May is Mental Health Awareness Month, and there are many stressors for people right now, from the pandemic to the economy.

There is a high prevalence of mental illness in Oregon compared with other states, and organizations are figuring out different ways to reach people who may be struggling.

Adrienne Scavera, training and outreach director for the Mental Health and Addiction Association of Oregon (MHAAO), said her organization has people with lived experiences to provide peer-support services, which she believes is a unique way to connect with people.

"The fact that folks can openly share about their previous life experience can really be meaningful when it comes to reducing stigma," Scavera explained.

Scavera pointed out peer-support services have become more recognized and valued over her time working with the association. An annual study from Mental Health America ranked Oregon in the bottom five this year for factors such as mental-health prevalence and access to care.

Dr. Rhonda Randall, executive vice president and chief medical officer for UnitedHealthcare employer and individual, said she has noticed less stigma around conversations around mental health, especially among young people. She said for a long time, mental-health care was siloed from other parts of the health care system.

"Mental health is part of our health," Randall stated. "It's a conversation you should be having with your primary-care physician when you go get your annual checkup."

Scavera noted everyone is dealing with mental-health issues to some degree. She added people should not be judgmental and should keep an open mind, so they can listen and learn from others about their experiences.

"That can really help to challenge the misconceptions that exist about people with lived experience," Scavera emphasized. "Because at MHAAO, we believe that everyone can recover and that what that looks like is also going to look different from person to person."

Your first heartbreak, accident, loss of a loved-one or being chased by a dog - these and so many other incidents can be lasting traumatic experiences, and mental-health practitioners are working to shift the way traumas of the past are being addressed today.

Trauma-informed care is growing effort around the country to shift the mindset and understanding that humans are deeply affected by their past. Studies show more people are dealing with something traumatic without society acknowledging it.

Yuki Reese knows this all too well, as the director of school-based services for ViewPoint Health - a public mental-health organization serving several Georgia counties. Reese said they've adjusted the way they speak to clients or families to avoid exacerbating the problem.

"So, you might be saying, 'What's wrong with you?'" said Reese, "when what you really want to say to the person is, 'What happened to you? What did you experience that might be causing you to react in this way?'"

Reese said it's important to uncover the causes of traumatic situations that may be contributing to anxiety or depressive disorders, addictions or abuse. It's only then you can more accurately treat the source of the problem.

There are currently two bills in Congress that would make these types of practices a requirement. However, some critics worry about the impact of labeling young people by their trauma, and that the practice should be more culturally responsive.

It's estimated that one in four children experiences child abuse or neglect in their lifetime, according to a study in the National Library of Medicine.

Reese said their approach is to find out what's going on in a person's life with more carefully crafted questions.

"All kind of things could happen many, many years ago and the person might be just fine for these years," said Reese, "but then something happens recently or you might be responding to the trauma that you experienced years ago without really knowing. "

In order for it to work, however, it depends on the person to be transparent with their past. The Campaign for Trauma-Informed Policy and Practices is a national movement to help communities adapt and shift to trauma-informed care.

As college students head to campus in the coming weeks, mental-health experts are urging both students and parents to familiarize themselves with the school's on-site mental-health resources.

Three in five college students nationwide reported being diagnosed with anxiety, depression or another mental-health condition by a professional, according to a Harris Poll released this year.

Virginia Rodilla, manager of the helpline and on-campus support for the National Alliance on Mental Illness-North Carolina, said especially for incoming college freshmen, the coronavirus has disrupted preparing for a new chapter.

"A lot of young people were stuck at home," Rodilla pointed out. "They were relying on social media and screen time, less social interaction, and a lot of uncertainty around the pandemic and societal issues."

She added while colleges generally are not staffed to handle severe psychiatric disorders, counselors located in health and wellness centers are a first stop for students living on campus. If you or someone you know may be considering suicide, contact the Suicide and Crisis Lifeline at 988.

Rodilla pointed out younger students may be used to a parent handling health care needs or making appointments, and might be in the dark about the details of their health insurance plan and what it covers, if they are insured.

She noted there also are places to turn for students who are far from home. The Alliance runs a helpline in North Carolina, at 1-800-451-9682, available Monday through Friday, 9 a.m. to 5 p.m. She added experts are on call to help connect students to the right resources.

"After those hours, a student can text the word NAMI to 741-741," Rodilla urged. "That's 24 hours a day, never closes, and a helping professional would be able to direct that person to services and help."

She emphasized NAMI is working with campuses across the state.

"If anybody is ever interested in bringing awareness to mental health on their campus, forming some student support groups, having some awareness and health events, healthy events," Rodilla outlined. "They can work on forming a NAMI On Campus club at their school."

Nationwide, people are becoming more informed on mental health. In a 2019 poll by the American Psychological Association, nearly 90% of adults agreed having a mental-health condition is nothing to be ashamed of, and 86% said they believe people with mental-health disorders can get better.

Support for this reporting was provided by Lumina Foundation.

Many parents in Oregon and around the country will soon be bidding their children farewell as they head off to college for the first time, and a growing question on some parents' minds is about the mental health supports schools provide.

According to a recent survey, three of five college students have been diagnosed with a mental health condition. Schools like the University of Oregon have beefed up their services in recent years to meet the growing demand.

Mariko Lin, assistant director of counseling services at the university, said when they first come to college, students can be scared about making appointments with health services.

"But I want to make sure that parents and family members know that we really want to help their students," Lin stressed. "And are looking forward to them reaching out to us to make those appointments and to get the care that we want to give them."

Lin pointed out the University of Oregon is contracting with an outside company this year to meet any overflow in demand. Along with individual therapy, Lin noted her school also provides group therapies related to specific topics such as sexual assault survivors, as well as for marginalized community members.

Nance Roy, chief clinical officer of the Jed Foundation, which aims to prevent suicide among young people, encouraged parents to ask schools about their mental health supports when their children are deciding on a school, such as on college tours. Roy also urged parents to explore what the university is like beyond the walls of its counseling department.

"It's helpful to ask some questions about what is the culture like on their campus?" Roy emphasized. "Is it a campus where there's no wrong door for a student to walk through for support? Is everyone open and accepting, offering a warm hand? Are faculty and staff engaged in student well-being?"

Roy advised parents who know their children already have therapy needs may want to find local options off campus as well. And while stigmas around mental health are slowly coming down, she added it is important for parents to talk about this issue. For prospective students, Roy acknowledged going away to college can be scary, and it is OK to reach out to someone if they need help.

"Talk to a friend, talk to us," Roy recommended. "Don't feel like you're alone in that because it's very normal during periods of transition to feel a little bit of anxiety, and that's all right."

Support for this reporting was provided by Lumina Foundation.