MANCHESTER, N.H. - New Hampshire has not been known for its ethnic or cultural diversity. However, in the last decade, the face of the state is changing, with growing refugee and immigrant communities in more populated areas such as Manchester, Concord and Nashua.

With that change comes the need for education and outreach, says Bobbie Bagley, who chairs the New Hampshire Minority Health Coalition board of directors. This is especially true for mental-health issues, she says, because many refugees come to the state from war-torn countries in Africa, the Middle East and elsewhere.

"Where they've suffered trauma and situations, have had experiences that can really tax their mental-health status. These individuals are being placed in areas where that access may not be available, or where people don't even identify or even understand what the families could be going through."

This is especially true in schools, Bagley says, where refugee children may be struggling with horrific experiences, on top of adjusting to new children, teachers and an entirely new way of life.

"That 'acting out' may not be because it's a 'bad' child, but maybe because of some of the trauma that they've experienced, and now they're having some residual effects of that, that's impacting their mental health."

Because of stigmas surrounding mental health, especially in minority populations, Bagley says, many do not seek help. She says her coalition is working to change that.

July is National Minority Mental Health Awareness Month, and Bagley says her coalition, in collaboration with NAMI New Hampshire (the state branch of the National Alliance on Mental Illness), is ramping up efforts to educate mental health professionals and other service providers about changing needs. They're holding workshops and reaching out to immigrant groups about the importance of seeking assistance when needed.

More information is online at naminh.org.


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Studies show suicide is a serious public health problem, claiming more than 48,000 lives each year in the nation.

A new initiative from the Zero Suicide Institute aims to change it and demonstrate how a diverse group of hospitals in South Carolina and elsewhere can improve their suicide prevention practices.

Allyson Sipes, director of clinical initiatives at G. Werber Bryan Psychiatric Hospital in Columbia, said the Institute worked with her staff to develop best practices.

"The Zero Suicide Institute brought in a group of individuals that we could learn from," Sipes recounted. "Then having an expert faculty with a change package that we used to set our facility and what to look at and address."

Sipes explained the program was developed by the Pew Charitable Trusts to test evidence-informed methods to detect suicide risk and connect patients to treatment.

Nearly 27% of U.S. hospitals do not practice recommended suicide prevention practices, including safety planning, warm handoffs to outpatient care, patient follow-up and lethal-means counseling.

Laurin Jozlin, senior project associate for the institute, said studies show half the people who die by suicide saw a health care professional in the month before their death but were never referred to a mental health professional.

"We know that there's an opportunity in health and behavioral health care systems to intervene," Jozlin acknowledged. "They are being seen by health and behavioral health care professionals but they're often not identified as someone who is at risk of suicide."

Sara Voelker, improvement adviser for the Education Development Center, said they take ideas proven successful elsewhere and develop them into best practices.

"We put it together into a change package," Voelker noted. "Then teams pulled out ideas that had worked in other places and then, essentially, figured out a way of, 'How do I adapt this to make it work in my organization?'"

If you are struggling with mental health, help is available by calling or texting 988, the Suicide and Crisis Lifeline.

Support for this reporting was provided by The Pew Charitable Trusts.


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As Children's Mental Health Awareness Week kicks off in Arkansas, an expert said parents can help their children have a healthy brain to thrive.

Charles Fay, child psychologist and president of the Love and Logic Institute, said national data show roughly 42% of adolescents aged 12-17 in Arkansas, mirroring national trends, receive services for severe depression.

He argued a healthy brain is the foundation of good parenting and Arkansas parents could foster children's ability to become mentally strong, responsible and successful.

"Parents creating a home where kids are really expected to take good care of themselves and show them how to do it, with the eating, the diet, with sleep," Fay outlined. "We're seeing more young people getting hardly any sleep and one of the biggest reasons is they have their phones or other devices in their bedrooms."

For children struggling with depression, anxiety or adjusting to challenging situations, the state program ARKids provides mental health resources online.

Fay stressed it is important for parents to identify signs of mental health struggles in their children. One indicator he suggested is a child's lack of interest in activities they normally enjoy. He added it is important for parents to consistently be firm and caring with their children.

"Firm means healthy limits and accountability," Fay emphasized. "There's been a number of studies recently that show that when kids do not have consistent limits, when they are not held accountable, they are far more likely to suffer from anxiety, depression, and a whole host of other mental health disorders."

Fay noted the importance of guiding children to translate their natural talents into fulfilling careers. He believes the path leads to greater happiness. His book, "Raising Mentally Strong Kids," features a strategy combining brain science with practical tools to cultivate resilient minds in children.

More than 1,000 family members of firefighters who died in the line of duty, including some from Texas, will gather in Emmitsburg, Maryland, starting this Friday, to honor their loved ones.

The occasion is the National Fallen Firefighters Memorial Weekend and 13 of the firefighters being honored are from Texas.

Victor Stagnaro, CEO of the National Firefighters Foundation, said their names will be added to a memorial wall.

"Every firefighter that's died in the line of duty since 1981 has their name inscribed on a bronze plaque that's mounted on a marble wall," Stagnaro explained. "The monument itself at the center is a marble sphere, I would say, and there's a flame that never goes out."

Fire chiefs from around the country will present the families with a rose, a badge and an American flag flown at the U.S. Capitol and the memorial site. Anyone who would like to honor the firefighters can participate in "Light the Night for Fallen Firefighters," this Wednesday through Sunday night, by lighting their homes, businesses and other landmarks with red lights, or by signing a virtual remembrance banner on the foundation's website.

The Foundation was formed in 1992 to not only honor those firefighters who pass away but provide support for their relatives. Through a "Fire Hero Family Network," survivors are matched with others who have similar experiences and circumstances. Stagnaro pointed out assistance is available for however long it's needed.

"We continue to support those families -- through scholarships, through wellness conferences, we have kid's camps -- all other types of activities to help support those families throughout the year," Stagnaro outlined.

He added relatives of people honored in previous years will be in attendance this weekend to offer support to those who are just beginning their journey. This year's tribute is for 226 fallen firefighters nationwide.


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