James Donaldson on Mental Health - When Grief Enters the Locker Room

Understanding suicide, identity, and collective loss in sport.

Tess M. Kilwein PhD, ABPP, CMPC

Reviewed by Jessica Schrader

THE BASICS

- Suicide Risk Factors and Signs
- Take our Depression Test
- Find a therapist near me
Key points
- Grief in sport settings affects identity, performance, and psychological safety.
- Athlete suicide risk is shaped by pressure, identity foreclosure, injury, and barriers to care.
- Teams need proactive suicide response protocols before a crisis occurs.

When a death occurs in a sport environment, particularly a death by suicide, its impact can ripple through entire organizations. Athletes, coaches, and sport staff, including those tasked with supporting organizations through crises (e.g., sport psychologists, athletic counselors), often experience collective waves of shock, grief, and unanswered questions.

This reality was central to a recent conversation with professional soccer player for RC Strasbourg Sierra Enge and adolescent mental health and suicide expert Dr. Kimberly O’Brien. Together, Sierra and O’Brien bring both lived and professional experience to the intersection of grief, suicide prevention, and athlete mental health. Throughout our discussion, their perspectives underscored a critical truth: we still do not fully understand the weight or complexity of grief and loss within sport environments, especially when that loss is due to suicide.

Athlete Identity and the Pressure to Perform

For many athletes, sport is not just something they do. Over time, it becomes central to who they are. Sierra described growing up excelling in soccer and receiving external reinforcement that her value was directly tied to performance. Social media, increased visibility, and constant evaluation intensified this dynamic over time. She continues to navigate these same pressures as a professional athlete today.

When performance declines, injury occurs, or life circumstances disrupt sport participation, many athletes experience a significant rupture in identity. In these moments, the internal message can quickly become, “If I am not performing, I am not valuable.” This belief can fuel social and emotional challenges, including anxiety, withdrawal from sport, and social isolation.

With time, peer and professional support, and meaningful shifts in perspective, Sierra learned that she functions best when she invests in multiple parts of herself, not solely soccer. While she continues to train intensely and care deeply about her sport, the difference is that performance alone no longer determines her self-worth.

O’Brien observes this same pattern in her work with athletes across the lifespan, particularly adolescents and young adults. She emphasized that overidentification with sport can limit coping flexibility when adversity hits. To support both mental health and long-term performance, athletes need identities that extend beyond their role on the field.

Why Today’s Athletes Are Carrying More

Athletes today are navigating higher stakes and broader demands than many prior generations. Dr. O’Brien emphasized the convergence of academic and athletic pressures, while Sierra highlighted the growing expectations tied to NIL deals, public scrutiny, and constant social media comparison.

A recent systematic review examining suicide risk among college student-athletes identified several contributors, including the convergence of academic and athletic pressures, toxic or psychologically unsafe team cultures, barriers to accessing confidential mental health services, identity foreclosure tied to sport, and injury-related stressors (Anton-Lotruglio & O’Brien, 2025). These factors accumulate over time, increasing vulnerability when coping resources are already strained.

Evidence suggests that this stress exposure begins well before college. One study of high school athletes revealed that 91% reported experiencing sport-related stress, with 27% endorsing moderate to extreme levels of stress associated with athletic participation (Ward et al., 2023). This chronic stress becomes normalized long before youth athletes enter elite or collegiate sport environments.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Remembering Katie Meyer

The reality of grief in sport is best understood through the experiences of those most closely impacted. Sierra and Katie Meyer were best friends, teammates, and co-captains at Stanford University. Katie’s death by suicide in 2022 shook the college sport world and brought renewed attention to athlete mental health.

When I asked Sierra what she would say to Katie now, her message was simple and urgent: Tell someone. Make one call. Hold on a little longer. Even one trusted person can change the trajectory of a life.

At the same time, Sierra acknowledged how difficult this can be for student-athletes who are taught to be tough from a young age. “It’s not going to be an easy road,” she shared, “but if you open up to one person, maybe they can walk with you.”

Sierra speaks openly about her own mental health and her use of therapy, encouraging others to do the same. She reflected that while she had developed many independent coping skills over the years, she came to recognize how essential asking for help became as she worked through the loss of Katie.

O’Brien emphasized that suicidal crises distort perception. Emotional pain overwhelms the brain’s ability to generate alternatives. In moments of extreme distress, suicide can feel like the only option, not because others do not exist, but because the brain under intense stress cannot access them. This is why both O’Brien and Sierra emphasize the importance of social connection and accessing support before distress reaches a critical point.

