RICHMOND, Va. - Substance-use disorder can go hand in hand with mental-health issues, and folks in rural Virginia can take a mental-health first-aid training course to better tackle the problem.

The free two-day program takes place starting January 7 and will focus on a five-step action plan that helps folks recognize signs and symptoms.

Certified Mental Health First Aid trainer Jordan Laney is the program coordinator for the Virginia Rural Health Association, and is leading the course sponsored by the association.

She said the session is especially timely as the Appalachian region, and much of America, has been hit hard by a spike in drug overdoses during the pandemic.

"While we're working through COVID," said Laney, "I think that mental-health issues are intensified really by isolation and anxiety that the pandemic has brought into everyday life. And being able to support one another and talk about things that are often stigmatized is incredibly important."

She said folks will need Internet access to participate in the virtual training. For more information or if you need help accessing broadband, go to the Virginia Rural Health Association website at VRHA.org.

Katrina Broughman is the director of Recover Virginia/Recover Fest, which is co-sponsoring the training session. She said folks who live in rural areas have been hit hard even before the pandemic by substance-use disorder and mental and behavioral issues.

"We don't have as much access to mental-health services and programs as people who may be in a more urban area," said Broughman. "So I find it very important, and anything we can do to help people to make them feel like they're not being left behind and that their mental health and physical health matters."

More than 100,000 Americans died of overdoses during the pandemic's 12-month peak that ended in April, up almost 30% from the 78,000 deaths the previous year, according to data from the National Center for Health Statistics.

Starting in July, Florida students and families will receive more information on the mental health services they are entitled to.

Rep. Christine Hunschofsky, D-Parkland, served as the mayor of Parkland during the Stoneman Douglas High School shooting, where 17 students were killed. She said her time as mayor influenced her decision to sponsor House Bill 899.

"If a student is receiving behavioral health services in the school, the school is then required to let their family and/or caregivers know about the services that are available to the family and caregivers, both at the school and in the community," Hunschofsky outlined.

The measure was signed into law last week. Florida and the rest of the nation continue to observe National Mental Health Month during May, as they have for seventy years.

This year, the observation comes as schools and families grapple with the COVID lockdowns and the threat of mass shootings. Hunschofsky argued more needs to be done to provide mental health services to all Floridians, as well as a change of attitude toward mental health.

"We've seen the toll the pandemic and just life has taken on the mental health of so many," Hunschofsky noted. "It's always interesting to me that people separate mental health from physical health. And they're incredibly interconnected."

Dr. Rhonda Randall, chief medical officer of UnitedHealthcare employer and individual, said southern states often have much less access to mental health services.

"In New England, those states have a tendency to have very high numbers of licensed mental health care professionals per capita, and in the Southeast, we see lower," Randall pointed out. "In fact, in some states, that can be a sevenfold difference."

Last year, the Florida legislature created a Commission on Mental Health and Substance Abuse to examine how the Sunshine State provides mental health and substance abuse services. It expects to make recommendations to lawmakers.

As the school year winds down, education leaders are shedding light on increased mental-health demands among students, including thoughts of suicide.

Various organizations in Iowa also are calling attention to the issue during Mental Health Awareness Month.

Lisa Cushatt, executive director of the trauma healing group Iowa ACES 360, said concerns were building prior to the pandemic, but adds the crisis has added layers of mental health issues for children and adolescents.

She said what's happening now shatters the myth that kids are born resilient, especially when adults in their lives feel extra stress simultaneously.

"We want to believe kids are born resilient," said Cushatt. "But we have such a responsibility as adults to help cultivate that and model that and it's really hard to do when we're in crisis ourselves."

According to new Centers for Disease Control and Prevention data, 44% of U.S. high school students recently reported persistently feeling sad or hopeless in the past year. And nearly 20% had seriously considered attempting suicide.

Last month, the U.S. Preventive Services Task Force recommended screening for anxiety in youths between the ages of 8 and 18.

While school counselors are responding to more referrals, there are calls to enhance training for all staff to help these students. Those suggestions coincide with gaps in locating enough providers who can help a child away from campus.

Erin Drinnin, community impact officer for health of the United Way Central Iowa, said Iowa Children's Behavioral System is feeling the impact of the workforce shortage.

"How do we recruit enough mental-health professionals to go into school," said Drinnin, "to go into these professions to serve youth and adults?"

The Coalition to Advance Mental Health in Iowa for Kids recommends actions such as student loan forgiveness and maintaining telehealth flexibilities.

Julia Webb, program director for NAMI Iowa, said parents and educators can be proactive by intervening when warning signs pop up.

"If you're seeing a young person isolating themselves," said Webb "not taking joy in the things they've previously found happiness in, ending relationships with friends, not wanting to interact with friends."

For crisis situations, signs include expressing great shame and plans that point to ending their life.

May is Mental Health Awareness Month and advocates are hoping Gov. Gavin Newsom will prioritize the issue in his revised budget, due by Sunday.

The governor's January budget proposed $4.7 million to fund the California Parent and Youth Helpline annually for three years. The helpline connects people with a trained counselor for free from 8 a.m. to 8 p.m., seven days a week.

Dr. Lisa Pion-Berlin, president and CEO of Parents Anonymous, which runs the California Parent and Youth Helpline, said additional funding is needed to keep up with demand for their services.

"With greater resources, we could have more trained clinicians to answer the phone," Pion-Berlin explained. "The demand outstrips our capacity right now. We have people on waiting lists to get into our free online weekly support groups."

The service has helped more than 40,000 people in California since it started two years ago, but they would like to help more of the Golden State's 9.3 million children.

Last week was Children's Mental Health Acceptance Week, when people are encouraged to take action and reach out to another person who might be struggling. Pion-Berlin emphasized no one should be blamed or shamed when they ask for help.

"Parents need support in identifying and accepting that change in behavior, mood swings, sleeping patterns, change in friends, that their child looks sad, and that they may need to seek help," Pion-Berlin outlined.

A 2021 study in the Journal of the American Medical Association found child suicide rates have been rising in recent years, and suicide is the 8th leading cause of death among children aged 5 to 11.