May is Mental Health Awareness Month, to bring awareness to our community we had an interview with Joe Trolian, Executive Director of Richland County Mental Health and Recovery Services Board. His 10th anniversary as Executive Director is coming up in October, though he has been on the Richland County Mental Health and Recovery Service Board since 2003 previously serving as the Clinical Director. Having graduated in 1993 from Heidelberg College with a Master of Arts in Mental Health Counseling, he brings nearly 25 years of total experience. We were very pleased to have the opportunity to speak with him. We covered many topics to address problems we have as a community in relation to domestic violence and mental health:
In Richland County, we see a connection between suicide and domestic violence for victims as well as perpetrators. For victims, the factors which contribute to suicide can be; isolation, fear, anxiety, depression, and many others. For perpetrators, the factors which can contribute to suicide are often; loss of control, and denial that they have a problem. However, there are many other factors which can lead to suicide that may not be domestic violence related.
Acceptance and understanding:
As a community, we are lacking acceptance that domestic violence exists, and is not gender specific. Joe said, “We often view domestic violence as strictly physical violence and laugh at the thought that a 250-pound man could be abused by a 120-pound woman but in reality, she doesn’t need to be hitting him to be abusive.” Abuse can take form in social control, such as, not allowing the significant other to visit friends and family, restricting phone use, and other similar behavior. Financial control, not allowing the significant other to have knowledge of finances and allotting them a specific amount that they are allowed to spend. Emotional control, and using children are other forms of domestic violence that are non-physical.
After dealing constantly with these other types of abuse, Joe stated, “Escalation to physical violence can be a relief for some abuse victims because they know that there will be an apology and honeymoon stage afterwards where they won’t experience abuse for a short-time. This period is often what convinces a victim to stay, though the abuse almost always resumes.”
Victims often change their behavior to compensate for the perpetrators behavior but in the end Joe said, “The perpetrator must change. There isn’t another way around it, but people can change. If people couldn’t change, I wouldn’t be in this field.”
Trauma Informed Care:
Joe is a major supporter for Trauma Informed Care. It is a new look at patient care where treatment is viewed as a whole person experience, taking all their life experiences into consideration. Instead of working only on the presenting problem and sending the person out the door. An example Joe gave of this is, “A person is experiencing depression because they hate their job. Working on the presenting problem, the solution would be to help the patient get a new job. Trauma-informed care would seek to understand why the patient hates their job. Does their boss remind them of an aggressive person from their past? Is there a smell in the air which triggers a bad memory, etc.?”
Men and Mental Health:
Men can have different symptoms of anxiety, depression, and other mental health issues, that may look like another problem entirely. If left untreated it can lead to negative reactions such as physical violence. Joe said, “Men are often taught to deal with problems simply; mad, sad, or glad. This leads to problems expressing emotions, causing them to lash out in a way they were taught is acceptable; physical violence, harsh words, shutting down, and isolation. These are not proper ways to handle emotions, we need to educate on how to properly handle emotions.”
Joe also stated, “When the General Motors plant closed in Mansfield, we saw a spike in domestic violence. This is not because the people working at this plant are just aggressive and mean, it is because the plant shutting down was a severely emotional event for many people. And instead of properly dealing with their emotions, they lashed out.”
Controlling medication is a major way a person can control another. Increasing or decreasing medication dosage can make it easier to control a person because they are not in a balanced state of mind. Control of medication can add to fear a victim might already be experiencing, this increases existing mental health issues and could create more. A partner could use this to create a case against the other, causing them to lose their job, and children.
Joe said we see this control often in domestic violence situations involving the elderly, because it creates a case against the victim causing their unwilling hospitalization. Eventually the perpetrator can receive full rights over the victims legal and financial matters through a power of attorney.
A child’s mental health is also impacted by domestic violence in the home. The ACE’s Study found that experiencing three or more adverse childhood experiences can cause physical, and mental issues which lead to poor school performance, bad behavior, substance abuse, future violence, and many other issues. Read about the ACE’s study: https://www.cdc.gov/violenceprevention/acestudy/about.html
Joe said, “Indirect trauma is just as devastating as direct abuse. Society teaches children to always listen to their parents, but how do we address the confusion when a child is in a domestic violence situation? Because we do not want the child to replicate the violent behavior.”
Richland County does have programs specifically structured to help children, and we are implementing a screening tool to help catch other underlying issues, as part of the trauma informed care initiative discussed above. An example Joe gave is, “Say a parent brings a child in because they have bad grades, the screening tool will help pin point what issues the child is experiencing instead of just focusing on the bad grades”.
Richland County Programs:
Programs within the Mental Health and Recovery Services are dual certified in mental health and substance abuse. Domestic violence falls under mental health and anyone experiencing domestic violence can receive assistance. All programs operate on a sliding scale fee. They also offer diagnosis, case management, and crisis assistance at no cost. Click on the image below to visit the Richland Mental Health and Recovery Services Board website and get connected with our local resources.