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Mental Health

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Older folks are going to be struggling mentally this holiday season, as with current travel and gathering restrictions it will be harder to connect over long distances. Stock photo

Before, during and after major storms, state and local officials typically urge residents to check on elderly friends and neighbors to make sure they have what they need.

While the pandemic hasn’t torn up trees or left a physical mess strewn across impassable roadways, it has triggered the kind of problems residents might have during an ongoing storm.

Indeed, after a brutal spring that included school and business lockdowns followed by a summer respite when the number of infected people declined, the fall has proceeded the way many infectious disease experts had anticipated, with a resurgence in positive tests, steadily rising hospital bed occupancy and the possibility of renewed lockdowns.

Dr. Youssef Hassoun, the medical director at South Oaks Hospital, offers advice with connecting to the elderly over the holidays. Photo from Northwell Health

All of this is happening against the backdrop of a time when elderly residents typically welcome friends and extended family during Thanksgiving and through the December holidays. Many people have canceled or postponed seasonal rituals indefinitely, things that normally offer an opportunity to reconnect.

Holidays are a “needed process that are embedded in our culture and society and, for most, bring significant joy and purpose,” said Dr. Youssef Hassoun, Medical Director of South Oaks Hospital. “For the elderly, that is exaggerated, simply because that is their time to connect back with their loved ones.”

Elderly residents are managing, though they are feeling numerous stressors.

The mental health toll on elderly residents has increased since the pandemic began. In the first few months after the virus upended life on Long Island, the number of elderly residents seeking mental health support declined at Stony Brook, according to Nikhil Palekar, Associate Professor of Psychiatry and Director of Geriatric Psychiatry at Stony Brook University’s Renaissance School of Medicine.

In the last few months, “we have seen a significant increase in referrals our center has received for mental health services,” Palekar explained in an email.

Stony Brook has not had to increase their staffing yet, but if the demand for mental health services continues to be as high as it has been for the past couple of months, the university “will be hiring more clinical staff to provide care,” Palekar explained.

Elderly residents are trapped in a battle between the fear of contracting the virus and the impact of loneliness, which can increase the rate of depression, anxiety and cognitive impairment, Palekar added.

Indeed, the number of nursing home residents contracting the virus has increased in the country and in Suffolk County, according County Executive Steve Bellone (D) during a Tuesday call with reporters.

For people who are battling against the loneliness triggered by isolation, “our recommendation to our elderly patients is to use televideo conferencing to connect with their loved ones, peers and support groups,” Palekar wrote.

Ongoing Stress

For Baby Boomers, concerns about loneliness predated the pandemic, said Adam Gonzalez, Founding Director of the Mind-Body Clinical Research Center and Assistant Professor of Psychiatry at the Renaissance School of Medicine at Stony Brook University.

“COVID adds a whole ‘nother layer of barriers that might get in the way of people connecting,” Gonzalez said. “It’s definitely a high-stress and overwhelming time for many.”

Indeed, ongoing stress, including from concerns about COVID, can trigger cognitive stress.

“Stress can make it harder for people to think,” said Chris Christodoulou, Research Assistant Professor of Psychiatry & Behavioral Health and Neurology at Stony Brook University’s Renaissance School of Medicine. When people are thrown out of their habits, that can be “disorienting and stressful.”

‘For the elderly, [that need for holiday joy] is exaggerated, simply because that is their time to connect back with their loved ones.’

—Dr. Youssef Hassoun

A stressful situation can also reveal cognitive vulnerability for people who are suddenly unsure of themselves and their environment.

“Chronic stress changes our brains in ways that are not healthy and may contribute to lots of diseases, including those affecting the brain,” Christodoulou said.

As for what to pay close attention to when checking in on elderly residents, Palekar suggested that people listen for key words or phrases, such as “feel lonely,” “don’t like myself,” “poor sleep and appetite,” or “can’t stop worrying.” Additionally, members of a support network should pay close attention if others feel helpless, can’t concentrate, have lost interest in doing things or are tired all day.

Solutions

Christodoulou said activities like yoga and aerobic exercise can prevent and slow the decline in cognition.

Hassoun also urged residents to have an open conversation with elderly family members.

“We are very good at assuming that someone appreciates” the risks of larger or even medium-sized family gatherings, Hassoun said. People may understand those risks differently.

