 9 and 10 - Did You Know?
1. What percent of American adults are diagnosed with bipolar disorder? 2.6%, 7.3%, or 25%? The correct answer is 2.6%.
2. What percent of American adults are diagnosed with a personality disorder? 2%, 5%, or 12%? The correct answer is 5%.
3. How many American adults are diagnosed with OCD? 1.2 million, 2.2 million, or 5.5 million? The correct answer is 2.2 million.
4. How many American adults are diagnosed with PTSD? 2 million, 4.6 million, or 7.7 million? The correct answer is 7.7 million.
5. How many American adults are diagnosed with schizophrenia? 1 million, 2.4 million, and 6.2 million. The correct answer is 2.4 million.
Page 11 and 12 – Employee Assistance Programs
When an individual or manager contacts EAP concerned about someone that they want to help, they should not attempt to use diagnostic language, but rather stay focused on the behaviors of concern and make sure they refer the person for help.
The vast majority of people seen in EAP’s are experiencing everyday life events that can cause stress. Specific mental health issues can occasionally arise, such as marital strife, adjustment issues at work, general life stress, etc. The good news is that the symptoms are often short-term, highly treatable, and can be managed with help.
It is not necessary to have a major mental health disorder, such as bipolar disorder or psychosis, to seek treatment from an EAP. Employee Assistance Programs are there to assist employees in dealing with all types of life events that impact an individual’s mental health.
Which of these is the correct way to describe an employee’s behavior to EAP?
“I think Sally is depressed and needs therapy.” Or, “I’m sure it’s nothing, but I’m a little concerned that Sally seems tearful lately.”
The correct way to describe Sally’s behavior is, “I’m sure it’s nothing, but I’m a little concerned that Sally seems tearful lately.”
Page 13 – Workplace Programs Panel - Video Transcript
[Round table discussion featuring Alan Rocha from the Texas Tribune, Dr. Lynda Frost of the Hogg Foundation for Mental Health, State Representative Garnet Coleman, Dr. Andy Keller of Meadows Mental Health Policy Institute, and Adrienne Kennedy from the National Alliance on Mental Illness]
MS. ROCHA: Representative Coleman, you've been very open about your issues relating to bipolar, and what consequences are there with not being open and up front about what you're dealing with?
REP. COLEMAN: Well first of all, if you're dealing in the work place, if you could have a confidential conversation with someone who understands what is happening with you and what the challenges are and to be as accepting as that, say as somebody who has cancer who can't get to work some days because of the cancer treatment.
DR. KELLER: I mean, I think a lot of times, you know, is we would expect with the health condition is you would go to your doctor and there would be screening for that and you'd be able to get help from your doctor to access specialists. That's really not the case for mental illness, it's something that, unfortunately, two-thirds of folks don't ask for help and I think that's really I think the tragedy around, you know, peoples' unwillingness to talk. I think, you know, as Representative Coleman said, folks are, you know, careful about all sorts of illnesses around work, but when it comes that you're not even willing to ask for help, I think that's the first barrier, is getting past that. And then when you want to ask for help, a lot of times you have to ask several times because you got to find somebody who could connect you with somebody and if you ask your family doctor a lot of times they have to go ask somebody, so I think there's really many barriers once people make that decision but, you know, I think the first barrier to overcome is to simply to ask. And I think as long as you're doing as Dr. Frost said, about talking to people who can keep it confidential who can kind of help you think through it, a lot of times that's a great way to access, whether that's a pasture, whether it's a teacher--if you're a student--whether it's a friend or a family member who can sometimes advocate and help you.
Dr. FROST: I think we also need to keep in mind that there are tremendous strengths that people who have faced big life challenges bring to the table and in looking at employment situations we're all trying to find a good fit where our strengths are appreciated, and so we've been talking about some challenges about disclosing some difficult life experiences but there are a great strengths that come with that and so I think everyone's hope is to find a place where that is valued and respected and it's a helpful thing in the workplace. So community mental health services play a key role. We want to address any kind of trauma, stress, challenges people have as early as possible, there's a lot of research that shows that the earlier you can address challenges the better off everybody is, the better off the individual is, the family member, the better off we all are as taxpayers, so having a robust system of supports in the community is essential to having the society that we want to have.
Page 14 – Be Heard
We want you to feel secure. In and of itself, seeking professional assistance for your mental health does not jeopardize your security clearance.
Violence and Mental Health
Only five percent to seven percent of violent acts can be attributed to individuals living with a serious mental illness.
