Policy Watch: Creating a Voluntary Do-Not-Sell List in the National Instant Criminal Background Check System for Firearm Purchases

Background

Currently, in the state of Alabama, the ability to buy a firearm is available to most adults over the age of 18, with certain weapons restricted to citizens over the age of 21. Individuals who have been convicted of certain violent or alcohol-related crimes are not able to legally purchase a firearm. Alabama follows federal regulations regarding background checks, where licensed gun dealers must process a potential buyer’s information through the National Instant Criminal Background Check System database, facilitated by the Federal Bureau of Investigation.

Alabama is one of the most lenient states in the country regarding gun laws. No additional background checks, evaluations, waiting periods, or training are required to purchase a firearm. In 2022, the state enacted a permitless concealed carry law allowing anyone over the age of 18 to carry a handgun without a permit, background check, or mandated safety training.

Voluntary Do-Not-Sell lists have been proposed in several states since 2019. Sometimes called “Donna’s Law,” the legislation was first initiated after Donna Nathan admitted herself to a psychiatric facility and later took her own life by firearm upon release.

Legislation

Voluntary Do-Not-Sell legislation was first submitted in 2022, by by Reps. Rafferty (D-Birmingham) and Farley (R-McCalla) as a bipartisan bill calling for the establishment of a database operated by the Alabama Department of Mental Health for individuals to volunteer their own names onto a Do-Not-Sell list. HB37, sponsored by Rep. Ensler, builds upon that legislation to be in compliance with constitutional requirements, and increases opportunities and access for individuals to utilize the service.

HB37 would restrict an individual’s ability to purchase or possess a firearm once their name was added to the list and creates criminal penalties for violations. The bill also provides a pathway for individuals to remove their name once it has been added. The purpose of this list is to restrict access to firearms to individuals when there is a fear that he or she may become a risk to himself or herself or others.

With a start date of June 1, 2025, the ADMH is tasked with developing the searchable database, along with creating and distributing a registration form for applicants. Individuals wishing to add their names to their name to the Do-Not-Sell List may do so in the following ways:

Submitted in person at a circuit clerk’s office with government-issued photo identification. A county clerk shall immediately transmit any received registration form to the department.
Mailed to the department with a copy of the registering individual’s government-issued photo identification.
In person at a healthcare provider’s office with a government-issued photo identification. The healthcare provider should immediately transmit the forms to the department for processing.
Submitted electronically to the department by short message service or multimedia messaging service along with a copy of government-issued photo identification and a photographic portrait of the individual that contains exchangeable image file format data proving that the photographic portrait was taken within one hour before transmission to the department.

Individuals who request to be added to the Do-Not-Sell List must wait 21 days before requesting their names to be removed. Their application for removal will be administered by the district court, where the individual must provide evidence stating that they are not a harm to themselves or others.

Impact

Self-harm is the 10th leading cause of death in adults in the United States, and access to a firearm triples the risk of suicide. Recently, several states such as Virginia and Washington have enacted legislation establishing voluntary Do-Not-Sell Lists for firearms to restrict access to individuals experiencing a mental health crisis. According to the Centers for Disease Control and Prevention, half of all suicides are caused by a firearm and are, by far, the deadliest method with the highest chance of mortality per attempt. Delaying firearm purchases has been found to reduce the number of suicides without increasing the number of suicides by other means, showing that suicide attempts by different methods “is unlikely to undermine the lifesaving potential of these laws.”

There is empirical data to support the creation of a Do-Not-Sell list. A survey conducted in Alabama distributed to 200 patients receiving psychiatric care found that 46% of responses indicated they would register for such a database. Broader internet surveys found up to ⅓ of all participants would add their name to a Do-Not-Sell List. According to the New England Journal of Medicine, the vast majority of individuals experiencing suicidal ideation or thoughts will see a clinician within a year of their death, putting medical practitioners in a position to screen their patients for suicidal tendencies:

“Clinicians routinely assess their patients’ risk of suicide, yet they are limited in terms of the practical interventions they can use for patients who are not actively suicidal but who fear they may become so. … [Voluntary Do-Not-Sell Lists] reduce suicide risk consensually and indefinitely in advance of a crisis. The majority of people who die by suicide see a primary care provider in the year before their death.”

