DES MOINES, Iowa - In Iowa and around the U.S, people have faced a flurry of stressful events and crises in the last year. During Mental Health Awareness Month, experts say it might not seem obvious that help is needed, but the signs may develop over time.

From the pandemic to the election, to last summer's derecho storm in Iowa, many segments of the population are emerging from a stressful era.

Peggy Huppert - executive director of the Iowa chapter of the National Alliance on Mental Illness - said altogether, it's a lot to simply shake off without being aware of the lasting effects on a person's mental well-being.

"We often think of a traumatic event, or events, as having an immediate impact," said Huppert. "But actually, it usually takes a while to see the full impact."

For example, she cited research showing suicides peaked nearly three years after the financial crisis of 2008.

Experts say the signs to monitor include changes in a person's sleeping habits, or a general lack of energy or interest in most activities.

Despite greater mental-health awareness, Huppert said people often are still reluctant to raise concerns about a loved one's situation.

Huppert said friends and family might feel like they're causing trouble if they speak up, but she insists that isn't the case.

"Sometimes people are waiting," said Huppert, "hoping that someone is going to say something and intervene."

She noted that young people might especially feel the effects from recent isolation, but are not likely to open up to others about those feelings.

Even with many Iowans vaccinated and much of society reopening, Huppert said it's hard to forget the emotional turmoil of the past year. As groups get together again, she said there's another way to spot a warning sign.

"If someone is constantly canceling plans," said Huppert, "to ask, 'What's happening? Is there something I can do to help?'"

And as more people head back to the office, she said it's important to foster a supportive environment in the workplace.

Rates of suicide among young people have increased by about 36% in roughly the last two decades and the surge has caught the attention of federal policymakers.

The Biden administration has a new National Strategy for Suicide Prevention and a Federal Action Plan, highlighting the need for a coordinated approach to prevention and equity in treatment and research. It follows the Bipartisan Policy Center's launch of a youth mental health task force in January.

Val Demings, co-chair of the Youth Mental Health and Substance Use Task Force and a former member of Congress from Florida, said in Sioux Falls last week rural communities face unique mental health challenges.

"For example, having access to care, the affordability of care, removing the stigma," Demings outlined. "You may be in a substandard educational setting. You may also have substance abuse, addiction in the household. And so we have got to, as a nation, deal with the social ills that cause decay in certain communities in the first place."

A big focus of the task force is a link between suicide and increased use of technology and social media. The U.S. Surgeon General said young teens who spend more than three hours a day on social media are at double the risk of mental health struggles, including depression and anxiety.

Technology can also be used to help deliver health care services in rural places. In 2021, the Helmsley Charitable Trust launched a virtual crisis care program in South Dakota, equipping law enforcement with iPads, so they can connect people with mental health professionals by video.

Walter Panzirer, trustee of the trust, has seen positive results.

"We had a 75% reduction of transports to the mental health facilities," Panzirer pointed out. "They were able to get care at home, locally; 25% of the calls were for youth."

People living in rural places are almost twice as likely to twice as likely than those living in large cities, according to the Centers for Disease Control and Prevention. The agency said South Dakota had the fifth-highest suicide rate in the country in 2021 at over 200 deaths.

If you or someone you know is in crisis, contact the Suicide and Crisis Lifeline at 988.

New continuing education classes can help New York psychologists better work with disabled patients.

The courses center on understanding disabilities - providing universal access for patients with disabilities, ethics, and cultural competence.

Sharon McLennon-Wier, Ph.D. - executive director of the Center for Independence of the Disabled New York - said in developing the curriculum, there were certain takeaways people should have.

"The first step really is for people to understand that a disability is a disability, and there are going to be barriers to the environment with it," said McLennon-Wier. "And we need to work together to ensure that each and every person has access to treatment."

Other takeaways are ensuring clinicians are aware of their expectations, noting they're not trained to work with every single client.

It's taken two years to get these courses up and running, and McLennon-Wier said she is eager to see how these will shape up.

The first course begins on May 29 and anyone interested can register online at www.cidny.org/ce.

There's also a hope psychologists will learn about confronting their stigmas toward disabilities.

McLennon-Wier said she feels this begins by looking through the lens of ableism. She said people should consider how they implement universal access for disabled patients.

"Does your biases prevent you from utilizing the knowledge of treatment that you have?" said McLennon-Wier. "Does it work with what's needed by that person who has a disability because first is the treatment practice, but also you have to understand the implications of disabilities."

Other considerations should be given to issues like the segregation disability creates. She said she thinks certain determinants of health like race and gender also impact a person's mental health.

Future classes could deal with different psychological treatments with an infusion of multicultural disability competence.

The 2024 Arizona Alzheimer's Consortium Public Conference kicks off Saturday, where industry experts and researchers will share the latest scientific developments and ongoing advances to fight Alzheimer's disease and other forms of dementia.

David Coon, director of the Center for Innovation in Healthy and Resilient Aging at Arizona State University, will lead the conference.

Coon said experts continue to see growing numbers of people developing dementia in the Grand Canyon State, which also means increased demand for care from family and friends.

"The reality is we're still facing this," he said, "and we're facing it also with a growing number of people living alone with cognitive decline, and that is very important for us to recognize as well."

It's a growing public health crisis in Arizona, according to the Alzheimer's Association. An estimated 152,000 people 65 and older are living with Alzheimer's disease in the state.

Coon said increasing awareness about the disease is critical to not only diminish stigma but also plan for the future.

Saturday's event is free and will take place from 8 a.m. to 1 p.m. at the Memorial Union on ASU's Tempe campus. Coon said a panel of experts will share information about treatment options, but also the resources and support systems available across the state.

He added that it is critical for people not to wait until a crisis strikes, and that the sooner patients know their cognitive-health status, the better they can have a voice in their own preferences for care.

"How you get assistance, who's engaged, and I think that is really important for you to be, in part, in the driver's seat," he said, "and similarly, for somebody that's going to help you along that way to have those conservations."

Coon called Saturday's event a "family affair," and encouraged anyone impacted by dementia or Alzheimer's to bring family and friends to learn more. Topics will range from new drug treatments to reducing the risk of Alzheimer's with exercise, as well as resources for caregivers.