Both also stress that therapy should not be a last resort for athletes. Instead, it should be treated as a protective resource. Building a relationship with a mental health professional when life feels stable creates a safety net for when it does not. “It can’t hurt,” Sierra emphasized.

Supporting Teams After Suicide

When a suicide affects a sports team, grief becomes collective, carried through the hallways, fields, and offices of athletic departments. O’Brien’s work centers on restoring psychological safety so teams and organizations can function, communicate, and ultimately heal.

This includes psychoeducation about suicide-specific grief, facilitating conversations about support needs, and helping teams navigate decisions related to memorials, daily routines, and returning to play. O’Brien emphasizes that there is no single correct response. Athletes grieve differently, and flexibility within structure is essential.

Sierra echoed this sentiment, noting that returning to structure supported her healing, while pressure to adhere to that structure when more time was needed to process caused long-term harm for one of her teammates.

Both Sierra and O’Brien emphasized that external consultants are often critical in moments of tragedy, particularly when loss involves suicide. Internal staff and coaches are grieving as well. Outside support offers containment, neutrality, and guidance at times when decision-making feels overwhelming or impossible for those closest to the loss.

Why Institutions Must Prepare in Advance

One of the clearest takeaways from my discussion with Sierra and O’Brien is that sport systems too often wait until tragedy strikes to develop a response. Suicide response protocols must exist before they are needed, especially when emotional resources are limited and decision-making capacity is compromised.

Effective institutional responses include:

- Clear suicide and crisis response protocols.
- Flexible attendance and training expectations without retaliation.
- Multiple layers of support for athletes, coaches, and staff.
- Centering survivors and respecting varied grief timelines.

Routine with flexibility allows athletes to re-engage at their own pace. “If you can come, come. If you cannot, do not,” stated Sierra.

Carrying Forward What Matters

At the end of our conversation, Sierra reflected on her friend Katie Meyer’s capacity to love deeply and consistently show up for others. Her legacy challenges sport communities to do the same. “Soccer is a sport. It’s not that serious,” Sierra shared. She expressed hope that it will not take another loss for teams to recognize this truth.

Grief and loss will continue to enter sport spaces. The critical question is whether those environments are prepared to meet it with humanity, structure, and care. Mental health support for athletes is not only a performance asset. In moments of profound loss, it is life-saving.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-when-grief-enters-the-locker-room/

James Donaldson on Mental Health - Kids and Multiple Medications

A checklist of things you should know about adding and mixing medications

Writer: Caroline Miller

Clinical Expert: Ron J. Steingard, MD

- What can go wrong with multiple medications?
- Things to consider if your doctor is proposing multiple medications

When children have complex psychiatric symptoms, or aren’t responding adequately to a medication they are taking, doctors often recommend adding another medication.

Taking multiple psychoactive medications is called “polypharmacy.” And studies show that the number of children taking more than one medication is soaring. Combining medications can be effective when they’re prescribed and monitored carefully by a doctor expert in using them with children. But it’s important for parents to know the risks inherent in adding medications, and how to tell if you should be concerned about what a doctor is recommending.

What can go wrong with multiple medications?

The risk in combining medications is that they can interact in ways that increase unwanted or harmful side effects. Let’s say your child is prescribed one medication that causes mild sedation, and a second does the same thing. The result can be so much sedation that the child isn’t herself and can’t stay awake, explains Dr. Ron Steingard, a child and adolescent psychiatrist at the Child Mind Institute.

Another medication interaction that can be problematic is if two medications use the same metabolic pathway—the mechanism in the body that breaks them down and delivers them to the target. In some cases these medications, taken together, can overwhelm that pathway and create a buildup of medication, Dr. Steingard says, and that can cause the kind of side effects you’d see with a much higher dose of one of the meds.

Finally, there’s a risk that a child is prescribed multiple medications when he would benefit more from other supports, including behavioral treatments that have been shown to be effective for kids with many issues, including ADHD, anxiety and depression.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Things to consider if your doctor is proposing multiple medications

- Your clinician should have specific training and substantial experience prescribing and managing these medications in children, not just adults. That’s because children, whose nervous systems are still maturing, don’t always respond to medication the same way adults do.
- Medications for your child should not be prescribed by two different doctors, unless they are coordinating their care and communicating with each other closely. If there are two prescribing doctors on your child’s treatment team, one should take the lead in your child’s care, and the other act as consultant.
- Whenever a medication is introduced, your doctor should explain clearly what symptoms it is expected to treat, and how you will evaluate whether the medication is helping your child.
- With any new medication, your doctor should explain what side effects to watch for, as well as anything in a child’s mood or behavior that might indicate that she’s having a bad reaction.