Video Transcript
[Music] [Title Card: Violence & Mental Health]
DR. STONE: The general public, I think, is at the mercy of what they read in the papers, uh, and so they often--and some of the crimes committed by mentally ill people are very dramatic and unusual. [Clears throat] For instance, some years ago, must be about maybe more than 20 years ago, uh, there was a fellow, Juan Gonzalez, on the Staten Island ferry that took a sword of some sort and killed two people. And that of course was very dramatic and was very much publicized, so that it's things of that sort that, uh, the public, not knowing the full statistical picture, are going to get the impression "Oh my god, mentally ill people you really better steer clear of them if you knew who they were because they are highly at risk to do something terrible and dramatic and violent." So, it gives the public the worry that "Oh my god, the people that are mentally ill are doing these things all the time and the people that do them must be mentally ill because it's crazy to commit murder." But the fact of the matter is from a standpoint of actual diagnosable psychosis by a qualified psychiatrist, the number of violent crimes that are committed by mentally ill people or psychotic people is relatively small, maybe 5 or 6 or 7 percent.
Ask the Expert 1
Statement: I’m not mentally ill, why should I get counseling?
Response: Making the decision to talk to a trained individual who is experienced in dealing with life stressors does not imply that an individual is “crazy.” Often the most immediate effect is to allow the individual to examine a problem objectively and assess options for dealing with it.
Warning Signs
There were popular sayings many years ago, "Don’t bring your problems to work" and "Leave your emotions at the door." Well, let’s be real; we’re humans, and emotions come with the package. Emotions can’t simply be turned on and off like a light switch. Through Emotional Intelligence they can be brought to our attention and managed, but not omitted; nor would we want them to be. They alert us to danger and allow us to love.
So, if you are experiencing occasional feelings of sadness, anger, or grief, that is expected; however, if these feelings expand over a period of time, and are interfering with your relationships or work, you may want to seek help. Some of those warning signs are:
1. Change in baseline behavior (going from engaging to quiet, becoming tearful when normally very even-keeled, etc.)
2. Consistent late arrivals or frequent absences
3. Lack of cooperation or a general inability to work with colleagues
4. Decreased productivity
5. Increased accidents or safety problems
6. Frequent complaints of fatigue or unexplained pains
7. Difficulty concentrating, making decisions, or remembering things
8. Making excuses for missed deadlines or poor work
9. Decreased interest or involvement in one's work
10. Working excessive overtime over a prolonged period of time
11. Expressions of strange or grandiose ideas
12. Displays of anger or blaming others
13. Poor hygiene
Ask the Expert 2
Statement: I can’t believe people with a mental disorder can get or keep their clearance.
Response: Violence is often not tied to a mental disorder. The vast majority of people who have a mental health issue are never violent and are simply in need of mental health treatment and support. Furthermore, the decision to seek treatment when someone does have a mental disorder is viewed as a positive sign that an individual recognizes that a problem exists and is willing to take steps towards resolving it. For the vast majority, seeking professional help does not adversely impact their career.
We Want You to Feel Secure – Be Heard
IC employees are not immune from the normal life stresses and difficulties that confront the population at large. Regardless of whether an individual holds a security clearance, at some time in life he or she may face problems with interpersonal relationships, depression, alcohol, family issues, or similar difficulties. Often, the decision to seek help is confounded by individuals' misperception that their security clearance may be in jeopardy regardless of the problem for which they seek help. Some believe that their judgment might be considered suspect if they seek assistance in dealing with a stressful situation. Seeking help for routine life crises does not reflect adversely on an individual's judgment, and, in fact, security and counter-intelligence officers view the commitment to seek help as a positive judgment factor. Seeking professional assistance in dealing with a problem does not jeopardize an individual’s security clearance.
Ask the Expert 3
Statement: I wonder what will happen when I come up for reinvestigation?
Response: The background investigator will ask a standard question about whether you have sought counseling for problems other than marital or family issues, combat-related trauma, or sexual assault. Replying that you have visited EAP satisfies the investigator who will then seek no further details. If you seek treatment from an outside therapist, the background investigator will ask limited questions after you sign a release.
Ask the Expert 4
Statement: I wish people understood.
Response: The clinicians at EAP offer a safe and supportive environment to help you better understand your situation and how to cope. Counseling available from EAP is confidential, except within an extremely limited set of circumstances. EAP will review these limits with you before you meet with a clinician. No one from EAP will report to your manager, security officer, or anyone in your office what is discussed during counseling without your permission or knowledge.
Inclusion for All
"Sticks and stones may break my bones, but words will never hurt me." A childhood saying that we now have come to realize is not necessarily true. Words can hurt, and an abundance of them can place us down a path of misery. But, through training, assistance, and professional counseling, we learn to debunk myths and gain understanding that will bring enlightenment, awareness, and inclusion for all.
Working with Diagnosis
My sister lives with depression and handles working well.
