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La Crosse County Health Department employees and other health-care advocates are trying to wrap their minds around the meaning and scope of the word stigma to assess its impact on mental health issues, Health Director Jen Rombalski said.

“We need to get at the stigma piece, because it truly is a burden to mental health,” Rombalski told attendees Thursday at an informational exchange meeting of the Mental Health Coalition of the Greater La Crosse Area.

One of the stumbling blocks is that the word itself carries its own stigma, an albatross around its neck, as the health department attempts to tackle the No. 1 priority in its five-year plan, she said.

County workers will research the issue in an attempt to design a tool to pinpoint stigma’s impact and reduce it, she said.

“If we don’t, how can we measure whether we are making progress?” she said. “If we want to get resources for this, we need to be able to measure it.”

Erasing the shameful feeling that stigmas inflict will help make people more open to seeking help and propel progress in identifying and treating people who are struggling with mental health, Rombalski said.

“Just about everybody who comes through the court system has some type of mental health issue,” and those problems often are unaddressed because they are disconnected from resources, La Crosse County Circuit Judge Todd Bjerke said.

The result is the county jail’s frequent description as the biggest mental health institution in the area, Bjerke said.

The judge told of a defendant in another jurisdiction who became so frustrated because the county attorney did not acknowledge the role of mental illness in his crime that he committed suicide.

That vacuum of information and treatment burdens law enforcement officials and jurists, he said.

The health department is exploring setting up a “community pathways hub model” to help those who need services connect with agencies “so that nobody drops out,” Rombalski said.

“Ideally, we can get far enough upstream so they don’t enter the system,” she said.

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Efforts such as the Campaign to Change Direction, the Changemaker grant the La Crosse Medical Health Science Consortium recently received to increase coordination of mental health services, are expected to play important roles in the effort, she said.

“With a screening tool and the ‘no-wrong-way-approach,’ we can identify what they need help with,” Rombalski said.

“Do they need help with housing? Help with calling, transportation, child care, taking care of their business?” she said.

“When you’re down and out, you focus on other things” just to survive, she said.

The task is a daunting one that will require efforts throughout the community, she said.

Along those lines, she encouraged people to get involved and become comfortable with the terminology of mental health, mental illness and serious mental illness. It also is important to learn protective factors as a more positive approach than just addressing risk factors.

“Become a caring adult … and recognize that it’s not only my kids but also the kids around my kids,” she said.

Recognizing signals of struggling or suffering, such as Change Direction’s five signs of mental struggles — personality change, agitation, withdrawal, poor self care and hopelessness — also are keys, Rombalski said.

Anyone who senses that a young person or people of any age might be struggling or even contemplating suicide should take the question-persuade-refer approach, she said.

Ask such individuals about any problems they may be encountering and whether they are considering hurting themselves, she said. If so, persuade them that they are important and people care about them.

Then, refer them to the appropriate service or agency to obtain help, she said.

“You can save a life just like CPR,” Rombalski said.

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