As a part of standard medical practice, clinicians can regularly encourage the use of advance directives such as determining a medical proxy, so this form of legislation offers patients an opportunity to create such a directive in reference to firearm-related decisions. Unlike other mental health interventions, voluntary registries develop opportunities to enhance patient autonomy and preserve their role in their healthcare decision-making processes.

Next Steps

HB37 is pending action in the Public Safety and Homeland Security Committee. If you want to make your voice heard on this or future legislation, click here to identify your elected officials.

Don’t know what to say? Check out this guide from the American Civil Liberties Union on drafting a letter to your government officials.

Learn More

Want to know more about firearm legislation and how gun violence impacts mental health? Take a look at these resources:

Gifford Law Center to Prevent Gun Violence

APHA Gun Violence Fact Sheet

EFSGV Public Health Approach to Gun Violence

Policy Watch: Alabama Lawmakers Propose Mandated Mental Health Professionals in K-12 Schools

March 17, 2022 | Kimberly Randall, Lister Hill Center Program Coordinator

Cutout of a head with puzzle pieces in brain

Image Courtesy of Getty Images

Background

In 2009, the Institute of Medicine compiled a report that recommended local and state governments develop a system to increase access to resources for students for the prevention and treatment of mental, emotional, and behavioral disorders. A year later, the state of Alabama created the School-Based Mental Health Coalition, a subsidiary of the Alabama Department of Mental Health. The agency’s goal was to bridge the various government offices such as the Department of Education and Department of Public Health to ensure that students enrolled in public K-12 schooling had adequate access to adequate mental health intervention, treatment, and prevention services.

Currently, there are 80 school systems statewide collaborating with just over a dozen mental health agencies to refer students for professional services. The program was expected to increase attendance, reduce the frequency of administrative corrections like suspensions, and integrate mental health practitioners into students’ lives.

However, the program is not currently statewide, only accounting for 57% of school districts. While the state does offer some funding available for schools to partake in the program, often, the local districts are responsible for a portion of the cost, limiting the ability for poorer districts to join.

Proposed Legislation

Senate Bill 306, proposed by Sen. Rodger Smitherman (D-Birmingham), works to establish a minimum set of requirements for a certified mental health services coordinator and mandate that at least one position be required in all school districts within the state. The bill would go into effect with the 2023-2024 academic year.

The coordinator must have one or more of the following qualifications:

(1) Have a bachelor’s degree in social work.

(2) Satisfy State Department of Education qualifications for a school counselor.

(3) Satisfy State Department of Education qualifications for a school nurse.

(4) Have professional mental health experience, or have been licensed in a mental health occupation including, but not limited to, licensure as a licensed professional counselor or marriage and family therapist.

(5) Other qualifications as determined by the Alabama Department of Mental Health and the State Department of Education.

Additionally, employees have one year after being hired to complete a certification program developed and implemented by the Alabama Department of Mental Health.

The legislation also outlines an implementation plan to enact the bill, requiring each local board of education to complete a needs assessment report and a resource map for all public schools in their jurisdiction. These documents are intended to document the status of mental health for the entire school system and create a baseline on which to improve once the program is implemented.

While the bill does not specify that school districts must join the School-Based Mental Health Coalition, there is substantial overlap between the legislation and the purpose of the SBMHC.

Impact

According to the World Health Organization, mental-health-related disabilities are a leading cause of mental health issues worldwide, with over ⅔ of patients receiving no or inadequate treatment for those conditions. Rates of depression have risen almost 50% in the last ten years, but access to mental health services has remained stagnant. Weare and Nind (2011) state that “childhood and adolescence provide key opportunities to develop the foundations for mental health and prevent mental health problems, and the school is a unique resource to help achieve this.” School-based services such as counselors and caseworkers have been shown to positively impact mental health prognosis in children and teens.

Multi-tiered systems of support (MTSS) are integral to providing proper support to students utilizing a school counselor, social worker, or psychologist. MTTS methods often utilize universal intervention as the primary mechanism for identifying at-risk students, primarily through widespread behavioral testing across the student body. A second tier, narrowed intervention, focuses on a select, smaller unit of students who may be at risk or suspected of behavioral disorders and includes increased monitoring and small-group counseling sessions. Lastly, the final stage of MTSS is an individualized plan of action which may consist of:

“(a) conducting a functional behavior assessment and developing an individualized behavior plan; (b) direct student-level mental health services provided by a counselor, school psychologist, or school social worker; (c) additional coordinated mental health services with community agencies; or (d) possible identification for special education.”