Video Transcript
[Music]
KERIS: Okay, so my name is Keris and, during my time in college, I was diagnosed with obsessive compulsive disorder as well as schizophrenia or schizoaffective, depends on which doctor you ask on which day. Um, I guess most people think of that as a serious mental illness, but I like to think of it as having a mental illness that at times can be serious. And what that really means is that, like other people may have a physical illness, there are a couple of days where I may need to take some time off, just like anybody else. It’s really all it really means for me.
[Title Card: HOW WERE YOUR COLLEAGUES MADE AWARE OF YOUR ILLNESS?] [Music]
KERIS: So we had these brown bag presentations, and it was like a training for staff, and we had a well-known lawyer, uh, advocate, mental health advocate, a lady who lives with schizophrenia herself, a diagnosis of schizophrenia. She was doing a presentation for the staff to raise awareness about mental illness, living with schizophrenia, the importance of telling a personal story, and, and she turned to me--we know each other--she turned to me and said, "So, Keris, as person living with schizophrenia, what do you feel about that?" Later a staff person stopped by my office and said, "Wow! I had no idea you had this diagnosis of schizophrenia." If you think about it, 1 in 4, 1 in 5 Americans are affected by mental health conditions some time in their lifetime. So if we do the math of all the employees that work here in our Agency, probably going to find a number of people that we're working with who are living successfully and in recovery and could use our support when they need a little bit of help.
[Title Card: WHAT ADVICE DO YOU HAVE FOR ANYONE AFRAID THEY'LL LOSE THEIR CLEARANCES OR RESPECT OF PEERS DUE TO ILLNESS?] [Music]
KERIS: I had my own fears about disclosing. But, of course, you know, you're obligated to tell the truth on the forms, and when I came to work here I thought, "Hmmm, some people are going to know and some people aren't going to know, and what happens if I have to disclose, and will I be safe?" So, I had my own, my own fears about that but, my bigger fear is, you know, getting to the point of not being well enough to come to work. That overrides everything for me to be, uh, to be able to, find someone that I can trust.
[Title Card: HOW SHOULD I APPROACH A COLLEAGUE WHO I SUSPECT MAY NEED HELP?] [Music]
KERIS: I think the first thing you can do is just ask somebody, "How can I help you?" "Hey, you know, I noticed, you know, this is happening" or, you know, "I'm here to be of support to you." I call it the difference between, you know, knowing the difference of when to support and possibly when to report. So, I think you can, you know, have both in mind when you're helping somebody out, no matter who that person is, whether they have a mental health condition or not.
Mental Wellness Overview
People who live with mental health disorders are often misunderstood and unfairly judged out of fear and lack of understanding. Stigma is the main reason people don’t talk about their mental health symptoms or seek help.
Some harmful effects of stigma include: the reluctance to seek help or treatment; lack of understanding by family, friends, and coworkers; fewer opportunities for work, school, and social activities; health insurance that doesn’t adequately cover mental health treatment; and the belief that you will never be able to succeed at certain challenges or change your situation.
You can help break the stigma by learning the truth about mental disorders and becoming a mental health advocate!
The Two Faces of Bipolar Disorder
Video Transcript
[Music] Bipolar disorder can have lots of effects on a person's day-to-day functioning. So for instance again, in the middle of an episode of either mania or depression, people who are manic will often do things that are really impulsive and really out of character. And so issues of infidelity can come up, for instance, and a patient with mania who's having a sexual partner or sexual partners outside of the relationship in the midst of a manic episode. People will often spend money that they really can't afford to spend in the midst of a manic episode, which you can imagine will cause a lot of strain for them personally, but also in the context of their families. People in the midst of mania often don't appear to be logical and so they will go to work and will have lots of irritability and you can imagine again that coworkers are confused, bosses are confused, and especially if they don't understand a lot about the illness it can affect their work relationships and their ability to maintain their employment. You can imagine that if it's hard to get up out of bed and even go to the supermarket and get your groceries for the day that it can be very difficult to go to work and get all the things that you needed to get done, either in your work life or, again, or in your personal life. People report guilt or sometimes feeling like they're worthless. People will also report that they feel like they're either kind of moving in slow motion, which is known psychomotor-retardation, and occasionally people will report that they often feel jittery, which is known psychomotor-agitation. In addition people will report disturbances in their sleep, which are most commonly insomnia, so either difficulty falling asleep, waking up in the middle of the night, or waking up earlier in the morning than one intends to. Occasionally this could be hypersomnia though, where people are sleeping for instance 10, 12, 13, 14 or more hours per day. [Music] Patients with bipolar disorder often are resistant to receiving treatment, especially during a manic episode. And this is really part of the illness in terms of not understanding that one is