Related: Side Effects ofADHD Medication

- If one medication isn’t working, or is barely helping, it can also be a sign that the disorder has been wrongly diagnosed. It’s important that your doctor reevaluate the diagnosis, and the treatment, before adding other medications.
- Before a child begins taking a second medication, other supports should be explored that might have lower risks and more benefit. The combination of a single medication and behavioral treatment should be carefully considered before more meds are added.
- If your child is experiencing side effects from one medication, it’s advisable to explore either cutting back on the dose or switching medications before adding another med to treat side effects.
- A child should not begin taking two or more medications at the same time. Meds should be introduced one at a time, enabling you and your doctor to monitor any side effects that occur, and to measure the effects on your child’s mood and behavior.
- If your child is taking more than one medication, dosages should be changed one at a time. It’s impossible to evaluate the effect of each change if more than one is altered.
- New medications should be added and dosage changes made when your child’s life and routine are as stable as possible. You want to avoid times like the start of a new school year, vacation, a move to a new home, or a medical illness.
- When you change or add medications, it’s important to let everyone on your child’s team know—including her teachers and other caregivers—and check in to find out how she is doing.
- When you evaluate the effects of a medication, it’s important to not assume that any change, for better or worse, is a result of the medication. Pay attention to other changes in your child’s life at home and at school that might affect her emotions and behavior.
https://standingabovethecrowd.com/james-donaldson-on-mental-health-kids-and-multiple-medications/

A checklist of things you should know about adding and mixing medications

Writer: Caroline Miller

Clinical Expert: Ron J. Steingard, MD

- What can go wrong with multiple medications?

- Things to consider if your doctor is proposing multiple medications

When children have complex psychiatric symptoms, or aren’t responding adequately to a medication they are taking, doctors often recommend adding another medication.

Taking multiple psychoactive medications is called “polypharmacy.” And studies show that the number of children taking more than one medication is soaring. Combining medications can be effective when they’re prescribed and monitored carefully by a doctor expert in using them with children. But it’s important for parents to know the risks inherent in adding medications, and how to tell if you should be concerned about what a doctor is recommending.

What can go wrong with multiple medications?

The risk in combining medications is that they can interact in ways that increase unwanted or harmful side effects. Let’s say your child is prescribed one medication that causes mild sedation, and a second does the same thing. The result can be so much sedation that the child isn’t herself and can’t stay awake, explains Dr. Ron Steingard, a child and adolescent psychiatrist at the Child Mind Institute.

Another medication interaction that can be problematic is if two medications use the same metabolic pathway—the mechanism in the body that breaks them down and delivers them to the target. In some cases these medications, taken together, can overwhelm that pathway and create a buildup of medication, Dr. Steingard says, and that can cause the kind of side effects you’d see with a much higher dose of one of the meds.

Finally, there’s a risk that a child is prescribed multiple medications when he would benefit more from other supports, including behavioral treatments that have been shown to be effective for kids with many issues, including ADHD, anxiety and depression.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Things to consider if your doctor is proposing multiple medications

- Your clinician should have specific training and substantial experience prescribing and managing these medications in children, not just adults. That’s because children, whose nervous systems are still maturing, don’t always respond to medication the same way adults do.

- Medications for your child should not be prescribed by two different doctors, unless they are coordinating their care and communicating with each other closely. If there are two prescribing doctors on your child’s treatment team, one should take the lead in your child’s care, and the other act as consultant.

- Whenever a medication is introduced, your doctor should explain clearly what symptoms it is expected to treat, and how you will evaluate whether the medication is helping your child.

- With any new medication, your doctor should explain what side effects to watch for, as well as anything in a child’s mood or behavior that might indicate that she’s having a bad reaction.

Related: Side Effects ofADHD Medication

- If one medication isn’t working, or is barely helping, it can also be a sign that the disorder has been wrongly diagnosed. It’s important that your doctor reevaluate the diagnosis, and the treatment, before adding other medications.