However, there can be a substantial delay in getting students access to necessary psychiatric and behavioral resources, negatively impacting mental health outcomes. A study completed by Guerra et al. (2019) found that the presence of a mental health services coordinator was vital to creating an environment that supports mental student health and learning. While there is no accessible data in the state of Alabama correlating improved health outcomes with mental health service coordinators, broad-scale investigations have shown a substantial impact on overall mental health outcomes across districts. The legislation would ensure that coordinators employed in every school district help streamline the processes to get students the help they need.

Next Steps

The Alabama Legislative Session is currently underway and will continue for several months. SB306 is presently being discussed in committee and has not yet gone to a vote. If you want to make your voice heard on this or future legislation, click here to identify your elected officials.

Don’t know what to say? Check out this guide from the American Civil Liberties Union on drafting a letter to your government officials.

Stay Informed

Want to learn more? Several state agencies are dedicated to mental health resources in the state, such as the Alabama Department of Mental Health and its subsidiaries, the National Alliance on Mental Health, and the Youth Services Institute.

Additionally, check out these previous publications that the Lister Hill Center has released about mental health services in Alabama:

Policy Review: Analyzing Alabama’s Efforts to Improve Mental Health

Policy Review: Medicaid Expansion’s Impact on Mental Health

Policy Review: Student Mental Health at UAB

Policy Watch: The Establishment of the Alabama Voluntary Firearm Do-Not-Sell Database

March 22, 2022 | Kimberly Randall, Lister Hill Center Program Coordinator

Background

Alabama is one of the most lenient states in the country regarding gun laws. No additional background checks, evaluations, waiting periods, or training are required to purchase a firearm. While there are stricter measures for individuals applying for a concealed carry permit, where applicants may be denied a permit if they are a registered sex offender or have previously been declared mentally unstable in a court of law, these restrictions are generally at the discretion of the issuing county.

Recent legislation (HB272) that was signed into law last month lifted additional restrictions for owning and carrying a firearm. Under the new legislation, a gun owner is able to have a weapon in a vehicle without a permit, and the bill revised the legal presumption that carrying a firearm is “prima facie” evidence or the intention to commit a crime of violence.

Legislation

HB462, sponsored by Reps. Rafferty (D-Birmingham) and Farley (R-McCalla) is a bipartisan bill calling for the establishment of a database operated by the Alabama Department of Mental Health for individuals to volunteer their own names onto a Do-Not-Sell list. This would restrict an individual’s ability to purchase or possess a firearm once their name was added to the list and creates criminal penalties for violations. The bill also provides a pathway for individuals to remove their name once it has been added. The purpose of this list is to restrict access to firearms to individuals “when there is a fear that he or she may become a risk to himself or herself or others.”

With a start date of June 1, 2023, the ADMH is tasked with developing the searchable database, along with creating and distributing a registration form for applicants. Individuals wishing to add their names to their name to the Do-Not-Sell List may do so in the following ways:

Submitted in person at a circuit clerk’s office with government-issued photo identification. A county clerk shall immediately transmit any received registration form to the department.
Mailed to the department with a copy of the registering individual’s government-issued photo identification.
Submitted electronically to the department by short message service or multimedia messaging service along with a copy of government-issued photo identification and a photographic portrait of the individual that contains exchangeable image file format data proving that the photographic portrait was taken within one hour prior to transmission to the department.

The bill also lays out additional actions to implement an online portal in 2024, with particular consideration to protecting the identity of applicants and preventing program misuse through fraudulent applications.

Impact

Self-harm is the 10th leading cause of death in adults in the United States and has been declared a public health crisis. Recently, Virginia and Washington have enacted legislation establishing voluntary Do-Not-Sell Lists for firearms to restrict access to individuals experiencing a mental health crisis. According to the Centers for Disease Control and Prevention, half of all suicides are caused by a firearm and are, by far, the deadliest method with the highest chance of mortality per attempt. Delaying firearm purchases has been found to reduce the number of suicides without increasing the number of suicides by other means, showing that suicide attempts by different methods “is unlikely to undermine the lifesaving potential of these laws.”

“Clinicians routinely assess their patients’ risk of suicide, yet they are limited in terms of the practical interventions they can use for patients who are not actively suicidal but who fear they may become so. … [Voluntary Do-Not-Sell Lists] reduce suicide risk consensually and indefinitely in advance of a crisis. The majority of people who die by suicide see a primarycare provider in the year before their death.”