sick. Bipolar disorder cannot be cured, however people will often find that they will go, you know, periods of time without having any illness or periods of euthymia. It really depends on the individual and how their clinical course goes, as well as finding treatments that work. The mainstay of treatments are the mood stabilizers, so these are medications that are used to keep somebody from having most notably a manic episode or a depressive episode. Finding the right treatment can sometimes be a little frustrating and patients really need to hang in there as their doctors try different medications to figure out what works best with their neurobiology. In order to support a loved one who has bipolar disorder, it's really important to realize that "this is an illness”, like any other illness. A lot of time people will think of mental illness as being something that's within the control of the individual. And the individual will often think that as well, feeling tremendous guilt when they do have episodes of either mania or depression. And so the first thing is realizing that people don't choose to have bipolar disorder and they would definitely choose to live with more mental wellness than having this illness. It's really important to be calm, present, and consistent with people with bipolar disorder as well as supporting them in maintaining their treatment. In the next 10, 20, 30, 50 years I really see a lot more research being done to try to find treatments that are effective and have less side effects than some of the medications that have we currently available today. I really only see better things for the future. [Music]
Quiz
1. Which of the following statements about bipolar disorder is true? A) Bipolar disorder can affect one’s day to day functioning. B) Medication is only required during manic or depressive episodes. Or, C) Moods can be controlled with practice. The correct answer is A) Bipolar disorder can affect one’s day to day functioning.
2. According to the video, which is NOT characteristic of an individual experiencing a manic episode? A) Impulsive actions B) Promiscuous behavior C) Anxiety or D) Irritability. The correct answer is C) Anxiety.
3. According to the video, which of the following is characteristic of an individual experiencing a depressive episode? A) Anger B) Insomnia C) Madness or D) Sadness. The correct answer is B) Insomnia.
4. Bipolar disorder is a combination of which two disorders? A) Depression and Anxiety B) Depression and Euphoria C) Depression and Mania or D) Anxiety and Euphoria. The correct answer is C) Depression and Mania.
5. What is the most effective treatment for Bipolar disorder? A) Mood Stabilizers B) Painkillers C) Muscle Relaxers or D) Shock Therapy. The correct answer is A) Mood Stabilizers.
6. True or False: Bipolar disorder can be cured with medication and therapy. The correct answer is False.
Brian Scans
Just because you can’t see it, doesn’t mean it is not there.
Music Therapy
Music has been used for hundreds of years to treat illnesses and restore harmony between mind and body. But recently, scientific studies have attempted to measure the potential benefits of music. They have found the following:
· Music’s form and structure can bring order and security to disabled and distressed children. It encourages coordination and communication, so it improves their quality of life.
· Listening to music on headphones reduces stress and anxiety in hospital patients before and after surgery.
· Music can help reduce the sensation and distress of both chronic pain and postoperative pain.
· Listening to music can relieve depression and increase self-esteem ratings in elderly people.
· Making music can reduce burnout and improve mood among nursing students.
· Music therapy significantly reduces emotional distress and boosts quality of life among adult cancer patients.
Depression and Bipolar
Depression is persistent and can significantly interfere with an individual’s thoughts, behavior, mood activity, and physical health. It is the leading cause of disability in the U.S. and many other developed countries.
Bipolar is a medical illness that causes extreme shifts in mood, energy, and functioning. Bipolar disorder is a chronic and generally life-long condition, with recurring episodes of mania and depression that can last from days to months and that often begin in adolescence or early adulthood and, occasionally, even in children.
Self-help Brochures
Schizophrenia and Psychosis
With medication, therapy, and support, many people with psychosis are able to manage their symptoms, gain greater independence, and lead fulfilling lives. Finding the right treatments takes time, and setbacks do happen, but most people with psychosis get better over time, not worse. So, no matter what challenges you presently face, there is always hope.
Click the following link for more information: http://www.helpguide.org/home-pages/schizophrenia.htm
Bipolar
You are not powerless when it comes to mania and depression. Understanding the signs and symptoms and seeking professional help are the first steps to feeling better. It is important to surround yourself with people you can count on, make healthy lifestyle choices, and monitor your moods. With good coping skills and a solid support system, you can live fully and productively and keep the symptoms of bipolar disorder in check.
Click the following link for more information: http://www.helpguide.org/home-pages/bipolar-disorder.htm
Depression
Depression can make you feel sad, mad, or empty. With the aid of new information, proven self-help strategies, and support, you can beat depression. The key to recovery is to start small and make daily investments in yourself. Full recovery takes time and can be a two-step forward one step backward process, but you can get there.