The South Oaks Hospital medical director suggested conversations begin not with the unknowns related to potential sicknesses or even new tests, treatments and vaccines, but rather with the knowns of what’s working. While residents may be tired of hearing it, the reality is that masks, social distancing and hand hygiene have reduced the spread of COVID-19, along with other pathogens and microbes that might spread through family contact during the holidays.

Doctors and mental health professionals urged people to be creative in their efforts to connect with others this year.

“How can we get dad, who has never enjoyed looking at an iPad, let alone using it, to find it more fun to have a zoom Thanksgiving together?” Hassoun asked.

He added that these unconventional Thanksgiving interactions could be a way to connect relatives and even children who may not participate as actively in group discussions during these holiday meals.

Residents can improve the holiday during this challenging year by making the most of each interaction, even if it’s not in the familiar personal setting.

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Stony Brook University's CPO Department has focused on student's mental state following the ongoing COVID-19 pandemic. Photo by Julianne Mosher

Stony Brook University knew that students might have a hard time this year as they returned to school in the midst of a global pandemic. 

But for those who went home to participate in hybrid and virtual learning, they too could use someone to talk to. That’s when the school stepped up and implemented new programs to help kids on campus and at home, near and far, to give them resources and let them know everything will be OK.

‘Now more than ever, we need to connect and feel a sense of belonging — and these spaces are intended to do just that’

— Danielle Merolla

The Center for Prevention and Outreach is collaborating across different university departments to support students’ mental health, and is in the process of hiring more mental health staff.

According to Danielle Merolla, a clinical psychologist and assistant director of mental health outreach and community-based interventions at CPO, her group offers ongoing support through various virtual and hybrid programming. 

With programs like Let’s Talk, a brief nonclinical conversation with a counselor, also workshops for coping and connection, balancing levels of care for self and others, and mindfulness, CPO provides suicide prevention bystander intervention training called Question, Persuade, Refer for students, faculty and staff.

“We have trained over 800 students since the onset of COVID via virtual platforms,” Merolla said. 

CPO has also implemented three mental health peer education programs called Chill, Global Minds Alliance and Minds Matter that have been developed and created spaces for students to connect and receive information about how to care for themselves and each other, according to the assistant director. 

“The resources on campus are intended to support students’ overall health and well-being,” she said. “We want to make sure students know that they are not alone, and there are supports literally at their fingertips as many of our resources are accessible virtually.”

According to a recent study with the Journal of Medical Internet Research, the COVID-19 pandemic has brought the vulnerable population of student’s mental health into focus. The study interviewed 195 students at a large public U.S. university to understand the effects of the pandemic on their mental health. 

Of the students questioned, 71% indicated increased stress and anxiety due to the coronavirus crisis. Multiple stressors were identified that contributed to the increased levels of stress, anxiety and depressive thoughts among students. These included fears and worry about their own health and of their loved ones, with 91% reporting negative impacts due to the pandemic, and 89% reporting a difficulty in concentrating. 

“Now more than ever, we need to connect and feel a sense of belonging — and these peer spaces are intended to do just that,” Merolla said. 

With an unusual mix of students either staying on campus or learning from home, CPO decided that it needed to make all its resources available to students within Stony Brook and abroad. 

“We adapted all our programs to meet the virtual needs of our students,” said Smita Majumdar Das, a clinical psychologist at CPO. “We also adjusted programming time — offering training at 6 a.m., or later in the day such as after 9 p.m. — to accommodate our students who are dispersed all over the U.S and also in international locations.”

Das said that at CPO, she has seen a five-fold increase in the utilization of virtual Let’s Talk since the onset of COVID-19 — not only domestically, but with their international students in France, India, Korea and Japan, as well. 

“CPO has worked with various employees to provide the needed training so they can be effectively present for our students and provide them the best support and care possible,” Das said. “It is impossible to pour from an empty jar, so as an organization we are extremely mindful to make sure staff feels cared for so that they can pay it forward to our students.”

Another program called Healing Arts provides students with engagement and learning opportunities around the themes of creative expression, self-care, coping skills, social support and campus health and wellness resources. 

During the age of COVID, the program looks a little different. 

“We adapted the Healing Arts model to create Healing Arts at Home in March,” said Christine Szaraz, coordinator of sexual violence prevention and outreach programs with CPO. “These programs offered livestreamed, interactive events through CPO’s social media, where students could participate in a virtual Healing Arts event using materials commonly found at home and engage with CPO staff and peer educators through the chat feature.”