- Before a child begins taking a second medication, other supports should be explored that might have lower risks and more benefit. The combination of a single medication and behavioral treatment should be carefully considered before more meds are added.

- If your child is experiencing side effects from one medication, it’s advisable to explore either cutting back on the dose or switching medications before adding another med to treat side effects.

- A child should not begin taking two or more medications at the same time. Meds should be introduced one at a time, enabling you and your doctor to monitor any side effects that occur, and to measure the effects on your child’s mood and behavior.

- If your child is taking more than one medication, dosages should be changed one at a time. It’s impossible to evaluate the effect of each change if more than one is altered.

- New medications should be added and dosage changes made when your child’s life and routine are as stable as possible. You want to avoid times like the start of a new school year, vacation, a move to a new home, or a medical illness.

- When you change or add medications, it’s important to let everyone on your child’s team know—including her teachers and other caregivers—and check in to find out how she is doing.

- When you evaluate the effects of a medication, it’s important to not assume that any change, for better or worse, is a result of the medication. Pay attention to other changes in your child’s life at home and at school that might affect her emotions and behavior. https://standingabovethecrowd.com/?p=16415

James Donaldson on Mental Health - Trump administration reverses itself, restores $2 billion in mental health, substance abuse grants

Officials with SAMHSA directed the Montana health department to disregard the previous notification about grants being canceled.

Less than 24 hours after terminating about $2 billion in substance abuse and mental health grants nationwide, the Trump administration reversed itself and restored the funding.  

In Montana, state public health officials and advocacy groups told Montana Free Press Wednesday that local suicide prevention, addiction recovery and other mental health programs had lost millions of dollars in federal funding overnight. Many expressed shock and confusion after receiving a letter from the U.S. Substance Abuse and Mental Health Services Administration, also known as SAMHSA, which said grant money that had already been distributed would be clawed back.

In a Thursday morning email to the Montana state health department, however, officials with SAMHSA directed the state to “disregard” the previous notification canceling the grants. The email was shared with MTFP by a state health department spokesperson.

“he termination of your federal award, previously communicated on January 13, 2026, pursuant to 2 C.F.R. § 200.340(a)(4), is hereby rescinded,” the federal notice read. “Your award will remain active under its original terms and conditions. Please disregard the prior termination notice and continue program activities as outlined in your award agreement.”

Montana public health officials and advocacy groups said that local suicide prevention, addiction recovery and other mental health programs had lost millions of dollars in federal funding, citing a letter from the Trump administration announcing that grant money that had already been distributed would be clawed back.

The email did not provide an explanation for the sudden reversal. The state spokesperson, Jon Ebelt, told MTFP that the notices referred to two grants totalling roughly $2 million annually: the Partnerships for Success grant that aims to reduce youth substance misuse, and the Strengthening Families Initiative that works to prevent substance use disorders among pregnant and postpartum women.

Sandy Whittington works at the Lewis and Clark Public Health Department on Jan. 15, 2026, in Helena. On Tuesday, the Trump administration announced cuts to grant funding from the U.S. Substance Abuse and Mental Health Services Administration, also known as SAMHSA. Later that day, the administration reversed its decision. Credit: Lauren Miller, Montana Free Press, CatchLight Local/Report for America

Lewis and Clark Public Health Officer Drenda Niemann also confirmed to MTFP that her office received notice that the termination — which would have ended a $125,000 suicide prevention grant — had been rescinded. 

“We will continue to have the grant funds for suicide prevention work through September 2026 as originally planned,” she wrote in an email Thursday. 

Missoula County received notice that funding was being restored for the Systems of Care program, which expands mental health and supportive services for youth and families, according to communications manager Allison Franz. The county, Franz said, is still waiting to hear the status of a grant supporting the Frenchtown Community Coalition.

Casey Schreiner, chief strategy officer at Alluvion Health in Great Falls, said the organization received notice Wednesday that a $545,000 grant for a program addressing substance abuse disorder among young people was cut. Organization leaders began speaking with staff members on the program about potential impacts, but by Thursday, Alluvion received notice of the reversal. 

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

The Lewis and Clark Public Health Department is pictured Jan. 15, 2026, in Helena. On Tuesday, the Trump administration announced cuts to grant funding from the U.S. Substance Abuse and Mental Health Services Administration, also known as SAMHSA. Later that day, the administration reversed its decision. Credit: Lauren Miller, Montana Free Press, CatchLight Local/Report for America

“It does not go without hiccups because you still had to have some hard conversations,” Schreiner said. 