Click the following link for more information: http://www.helpguide.org/home-pages/depression.htm
PTSD and Trauma
There is no right or wrong way to feel after traumatic events, yet there are many strategies that can help you work through feelings of pain, fear, and grief and regain your emotional balance. Whether the traumatic event happened years ago or yesterday, you can heal and move on with your life.
Click the following link for more information: http://www.helpguide.org/home-pages/schizophrenia.htm
Suicide Prevention
Many people ignore the topic of suicide. If you’re the one contemplating suicide, you may be afraid that you’ll be judged or labeled “crazy” if you open up. It’s just as tough for concerned friends and family members, who may hesitate to speak up for fear that they might say the wrong thing. Understand that people who consider suicide do not have a character defect; it only means that the person has more pain than they feel capable of coping with. Talking openly about suicidal thoughts and feelings to the EAP or an outside therapist, or reaching out via the Suicide Prevention Lifeline (800.273.8255), can save a life.
Click the following link for more information: http://www.helpguide.org/home-pages/suicide-prevention.htm
Anxiety
Anxiety isn’t always bad. At times, it can help you stay focused under pressure. But when worries, fears, or panic attacks start to get in the way of your life, you may be living with an anxiety disorder. There are many things you can do to manage your anxiety. Treatment is effective and recovery is possible.
Click the following link for more information: http://www.helpguide.org/home-pages/anxiety.htm
Any Given Day
Video Transcript
[Graphic reads: 8:23 am – Present Day]
[Music] [Opening sequence for News 7 Breaking News]
[News anchor onscreen with an image of first responders and soldiers at the site of a bombing. Graphics onscreen read “Six Dead in Terror Bombing,” “Six Americans Dead in Terrorist Bombing,” and “Bombing Linked to Unauthorized Disclosure”]
ANCHOR: In regional headlines this morning, a bomb exploded in a major international shopping district yesterday. Government officials have confirmed that six Americans were among those killed in the attack.
[Music] [Rich stands in a communal hallway, watching the news segment on a television screen]
ANCHOR: The bombing has been linked to the unauthorized disclosure of information involving U.S. activities in the region and is believed to be a retaliatory action.
[Julie, Rich’s co-worker, approaches him]
JULIE: Rich.
[Julie points at Karl, their co-worker, as he walks down the hallway wearing handcuffs and escorted by two agents]
RICH: Whoa, what's going on with Karl?
HEATHER: I just heard someone say that someone gave up our classified program, but...Karl?
[The news program continues to play onscreen]
ANCHOR: No organization has yet claimed responsibility.
RICH: You don't think it's connected to the bombing, do you?
HEATHER: Oh my god. I know he's been stressed lately but if only I could've done something...could I have prevented this?
[Title card reads: Any Given Day]
[Music] [Typing] [Onscreen text reads: 6 months earlier]
[Karl, Heather, and Rich are sitting at a table]
HEATHER: So, I'll make this final round of changes and then I will take it up to Danielle. That works right? We should be able to get approval for that.
RICH: I don't see why not.
[Karl fiddles with his wedding ring]
HEATHER: Karl?
KARL: Sure.
RICH: Karl, are we good?
KARL: Yeah. Why?
[Karl packs his notes up and walks over to his desk]
RICH: It's just we noticed you haven't been yourself lately. What’s going on?
[Music]
[Flash to white; Karl is at home, his wife is following him out of the kitchen]
KARL: Stop! Get off my back!
WIFE: I cannot keep doing everything by myself! You have got to help! [Baby crying] We are this close to losing the house!
KARL: No, we're not!
WIFE: Yes we are! You have got to get it together, Karl!
[Karl plops down onto the couch]
WIFE: Would you even care if I just took the baby and left? Not that we could afford that!
[Karl’s wife storms off, slamming her hand on the door frame as she heads back into the kitchen]
[Thump]
[Flash to white; the scene returns to Karl sitting at his desk]
RICH: Karl? What's going on?
KARL: Nothing. We're good.
HEATHER: (To Rich) Well, okay. (To Karl) Hey, we're thinking of heading over to Panama Jack’s, let the traffic die down. You want to come?
[Flash to white; Karl sits on the couch listening to messages on his phone cell] [Music]
BROTHER (on the phone): Hey, Karl, you're not picking up the phone, you’re not answering my texts, and you didn't show up to your niece’s birthday. Something’s not right, little brother.
[A bottle of whiskey sits on a table in front of Karl]
BROTHER (on the phone): Are you drinking again?
[Flash to white; scene returns to Karl sitting at desk]
JULIE: Or?
KARL: Uh, no thanks.
RICH: We can go somewhere else, you can pick.
[Karl grabs his bag as he stands up and begins walking out]
KARL: Uh, no. You guys go ahead.