Szaraz added that CPO provided a variety of synchronous and asynchronous virtual Healing Arts events throughout the summer and over Stony Brook’s opening weekend. 

“Using Facebook and YouTube live forums, we engaged students with professional staff and peer educators in conversations regarding coping and self-care in response to COVID, and in relation to their transition to the fall semester at SBU,” she said.

And since school started, students are feeling the weight of the world on their shoulders. 

“Often, we hear and feel that everything feels out of control which can lead to feeling unmotivated and/or stuck,” Merolla said. “It is important to acknowledge we have many choices throughout our day and there is power in each and every choice.”

“We must recognize we are stressed or struggling in order to choose to attend to what we may need,” she added. “The sooner you reach out the better. There is tremendous strength and resilience that comes from reaching out.” 

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Sunshine Prevention Center in Port Jefferson Station created a "Blessing Box" for people to take necessary items when they need it and drop it off as a donation. Photo from SPC Facebook

It’s been a stressful time. 

In the age of COVID-19, more and more organizations are attempting to adapt to the influx of people needing mental health. 

Last month, Steve Chassman, executive director of the Long Island Council on Alcoholism and Drug Dependence, said in a press conference in September regarding potential Suffolk healthcare cuts that substance abuse has skyrocketed because of the coronavirus crisis. “We have propelled to where we were six months ago,” he said at the time. 

And that’s why the Sunshine Prevention Center in Port Jefferson Station is here to help. Carol Carter, CEO/co-founder of the community youth and family agency that offers support and education in the areas of drug/alcohol prevention, socials skills, leadership and alternative education, said in the age of COVID, they had to adapt to help more people. 

“When COVID-19 first hit, we really scrambled,” she said. “We worked really hard to build a reputation in the community for still providing services.”

The center quickly learned how to Zoom and create Facebook Live and YouTube videos for kids and families to watch at home. 

“We had close to a thousand people watching them,” she said. 

According to Carter, the group learned that the rate of anxiety and depression was getting higher at the start of the pandemic, and domestic violence increased to at least by 20%. She and her organization knew how important it was to help people during such a trying time. 

“We would drop off [worksheets/exercises] to homes,” she said. “We tried not get so caught up in the fear, but we wanted to be there to help them.”

As the pandemic evolved, so did their online learning. Carter began writing daily, weekly and then monthly newsletters. “They would have resources and positive messages for the day,” she said. “We’d mention other programs that were running. … We tried to stay connected that way.”

The center began to Zoom meetings for kids, young adults and parents at night, but more recently in September, they began socially distanced in-person adult groups again. 

“We started in-person because of the demand,” she said. “They need more of the social interaction. … We’ve been told ‘thank you.’ We tried to get back to some type of normalcy. Although people are still afraid, they’re grateful.”

But along with the substance abuse problem as described by Chassman, everyone is feeling more anxious than before.

Further east at the North Shore Youth Council in Rocky Point, Dana Ellis, director of mental health and wellness programming, said she has seen a dramatic increase in anxiety among young adults. 

“Anxiety is the biggest thing I’m seeing more so compared to last year,” she said. “The amount of kids and interests approaching doubled. … A lot more people are looking for help and support during this time.”

Before COVID-19, her group would work with Rocky Point school district to help students with their mentoring program. This year, however, they were unable to meet because clubs were canceled. 

“My biggest thing is giving kids opportunities to socialize, meet people, talk with each other and recognize things will be OK,” she said. “Our goal is to increase mental health programing in general.”

The youth council also decided recently to restart in-person group meetings, because they know how important it is for young adults to talk about how they’re feeling. Upon arrival, they give temperature checks, must wear masks and have the option to Zoom in, if they choose. 

“I’ve definitely started off my groups with coping skills,” Ellis said. “I started treating them like stressless groups because more than ever kids are stressed, and I’m trying to make that the forefront of the groups that I run.”

In those groups, people talk about the worries they face in day-to-day life. ““I  think that’s from a variety of things,” she said. “In general, it’s a very stressful time we’re living in.”

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Smithtown fifth-graders visited with residents at St. James Nursing Home on Oct. 30 to bring them some Halloween cheer. Photo from Smithtown school district

With the approaching emotions of the holidays, Suffolk County residents may face persistent and unwanted changes in their lives, from not seeing a cherished family member to remaining confined to the same house where they work, live, eat and study. Between now and the end of the year, TBR News Media will feature stories about the impact of the ongoing pandemic on mental health. The articles will explore how to recognize signs of mental health strain and will provide advice to help get through these difficult times. This week, the article focuses on youth.