Next Steps

Downtown Birmingham Want to know how gun violence is impacting Birmingham? Katie White, a former Lister Hill Center Intern, compiled research on the history, policy, and impact of firearms in the city. Read her full report here.

HB462 is currently in discussion in the Alabama House of Representatives, having been read on the floor and placed on the calendar for formal debate. If you want to make your voice heard on this or future legislation, click here to identify your elected officials.

DDon’tknow what to say? Check out this guide from the American Civil Liberties Union on drafting a letter to your government officials.

Learn More

Want to know more about firearm legislation and how gun violence impacts mental health? Take a look at these resources:

Gifford Law Center to Prevent Gun Violence

APHA Gun Violence Fact Sheet

EFSGV Public Health Approach to Gun Violence

Policy Review: Medicaid Expansion’s Impact on Mental Health

November 15, 2021 – Anushree Gade, LHC Student Assistant

Background

Medicaid and Medicare are often used together, but the qualifications and operations for each are vastly different. Medicare is regulated by the federal government and is age-dependent (for people that are 65 years of age or older). Medicare is not income-based and functions as an insurance plan, providing coverage to seniors who no longer have access to private insurance through an employer. Medicaid, on the other hand, is managed at the state level, which independently creates its own qualification criteria. In Alabama, you must meet income qualifications and fall into one of these categories:

Pregnant
Blind
Have a disability or a family member in the household has a disability
Be responsible for someone 18 or younger
Be 65 years of age

The low-income designation is assigned depending on the annual household income and the number of people in the household. Medicaid Expansion under the Affordable Care Act (ACA) allowed for more people to be considered eligible for Medicaid. The expansion would ease some of the guidelines that would make Medicaid more inclusive and increase the number of people who qualify for Medicaid. However, Alabama remains one of twelve states who have yet to expand Medicaid even as most states in the northeast and west and adopted and implemented the expansion already.

In March of 2021, President Biden signed the American Rescue Plan into law which contained financial incentives for the remaining states to adopt Medicaid expansion. According to the Georgetown University Health Policy Institute, “the American Rescue Plan encourages states to finally take up the Medicaid expansion by offering even more favorable financial incentives than those already in place and allows states to provide longer postpartum health coverage for new mothers. Among its private insurance provisions, the American Rescue Plan provides full premium subsidies for COBRA coverage, substantially increases subsidies for the purchase of health plans offered through the Affordable Care Act’s marketplaces, and targets additional marketplace subsidies to those receiving unemployment benefits.”

Impact on Mental Health

In a study conducted by researchers at Indiana University, it was identified that Medicaid expansion was responsible for increasing the use of preventative care visits, mental health services, and primary care. Furthermore, this study also observed that Medicaid expansion increased how people perceived their own health. There were lower rates of poor mental health days/psychological distress; moreover, there was increased reporting of better perceived physical health. Researchers suggested that the increase in better mental health perception could be an effect of increased access to medical services. The inability to access health care services could potentially place stress and impact the mental health of individuals. Medicaid expansion would allow more people to access health services; thereby, positively impacting mental health.

Medicaid expansion would allow for more people who are diagnosed with mental health illness to qualify for Medicaid. The expansion would allow for people, despite disability status, to qualify depending on their income level. This would increase the number of people that can access health care services and mental health care. Medicaid would allow for people with mental illness to access services such as psychotherapy, inpatient psychiatric treatment, and prescription medications.

If a patient makes an appointment with a primary care physician for a checkup, the physician would be able to refer the patient to mental health services covered under Medicaid. However, there are challenges that come with Medicaid referrals including delays associated with processing the referral request and the lack of cooperation between services. These challenges significantly impact one’s ability to get access to health services in a timely manner. Furthermore, there are also challenges associated with continuous access to mental health services. In order to provide continuous care, the social workers are required to justify why the recipient is still in need of mental health services and requires a diagnosis and formalized treatment plan.

Opposition

Medicaid expansion was initially suggested in 2015 by Governor Robert Bentley’s task force. These plans were put forth with intentions to transition to a managed care model. This type of insurance model would allow for contracts with medical professionals and facilities by which they would provide care at reduced costs for those who are covered by that health insurance (if implemented, it would be Alabama Medicaid). However, this would entail increased costs associated with financing it. Eventually, Gov. Bentley dropped the idea as it would promote strong opposition from the state legislature.