[Karl leaves]
HEATHER: I give up. I don't what's going on with him.
RICH: I don't know.
[Music] [Karl stands in the office with Danielle, his supervisor, within earshot of Julie as she speaks with Rich at his desk]
KARL: I can't believe this!
DANIELLE: The promotion board thought you needed more experience with interagency missions.
KARL: I deserve to be promoted! I was counting on that this year! This is because I spoke my mind at the working group, isn't it?
DANIELLE: Karl, your opinion is valued. You’re a key member of the project team!
[Karl storms out of Danielle’s office]
DANIELLE: Karl!
[Music swells] [Karl passes Rich and Julie as he heads back to his desk]
RICH: You okay, Karl?
[Karl sits down at his desk]
KARL: No, I'm not okay! I got passed over for promotion...again!
HEATHER: Well, join the club. I was passed over, too.
KARL: Yeah, but this is your first board. I’ve been on this project a lot longer and I know more about this program than anybody on the team.
Our target rewards loyalty and commitment more than we do. And they pay for it.
[Soft music] [Music swells] [Karl leaves the room]
RICH: Did he really just say that?
HEATHER: Yeah, but he's just blowing off steam.
RICH: Maybe.
HEATHER: Hey, I got to run to a meeting.
RICH: Yeah, sure.
[Soft music] [Rich reflects on what he just heard]
[Scene cuts to Rich passing Karl’s desk, Karl is on the phone]
[Intense music] [Rich continues reflecting]
[Scene cuts to Karl on the phone again, Rich is in earshot]
KARL: No. Look, it's only two months late. I thought I set up auto pay, I told you that. Yeah, but it's only...it's only two months late.
KARL: Would you get off my back? I'm not drinking any more than I ever have. It was one happy hour!
[Music swells] [The scene returns to Rich, sitting at his desk]
[Rich notices a poster that reads “Are You Working with a Wolf: Protect Sensitive Information! Report Suspicious or Concerning Behavior to Your Insider Threat Office 1-866-PROTECT”]
[Soft music] [Rich picks up the phone]
[Dialing] [Ringing]
[TONY sits at his desk and picks up the phone]
TONY: Insider Threat Office. Tony speaking.
RICH: Hi, I have something I'd like to ask about. Um, it's probably nothing.
TONY: Why don't you tell me about it, we can help you figure it out?
[Typing] [Onscreen text reads: “Insider Threat Program Office”] [Music]
[Audrey sits in the lobby as Bill approaches]
BILL: Hi, Audrey. It's great to have you on the Insider Threat Mitigation team.
AUDREY: Thanks! I'm really excited to be here.
BILL: Get your stuff, follow me. Let's get started.
[Elevator bell] [Bill and Audrey exit the elevator]
BILL: You see, our job is critical to protecting the Agency's sensitive information. We analyze data to mitigate potential threats. We see everything from unsubstantiated reports to possible espionage issues.
AUDREY: Wow, that's interesting.
[They approach the break room]
BILL: Coffee?
AUDREY: Yeah, thanks. Uh, black. So, how much information is available to our analysts?
[Bill pours her coffee]
BILL: Well, quite a bit actually. But not more than we need to do the job. You see, our civil liberties and our privacy officer was a key player in getting our program up and running. And it's an ongoing process to make sure that we strike the right balance. Come on, I'll show you.
[Music] [Bill and Audrey arrive at Tony’s desk]
BILL: This is Tony. He's our operation supervisor. Audrey’s new on our team.
TONY: Welcome.
AUDREY: Oh, thanks!
BILL: Why don't you explain to Audrey how our process works?
TONY: Sure. Actually this is perfect timing. I’m just finalizing an inquiry we conducted on an employee with access to a sensitive program.
[Tony pulls up Karl’s information on his computer]
TONY: A co-worker reported that this guy seemed to be under a lot of stress and might be compromising a classified project. He was recently passed over for promotion and it appears that his marriage is in trouble. There are also indications of financial problems and a previous alcohol incident. And over the past six months his interactions with colleagues have been described as "tenuous" and "challenging."
AUDREY: So he hasn't done anything yet?
TONY: No, not at this point.
BILL: Our next step is to get our findings in front of the right people so they can decide what happens next.
TONY: In a lot of cases a supervisor can help address a person's behaviors before classified information is at risk.
BILL: But, if it's serious law enforcement, intelligence, and security offices would be notified.
[Typing] [Onscreen text reads: “8:23 a.m. – Present Day”] [Music]
[News 7 Primetime News comes onscreen, the lower text reads: “International Cooperation: Rebel Groups Agree to Negotiations”]
ANCHOR: Moving now to international news. In the Middle East, U.S. officials are attributing a decline in violence to enhanced communication and cooperation between Coalition forces and rebel factions that are holding key cities...