School districts are letting their students know that it’s okay to be in touch with their feelings.

During this unprecedented and scary time, district officials across the North Shore said they immediately knew that they needed to buckle down and implement different mental programs to accommodate the changing landscape of education and the COVID-19 pandemic worry.

Jennifer Bradshaw, assistant superintendent for instruction and administration with Smithtown Central School District, said they started the school year with training for all staff members in social and emotional learning. 

“We’ve always privileged student and staff mental health and wellness, so we’re doing what we did in years past, just a lot more of it,” she said. 

Smithtown fifth-graders visited with residents at St. James Nursing Home on Oct. 30 to bring them some Halloween cheer. Photo from Smithtown school district

Smithtown has been including ongoing contact among school counselors, social workers, psychologists, administrators, teachers and other staff members to evaluate student and family needs for food, technology, mental health, counseling, and academic support.

Farther east in Rocky Point, Toni Mangogna, a social worker at Rocky Point High School, said they have been seeing an increase in student anxiety surrounding the pandemic. “Coming back to school is so different,” she said. “We’re trying to get our services out to as many students and families as we can.”

As part of their SEL programs, the district offers a virtual classroom that students can access at home or while in school to request an appointment with a school counselor or psychologist. 

“It’s a great option for kids who are working from home,” she said. “I think students miss that one-on-one connection.”

The virtual office also offers breathing exercises and tips for practicing mindfulness. Mangogna said she sees students sharing the services with their family and friends. 

“These students are really in touch with their feelings,” she said. “If we can make that connection with parents and students, I think we’re really making a difference.”

The Rocky Point social worker added that while the kids are stressed, parents are seeking help, too. 

“Parents have anxiety,” she said. “It’s difficult for parents to be that support for students when they’re having their own struggles and anxiety.” 

Her colleagues have been working to help and refer parents to local psychologists. 

“Because we don’t have that face-to-face opportunity anymore, it increases wanting to talk to social workers,” she said. “Just to have somebody in front of them that can validate that feeling. I think students miss that one-on-one connection.”

Dr. Robert Neidig, principal at Port Jefferson Middle School, said they are implementing different programs specific to his and the high school’s students. 

“At the middle school, we have a wellness and mental health curriculum with different types of activities students can do,” he said. 

Dr. Robert Neidig, the PJ Middle School Principal, talked about the different programs the district implemented for student’s mental health. Photo from PJSD

Neidig said they’ve had the program for a while, but during the COVID crisis, they “suped it up and since implemented character education lessons.” Since September, they hired a full-time psychologist for the middle school and the high school.

“During this time, it’s taken on new meaning,” he said. “Stress levels, anxiousness — we’re all feeling the effects of it. We’re trying to do the very best we can.”

He added that every teach is going above and beyond to make sure their students are doing alright.

“It doesn’t matter if you walk into a health class, an English class or math class,” he said. “Teachers are taking the time to check in students they understand if kids aren’t there mentally, the learning will be lost.”

Three Village Central School District’s executive director of Student and Community Services Erin Connolly said they also implemented a virtual program to continue and promote SEL. 

“Our district really values mental health,” she said. “We have been working on return to school protocol and mental health plan for students and family for pre-k through grade 12.” 

Their three-tier plan has a strong emphasis on supporting the district’s staff. 

“By supporting them, we’re supporting the students,” she added. “It’s a dynamic plan.”

Dr. Alison Herrschaft, a social worker at Three Village, said that early on in the school year, counselors and social work staff met with each and every student in the school. 

“By doing that, it gave those kids the opportunity to put a face to the staff who can help,” she said. “They’re more likely to seek out help if they’re really struggling and acknowledge that it’s okay to not be okay.”

By integrating themselves more into the hallways and classrooms, Herrschaft said the kids who might not have been aware of the staff before, now see these staff as “rock stars.”

“We wanted to normalize asking for help,” she said. “It’s accessible to anyone who needs it.”

Although Three Village buckled down during the pandemic to make mental health more available, they won’t stop their program even if a second wave hits. 

“A big goal with the plans we developed is if we had to go remote again, based on numbers, our SEL plans will continue while we’re out,” Connolly said. “It was really important to have a seamless transition so that doesn’t change, and it still gives kids points of contact if they’re home again, they’ll be well-versed.”