Johns Hopkins Center for Indigenous Health, which on Wednesday announced the cuts would cancel a substance use prevention project on the Rocky Boy’s Reservation, wrote in a Thursday statement it was “tremendously relieved” to see the terminations reversed. 

“Yesterday was such a challenging one for our staff and the families we serve,” the group wrote in a public Facebook post. 

Also on Thursday morning, a spokesperson for U.S. Sen. Steve Daines emailed a MTFP reporter a link to a POLITICO article stating that the grants had been reinstated, with no other context or statements.

Daines’ office had not responded to Wednesday’s inquiries from MTFP about the cuts. A spokesperson, Gabby Wiggins, did not reply to an additional request for a statement from Daines about the reversal or a question about whether the senator had communicated with the Trump administration about the grant cuts.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-trump-administration-reverses-itself-restores-2-billion-in-mental-health-substance-abuse-grants/

Officials with SAMHSA directed the Montana health department to disregard the previous notification about grants being canceled.

Less than 24 hours after terminating about $2 billion in substance abuse and mental health grants nationwide, the Trump administration reversed itself and restored the funding.  

In Montana, state public health officials and advocacy groups told Montana Free Press Wednesday that local suicide prevention, addiction recovery and other mental health programs had lost millions of dollars in federal funding overnight. Many expressed shock and confusion after receiving a letter from the U.S. Substance Abuse and Mental Health Services Administration, also known as SAMHSA, which said grant money that had already been distributed would be clawed back.

In a Thursday morning email to the Montana state health department, however, officials with SAMHSA directed the state to “disregard” the previous notification canceling the grants. The email was shared with MTFP by a state health department spokesperson.

“he termination of your federal award, previously communicated on January 13, 2026, pursuant to 2 C.F.R. § 200.340(a)(4), is hereby rescinded,” the federal notice read. “Your award will remain active under its original terms and conditions. Please disregard the prior termination notice and continue program activities as outlined in your award agreement.”

Montana public health officials and advocacy groups said that local suicide prevention, addiction recovery and other mental health programs had lost millions of dollars in federal funding, citing a letter from the Trump administration announcing that grant money that had already been distributed would be clawed back.

The email did not provide an explanation for the sudden reversal. The state spokesperson, Jon Ebelt, told MTFP that the notices referred to two grants totalling roughly $2 million annually: the Partnerships for Success grant that aims to reduce youth substance misuse, and the Strengthening Families Initiative that works to prevent substance use disorders among pregnant and postpartum women.

Sandy Whittington works at the Lewis and Clark Public Health Department on Jan. 15, 2026, in Helena. On Tuesday, the Trump administration announced cuts to grant funding from the U.S. Substance Abuse and Mental Health Services Administration, also known as SAMHSA. Later that day, the administration reversed its decision. Credit: Lauren Miller, Montana Free Press, CatchLight Local/Report for America

Lewis and Clark Public Health Officer Drenda Niemann also confirmed to MTFP that her office received notice that the termination — which would have ended a $125,000 suicide prevention grant — had been rescinded. 

“We will continue to have the grant funds for suicide prevention work through September 2026 as originally planned,” she wrote in an email Thursday. 

Missoula County received notice that funding was being restored for the Systems of Care program, which expands mental health and supportive services for youth and families, according to communications manager Allison Franz. The county, Franz said, is still waiting to hear the status of a grant supporting the Frenchtown Community Coalition.

Casey Schreiner, chief strategy officer at Alluvion Health in Great Falls, said the organization received notice Wednesday that a $545,000 grant for a program addressing substance abuse disorder among young people was cut. Organization leaders began speaking with staff members on the program about potential impacts, but by Thursday, Alluvion received notice of the reversal. 

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

The Lewis and Clark Public Health Department is pictured Jan. 15, 2026, in Helena. On Tuesday, the Trump administration announced cuts to grant funding from the U.S. Substance Abuse and Mental Health Services Administration, also known as SAMHSA. Later that day, the administration reversed its decision. Credit: Lauren Miller, Montana Free Press, CatchLight Local/Report for America

“It does not go without hiccups because you still had to have some hard conversations,” Schreiner said. 

Johns Hopkins Center for Indigenous Health, which on Wednesday announced the cuts would cancel a substance use prevention project on the Rocky Boy’s Reservation, wrote in a Thursday statement it was “tremendously relieved” to see the terminations reversed. 