Reviewing Alabama’s Policy Efforts to Improve Mental Health

December 13, 2021 | Anushree Gade, LHC Intern

Mental Hospital

Closed mental health institution in Alabama | Photo courtesy of Getty Images

Mental health has been a growing concern in our state of Alabama over the past decade. However, despite its growing prevalence, mental health has been pushed aside due to funding issues that came with the Great Recession. This had caused three mental health institutions to be closed. Since 1990, at least 10 total mental health institutions have been closed and with the Great Recession, more were closed.

With mental health at the forefront of our concerns, Alabama’s legislature has been attempting to improve access to mental health care and services in order to support mental health in the state of Alabama. In February 2021, HB 284 was passed, which allows for law enforcement to take individuals into custody if that individual is capable of inflicting harm to themselves or others. Law enforcement will escort them to the care facilities and will have them in custody for 72 hours. There were concerns about the bill regarding the 72 hour hold as well as detaining children. As the bill progressed, changes were made to address these concerns and the bill would not apply to children under 14.

Additionally, another bill was passed where a mental health service coordinator was required for each school district. As of October 2020, 102 Alabama school districts had a mental health service coordinator. These coordinators ensure that students are receiving counseling and other mental health services they are in need of. There is an increasing number of students who are suffering from mental health problems and are in need of proper care. This bill aids, somewhat, with improving mental health for school children.

Another one of Alabama’s growing mental health concerns comes with the increased rates of incarcerated individuals developing mental health issues such as depression and anxiety. Incarcerated individuals are almost 6 times more likely to develop such conditions and jails spend a large sum of money to address this. Rep. Anthony Daniels has been encouraging Alabama counties to adopt the Stepping Up Initiative, which aims to reduce the prevalence of mental health in jails. Currently, 26 counties are involved in the Stepping Up Initiative, including Jefferson County, Mobile County, and Madison County.

As mentioned previously, several mental health institutions were shut down due to a lack of funding. Senator Garlan Gudger proposed a resolution for implementing crisis diversion centers in the state in order to provide facilities where people can go to seek mental health care. This was enacted in May 2020 as Act 2020-86. Medicaid expansion was also suggested as an option to address mental health in the state; however, Alabama is not anticipated to expand Medicaid under the Affordable Care Act. For more information on the impact of Medicaid Expansion on Mental Health, be sure to read this article.

The Widespread Impact of Eco-Anxiety

January 31, 2022 | Anushree Gade, Lister Hill Center Intern

Head in clouds

Climate change has been gathering large amounts of attention in recent years. Since the late twentieth century, temperatures have been rising, and 2020 was the second warmest year in recorded history. Greenhouse gas emissions have tremendously contributed to the observed increase in atmospheric temperature. As a result, ice sheets have been melting worldwide, making some cities more prone to flooding because of the rising sea levels. One example is the city of Jakarta, Indonesia, which has been experiencing frequent flooding and is expected to be entirely submerged by the year 2050.

With the climate changing so rapidly, many people are becoming anxious about their future and future generations, a phenomenon often called eco-anxiety. Eco-anxiety is experienced more extensively by today’s youth. In a large study done with 10,000 young adults, more than half of those that participated were worried for their future. Additionally, about half of the respondents indicated that their anxiety regarding climate change impacted their daily lives. Many people experiencing eco-anxiety believe that their country’s governments have not been doing enough to address the growing issue of climate change and global warming. In a poll conducted by the Post-Kaiser Family Foundation, 57% of the teenagers said that climate change scared them, and 52% said it made them sad. Only 29% of the teenagers reported that they were optimistic.

The youth today think significantly about climate change and its associated consequences in the future. As a result, eco-anxiety is a common experience for today’s youth, more so than older adults. This anxiety also stems from the fear of uncertainty that humans generally possess. The youth also report low levels of optimism for the future due to the climate crisis. The impacts of climate change on mental health are immense and must be recognized. Anxiety and stress can have adverse long-term effects on health. Experiencing prolonged anxiety can develop other health complications such as respiratory problems, gastrointestinal issues, weakened immune system, heart disease, hypertension, and more. With the likelihood of anxiety leading to additional health consequences, we must address this anxiety stemming from the changing climate.