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With the approaching emotions of the holidays, Suffolk County residents may face persistent and unwanted changes in their lives, from not seeing a cherished family member to remaining confined to the same house where they work, live, eat and study. Between now and the end of the year, TBR News Media will feature stories about the impact of the ongoing pandemic on mental health. The articles will explore how to recognize signs of mental health strain and will provide advice to help get through these difficult times. This week, the article focuses on youth.

In a normal year, when school is out, the number of referrals Dr. Sharon Skariah, Director of Child Adolescent Psychiatry at South Oaks Hospital in Amityville, declines during the summer.

Dr. Sharon Skariah says parents should recognize their own issues in order to help their children. Photo by Sharon Skariah

That’s not the case this year, as children continued to seek help for mental health challenges caused by the loss of a parent, the loss of financial or health security and the decline in social contact amid social distancing.

“We’ve been seeing significant anxiety and depression,” Skariah said. “Part of that is the prolonged time that [children] have been out of school.”

Skariah expects that the ongoing pandemic losses and restrictions will likely continue to cause those figures to increase.

Several mental health professionals shared their dos and don’ts for parents with grieving children.

Grieving Dos

For starters, Skariah suggests that parents should recognize their own anxiety and depression.

“If they find that they are themselves overwhelmed with the chaos of the pandemic, they should be aware that their own anxiety and mood can play a role in their children’s behavior,” she said.

Dr. Meghan Downey, clinical psychologist and Director of Northwell Health’s OnTrackNY, urged people to maintain a routine.

“Often, a holiday can exacerbate our stress levels,” Downey said. “Changes to our routine can increase stress. Continuing with the same sleep wake routine, normal eating and [finding time] for joy and relaxation provide a good foundation for managing grief.”

Based on prior group traumatic events, like the 9/11 terrorist attacks and the SARS virus, Skariah said the restoration of order happens over time and depends on personal and predisposing factors.

She urged families to be genuine and open and actively listen to what children say. Downey suggests children need to feel that they are allowed to mourn.

A support network can and should consider showing empathy, care and concern. Approaching people when they are calm, rather than in a distressed state, can provide some mental health relief.

People who are experiencing grief also can benefit from staying connected, even through holiday letters, phone calls, or a card, Downey said.

When Downey gives presentations to children and educators in school, she advises people working with young children to allow them to play death, to display their emotions through play.

Grieving Don’ts

Telling children platitudes like “time heals all wounds” may not be helpful for someone who is “acutely grieving,” Skariah said.

Downey added that telling children that a loved one is “sleeping” or that they should “stop crying, other people might get upset” provides mixed and confusing messages.

Telling children that “at least [the person who died is] not in pain anymore, they are in a better place” often doesn’t help and distracts people from feeling their emotional intensity, Downey said.

Downey cautioned youths, and their adult guardians, to manage over-indulgent behavior, such as with food or with excess spending.

While those indulgences provide temporary relief, they can also contribute to feelings of guilt, which can exacerbate grief, Downey cautioned.

Bradley Lewis, Administrative Manager for School Based Mental Health Services for South Oaks Hospital, said he has received numerous requests during the pandemic for support related to COVID-19.

Lewis said Downey’s presentations to some of the 11 school districts went beyond the thought of death, but include losses in other areas, like access to friends, senior awards dinners, and graduations.

“A lot of families appreciated the opportunity to learn more about grief and loss, to understand the different types of grief their children might be going through,” Lewis said.

With parents, Lewis urges parents to “end the stigma of mental health,” he said.

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County Executive Steve Bellone (D) reminded Suffolk County residents as they grapple with the mental health toll from the public health and economic crisis of the services that can help.

Residents can reach out to the Family Services League at FSL-LI.com. They can also call a hotline that is available 24 hours a day and seven days a week at (631) 952-3333.

Residents who know people who are struggling with their mental health or substance abuse that are exacerbated by COVID-19 should reach out to these services, Bellone urged.

As for the viral data, the numbers continued to move in a favorable direction for a region that is still recovering from the virus.

Over the last 24 hours, an additional 45 people tested positive, bringing the total to 41,253. These positive tests represented less than a percent of the total tests.

An additional 18,816 people tested positive for antibodies.

Hospitalizations remained steady, with one person leaving the Intensive Care Unit, bringing that total to 25.