“Yesterday was such a challenging one for our staff and the families we serve,” the group wrote in a public Facebook post. 

Also on Thursday morning, a spokesperson for U.S. Sen. Steve Daines emailed a MTFP reporter a link to a POLITICO article stating that the grants had been reinstated, with no other context or statements.

Daines’ office had not responded to Wednesday’s inquiries from MTFP about the cuts. A spokesperson, Gabby Wiggins, did not reply to an additional request for a statement from Daines about the reversal or a question about whether the senator had communicated with the Trump administration about the grant cuts. https://standingabovethecrowd.com/?p=16413

James Donaldson on Mental Health - What Brevard mental health experts say late-night scrolling can expose

Jennifer M. Torres

- New research suggests passive phone scrolling late at night may be an early warning sign of worsening mental health.
- Passively watching videos is linked to higher suicidal thoughts, while actively typing or messaging is tied to lower risk.
- Mental health experts say late-night phone use can be a barometer of underlying psychological states like anxiety or depression.

Can passive scrolling before bedtime be an early warning sign of worsening mental health?

The most vulnerable moments often happen when no one else is awake. Alone in the dark, many people turn to their phones — scrolling through videos, photos and news to distract themselves from anxious or intrusive thoughts.

But while that late night scroll may feel mindless, new research suggests that passive scrolling before bed (from 11 p.m. to 1 a.m.) could increase suicidal thoughts the following day, raising new questions about whether understanding a person’s digital habits could help mental health professionals flag people in crisis earlier.

However, not all late-night screen time carries the same risk. According to the data, it’s the passive scrolling — watching videos or flipping through social media — that is linked to higher suicidal thoughts the next day. Actively engaging on your phone (typing, commenting or messaging later in the night) appears tied to a lower risk. And while the research also found that longer phone-free periods overnight are associated with lower suicide risk indicators, it also suggests the difference between scrolling and connecting may matter more than the screen time itself.

What late-night phone use may be signaling

Neeley Hughey, a licensed mental health counselor, certified life coach and founder of Coastal Wellness and Life Coaching Center in Melbourne, said the study challenges the assumption that all nighttime phone use is inherently unhealthy and highlights the importance of understanding the reason for the behavior, not just its presence.

Hughey noted that late-night phone use between 11 p.m. and 1 a.m. may signal that someone is stuck in negative thought loops, feeling emotionally on edge, or trying to avoid sleep — patterns that are commonly seen in people who are struggling or at higher risk for mental health crises.

“Rather than viewing nighttime phone use as a single risk behavior, this research suggests it may function more as a barometer of underlying psychological states,” Hughey said. “Late-night use in the 11 p.m. to 1 a.m. window may reflect difficulty disengaging.”

 In that sense, she added, while scrolling before bedtime may not cause worsening mental health, it may expose it, especially when it represents a change from someone’s normal activities.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

When algorithms feed vulnerability

According to Mindy Tanner, a licensed mental health counselor at LiveWell Behavioral Health in Melbourne, the link between passive nighttime phone use and increased next-day suicidal thoughts may be influenced by the type of content being consumed.

“We know that social media creates algorithms based on previously watched ads, articles, and ‘liked’ videos and these algorithms can be dangerous,” Tanner said. “If someone is very depressed or anxious, and they have previously been watching videos that correlate to that, then the algorithm will continue to send that information.”

And, she explained, that risk may be amplified at night, when people are often alone with their thoughts and less likely to reach out for support.

 “If someone is very depressed and suicidal, often they are looking for a reason to follow through on their plan,” Tanner said. “By viewing social media that is programmed at that point to show that person videos about depression and suicide, that might be the ‘push’ they needed to follow through on their plan. This speaks to the importance of suicide hotlines."

The night shift in crisis calls

In Brevard County, 211 Brevard is a 24/7 community helpline that provides callers with immediate assistance and connection to community resources in times of personal and financial crisis. Belinda Stewart, Brevard 211’s communications manager, said they track every call by the hour of day received.

Stewart noted that more than half of all calls (around 65%) come from those in financial distress, and about 30% come from those who are struggling with mental health issues, addiction or thoughts of suicide.

“In general, we get many more calls during traditional business hours,” she said. “But we get more mental health calls at night.”