[Rich holds two cups of coffee as watches News 7 on a television in a communal hallway, Julie approaches]
HEATHER: Karl's more himself lately.
[Rich hands Julie a cup of coffee as they both turn to look down the hallway]
[Music swells] [Karl walks down the hallway]
RICH: Yeah.
[Rich and Julie pass Karl in the hallway]
HEATHER: Hi, Karl.
[Karl nods at Julie and Rich, then enters the Employee Assistance Program (EAP) office]
[News 7 can be seen on the wall next to the EAP office]
ANCHOR: And good news for the regional economy. A trade agreement has been approved, all parties are expressing optimism that the new effort will increase safety and stability in the region. We'll return after these messages.
[Music fades out]
[NATIONAL INSIDER THREAT TASK FORCE logo fades in]
NARRATOR: Malicious insiders have done tremendous damage to our national security. In many of these cases the damage could've been avoided if one concerned, observant colleague spoke up. By saving a co-worker from making a bad decision you might be protecting our national security as well. If you see something, say something that just doesn't seem right, say something.
[Fade out]
Talk to Your Coworkers
Talking about mental health doesn’t have to be scary.
Video Transcript
WHAT WE ARE ABOUT TO LEARN ABOUT BRAIN SCIENCE WILL BLOW YOUR MIND Transcript
[Music] [TITLE CARD: Past and Present]
[Dr. Thomas Insel, Director, National Institute of Mental Health]
DR. INSEL: We've had these disorder forever, you know, they were written about in Ancient Greece, in Ancient Rome in writings, you can see beautiful descriptions of bipolar disorder, and schizophrenia, and depression. It's called "melancholia", but same thing. Part of what you see happening now is a new understanding in a new way of explaining it, which probably isn't completely accurate but it at least it gets us to a point where we can begin to talk about this without a lot of finger pointing, without having to say, "This is her fault or his fault," and we can say, "No, this is the fault of an illness." And I think one of the things that maybe has gotten lost in this conversation over the last few years is that not only are these real disorders but we have real treatments, if people could get simply get access and get high quality care, you actually are better off with the mental disorder than with most medical disorders because here you actually can recover, and that's a message that really got to keep hammering home so that people can understand that they're losing out by avoiding care and they have a lot to gain by embracing it.
[Music]
[TITLE CARD: Progress in the Future]
DR. INSEL: We know the brain goes, it's a computer, it processes information but it doesn't work anything like any of the computers that we have in our own hands. We actually don't have a clear understanding of what the brain is doing or what the mechanisms are for this amazing organ to take in information from the world, to process that information, and then to store it and to retrieve it later. Those are all still quite mysterious to us. Having said that it's an amazing time because we have the tools to actually, for the first time, answer some of these big, big questions about how the brain works. Genetics have gotten a lot of attention and it's maybe not surprising because it's transforming every area of medicine and it's really going to provide for us the transformative insight about what is the biology of schizophrenia and depression. In terms of therapeutics there is a lot going on, the advent of what we call "rapid treatments for depression", that's transformative. The idea that for most anti-depressants you're waiting 6 to 8 to 12 weeks for a response, today we're talking about 6 to 8 to 12 hours for a response. It's a different perspective, we've moved the goal post much, much closer and our definition of success is now very different than it was even 5 years ago. I think the more relevant piece to people who are struggling are the advances that happen today around the way we think of diagnoses, so let's get to a different way of approaching diagnoses that's more predictive, that looks earlier in the process and that brings in other kinds of tools: genetics, neuroscience, cognitive science, social science, brings all of that to the table to give us a much broader picture of what somebody's actually struggling with in potentially a much more precise diagnoses. So I'm hopeful that suddenly the public is aware, suddenly people care, and suddenly people say, "Wait a second. This is like the civil rights problem of our decade. We have to think about how to do this differently at the level of policy, at the level of practice, at the level of science." And if we can do that, if we can put those three together, oh yeah, then I'm very hopeful that the future's going to look very different for people with these illnesses.
[Music] [Fade out]
Post-Traumatic Stress Disorder
Post-traumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after someone experiences a traumatic event that caused intense fear, helplessness, or horror. People with PTSD continually re-experience the traumatic event and avoid individuals, thoughts, or situations associated with the event. They frequently have symptoms of excessive emotions. PTSD symptoms usually appear within three months of the traumatic experience, however, they sometimes occur months or even years later.
Coworker Dialogue Examples
Coworker One: I never understood how many people live with these conditions…
Coworker Two: I’m glad that I sought treatment… We have an amazing EAP department.