Hospital occupancy was at 70 percent, while ICU occupancy was at 60 percent.

An additional three people died in the last 24 hours, bringing the total for the region to 1,978.

The county distributed 20,000 pieces of personal protective equipment in the last day.

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*Update: Police said they found Luke Bowen unharmed.

Original story:

Suffolk County Police have issued a silver alert for a missing Port Jefferson man who they said is schizophrenic, suffers from seizures and may be in need of medication.

Luke Bowen, 62, was discharged from Southside Hospital Oct. 29. He was last seen in the lobby waiting for a taxi and did not return to his residence, located at 136 North Country Road.

Bowen is white, 5 feet 9 inches tall and 160 pounds with gray hair and blue eyes. He was last seen wearing blue jeans, a navy blue sweatshirt and black sneakers.

Police are asking anyone with information about Bowen’s location to call the 6th Squad at 631-854-8652 or 911.

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Superintendent's Council creates 31-minute video to share with their peers

Kings Park student members of the Superintendent's Council stand with school staff and elected officials. Photo from Kings Park school district

By Amanda Perelli

Kings Park students are going digital in the national debate of mental health awareness to raise awareness among their peers and inform community leaders.

Students in Kings Park school district worked to create a nearly 31-minute video to spread mental health awareness in the community and with elected officials.

The Superintendent’s Council, a group of more than 30 Kings Park students from grades four through 12. The council is made up of approximately four students per grade, who are elected by their peers in fourth grade and remain a part of the council through graduation.

“We got to talk about mental health, a big conversation not only in Kings Park, but all around the country.”
– Timothy Eagen

Timothy Eagen, superintendent of Kings Park school district, said that this year’s council was focused on mental health. The students invited Suffolk County Legislator Rob Trotta (R-Fort Salonga) to a council meeting in March, where he spoke about his role in local government. As a result of that meeting, council members decided to create a video covering stress and anxiety; vaping, smoking, and substance use/abuse; and online safety to raise awareness of mental health in the community.

“They are just a great group of student leaders that I use to bounce ideas off of and pick their brain and insight on a student perspective,” Eagen said. “We got to talk about mental health, a big conversation not only in Kings Park, but all around the country.”

The students filmed themselves, teachers and their classmates in the district for the video. Several Kings Park staff members who assisted include district Assistant Superintendent Ralph Cartisano; Rudy Massimo, principal of R.J.O. Intermediate School; Ken Ferrazzi, assistant principal at William T. Rogers Middle School; and Danielle Thompson, technology integration specialist, helped the students create the video which was filmed on iPhones and iPads. Thompson then edited and pieced together the footage using iMovie.

“If we can get the students to share what they are experiencing, just encourage them to speak about it… maybe we can save a life or two.”
– Rudy Massimo

“We broke it into different groups and being that I am one of the participants of the Superintendents Council, I worked with middle school students on drug and alcohol abuse, including vaping,” Massimo said.

The entire video, from the script to where they filmed, was driven by the students. They filmed parts in areas of the building where students might go to do things against school policy, including the stairwells, bathrooms and basement. They used their smartphones to gather information and read off of them like a script. Throughout filming, the students had one goal to get their peers to listen, according to Massimo.

“Mr. Trotta was the first audience that the kids had to show off their video, Eagen said. “We have it posted to our website and we’ve also shared it with our elected officials, so they can best understand how our students are feeling.”

The principal of R.J. O Intermediate said he has plans to show pieces of the video in the fourth- and fifth-grade classrooms next year.

“What the kids say is that they are tired of the same kind of information coming to them,” said Massimo. “If they hear it from their peers, it means more.”

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Thank you, mental health workers. If it weren’t for you, we might be living with even more unimaginable tragedies.

For reasons most of us, fortunately, can only imagine at a distance, people are tormented by destructive urges. When these moments arise, hopefully, a psychologist, psychiatrist, counselor or someone in a position to recognize the signs can step in and offer support, while redirecting that person toward a course of action that’s safer for them and for society.

Much of the time, we don’t see the people who soothe the minds. When they do their job well, the sun rises in the morning, we send our children to school, we clap at the end of their concerts and we feed them their meals before sending them to bed for the night.

When I was in junior high school, I read books such as “Lord of the Flies” and “The Crucible,” which my teacher Mrs. Wickle suggested were an important way to look at the “dark side” of the heart.