211 Brevard is part of the national "988" suicide and crisis lifeline network, which provides 24/7 support for people experiencing a crisis with mental health or substance use. Since launching in July 2022, the “988” lifeline has handled nearly 20 million calls, texts and chats nationwide. While publicly available data does not break down call volume by time of day, mental health professionals say demand for crisis support often increases during overnight hours, when isolation and distress tend to peak.

Two kinds of screen time, two very different signals

While passive scrolling is more likely tied to disengagement or avoidance, the research also revealed that active engagement (typing) later at night from 1 a.m. to 5 a.m. was actually linked with lower risk the following day.

“What I find especially interesting is the apparent protective association of active engagement later in the night,” Hughey said. “Typing, messaging or creating content suggests agency, cognitive organization and connection.”

A signal, she said, that someone is organizing their thoughts or reaching out, rather than passively scrolling or withdrawing.

Clinically, Hughey said the takeaway is less about pathologizing scrolling and more about using nighttime phone behavior as a “gentle assessment portal,” with the focus on asking questions about phone use to open meaningful conversations about distress, sleep and coping — without being alarmist.

“Overall, I see real potential here for informing early intervention and risk monitoring,” Hughey said. “Provided these signals are interpreted contextually, compassionately, and in relation to an individual’s baseline rather than as standalone red flags.”

https://standingabovethecrowd.com/james-donaldson-on-mental-health-what-brevard-mental-health-experts-say-late-night-scrolling-can-expose/

James Donaldson on Mental Health - Not All Attention Problems Are ADHD

It's a common assumption, but there are other causes that are easily overlooked

Clinical Experts: Jerry Bubrick, PhD , Jamie Howard, PhD

https://www.youtube.com/watch?v=VVlJ-ni3KYs

What You'll Learn

- What do symptoms of ADHD look like?
- What other conditions cause problems with attention?
- How can I make sure my child gets the right diagnosis?
- Quick Read
- Full Article
- Anxiety
- Obsessive-compulsive disorder
- Stress or trauma
- Learning disorders
- Is it really ADHD?

Lots of kids have short attention spans. They get easily distracted. They have trouble following instructions or sitting still. These can be symptoms of ADHD. But there are also other conditions that cause attention problems. It’s important to rule these out or a child can be misdiagnosed with ADHD and get the wrong treatment. 

Anxiety is one issue that can cause attention problems. When kids worry a lot, it can make concentrating in school very hard. For example, kids with separation anxiety may be distracted worrying that something will happen to their parents. Some kids might not hand in homework or respond to teachers because they are so worried their answers won’t be perfect. 

OCD is another condition that can be confused with ADHD. Kids with OCD have obsessive worries about bad things happening. When a teacher calls on them, they seem like they’re not paying attention. 

Trauma can also make it hard for kids to pay attention. Kids who have been through very scary or stressful experiences can be nervous, jumpy, or spacey. These behaviors can make it look like they have ADHD. 

A learning disorder can also cause an attention problem. These kids might be having trouble with their academic work, and they often get frustrated and embarrassed when they can’t keep up.  

It’s important not to jump to the conclusion that your kid has ADHD just because a teacher reports an attention problem. A mental health expert should examine your child. That expert should ask a lot of questions and observe their behavior. Then they’ll be able to figure out the real problem and give your child the right treatment. 

Trouble paying attention is often first identified by a teacher who notices that a student seems more easily distracted than most other kids their age.

Maybe the child takes an unusually long time to finish schoolwork in class. Maybe when the teacher calls on them, they don’t seem to have been following the lesson. Maybe they seem to tune out when instructions are given, or forget what they’re supposed to be doing. Maybe homework assignments often go missing.

While all children, especially those who are very young, tend to have shorter attention spans and be more distractible than adults, some have much more trouble focusing and staying on task than others.

Since difficulty paying attention is widely associated with ADHD, that tends to be the first thing teachers, parents, and clinicians suspect. But there are a number of other possibilities that can be contributing to attention problems. To avoid misdiagnosis, it’s important that these other possibilities, which are not always obvious, not be overlooked.

Here is a checklist of some of the other issues that may make a child struggle to pay attention in school:

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Anxiety

A child who seems not to be focusing in school could have chronic worries that teachers (and even parents) are not aware of. There are many different kinds of anxiety, but what they have in common, says neurologist and former teacher Ken Schuster, PsyD, is that anxiety “tends to lock up the brain,” making school hard for anxious kids.

A child with separation anxiety might be so preoccupied about something bad happening to their parents while they are apart from them that they are unable to concentrate on schoolwork.