Coworker Three: I never understood how many people live with these conditions…
Coworker Four: I should have opened up about the stress I’m under…
Conclusion
During this course, you've received a lot of information pertaining to mental health. Mental disorders like bipolar disorder, depression, and post-traumatic stress disorder (PTSD) were defined and described, and the facts about just how prevalent mental disorders like these are in the population were provided. Many of the myths and stigmas surrounding mental disorders were identified and debunked. You’ve learned that mental disorders in and of themselves are not of concern from a personnel security perspective but rather specific behaviors that demonstrate a security risk are what matter most. You've heard directly from someone living with a mental disorder about what it is like in the workplace.
Most importantly, you've been given information about how to recognize some of the specific warning signs that signify that someone, maybe even you, may be experiencing a mental disorder. Resources like the Employee Assistance Program were discussed, and you have learned that most of the mental health concerns that lead individuals to seek professional help are simply part-of-life issues.
Now that you have all of this information, it is essential that you put it to good use. The content of this course will be most valuable if it impacts your thoughts and actions in ways that increase your mental wellness and that of your coworkers on a daily basis. By implementing what you've learned, you'll help to improve the work environment and make it one in which everybody feels comfortable, supported, and accepted. Thank you for your time, and don’t forget to put what you've learned into practice in your day-to-day activities at work.
Knowledge Check
1. True or False: According to the Two Faces of Bipolar Disorder video, patients with bipolar disorder are often resistant to receiving treatment. The correct answer is true.
2. According to the Violence and Mental Health video, which is NOT an emotional state? A) Joy B) Contempt C) Surprise D) Shame or E) Happiness. The correct answer is E) Happiness.
3. According to the Violence and Mental Health video, what percent of violent acts can be attributed to individuals living with a serious mental illness? A) 20%-25% B) 5%-7% or C) 10%-13%. The correct answer is B) 5%-7%.
4. Fill in the Blank: According to the Violence and Mental Health video, depression has been referred to as the “blank” of disorders, due to the vast number of individuals affected. A) Silent killer B) Common cold or C) Family destroyer. The correct answer is B) Common cold.
5. Which of the following is a sign of a manic episode? A) Engaging in risky behaviors B) Spending money one does not have C) Irritability at work or at home or D) All of the above. The correct answer is D) All of the above.
6. What is the most effective treatment for bipolar disorder? A) Counseling/Therapy B) Exercise C) Medication or D) Diet. The correct answer is C) Medication.
7. Which is NOT a sign of depression? A) Weight loss or gain B) Too little or too much sleep C) Feelings of guilt or D) Impulsive actions. The correct answer is D) Impulsive actions.
8. When your reinvestigation occurs, the background investigator will ask whether you have sought counseling for programs, to include marital or family issues, combat-related trauma, or sexual assault. Which of the following statements is TRUE? A) Replying that you have visited the EAP satisfies the question; the investigator will not seek further details. B) The investigator will ask about the type of disorder you have and then select specific questions that will allow him or her to make a decision about your clearance. Or C) Seeking counseling automatically triggers a secondary background investigation. The correct answer is A) Replying that you have visited EAP satisfies the question; the investigator will not seek further details.
Reporting
Reporting at ODNI
A question regarding mental health is asked on the Standard Form 86 because certain emotional, mental, and personality conditions can impair judgment, reliability, or trustworthiness. However, the U.S. government recognizes the critical importance of mental health and advocates proactive management of mental health conditions to support the wellness and recovery of federal employees and others. Therefore, mental health treatment and counseling, in and of itself, is not a reason to revoke or deny eligibility for access to classified information or for holding a sensitive position, suitability or fitness to obtain or retain federal or contract employment, or eligibility for physical or logical access to federally controlled facilities or information systems.
In reality, personnel security professionals are most concerned with specific behaviors that demonstrate a security risk, not mental disorders. Examples of such behaviors include:
1. Witting or unwitting exposure of the names of IC personnel to Foreign Intelligence Service or the media.
2. Breaches in security of government facilities.
3. An employee providing classified information, wittingly or unwittingly, to unauthorized persons.
4. Attempts to gain access to information for which they have no need-to-know.
5. Coming in early to work or working late for no obvious reason.
6. Sending materials to print to other than their normal printer.
7. Not reporting foreign travel or meetings with foreign nationals.
If you observe someone performing these behaviors or other behaviors of security concerns, you should report that behavior. There are several methods for reporting such as contacting your manager/supervisor, MSD/CI, or the Employee Assistance Program. The fastest way to report a behavior of concern is to email ODNI-Insider on your classified system.
Resources
· Attitudes about Mental Illness and Its Treatment
· EEOC Enforcement Guide on the ADA Part 1
· EEOC Enforcement Guide on the ADA Part 2
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