At the time, I found the subjects depressing and unnecessary. Why, I thought, did I have to read about such violence or mass hysteria.

In the modern world, we are in the crosshairs of everything from overseas terrorists to storms and earthquakes and, yes, to people without an apparent ideology whose final act before they take their own lives is to commit mass murder.

We look at the faces of the victims and feel the loss of those we never met. They look like our friends and neighbors, and we know their smiles, once filled with potential, will never again light up a room.

At the same time, hundreds of people lined up for hours to do what they could — give blood — to help save those in immediate need.

Clearly, a few people in our midst have headed toward the dark side of their hearts and minds, allowing the demons that plague their lives to release the unthinkable and unimaginable.

Maybe, in addition to the discussion about gun control, we ought to appreciate the legion of mental health professionals who dedicate themselves to helping those battling against destructive urges, whose thoughts wander into the wilderness of despair.

The toll their work often takes on some of these mental health helpers is enormous, as other people’s nightmares leap from the minds of their patients into their own subconscious. The flow of information travels both ways, putting psychologists, psychiatrists and social workers at risk.

These mental health workers often talk to others in their field to help them get through the difficulties of their jobs.

They listen, they encourage, they become involved and, ultimately, they can and so often do set people on better courses in their lives, helping them feel better and live better.

By the time you read this, perhaps we’ll have an idea of what triggered the madness from this latest gunman, and maybe it will have less to do with off-the-rails thinking than with an ideology that encourages mass violence.

If it wasn’t lone-wolf insanity, but, rather, someone following instructions, we ought to find the ones who encouraged these senseless and brutal murders.

Either way, we ought to dedicate more resources to battling with the burden of a broken brain. If, somehow, a mental health professional can redirect someone who might otherwise commit incomprehensible violence, that person not only has saved a life but may have turned a would-be murderer into another conscientious citizen lining up for hours to give blood instead of planning to spill it.

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CN Guidance & Counseling Services is setting up shop at Horizons Counseling & Education Center on Main Street in Smithtown. Photo by Jared Cantor

The fight against drug abuse has a new home in Smithtown.

In response to a multiyear surge of heroin and opiate pill use across the North Shore and greater Long Island, CN Guidance & Counseling Services, which works on addressing substance use and mental health disorders, has launched outpatient detoxification and withdrawal support services to residents of Smithtown.

Two new sites — one at Horizons Counseling & Education Center at 161 East Main St. in Smithtown and the other at CN Guidance’s main office at 950 S. Oyster Bay Road in Hicksville — have begun delivering a combination of services to local residents addicted to opiates. The services, supported by funds from both county governments, include assessment, detoxification, symptom relief with addiction medications, monitoring of vital signs and instant connection to longer-term treatment and relapse prevention.

Heroin killed a record-high 144 people on Long Island in 2013, a death toll increasing 91 percent in Nassau County and 163 percent in Suffolk County since just 2010, CN said in a statement. Opioid pills, including oxycodone, were linked to 343 additional deaths on Long Island in 2012 and 2013.

“We are filling a critical gap,” said Jeffrey Friedman, chief executive officer of CN Guidance. “The havoc connected to untreated opiate addiction on Long Island has been slicing through our Long Island families and communities. These new outpatient detoxification and support services are enabling opiate-addicted individuals — and their families — to receive the help they need immediately, with no lag in connection to the longer-term treatment and recovery services they need after detoxification. If you know someone in need, please call us.”

During a studied nine-month period in 2013, 4,409 individuals requested detoxification services in Nassau County, but only 26 percent, or 1,157, were actually admitted, according to Nassau County’s Department of Human Services, Office of Mental Health, Chemical Dependency and Developmental Disabilities Services. Suffolk County struggles analogously.

Data from the New York State Office of Alcoholism and Substance Abuse Services show that 85 percent of detoxification in New York State is done in hospitals, often with long waits, at high costs and lacking results, whereas other states use such hospital-based detoxification primarily for medically or psychiatrically complicated cases. The new outpatient programs offer an alternative for the many residents who face mild to moderate severity of withdrawal from opiates, rather than severe withdrawal most commonly associated with emergency-level crises.

Because CN Guidance is a comprehensive behavioral health services provider that offers full-service care coordination, it is able to link clients in the new outpatient programs immediately to a whole array of often- needed services ranging from mental health counseling and treatment to long-term substance use treatment.

Residents and other service providers in either county may call 516-822-6111 to accesDs the program.

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