If you are experiencing eco-anxiety or are passionate about addressing this issue of climate change, here are some things you can do:

Make lifestyle changes to be more environmentally conscious and sustainable.
- Example: Re-evaluating how you commute to work. You can consider carpooling, using public transportation, walking, or cycling to places near where you live.
Identifying small things in your life that can help make a change
Participate in the political processes to promote environmental policies where you live.
Talk to your family and friends to express your concern.
Connect with others who are also going through the same as you.

Student Mental Health at UAB

October 12, 2021 by Anushree Gade, LHC Student Assistant

Mental health is often defined as “emotional, psychological, and social well-being” (U.S. Department of Health and Human Services, 2020). It was not until recent times that there was more awareness of mental health. Furthermore, there is also a stigma associated with the discussion and acceptance of mental health which may vary with culture.

In certain Asian cultures, the stigma surrounding mental health is colossal. Discussing mental health is considered taboo in these cultures. These aspects of culture that impact mental health cause people of that culture to undermine their mental health and well-being. As a result of this, many avoid seeking medical care to address it and avoid talking about it (Nishi, 2012). This stigma can also be seen in African American culture. In one study, 63% of African Americans responded that mental illnesses are seen as signs of weakness (National Alliance on Mental Illness [NAMI], n.d.). In Hispanic culture, it is common to keep private challenges to one’s self. This lack of discussion on such topics inhibits the acknowledgement of mental health and also creates a gap in knowledge in mental health issues and symptoms. Furthermore, this can contribute to strengthening the stigma surrounding mental health in this culture (NAMI, n.d.). As we can see through these examples, culture influences the level of stigma that surrounds the topic of mental health; it can positively reinforce that stigma if there is a lack of awareness around it.

Development of Mental Health at UAB

The mental health of college students has been of growing concern in the past couple of years. A survey conducted by Dr. Sarah Ketchen Lipson in 2020 revealed that half of the students that were surveyed presented symptoms of depression or anxiety and at least 83% said that their mental health was negatively impacting their academic success (McAlpine, 2021). With increases in mental health issues in students across college campuses, it is necessary for university administrations to implement policies, programs, and services which address this.

UAB has implemented several initiatives and services that aimed to address the issue of mental health on campus. One such initiative was the UAB CARES Suicide Prevention Initiative. CARES stands for “communicate, assess, refer, educate.” The goal of the UAB CARES initiative is to help connect students experiencing mental health concerns to resources that are on campus and off in order to help them. This initiative was started in the Fall of 2018 and was unanimously approved by the University’s President and senior cabinet (University of Alabama at Birmingham [UAB], n.d.).

Through the development of the UAB CARES initiative, several recommendations were made after reviewing the existing policies at the time (and were unanimously approved). These recommendations are categorized into three main groups: Prevention and Awareness; Education; and Policies, Procedures, and Services. The full listing of recommendations can be found here. As a result of this initiative, UAB has established that students and faculty should all be able to have continuity in care to support their mental health. Furthermore, the initiative prompted campus wide education efforts on the various crisis response teams available to UAB faculty, students, and staff. Crisis Text Lines specific to UAB were established and the University also began to offer training through the Kognito At-Risk program. Below is a list of resources that UAB provides for students’ mental health!

Incorporating Mindfulness in Schools

October 28, 2021 – Anushree Gade, LHC Student Assistant

Children meditation

Mindful describes mindfulness as the “ability to be fully present, aware of where we are and what we’re doing and feeling”. We can practice mindfulness through meditation. However, mindfulness is not just limited to meditation but also various other practices. You can practice mindfulness throughout the course of your entire day. For example, when you wake up, you can sit in your bed, upright, or find a chair to sit in and just think to yourself about your intentions for the day. You can even practice mindful workouts. Being mindful about your day and your emotions helps you become more aware of your thoughts.

Researches Tang, Holzel, and Posner have shown that mindfulness practices contribute significantly towards improving physical and mental health; it also helps us improve our cognitive processes. It has also further shown that meditative practices promote awareness, attention, emotion regulation, and self-awareness. Not only does meditation improve these functions, but it also causes physical changes in the brain. Furthermore, the “Mindfulness-Based Stress Reduction and Change in Health Related Behaviors” study found the impact of mindfulness on health behaviors has shown that mindfulness enhances dietary choices, physical activity, and sleep quality. Not only does mindfulness promote mental health, but it also positively influences healthy behaviors. This makes it more important for us to discuss mindfulness and its significance in terms of our physical and mental well-being.