Some kids are extremely worried about making a mistake or embarrassing themselves. When the teacher is calling on them, they may try to disappear, Dr. Shuster notes. “They might look down, they might start writing something even though they’re not really writing something. They’re trying to break the connection with the teacher in order to avoid what’s making them feel anxious.” 

Sometimes when a child takes an unusually long time to finish their work in class, it’s not because they’re daydreaming but because they’re struggling with perfectionism that requires them to do things exactly the right way. Or if they doesn’t turn in their homework, it could be not because they didn’t do it, but because they are worried that it isn’t good enough.

Obsessive-compulsive disorder

Kids with OCD, which often starts in the grade-school years, have an added source of distraction: They not only have obsessive thoughts, but feel they must perform rituals, or compulsions, to prevent bad things from happening. A child with OCD might be compulsively lining things up on their desk, or tapping, or counting in their head. Or they might be focused on needing to go to the lavatory to wash their hands.

“A kid may be sitting in class having anobsession about needing to fix something, to avoid something terrible happening. Then the teacher calls on them,” says Jerry Bubrick, PhD, a clinical psychologist who treated many children with anxiety and OCD at the Child Mind Institute. “When they doesn’t know the answer to the question, it looks like they weren’t paying attention, but it’s really because they were obsessing.”

Since children with OCD are often ashamed of their symptoms, they may go to great lengths to hide their compulsions while they’re in school. To a teacher who’s not aware of the OCD, distraction might look like ADHD, but it isn’t.

Stress or trauma

Children can also appear to be suffering from inattention when they have been impacted by a trauma. Kids who’ve witnessed violence or other disturbing experiences may demonstrate difficulty paying attention and a persistent sense of insecurity called hypervigilance.

Kids whose home lives involve acute stress may develop these symptoms, or even post-traumatic stress disorder.

“Many of the symptoms of PTSD look like ADHD,” explains Jamie Howard, PhD, a clinical psychologist who specializes in trauma. “Symptoms common in PTSD, such as difficulty concentrating, exaggerated startle response, and hypervigilance, can make it seem like a child is jumpy and spacy.”

Learning disorders

When a child seems to be looking everywhere but at the pages of the book they are supposed to be reading, another possible cause is that they have a learning disorder.

Children with undiagnosed dyslexia might fidget with frustration or feel ashamed that they can’t seem to do what the other kids can do, and be intent on covering that fact up.

If a child struggling with math, they might welcome distractions that allow them to think about something else, or avoid completing the assignment.

Auditory processing problems could cause a child to miss some of what the teacher is saying, even if they are listening, and that could look as if they are not paying attention.

Some kids are able to compensate for their learning disabilities by working extra hard, and they may be successful until they reach a grade where the work becomes too challenging.

“They’ve been able to hide their weakness until they get older and there’s just too much heavy lifting,” notes Nancy Rappaport, MD, a Harvard Medical School professor who specializes in mental health care in school setting. “They’re often diagnosed with ADHD or depression, unless someone catches the learning problem.”

Is it really ADHD?

Inattention that is outside the typical range is one of the three key symptoms of ADHD, along with impulsivity and hyperactivity. Some kids do demonstrate only inattentive symptoms. But adiagnosis of ADHD shouldn’t be made just on the basis of teacher reports or one quick visit to the pediatrician.

To make an accurate diagnosis, a clinician should collect information from several people who have observed your child, including you, other caregivers, and teachers. Parents and teachers should be asked to fill out a rating scale, to capture an accurate assessment of the frequency of symptoms. The behavior has to continue over an extended period, and be observed in more than one setting — both at home and at school, for instance. And clinicians should carefully rule out other possible reasons for his behavior.

It’s also important that a child’s ability to pay attention be compared to others of their own age, not everyone in his grade. A study published in 2012 found that boys who are the youngest in their class are 30% more likely to be diagnosed with ADHD than the oldest boys in the class, and younger girls are 70% more likely to be diagnosed than the oldest girls. This suggests that that immaturity may also be mistaken for ADHD.

Frequently Asked Questions

What causes lack of concentration in a child?

How can I help a child who has trouble focusing?

To help a child who has trouble focusing, you can work with a mental health professional to get the child an accurate diagnosis. A number of different challenges can cause trouble focusing, including ADHD, anxiety, trauma, and learning disorders. Getting the right diagnosis is the first step to getting your child the support they need.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-not-all-attention-problems-are-adhd/