YogaSchools Having said this, how are we promoting mindful practices in the state of Alabama? Earlier this year, in May, Governor Kay Ivey signed a bill (alabama reporter/alabama legislation) that lifted the ban on yoga in public schools. This ban was initiated back in 1993 due to its implication of Hindu and Buddhist cultures on the elementary, middle, and high school children in Alabama. The Centers for Disease Control and Prevention has posited that the meditation involved in yoga helps those who practice yoga to de-stress and focus their attention better than those who do not. Though public schools across Alabama are allowed to teach yoga now, this bill comes with caveats. The bill still prohibits meditation alongside other things such as saying “Namaste” or even using chanting, mudras, or mantras. Yoga can significantly help children with de-stressing and focusing. Furthermore, in accordance with the research we discussed earlier, yoga can also help children be more self-aware and regulate their emotions at an early age. In the long-run, these children will be able to cope better with stressors and maintain good physical/mental health.

Located in Homewood, Ala., the Magic City Acceptance Academy is a local charter school that is working to promote mindfulness and better mental health in their students. Originally, the intitution was founded to create an affirming LGBTQ environment, however, they have affirmed their commitment to increasing access to mental health resources by:

Assuring the presence of a social worker in the academy
Providing access to therapy groups
Including trained mental health professionals in the academy’s staff
Ensuring the existence of a functional crisis team/crisis response team

The social workers, mental health professionals, and teachers support the students through various areas of stress and hardship. Furthermore, they also utilize journaling and mindfulness in their everyday routines. Overall, this academy operates as a local example of how to integrate mindfulness practices and mental health resources in a school environment.

Suicide Prevention

September 11, 2019 by Sean McMahon, LHC Outreach Coordinator

September is National Suicide Prevention Month, and specifically this week is National Suicide Prevention Week. A friend of mine recently died by suicide, and since then I’ve been diving into national statistic and prevention strategies.

A month ago, I was at my desk, stumped about what to share on the Lister Hill Center’s Facebook page. This is always an involved process. I’d like to share the new Healthcare Triage video each week, but that would be redundant. I’d like to make another post about Medicaid policy changes, but I’d already made a few that month. Still deciding, I logged on and the first this I saw was a post from a former pastor of mine, someone my family has kept in touch with for nearly two decades.

Normally, when I log into Facebook to interact as the Lister Hill Center, I quickly navigate away from the home page so that I don’t bring my personal life to my work desk. However, when you see the words “my oldest son has passed away,” your heart jumps a little bit and you have to take a moment to investigate. Almost immediately I received a text from my sister to tell me the news. She was with the family. She was with them shortly after they were told that their son had taken his own life.

After a week of going through the motions, I went to be with my family and friends. We had an informal memorial; a funeral wasn’t possible just yet. After another week of going through the motions, I went back for the formal funeral service.

Just two months before my friend took his own life, I was taking a policy advocacy course at Johns Hopkins University, crafting a mock proposal (similar to UAB’s annual Global Health Case Competition) for an advocacy plan to decrease suicide rates in India. And now I’m dealing with the very real occurrence of suicide happening within my circle of friends.

NSPL Logo 2 Nationwide, a staggering 47,173 people died by suicide in 2017. After adjusting for age, that’s a mortality rate of 14 per 100,000 population. If that doesn’t sound like much to you, just remember that intentional self-harm was the 10^th leading cause of death that year. Alabama’s rate (16.2) is higher than the national average.

As for policies enacted to prevent suicide, include: restricting the means (tighter gun control, regulating certain medications, etc.); integrating mental health with primary care; and of mental health services. Someday we’ll find the perfect combination of policies to keep the suicide rate down, but until then there are things we can all do at the individual level to prevent suicides.

If you’re having thoughts of suicide, please take the time to call the National Suicide Prevention Hotline at 1-(800)-273-8255. To learn more about how the Lifeline operates, join this webinar on September 18.

If you want to get involved with prevention efforts, you can volunteer with the Crisis Center right here in Birmingham.

If someone reaches out to you about having suicidal thoughts, listen to them and help guide them towards seeking help. Don’t tell them everything will be fine, and don’t promise to keep it a secret. This fact sheet from the Alabama Department of Public Health has more information about how to help.